Glaucoma Screening

HCPCS/CPT Codes

• G0117 – Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist
• G0118 – Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist

ICD-10 Codes

B73.02 Onchocerciasis with glaucoma
H26.231 Glaucomatous flecks (subcapsular), right eye
H26.232 Glaucomatous flecks (subcapsular), left eye
H26.233 Glaucomatous flecks (subcapsular), bilateral
H26.239 Glaucomatous flecks (subcapsular), unspecified eye
H40.001 Preglaucoma, unspecified, right eye
H40.002 Preglaucoma, unspecified, left eye
H40.003 Preglaucoma, unspecified, bilateral
H40.009 Preglaucoma, unspecified, unspecified eye
H40.061 Primary angle closure without glaucoma damage, right eye
H40.062 Primary angle closure without glaucoma damage, left eye
H40.063 Primary angle closure without glaucoma damage, bilateral
H40.069 Primary angle closure without glaucoma damage, unspecified eye
H40.10X0 Unspecified open-angle glaucoma, stage unspecified
H40.10X1 Unspecified open-angle glaucoma, mild stage
H40.10X2 Unspecified open-angle glaucoma, moderate stage
H40.10X3 Unspecified open-angle glaucoma, severe stage
H40.10X4 Unspecified open-angle glaucoma, indeterminate stage
H40.1110 Primary open-angle glaucoma, right eye, stage unspecified
H40.1111 Primary open-angle glaucoma, right eye, mild stage
H40.1112 Primary open-angle glaucoma, right eye, moderate stage
H40.1113 Primary open-angle glaucoma, right eye, severe stage
H40.1114 Primary open-angle glaucoma, right eye, indeterminate stage
H40.1120 Primary open-angle glaucoma, left eye, stage unspecified
H40.1121 Primary open-angle glaucoma, left eye, mild stage
H40.1122 Primary open-angle glaucoma, left eye, moderate stage
H40.1123 Primary open-angle glaucoma, left eye, severe stage
H40.1124 Primary open-angle glaucoma, left eye, indeterminate stage
H40.1130 Primary open-angle glaucoma, bilateral, stage unspecified
H40.1131 Primary open-angle glaucoma, bilateral, mild stage
H40.1132 Primary open-angle glaucoma, bilateral, moderate stage
H40.1133 Primary open-angle glaucoma, bilateral, severe stage
H40.1134 Primary open-angle glaucoma, bilateral, indeterminate stage
H40.1190 Primary open-angle glaucoma, unspecified eye, stage unspecified
H40.1191 Primary open-angle glaucoma, unspecified eye, mild stage
H40.1192 Primary open-angle glaucoma, unspecified eye, moderate stage
H40.1193 Primary open-angle glaucoma, unspecified eye, severe stage
H40.1194 Primary open-angle glaucoma, unspecified eye, indeterminate stage
H40.1210 Low-tension glaucoma, right eye, stage unspecified
H40.1211 Low-tension glaucoma, right eye, mild stage
H40.1212 Low-tension glaucoma, right eye, moderate stage
H40.1213 Low-tension glaucoma, right eye, severe stage
H40.1214 Low-tension glaucoma, right eye, indeterminate stage
H40.1220 Low-tension glaucoma, left eye, stage unspecified
H40.1221 Low-tension glaucoma, left eye, mild stage
H40.1222 Low-tension glaucoma, left eye, moderate stage
H40.1223 Low-tension glaucoma, left eye, severe stage
H40.1224 Low-tension glaucoma, left eye, indeterminate stage
H40.1230 Low-tension glaucoma, bilateral, stage unspecified
H40.1231 Low-tension glaucoma, bilateral, mild stage
H40.1232 Low-tension glaucoma, bilateral, moderate stage
H40.1233 Low-tension glaucoma, bilateral, severe stage
H40.1234 Low-tension glaucoma, bilateral, indeterminate stage
H40.1290 Low-tension glaucoma, unspecified eye, stage unspecified
H40.1291 Low-tension glaucoma, unspecified eye, mild stage
H40.1292 Low-tension glaucoma, unspecified eye, moderate stage
H40.1293 Low-tension glaucoma, unspecified eye, severe stage
H40.1294 Low-tension glaucoma, unspecified eye, indeterminate stage
H40.1310 Pigmentary glaucoma, right eye, stage unspecified
H40.1311 Pigmentary glaucoma, right eye, mild stage
H40.1312 Pigmentary glaucoma, right eye, moderate stage
H40.1313 Pigmentary glaucoma, right eye, severe stage
H40.1314 Pigmentary glaucoma, right eye, indeterminate stage
H40.1320 Pigmentary glaucoma, left eye, stage unspecified
H40.1321 Pigmentary glaucoma, left eye, mild stage
