Texas Department of Aging and Disability Services Approved Diagnostic Codes for Persons with Related Conditions

Transcription

1 Texas Department of Aging and Disability Services Approved Diagnostic Codes for Persons with Related Conditions The following diagnostic codes are based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), 2006, and are recognized by the Department of Aging and Disability Services (DADS) as conditions which may qualify an individual as having a related condition as described in federal and state law. In accordance with the Code of Federal Regulations, Title 42, , a related condition is a severe and chronic disability that: (A) is attributed to: i. cerebral palsy or epilepsy; or ii. any other condition, other than mental illness, found to be closely related to mental retardation because the condition results in impairment of general intellectual functioning or adaptive behavior similar to that of individuals with mental retardation, and requires treatment or services similar to those required for individuals with mental retardation; (B) is manifested before the individual reaches age 22; (C) is likely to continue indefinitely; and (D) results in substantial functional limitation in at least three of the following areas of major life activity: i. self-care; ii. understanding and use of language; iii. learning; iv. mobility; v. self-direction; and vi. capacity for independent living. A primary diagnosis by a licensed physician (or designee as defined in program rules) of a related condition may be required to meet eligibility for the following Medicaid programs: Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID), Community Living Assistance and Support Services (CLASS), Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Deaf Blind with Multiple Disabilities (DBMD). Complete information regarding eligibility is described in the rules governing each program. July 2015 Page 1

2 Approved Diagnostic Codes for Persons with Related Conditions in Numerical Order Infectious and Parasitic Diseases ( ) 138 Late effects of acute poliomyelitis Neoplasm of the Brain ( ) 191 Malignant neoplasm of the brain 237 Neoplasm of uncertain behavior of endocrine glands and nervous system Neurofibromatosis (von Recklinghausen s Disease) Endocrine, Nutritional and Metabolic Diseases and Immunity Disorders ( ) 243 Congenital hypothyroidism 244 Acquired hypothyroidism Unspecified hypothyroidism Hyperparathyroidism Lowe (-Terrey MacLachlan) syndrome (oculocerebrorenal dystrophy) Lipidoses Other disorders of calcium metabolism (pseudohypoparathyroidism) Other disorders of purine and pyrimidine metabolism (Lesch-Nyhan syndrome) Mucopolysaccharidosis (Hunter s syndrome, Hurler s syndrome, Scheie s syndrome) Other specified disorders of metabolism Unspecified disorder of metabolism (enzymopathy NOS) DiGeorge s syndrome Diseases of the Blood and Blood-Forming Organs ( ) Primary thrombocytopenia Primary thrombocytopenia unspecified Congenital and hereditary thrombocytopenic purpura (congenital and hereditary thrombocytopenia; Thrombocytopenia with Absent Radi (TAR) syndrome Psychoses with Origin Specific to Childhood (299) Autistic disorder (childhood autism; infantile psychosis; Kanner s syndrome) Childhood disintegrative disorder Other specified pervasive developmental disorders (Asperger s disorder, atypical childhood psychosis; borderline psychosis of childhood) Unspecified pervasive developmental disorder (pervasive developmental disorder NOS) Gilles de la Tourettes Disorder (307.23) Tourette s disorder (motor-verbal tic disorder) Specific Nonpsychotic Mental Disorders - Due to organic brain damage ( ) Frontal lobe syndrome (lobotomy syndrome; postleucotomy syndrome [state]) Postconcussion syndrome Other specified nonpsychotic mental disorders following organic brain damage (postencephalitic syndrome) Unspecified non-psychotic mental disorder following organic brain damage July 2015 Page 2