H40.1322 Pigmentary glaucoma, left eye, moderate stage
H40.1323 Pigmentary glaucoma, left eye, severe stage
H40.1324 Pigmentary glaucoma, left eye, indeterminate stage
H40.1330 Pigmentary glaucoma, bilateral, stage unspecified
H40.1331 Pigmentary glaucoma, bilateral, mild stage
H40.1332 Pigmentary glaucoma, bilateral, moderate stage
H40.1333 Pigmentary glaucoma, bilateral, severe stage
H40.1334 Pigmentary glaucoma, bilateral, indeterminate stage
H40.1390 Pigmentary glaucoma, unspecified eye, stage unspecified
H40.1391 Pigmentary glaucoma, unspecified eye, mild stage
H40.1392 Pigmentary glaucoma, unspecified eye, moderate stage
H40.1393 Pigmentary glaucoma, unspecified eye, severe stage
H40.1394 Pigmentary glaucoma, unspecified eye, indeterminate stage
H40.1410 Capsular glaucoma with pseudoexfoliation of lens, right eye, stage unspecified
H40.1411 Capsular glaucoma with pseudoexfoliation of lens, right eye, mild stage
H40.1412 Capsular glaucoma with pseudoexfoliation of lens, right eye, moderate stage
H40.1413 Capsular glaucoma with pseudoexfoliation of lens, right eye, severe stage
H40.1414 Capsular glaucoma with pseudoexfoliation of lens, right eye, indeterminate stage
H40.1420 Capsular glaucoma with pseudoexfoliation of lens, left eye, stage unspecified
H40.1421 Capsular glaucoma with pseudoexfoliation of lens, left eye, mild stage
H40.1422 Capsular glaucoma with pseudoexfoliation of lens, left eye, moderate stage
H40.1423 Capsular glaucoma with pseudoexfoliation of lens, left eye, severe stage
H40.1424 Capsular glaucoma with pseudoexfoliation of lens, left eye, indeterminate stage
H40.1430 Capsular glaucoma with pseudoexfoliation of lens, bilateral, stage unspecified
H40.1431 Capsular glaucoma with pseudoexfoliation of lens, bilateral, mild stage
H40.1432 Capsular glaucoma with pseudoexfoliation of lens, bilateral, moderate stage
H40.1433 Capsular glaucoma with pseudoexfoliation of lens, bilateral, severe stage
H40.1434 Capsular glaucoma with pseudoexfoliation of lens, bilateral, indeterminate stage
H40.1490 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, stage unspecified
H40.1491 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, mild stage
H40.1492 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, moderate stage
H40.1493 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, severe stage
H40.1494 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye, indeterminate stage
H40.151 Residual stage of open-angle glaucoma, right eye
H40.152 Residual stage of open-angle glaucoma, left eye
H40.153 Residual stage of open-angle glaucoma, bilateral
H40.159 Residual stage of open-angle glaucoma, unspecified eye
H40.20X0 Unspecified primary angle-closure glaucoma, stage unspecified
H40.20X1 Unspecified primary angle-closure glaucoma, mild stage
H40.20X2 Unspecified primary angle-closure glaucoma, moderate stage
H40.20X3 Unspecified primary angle-closure glaucoma, severe stage
H40.20X4 Unspecified primary angle-closure glaucoma, indeterminate stage
H40.211 Acute angle-closure glaucoma, right eye
H40.212 Acute angle-closure glaucoma, left eye
H40.213 Acute angle-closure glaucoma, bilateral
H40.219 Acute angle-closure glaucoma, unspecified eye
H40.2210 Chronic angle-closure glaucoma, right eye, stage unspecified
H40.2211 Chronic angle-closure glaucoma, right eye, mild stage
H40.2212 Chronic angle-closure glaucoma, right eye, moderate stage
H40.2213 Chronic angle-closure glaucoma, right eye, severe stage
H40.2214 Chronic angle-closure glaucoma, right eye, indeterminate stage
H40.2220 Chronic angle-closure glaucoma, left eye, stage unspecified
H40.2221 Chronic angle-closure glaucoma, left eye, mild stage
H40.2222 Chronic angle-closure glaucoma, left eye, moderate stage
H40.2223 Chronic angle-closure glaucoma, left eye, severe stage
H40.2224 Chronic angle-closure glaucoma, left eye, indeterminate stage
H40.2230 Chronic angle-closure glaucoma, bilateral, stage unspecified
H40.2231 Chronic angle-closure glaucoma, bilateral, mild stage
H40.2232 Chronic angle-closure glaucoma, bilateral, moderate stage