3 Specific Delays in Development (315.9) Unspecified delay in development (developmental disorder NOS) Nervous System and Sense Organs ( ) Meningitis due to unspecified bacterium 323 Encephalitis, myelitis, encephalomyelitis Unspecified cause of encephalitis 330 Cerebral degenerations usually manifest in childhood Metachromatic leukodystrophy Other specified cerebral degenerations in childhood (Alper s disease or gray-matter degeneration; infantile necrotizing encephalomyelopathy; Leigh s disease; subacute necrotizing encephalopathy or encephalomyelopathy, Rett s syndrome); Other degenerative diseases of the basal ganglia (Neuronal Degeneration with Brain Iron Accumulation) Pick s disease Communicating hydrocephalus Obstructive hydrocephalus Other cerebral degeneration Reye s syndrome Cerebral ataxia Cerebral degeneration, unspecified Paralysis agitans (Parkinson s disease) Secondary Parkinsonism Huntington s chorea Idiopathic torsion dystonia Symptomatic torsion dystonia (athetoid cerebral palsy) Friedreich s ataxia Other spinocerebellar diseases (ataxia-telangiectasia [Louis-Bar syndrome]) Spinal muscular atrophy, unspecified Kugelberg-Welander disease Unspecified disease of spinal cord 340 Multiple sclerosis Demyelinating disease of central nervous system, unspecified Spastic hemiplegia Hemiplegia, unspecified Diplegic (congenital diplegia) Infantile cerebral palsy, unspecified Quadriplegia and quadriparesis Paraplegia (paralysis of both lower limbs) Unspecified monoplegia Paralysis, unspecified Generalized non-convulsive epilepsy Generalized convulsive epilepsy Petit mal status Grand mal status Partial epilepsy, with impairment of consciousness (psychomotor epilepsy) Epilepsy, unspecified July 2015 Page 3

4 348.0 Cerebral cysts (arachnoid cyst) Anoxic brain damage Encephalopathy, not elsewhere classified Other specified disorders of nervous system Unspecified disorders of nervous system Trigeminal neuralgia Myasthenia gravis Congenital hereditary muscular dystrophy Hereditary progressive muscular dystrophy Other myopathies Myotonic Dystrophy (as of 7/10/2015) Profound impairment, both eyes Moderate or severe impairment, better eye, profound impairment lesser eye Legal blindness, as defined in U.S.A Disorders of visual cortex Cortical blindness Conductive hearing loss Sensorineural hearing loss Mixed conductive and sensorineural hearing loss Deaf mutism, not elsewhere classifiable Other specified forms of hearing loss Unspecified hearing loss Cerebrovascular Disease ( ) 436 Acute, but ill-defined cerebrovascular disease 438 Late effects of cerebrovascular disease Arthropathies and Related Disorders ( ) Polymyositis Juvenile chronic polyarthritis Rheumatism, Excluding the Back ( ) Other specific muscle disorders (arthrogryposis) Congenital Anomalies ( ) Spina bifida with hydrocephalus Spina bifida without mention of hydrocephalus Encephalocele Reduction deformities of brain Congenital hydrocephalus Other specified anomalies of nervous system (familial dysautonomia; Riley-Day syndrome) Unspecified anomaly of brain, spinal cord, and nervous system Anomalies of cerebrovascular system (arteriovenous malformation of brain; cerebral arteriovenous aneurysm, congenital; congenital anomalies of cerebral vessels) [EXCLUDES ruptured cerebral (arteriovenous) aneurysm (430)] Larsen s syndrome 755 Other congenital anomalies of limbs July 2015 Page 4

5 Longitudinal deficiency, combined, involving humerus, radius, and ulna (complete or incomplete) Longitudinal deficiency, radioulnar, complete or partial (with or without distal deficiencies, incomplete) Longitudinal deficiency, combined, involving femur, tibia, and fibula (complete or incomplete) Acrocephalosyndactyly (Apert s syndrome) Anomalies of skull and face bones (Hallerman-Streiff syndrome, craniosynostosis) Anomalies of spine, unspecified Osteogenesis imperfect Conradi syndrome Down s syndrome Patau s syndrome Trisomy 18 (Edwards syndrome) Autosomal deletion syndromes Gonadal dysgenesis (Turner s syndrome) Klinefelter s syndrome Other conditions due to chromosome anomalies (Ring 18) Conditions due to anomaly of unspecified chromosome Tuberous sclerosis Prader-Willi syndrome Marfan syndrome Fragile X syndrome Other specified anomalies (Cornelia de Lange s syndrome, Seckel syndrome); Congenital malformation syndromes affecting multiple systems, NEC; Angelman s Syndrome; Cerebrocostomandibular syndrome, Bardet-Biedl Syndrome) Certain Conditions Originating in the Perinatal Period ( ) Fetal alcohol syndrome Injury to spine and spinal cord Severe birth asphyxia Congenital rubella 779 Other and ill-defined conditions originating in the perinatal period Codes The following fifth digit sub-classification is for use with the appropriate codes in categories 800, 801, 803, 804, and : 0 unspecified state of consciousness 1 with no loss of consciousness 2 with brief (less than one hour) loss of consciousness 3 with moderate (1-24 hours) loss of consciousness and return to pre-existing conscious level 4 with moderate (1-24 hours) loss of consciousness 5 with prolonged (more than 24 hours) loss of consciousness, without return to pre-existing conscious level. Use the fifth-digit 5 to designate when a patient is unconscious and dies before regaining consciousness, regardless of the duration of the loss of consciousness July 2015 Page 5