H40.2233 Chronic angle-closure glaucoma, bilateral, severe stage
H40.2234 Chronic angle-closure glaucoma, bilateral, indeterminate stage
H40.2290 Chronic angle-closure glaucoma, unspecified eye, stage unspecified
H40.2291 Chronic angle-closure glaucoma, unspecified eye, mild stage
H40.2292 Chronic angle-closure glaucoma, unspecified eye, moderate stage
H40.2293 Chronic angle-closure glaucoma, unspecified eye, severe stage
H40.2294 Chronic angle-closure glaucoma, unspecified eye, indeterminate stage
H40.231 Intermittent angle-closure glaucoma, right eye
H40.232 Intermittent angle-closure glaucoma, left eye
H40.233 Intermittent angle-closure glaucoma, bilateral
H40.239 Intermittent angle-closure glaucoma, unspecified eye
H40.241 Residual stage of angle-closure glaucoma, right eye
H40.242 Residual stage of angle-closure glaucoma, left eye
H40.243 Residual stage of angle-closure glaucoma, bilateral
H40.249 Residual stage of angle-closure glaucoma, unspecified eye
H40.30X0 Glaucoma secondary to eye trauma, unspecified eye, stage unspecified
H40.30X1 Glaucoma secondary to eye trauma, unspecified eye, mild stage
H40.30X2 Glaucoma secondary to eye trauma, unspecified eye, moderate stage
H40.30X3 Glaucoma secondary to eye trauma, unspecified eye, severe stage
H40.30X4 Glaucoma secondary to eye trauma, unspecified eye, indeterminate stage
H40.31X0 Glaucoma secondary to eye trauma, right eye, stage unspecified
H40.31X1 Glaucoma secondary to eye trauma, right eye, mild stage
H40.31X2 Glaucoma secondary to eye trauma, right eye, moderate stage
H40.31X3 Glaucoma secondary to eye trauma, right eye, severe stage
H40.31X4 Glaucoma secondary to eye trauma, right eye, indeterminate stage
H40.32X0 Glaucoma secondary to eye trauma, left eye, stage unspecified
H40.32X1 Glaucoma secondary to eye trauma, left eye, mild stage
H40.32X2 Glaucoma secondary to eye trauma, left eye, moderate stage
H40.32X3 Glaucoma secondary to eye trauma, left eye, severe stage
H40.32X4 Glaucoma secondary to eye trauma, left eye, indeterminate stage
H40.33X0 Glaucoma secondary to eye trauma, bilateral, stage unspecified
H40.33X1 Glaucoma secondary to eye trauma, bilateral, mild stage
H40.33X2 Glaucoma secondary to eye trauma, bilateral, moderate stage
H40.33X3 Glaucoma secondary to eye trauma, bilateral, severe stage
H40.33X4 Glaucoma secondary to eye trauma, bilateral, indeterminate stage
H40.40X0 Glaucoma secondary to eye inflammation, unspecified eye, stage unspecified
H40.40X1 Glaucoma secondary to eye inflammation, unspecified eye, mild stage
H40.40X2 Glaucoma secondary to eye inflammation, unspecified eye, moderate stage
H40.40X3 Glaucoma secondary to eye inflammation, unspecified eye, severe stage
H40.40X4 Glaucoma secondary to eye inflammation, unspecified eye, indeterminate stage
H40.41X0 Glaucoma secondary to eye inflammation, right eye, stage unspecified
H40.41X1 Glaucoma secondary to eye inflammation, right eye, mild stage
H40.41X2 Glaucoma secondary to eye inflammation, right eye, moderate stage
H40.41X3 Glaucoma secondary to eye inflammation, right eye, severe stage
H40.41X4 Glaucoma secondary to eye inflammation, right eye, indeterminate stage
H40.42X0 Glaucoma secondary to eye inflammation, left eye, stage unspecified
H40.42X1 Glaucoma secondary to eye inflammation, left eye, mild stage
H40.42X2 Glaucoma secondary to eye inflammation, left eye, moderate stage
H40.42X3 Glaucoma secondary to eye inflammation, left eye, severe stage
H40.42X4 Glaucoma secondary to eye inflammation, left eye, indeterminate stage
H40.43X0 Glaucoma secondary to eye inflammation, bilateral, stage unspecified
H40.43X1 Glaucoma secondary to eye inflammation, bilateral, mild stage
H40.43X2 Glaucoma secondary to eye inflammation, bilateral, moderate stage
H40.43X3 Glaucoma secondary to eye inflammation, bilateral, severe stage
H40.43X4 Glaucoma secondary to eye inflammation, bilateral, indeterminate stage
H40.50X0 Glaucoma secondary to other eye disorders, unspecified eye, stage unspecified
H40.50X1 Glaucoma secondary to other eye disorders, unspecified eye, mild stage
H40.50X2 Glaucoma secondary to other eye disorders, unspecified eye, moderate stage
H40.50X3 Glaucoma secondary to other eye disorders, unspecified eye, severe stage
H40.50X4 Glaucoma secondary to other eye disorders, unspecified eye, indeterminate stage
H40.51X0 Glaucoma secondary to other eye disorders, right eye, stage unspecified
H40.51X1 Glaucoma secondary to other eye disorders, right eye, mild stage
H40.51X2 Glaucoma secondary to other eye disorders, right eye, moderate stage
H40.51X3 Glaucoma secondary to other eye disorders, right eye, severe stage
H40.51X4 Glaucoma secondary to other eye disorders, right eye, indeterminate stage
H40.52X0 Glaucoma secondary to other eye disorders, left eye, stage unspecified
H40.52X1 Glaucoma secondary to other eye disorders, left eye, mild stage
H40.52X2 Glaucoma secondary to other eye disorders, left eye, moderate stage
H40.52X3 Glaucoma secondary to other eye disorders, left eye, severe stage
H40.52X4 Glaucoma secondary to other eye disorders, left eye, indeterminate stage
H40.53X0 Glaucoma secondary to other eye disorders, bilateral, stage unspecified
H40.53X1 Glaucoma secondary to other eye disorders, bilateral, mild stage
H40.53X2 Glaucoma secondary to other eye disorders, bilateral, moderate stage
H40.53X3 Glaucoma secondary to other eye disorders, bilateral, severe stage
H40.53X4 Glaucoma secondary to other eye disorders, bilateral, indeterminate stage
H40.60X0 Glaucoma secondary to drugs, unspecified eye, stage unspecified
H40.60X1 Glaucoma secondary to drugs, unspecified eye, mild stage
H40.60X2 Glaucoma secondary to drugs, unspecified eye, moderate stage
H40.60X3 Glaucoma secondary to drugs, unspecified eye, severe stage
H40.60X4 Glaucoma secondary to drugs, unspecified eye, indeterminate stage
H40.61X0 Glaucoma secondary to drugs, right eye, stage unspecified
H40.61X1 Glaucoma secondary to drugs, right eye, mild stage
H40.61X2 Glaucoma secondary to drugs, right eye, moderate stage
H40.61X3 Glaucoma secondary to drugs, right eye, severe stage
H40.61X4 Glaucoma secondary to drugs, right eye, indeterminate stage
H40.62X0 Glaucoma secondary to drugs, left eye, stage unspecified
H40.62X1 Glaucoma secondary to drugs, left eye, mild stage
H40.62X2 Glaucoma secondary to drugs, left eye, moderate stage
H40.62X3 Glaucoma secondary to drugs, left eye, severe stage
H40.62X4 Glaucoma secondary to drugs, left eye, indeterminate stage
H40.63X0 Glaucoma secondary to drugs, bilateral, stage unspecified
H40.63X1 Glaucoma secondary to drugs, bilateral, mild stage
H40.63X2 Glaucoma secondary to drugs, bilateral, moderate stage
H40.63X3 Glaucoma secondary to drugs, bilateral, severe stage
H40.63X4 Glaucoma secondary to drugs, bilateral, indeterminate stage
H40.811 Glaucoma with increased episcleral venous pressure, right eye
H40.812 Glaucoma with increased episcleral venous pressure, left eye
H40.813 Glaucoma with increased episcleral venous pressure, bilateral
H40.819 Glaucoma with increased episcleral venous pressure, unspecified eye
H40.821 Hypersecretion glaucoma, right eye
H40.822 Hypersecretion glaucoma, left eye
H40.823 Hypersecretion glaucoma, bilateral
H40.829 Hypersecretion glaucoma, unspecified eye
H40.89 Other specified glaucoma
H40.9 Unspecified glaucoma
H42 Glaucoma in diseases classified elsewhere
H44.511 Absolute glaucoma, right eye
H44.512 Absolute glaucoma, left eye
H44.513 Absolute glaucoma, bilateral
H44.519 Absolute glaucoma, unspecified eye
H47.231 Glaucomatous optic atrophy, right eye
H47.232 Glaucomatous optic atrophy, left eye
H47.233 Glaucomatous optic atrophy, bilateral
H47.239 Glaucomatous optic atrophy, unspecified eye
Q15.0 Congenital glaucoma
Z01.020 Encounter for examination of eyes and vision following failed vision screening without abnormal findings
Z01.021 Encounter for examination of eyes and vision following failed vision screening with abnormal findings
Z71.84 Encounter for health counseling related to travel
Z83.511 Family history of glaucoma
Z98.83 Filtering (vitreous) bleb after glaucoma surgery status