6 6 with loss of consciousness of unspecified duration 9 with concussion, unspecified Fracture of Skull ( ) Fracture of Vault of Skull (800) (Requires fifth digit - see chart on page 5 for codes and definitions) Includes: frontal bone and parietal bone Closed without mention of intracranial injury Closed with cerebral laceration and contusion Closed with subarachnoid, subdural, and extradural hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with intracranial injury of other and unspecified nature Open without mention of intracranial injury Open with cerebral laceration and contusion Open with subarachnoid, subdural, and extradural hemorrhage Open with other and unspecified intracranial hemorrhage Open with intracranial injury of other and unspecified nature Fracture of Base of Skull (801) (Requires fifth digit - see chart on page 5 for codes and definitions) Includes: fossa, sinus, anterior, ethmoid, middle, frontal, posterior, sphenoid bone, occiput bone, temporal bone, and orbital roof Closed without mention of intracranial injury Closed with cerebral laceration and contusion Closed with subarachnoid, subdural, and extradural hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with intracranial injury of other and unspecified nature Open without mention of intracranial injury Open with cerebral laceration and contusion Open with subarachnoid, subdural, and extradural hemorrhage Open with other and unspecified intracranial hemorrhage Open with intracranial injury of other and unspecified nature Other and Unqualified Skull Fractures (803) (Requires fifth digit - see chart on page 5 for codes and definitions) Includes: skull NOS and skull multiple NOS Closed without mention of intracranial injury Closed with cerebral laceration and contusion Closed with subarachnoid, subdural, and extradural hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with intracranial injury of other and unspecified nature Open without mention of intracranial injury Open with cerebral laceration and contusion Open with subarachnoid, subdural, and extradural hemorrhage Open with other and unspecified intracranial hemorrhage Open with intracranial injury of other unspecified nature July 2015 Page 6

7 Multiple Fractures Involving Skull or Face with Other Bones (804) (Requires fifth digit see chart on page 5 for codes and definitions) Closed without mention of intracranial injury Closed with cerebral laceration and contusion Closed with subarachnoid, subdural, and extradural hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with intracranial injury of other and unspecified nature Open without mention of intracranial injury Open with cerebral laceration and contusion Open with subarachnoid, subdural, and extradural hemorrhage Open with other and unspecified intracranial hemorrhage Open with intracranial injury of other and unspecified nature Intracranial Injury, Excluding Those with Skull Fracture ( ) Concussion (850) Includes: commotion cerebri With no loss of consciousness (concussion with mental confusion or disorientation, without loss of consciousness) With brief loss of consciousness (of consciousness for less than one hour) With moderate loss of consciousness (loss of consciousness for 1-24 hours) With prolonged loss of consciousness and return to pre-existing conscious level (loss of consciousness for more than 24 hours with complete recovery) With prolonged loss of consciousness, without return to pre-existing conscious level With loss of consciousness of unspecified duration, unspecified Concussion, unspecified Cerebral Laceration and Contusion (851) (Requires fifth digit - see chart on page 5 for codes and definitions) Cortex (cerebral) contusion without mention of open intracranial wound Cortex (cerebral) contusion with open intracranial wound Cortex (cerebral) laceration without mention of open intracranial wound Cortex (cerebral) laceration with open intracranial wound Cerebellar or brain stem contusion without mention of open intracranial wound Cerebellar or brain stem contusion with open intracranial wound Cerebellar or brain stem laceration without mention of open intracranial wound Cerebellar or brain stem laceration with open intracranial wound Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound Other and unspecified cerebral laceration and contusion, with open intracranial wound Subarachnoid, Subdural, and Extradural Hemorrhage Following Injury (852) (Requires fifth digit see chart on page 5 for codes and definitions) July 2015 Page 7

8 852.0 Subarachnoid hemorrhage following injury without mention of open intracranial wound (middle meningeal hemorrhage following injury) Subarachnoid hemorrhage following injury with open intracranial wound Subdural hemorrhage following injury without mention of open intracranial wound Subdural hemorrhage following injury with open intracranial wound Extradural hemorrhage following injury without mention of open intracranial wound (epidural hematoma following injury) Extradural hemorrhage following injury with open intracranial wound Other and Unspecified Intracranial Hemorrhage Following Injury (853) (Requires fifth digit see chart on page 5 for codes and definitions) Without mention of open intracranial wound (cerebral compression due to injury, intracranial hematoma following injury, traumatic cerebral hemorrhage) With open intracranial wound Intracranial Injury of Other and Unspecified Nature (854) (Requires fifth digit see chart on page 5 for codes and definitions) Includes: Brain injury NOS Without mention of open intracranial wound With open intracranial wound Open Wound of Head, Neck, and Trunk Open Wound of Ocular Adnex ( ) Laceration of skin of eyelid and periocular area Laceration of eyelid, full-thickness, not involving lacrimal passages Laceration of eyelid involving lacrimal passages Penetrating wound of orbit, without mention of foreign body Penetrating wound of orbit with foreign body in orbit Other specified open wounds of ocular adnexa Unspecified open wound of ocular adnexa Injury to Nerves and Spinal Cord ( ) Injury to Optic Nerve and Pathways (950) Optic nerve injury (second cranial nerve) Injury to optic chiasm Injury to optic pathways Injury to visual cortex Unspecified (traumatic blindness NOS) Injury to Other Cranial Nerves (951) Injury to oculomotor nerve (third cranial nerve) Injury to trochlear nerve (fourth cranial nerve) Injury to trigeminal nerve (fifth cranial nerve) Injury to abducens nerve (sixth cranial nerve) Injury to facial nerve (seventh cranial nerve) Injury to acoustic nerve (auditory nerve, eighth cranial nerve) July 2015 Page 8

9 951.6 Injury to accessory nerve (eleventh cranial nerve) Injury to hypoglossal nerve (twelfth cranial nerve) Injury to other specified cranial nerves (glossopharyngeal [ninth cranial] nerve; olfactory [first cranial] nerve; pneumogastric [tenth cranial] nerve; traumatic anosmia NOS; vagus [tenth cranial] nerve Injury to unspecified cranial nerve Spinal Cord Injury Without Evidence of Spinal Bone Injury (952) Cervical C1-C4 level with unspecified spinal cord injury (spinal cord injury, cervical region NOS) C1-C4 level with complete lesion of spinal cord C1-C4 level with anterior cord syndrome C1-C4 level with central cord syndrome C1-C4 level with other specified spinal cord injury (incomplete spinal cord lesion at C1-C4 level: NOS with posterior cord syndrome) C5-C7 level with unspecified spinal cord injury C5-C7 level with complete lesion of spinal cord C5-C7 level with anterior cord syndrome C5-C7 level with central cord syndrome C5-C7 level with other specified spinal cord injury (incomplete spinal cord lesion at C5-C7 level: NOS with posterior cord syndrome) Dorsal (thoracic) T1-T6 level with unspecified spinal cord injury (spinal cord injury, thoracic region NOS) T1-T6 level with complete lesion of spinal cord T1-T6 level with anterior cord syndrome T1-T6 level with central cord syndrome T1-T6 level with other specified spinal cord injury (incomplete spinal cord lesion at T1-T6 level: NOS with posterior cord syndrome) T7-T12 level with unspecified spinal cord injury T7-T12 level with complete lesion of spinal cord T7-T12 level with anterior cord syndrome T7-T12 level with central cord syndrome T7-T12 level with other specified spinal cord injury (incomplete spinal cord lesion at T7-T12 level: NOS with posterior cord syndrome) Lumbar Sacral Cauda equina Multiple sites of spinal cord Unspecified site of spinal cord Certain Traumatic Complications and Unspecified Injuries ( ) Head injury, unspecified July 2015 Page 9