Who Is Covered

Medicare beneficiaries who fall into at least one of the following categories:

• Have diabetes mellitus
• Have a family history of glaucoma
• Are African-Americans aged 50 and older
• Are Hispanic-Americans aged 65 and older

Frequency

• Annually for covered Medicare beneficiaries

Medicare Beneficiary Pays

• Copayment/coinsurance applies
• Deductible applies

Diabetes Self-Management Training CPT G0108 and G0109

 HCPCS/CPT Codes

• G0108 – DSMT, individual, per 30 minutes
• G0109 – DSMT, group (2 or more), per 30 minutes

Who Is Covered

Certain Medicare beneficiaries when all of the following are true:

• Diagnosed with diabetes
• Receive an order for DSMT from the physician or qualified NPP treating the Medicare beneficiary’s diabetes

Frequently Used ICD Codes

• E24.4 Alcohol-induced pseudo-Cushing's syndrome
• F10.10 Alcohol abuse, uncomplicated
• F10.120 Alcohol abuse with intoxication, uncomplicated
• F10.121 Alcohol abuse with intoxication delirium
• F10.129 Alcohol abuse with intoxication, unspecified
• F10.14 Alcohol abuse with alcohol-induced mood disorder
• F10.150 Alcohol abuse with alcohol-induced psychotic disorder with delusions
• F10.151 Alcohol abuse with alcohol-induced psychotic disorder with hallucinations
• F10.159 Alcohol abuse with alcohol-induced psychotic disorder, unspecified
• F10.180 Alcohol abuse with alcohol-induced anxiety disorder
• F10.181 Alcohol abuse with alcohol-induced sexual dysfunction
• F10.182 Alcohol abuse with alcohol-induced sleep disorder
• F10.188 Alcohol abuse with other alcohol-induced disorder
• F10.19 Alcohol abuse with unspecified alcohol-induced disorder
• F10.20 Alcohol dependence, uncomplicated
• F10.21 Alcohol dependence, in remission
• F10.220 Alcohol dependence with intoxication, uncomplicated
• F10.221 Alcohol dependence with intoxication delirium
• F10.229 Alcohol dependence with intoxication, unspecified
• F10.230 Alcohol dependence with withdrawal, uncomplicated
• F10.231 Alcohol dependence with withdrawal delirium
• F10.232 Alcohol dependence with withdrawal with perceptual disturbance
• F10.239 Alcohol dependence with withdrawal, unspecified
• F10.24 Alcohol dependence with alcohol-induced mood disorder
• F10.250 Alcohol dependence with alcohol-induced psychotic disorder with delusions
• F10.251 Alcohol dependence with alcohol-induced psychotic disorder with hallucinations
• F10.259 Alcohol dependence with alcohol-induced psychotic disorder, unspecified
• F10.26 Alcohol dependence with alcohol-induced persisting amnestic disorder
• F10.27 Alcohol dependence with alcohol-induced persisting dementia
• F10.280 Alcohol dependence with alcohol-induced anxiety disorder
• F10.281 Alcohol dependence with alcohol-induced sexual dysfunction
• E08.00 Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
• E08.01 Diabetes mellitus due to underlying condition with hyperosmolarity with coma
• E08.10 Diabetes mellitus due to underlying condition with ketoacidosis without coma
• E08.11 Diabetes mellitus due to underlying condition with ketoacidosis with coma
• E08.21 Diabetes mellitus due to underlying condition with diabetic nephropathy
• E08.22 Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
• E08.29 Diabetes mellitus due to underlying condition with other diabetic kidney complication
• E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
• E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
• E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
• E08.3212 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
• E08.3213 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
• E08.3219 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E08.3291 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
• E08.3292 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
• E08.3293 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
• E08.3299 Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E08.3311 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
• E08.3312 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
• E08.3313 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
• E08.3319 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E08.3391 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
• E08.3392 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
• E08.3393 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
• E08.3399 Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E08.3411 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
• E08.3412 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
• E08.3413 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
• E08.3419 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E08.3491 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
• E08.3492 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
• E08.3493 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
• E08.3499 Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E08.3511 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
• E08.3512 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
• E08.3513 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
• E08.3519 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye
• E08.3521 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
• E08.3522 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
• E08.3523 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
• E08.3529 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
• E08.3531 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
• E08.3532 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
• E08.3533 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
• E08.3539 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
• E08.3541 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
• E08.3542 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
• E08.3543 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
• E08.3549 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
• E08.3551 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
• E08.3552 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
• E08.3553 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
• E08.3559 Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, unspecified eye
• E08.3591 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
• E08.3592 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
• E08.3593 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
• E08.3599 Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, unspecified eye
• E08.36 Diabetes mellitus due to underlying condition with diabetic cataract
• E08.37X1 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
• E08.37X2 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
• E08.37X3 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
• E08.37X9 Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, unspecified eye
• E08.39 Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
• E08.40 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
• E08.41 Diabetes mellitus due to underlying condition with diabetic mononeuropathy
• E08.42 Diabetes mellitus due to underlying condition with diabetic polyneuropathy
• E08.43 Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
• E08.44 Diabetes mellitus due to underlying condition with diabetic amyotrophy
• E08.49 Diabetes mellitus due to underlying condition with other diabetic neurological complication
• E08.51 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene
• E08.52 Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
• E08.59 Diabetes mellitus due to underlying condition with other circulatory complications
• E08.610 Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
• E08.618 Diabetes mellitus due to underlying condition with other diabetic arthropathy