10 Approved Diagnostic Codes for Persons with Related Conditions in Alphabetical Order Related Condition Diagnostic Code Acquired hypothyroidism 244 Acrocephalosyndactyly (Apert s syndrome) Acute, but ill-defined cerebrovascular disease 436 Angelman's Syndrome Anomalies of cerebrovascular system (arteriovenous malformation of brain; cerebral arteriovenous aneurysm, congenital; congenital anomalies of cerebral vessels) [EXCLUDES ruptured cerebral (arteriovenous) aneurysm (430)] Anomalies of skull and face bones (Hallerman-Streiff syndrome, craniosynostosis) Anomalies of spine, unspecified Anoxic brain damage Autistic disorder (childhood autism; infantile psychosis; Kanner s syndrome) Autosomal deletion syndromes C1-C4 level with anterior cord syndrome C1-C4 level with central cord syndrome C1-C4 level with complete lesion of spinal cord C1-C4 level with other specified spinal cord injury (incomplete spinal cord lesion at C1-C4 level: NOS with posterior cord syndrome) C1-C4 level with unspecified spinal cord injury (spinal cord injury, cervical region NOS) C5-C7 level with anterior cord syndrome C5-C7 level with central cord syndrome C5-C7 level with complete lesion of spinal cord C5-C7 level with other specified spinal cord injury (incomplete spinal cord lesion at C5-C7 level: NOS with posterior cord syndrome) C5-C7 level with unspecified spinal cord injury Cauda equina Cerebellar or brain stem contusion with open intracranial wound Cerebellar or brain stem contusion without mention of open intracranial wound Cerebellar or brain stem laceration with open intracranial wound Cerebellar or brain stem laceration without mention of open intracranial wound Cerebral ataxia Cerebral cysts (arachnoid cyst) Cerebral degeneration, unspecified Cerebral degenerations usually manifest in childhood 330 Cerebrocostomandibular syndrome Cervical Childhood disintegrative disorder Closed with cerebral laceration and contusion Closed with cerebral laceration and contusion Closed with cerebral laceration and contusion Closed with cerebral laceration and contusion July 2015 Page 10

11 Related Condition Diagnostic Code Closed with intracranial injury of other and unspecified nature Closed with intracranial injury of other and unspecified nature Closed with intracranial injury of other and unspecified nature Closed with intracranial injury of other and unspecified nature Closed with other and unspecified intracranial hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with other and unspecified intracranial hemorrhage Closed with subarachnoid, subdural, and extradural hemorrhage Closed with subarachnoid, subdural, and extradural hemorrhage Closed with subarachnoid, subdural, and extradural hemorrhage Closed with subarachnoid, subdural, and extradural hemorrhage Closed without mention of intracranial injury Closed without mention of intracranial injury Closed without mention of intracranial injury Closed without mention of intracranial injury Communicating hydrocephalus Concussion, unspecified Conditions due to anomaly of unspecified chromosome Conductive hearing loss Congenital and hereditary thrombocytopenic purpura (congenital and hereditary thrombocytopenia; Thrombocytopenia with Absent Radi (TAR) syndrome Congenital hereditary muscular dystrophy Congenital hydrocephalus Congenital hypothyroidism 243 Congenital malformation syndromes affecting multiple systems, NEC Congenital rubella Conradi syndrome Cortex (cerebral) contusion with open intracranial wound Cortex (cerebral) contusion without mention of open intracranial wound Cortex (cerebral) laceration with open intracranial wound Cortex (cerebral) laceration without mention of open intracranial wound Deaf mutism, not elsewhere classifiable Demyelinating disease of central nervous system, unspecified DiGeorge s syndrome Disorders of visual cortex Dorsal (thoracic) Down s syndrome Encephalitis, myelitis, encephalitis 323 Encephalocele Encephalopathy, not elsewhere classified Epilepsy, unspecified Extradural hemorrhage following injury with open intracranial wound July 2015 Page 11