• E08.620 Diabetes mellitus due to underlying condition with diabetic dermatitis
• E08.621 Diabetes mellitus due to underlying condition with foot ulcer
• E08.622 Diabetes mellitus due to underlying condition with other skin ulcer
• E08.628 Diabetes mellitus due to underlying condition with other skin complications
• E08.630 Diabetes mellitus due to underlying condition with periodontal disease
• E08.638 Diabetes mellitus due to underlying condition with other oral complications
• E08.641 Diabetes mellitus due to underlying condition with hypoglycemia with coma
• E08.649 Diabetes mellitus due to underlying condition with hypoglycemia without coma
• E08.65 Diabetes mellitus due to underlying condition with hyperglycemia
• E08.69 Diabetes mellitus due to underlying condition with other specified complication
• E08.8 Diabetes mellitus due to underlying condition with unspecified complications
• E08.9 Diabetes mellitus due to underlying condition without complications
• E09.00 Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
• E09.01 Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
• E09.10 Drug or chemical induced diabetes mellitus with ketoacidosis without coma
• E09.11 Drug or chemical induced diabetes mellitus with ketoacidosis with coma
• E09.21 Drug or chemical induced diabetes mellitus with diabetic nephropathy
• E09.22 Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
• E09.29 Drug or chemical induced diabetes mellitus with other diabetic kidney complication
• E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema
• E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema
• E09.3211 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
• E09.3212 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
• E09.3213 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
• E09.3219 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E09.3291 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
• E09.3292 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
• E09.3293 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
• E09.3299 Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E09.3311 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
• E09.3312 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
• E09.3313 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
• E09.3319 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E09.3391 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
• E09.3392 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
• E09.3393 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
• E09.3399 Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E09.3411 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
• E09.3412 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
• E09.3413 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
• E09.3419 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E09.3491 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
• E09.3492 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
• E09.3493 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
• E09.3499 Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E09.3511 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
• E09.3512 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
• E09.3513 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
• E09.3519 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
• E09.3521 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
• E09.3522 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
• E09.3523 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
• E09.3529 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
• E09.3531 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
• E09.3532 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
• E09.3533 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
• E09.3539 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
• E09.3541 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
• E09.3542 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
• E09.3543 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
• E09.3549 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
• E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye
• E09.3552 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye
• E09.3553 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
• E09.3559 Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
• E09.3591 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
• E09.3592 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
• E09.3593 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
• E09.3599 Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
• E09.36 Drug or chemical induced diabetes mellitus with diabetic cataract
• E09.37X1 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
• E09.37X2 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
• E09.37X3 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
• E09.37X9 Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
• E09.39 Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
• E09.40 Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified
• E09.41 Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
• E09.42 Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
• E09.43 Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
• E09.44 Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
• E09.49 Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication
• E09.51 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene
• E09.52 Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
• E09.59 Drug or chemical induced diabetes mellitus with other circulatory complications
• E09.610 Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
• E09.618 Drug or chemical induced diabetes mellitus with other diabetic arthropathy
• E09.620 Drug or chemical induced diabetes mellitus with diabetic dermatitis
• E09.621 Drug or chemical induced diabetes mellitus with foot ulcer
• E09.622 Drug or chemical induced diabetes mellitus with other skin ulcer
• E09.628 Drug or chemical induced diabetes mellitus with other skin complications
• E09.630 Drug or chemical induced diabetes mellitus with periodontal disease
• E09.638 Drug or chemical induced diabetes mellitus with other oral complications
• E09.641 Drug or chemical induced diabetes mellitus with hypoglycemia with coma
• E09.649 Drug or chemical induced diabetes mellitus with hypoglycemia without coma
• E09.65 Drug or chemical induced diabetes mellitus with hyperglycemia
• E09.69 Drug or chemical induced diabetes mellitus with other specified complication
• E09.8 Drug or chemical induced diabetes mellitus with unspecified complications
• E09.9 Drug or chemical induced diabetes mellitus without complications
• E10.10 Type 1 diabetes mellitus with ketoacidosis without coma
• E10.11 Type 1 diabetes mellitus with ketoacidosis with coma
• E10.21 Type 1 diabetes mellitus with diabetic nephropathy
• E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease
• E10.29 Type 1 diabetes mellitus with other diabetic kidney complication
• E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
• E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
• E10.3211 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
• E10.3212 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
• E10.3213 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
• E10.3219 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E10.3291 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
• E10.3292 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
• E10.3293 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
• E10.3299 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E10.3311 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