12 Related Condition Diagnostic Code Extradural hemorrhage following injury without mention of open intracranial wound (epidural hematoma following injury) Fetal alcohol syndrome Fragile X syndrome Friedreich s ataxia Frontal lobe syndrome (lobotomy syndrome; postleucotomy syndrome [state]) Generalized convulsive epilepsy Generalized non-convulsive epilepsy 345 Gonadal dysgenesis (Turner s syndrome) Grand mal status Head injury, unspecified Hemiplegia, unspecified Hereditary progressive muscular dystrophy Huntington s chorea Hyperparathyroidism Idiopathic torsion dystonia Infantile cerebral palsy, unspecified Injury to abducens nerve (sixth cranial nerve) Injury to accessory nerve (eleventh cranial nerve) Injury to acoustic nerve (auditory nerve, eighth cranial nerve) Injury to facial nerve (seventh cranial nerve) Injury to hypoglossal nerve (twelfth cranial nerve) Injury to oculomotor nerve (third cranial nerve) Injury to optic chiasm Injury to optic pathways Injury to other specified cranial nerves (glossopharyngeal [ninth cranial] nerve; olfactory [first cranial] nerve; pneumogastric [tenth cranial] nerve; traumatic anosmia NOS; vagus [tenth cranial] nerve Injury to spine and spinal cord Injury to trigeminal nerve (fifth cranial nerve) Injury to trochlear nerve (fourth cranial nerve) Injury to unspecified cranial nerve Injury to visual cortex Juvenile chronic polyarthritis Klinefelter s syndrome Kugelberg-Welander disease Laceration of eyelid involving lacrimal passages Laceration of eyelid, full-thickness, not involving lacrimal passages Laceration of skin of eyelid and periocular area Larsen s syndrome Late effects of acute poliomyelitis 138 Late effects of cerebrovascular disease 438 Legal blindness, as defined in U.S.A Longitudinal deficiency, combined, involving femur, tibia, and fibula (complete or July 2015 Page 12

13 Related Condition Diagnostic Code incomplete) Longitudinal deficiency, combined, involving humerus, radius, and ulna (complete or incomplete) Longitudinal deficiency, radioulnar, complete or partial (with or without distal deficiencies, incomplete) Lowe (-Terrey-MacLachlan) syndrome (oculocerebrorenal dystrophy) Lumbar Malignant neoplasm of the brain 191 Marfan syndrome Meningitis due to unspecified bacterium Metachromatic leukodystrophy Mixed conductive and sensorineural hearing loss Moderate or severe impairment, better eye, profound impairment lesser eye Mucopolysaccharidosis (Hunter s syndrome, Hurler s syndrome, Scheie s syndrome) Multiple sclerosis 340 Multiple sites of spinal cord Myasthenia gravis Myotonic Dystrophy (as of 7/10/2015) Neoplasm of uncertain behavior of endocrine glands and nervous system 237 Neurofibromatosis (von Recklinghausen s Disease) Obstructive hydrocephalus Open with cerebral laceration and contusion Open with cerebral laceration and contusion Open with cerebral laceration and contusion Open with cerebral laceration and contusion Open with intracranial injury of other and unspecified nature Open with intracranial injury of other and unspecified nature Open with intracranial injury of other and unspecified nature Open with intracranial injury of other unspecified nature Open with other and unspecified intracranial hemorrhage Open with other and unspecified intracranial hemorrhage Open with other and unspecified intracranial hemorrhage Open with other and unspecified intracranial hemorrhage Open with subarachnoid, subdural, and extradural hemorrhage Open with subarachnoid, subdural, and extradural hemorrhage Open with subarachnoid, subdural, and extradural hemorrhage Open with subarachnoid, subdural, and extradural hemorrhage Open without mention of intracranial injury Open without mention of intracranial injury Open without mention of intracranial injury Open without mention of intracranial injury Optic nerve injury (second cranial nerve) Osteogenesis imperfect July 2015 Page 13

14 Related Condition Diagnostic Code Other and ill-defined conditions originating in the perinatal period 779 Other and unspecified cerebral laceration and contusion, with open intracranial wound Other and unspecified cerebral laceration and contusion, without mention of open intracranial wound Other cerebral degeneration Other congenital anomalies of limbs 755 Other disorders of calcium metabolism (pseudohypoparathyroidism) Other disorders of purine and pyrimidine metabolism (Lesch-Nyhan syndrome) Other myopathies Other specific muscle disorders (arthrogryposis) Other specified anomalies (Cornelia de Lange s syndrome, Seckel syndrome) Other specified anormalies of nervous system (familial dysautonomia; Riley-Day syndrome) Other specified cerebral degenerations in childhood (Alper's disease or graymatter degeneration; infantile necrotizing encephalomyelopathy; Leigh's disease; subacute necrotizing encephalopathy or encephalomyelopathy, Rett's syndrome) Other specified disorders of metabolism Other specified disorders of nervous system Other specified forms of hearing loss Other specified nonpsychotic mental disorders following organic brain damage (postencephalitic syndrome) Other specified open wounds of ocular adnexa Other specified pervasive developmental disorders (Asperger s disorder, atypical childhood psychosis; borderline psychosis of childhood) Other spinocerebellar diseases (ataxia-telangiectasia [Louis-Bar syndrome]) Paralysis agitans (Parkinson s disease) Paralysis, unspecified Paraplegia (paralysis of both lower limbs) Partial epilepsy, with impairment of consciousness (psychomotor epilepsy) Patau s syndrome Penetrating wound of orbit with foreign body in orbit Penetrating wound of orbit, without mention of foreign body Petit mal status Pick s disease Polymyositis Postconcussion syndrome Prader-Willi syndrome Primary thrombocytopenia Primary thrombocytopenia unspecified Profound impairment, both eyes Quadriplegia and quadriparesis Reduction deformities of brain July 2015 Page 14

15 Related Condition Diagnostic Code Reye s syndrome Sacral Secondary Parkinsonism Sensorineural hearing loss Severe birth asphyxia Spastic hemiplegia Spina bifida with hydrocephalus Spina bifida without mention of hydrocephalus Spinal muscular atrophy, unspecified Subarachnoid hemorrhage following injury with open intracranial wound Subarachnoid hemorrhage following injury without mention of open intracranial wound (middle meningeal hemorrhage following injury) Subdural hemorrhage following injury with open intracranial wound Subdural hemorrhage following injury without mention of open intracranial wound Symptomatic torsion dystonia (athetoid cerebral palsy) T1-T6 level with anterior cord syndrome T1-T6 level with central cord syndrome T1-T6 level with complete lesion of spinal cord T1-T6 level with other specified spinal cord injury (incomplete spinal cord lesion at T1-T6 level: NOS with posterior cord syndrome) T1-T6 level with unspecified spinal cord injury (spinal cord injury, thoracic region (NOS) T7-T12 level with anterior cord syndrome T7-T12 level with central cord syndrome T7-T12 level with complete lesion of spinal cord T7-T12 level with other specified spinal cord injury (incomplete spinal cord lesion at T7-T12 level: NOS with posterior cord syndrome) T7-T12 level with unspecified spinal cord injury Tourette s disorder (motor-verbal tic disorder) Trigeminal neuralgia Trisomy 18 (Edwards syndrome) Tuberous sclerosis Unspecified (traumatic blindness NOS) Unspecified anomaly of brain, spinal cord, and nervous system Unspecified cause of encephalitis Unspecified delay in development (developmental disorder NOS) Unspecified disease of spinal cord Unspecified disorder of metabolism (enzymopathy NOS) Unspecified disorders of nervous system Unspecified hearing loss Unspecified hypothyroidism Unspecified monoplegia Unspecified non-psychotic mental disorder following organic brain damage July 2015 Page 15

16 Related Condition Diagnostic Code Unspecified open wound of ocular adnexa Unspecified site of spinal cord With brief loss of consciousness (of consciousness for less than one hour) With loss of consciousness of unspecified duration With moderate loss of consciousness (loss of consciousness for 1-24 hours) With no loss of consciousness (concussion with mental confusion or disorientation without loss of consciousness) With open intracranial wound With open intracranial wound With prolonged loss of consciousness and return to pre-existing conscious level (loss of consciousness for more than 24 hours with complete recovery) With prolonged loss of consciousness without return to pre-existing conscious level Without mention of open intracranial wound Without mention of open intracranial wound (cerebral compression due to injury, intracranial hematoma following injury, traumatic cerebral hemorrhage) July 2015 Page 16