• E10.3312 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
• E10.3313 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
• E10.3319 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E10.3391 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
• E10.3392 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
• E10.3393 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
• E10.3399 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E10.3411 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
• E10.3412 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
• E10.3413 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
• E10.3419 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E10.3491 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
• E10.3492 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
• E10.3493 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
• E10.3499 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E10.3511 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
• E10.3512 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
• E10.3513 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
• E10.3519 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
• E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
• E10.3522 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
• E10.3523 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
• E10.3529 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
• E10.3531 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
• E10.3532 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
• E10.3533 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
• E10.3539 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
• E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
• E10.3542 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
• E10.3543 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
• E10.3549 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
• E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
• E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
• E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
• E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
• E10.3591 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
• E10.3592 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
• E10.3593 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
• E10.3599 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
• E10.36 Type 1 diabetes mellitus with diabetic cataract
• E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
• E10.37X2 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
• E10.37X3 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
• E10.37X9 Type 1 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
• E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication
• E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified
• E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy
• E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy
• E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
• E10.44 Type 1 diabetes mellitus with diabetic amyotrophy
• E10.49 Type 1 diabetes mellitus with other diabetic neurological complication
• E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
• E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
• E10.59 Type 1 diabetes mellitus with other circulatory complications
• E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy
• E10.618 Type 1 diabetes mellitus with other diabetic arthropathy
• E10.620 Type 1 diabetes mellitus with diabetic dermatitis
• E10.621 Type 1 diabetes mellitus with foot ulcer
• E10.622 Type 1 diabetes mellitus with other skin ulcer
• E10.628 Type 1 diabetes mellitus with other skin complications
• E10.630 Type 1 diabetes mellitus with periodontal disease
• E10.638 Type 1 diabetes mellitus with other oral complications
• E10.641 Type 1 diabetes mellitus with hypoglycemia with coma
• E10.649 Type 1 diabetes mellitus with hypoglycemia without coma
• E10.65 Type 1 diabetes mellitus with hyperglycemia
• E10.69 Type 1 diabetes mellitus with other specified complication
• E10.8 Type 1 diabetes mellitus with unspecified complications
• E10.9 Type 1 diabetes mellitus without complications
• E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
• E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma
• E11.21 Type 2 diabetes mellitus with diabetic nephropathy
• E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease
• E11.29 Type 2 diabetes mellitus with other diabetic kidney complication
• E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
• E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
• E11.3211 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
• E11.3212 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
• E11.3213 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
• E11.3219 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E11.3291 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
• E11.3292 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
• E11.3293 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
• E11.3299 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E11.3311 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
• E11.3312 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
• E11.3313 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
• E11.3319 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E11.3391 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
• E11.3392 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
• E11.3393 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
• E11.3399 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E11.3411 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
• E11.3412 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
• E11.3413 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
• E11.3419 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E11.3491 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
• E11.3492 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
• E11.3493 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
• E11.3499 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E11.3511 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
• E11.3512 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
• E11.3513 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
• E11.3519 Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
• E11.3521 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
• E11.3522 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
• E11.3523 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
• E11.3529 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
• E11.3531 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
• E11.3532 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
• E11.3533 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
• E11.3539 Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
• E11.3541 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
• E11.3542 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
• E11.3543 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
• E11.3549 Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
• E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
• E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
• E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
• E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
• E11.3591 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
• E11.3592 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
• E11.3593 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
• E11.3599 Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
• E11.36 Type 2 diabetes mellitus with diabetic cataract
• E11.37X1 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
• E11.37X2 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
• E11.37X3 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
• E11.37X9 Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
• E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication
• E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified
• E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy
• E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy
• E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
• E11.44 Type 2 diabetes mellitus with diabetic amyotrophy
• E11.49 Type 2 diabetes mellitus with other diabetic neurological complication
• E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
• E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
• E11.59 Type 2 diabetes mellitus with other circulatory complications
• E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy
• E11.618 Type 2 diabetes mellitus with other diabetic arthropathy
• E11.620 Type 2 diabetes mellitus with diabetic dermatitis
• E11.621 Type 2 diabetes mellitus with foot ulcer
• E11.622 Type 2 diabetes mellitus with other skin ulcer
• E11.628 Type 2 diabetes mellitus with other skin complications
• E11.630 Type 2 diabetes mellitus with periodontal disease
• E11.638 Type 2 diabetes mellitus with other oral complications
• E11.641 Type 2 diabetes mellitus with hypoglycemia with coma
• E11.649 Type 2 diabetes mellitus with hypoglycemia without coma
• E11.65 Type 2 diabetes mellitus with hyperglycemia
• E11.69 Type 2 diabetes mellitus with other specified complication
• E11.8 Type 2 diabetes mellitus with unspecified complications
• E11.9 Type 2 diabetes mellitus without complications
• E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
• E13.01 Other specified diabetes mellitus with hyperosmolarity with coma
• E13.10 Other specified diabetes mellitus with ketoacidosis without coma
• E13.11 Other specified diabetes mellitus with ketoacidosis with coma
• E13.21 Other specified diabetes mellitus with diabetic nephropathy
• E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease
• E13.29 Other specified diabetes mellitus with other diabetic kidney complication
• E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
• E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
• E13.3211 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
• E13.3212 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
• E13.3213 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
• E13.3219 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E13.3291 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
• E13.3292 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
• E13.3293 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
• E13.3299 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E13.3311 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
• E13.3312 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
• E13.3313 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
• E13.3319 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E13.3391 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
• E13.3392 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
• E13.3393 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
• E13.3399 Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E13.3411 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
• E13.3412 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
• E13.3413 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
• E13.3419 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, unspecified eye
• E13.3491 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
• E13.3492 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
• E13.3493 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
• E13.3499 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, unspecified eye
• E13.3511 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
• E13.3512 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
• E13.3513 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
• E13.3519 Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, unspecified eye
• E13.3521 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
• E13.3522 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
• E13.3523 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
• E13.3529 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, unspecified eye
• E13.3531 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
• E13.3532 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
• E13.3533 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
• E13.3539 Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, unspecified eye
• E13.3541 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
• E13.3542 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
• E13.3543 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
• E13.3549 Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, unspecified eye
• E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye
• E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye
• E13.3553 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
• E13.3559 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, unspecified eye
• E13.3591 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
• E13.3592 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
• E13.3593 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
• E13.3599 Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, unspecified eye
• E13.36 Other specified diabetes mellitus with diabetic cataract
• E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
• E13.37X2 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
• E13.37X3 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
• E13.37X9 Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, unspecified eye
• E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication
• E13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecified
• E13.41 Other specified diabetes mellitus with diabetic mononeuropathy
• E13.42 Other specified diabetes mellitus with diabetic polyneuropathy
• E13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
• E13.44 Other specified diabetes mellitus with diabetic amyotrophy
• E13.49 Other specified diabetes mellitus with other diabetic neurological complication
• E13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene
• E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
• E13.59 Other specified diabetes mellitus with other circulatory complications
• E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy
• E13.618 Other specified diabetes mellitus with other diabetic arthropathy
• E13.620 Other specified diabetes mellitus with diabetic dermatitis
• E13.621 Other specified diabetes mellitus with foot ulcer
• E13.622 Other specified diabetes mellitus with other skin ulcer
• E13.628 Other specified diabetes mellitus with other skin complications
• E13.630 Other specified diabetes mellitus with periodontal disease
• E13.638 Other specified diabetes mellitus with other oral complications
• E13.641 Other specified diabetes mellitus with hypoglycemia with coma
• E13.649 Other specified diabetes mellitus with hypoglycemia without coma
• E13.65 Other specified diabetes mellitus with hyperglycemia
• E13.69 Other specified diabetes mellitus with other specified complication
• E13.8 Other specified diabetes mellitus with unspecified complications
• E13.9 Other specified diabetes mellitus without complications
• R73.01 Impaired fasting glucose
• R73.02 Impaired glucose tolerance (oral)
• R73.03 Prediabetes
• R73.09 Other abnormal glucose
• R73.9 Hyperglycemia, unspecified
• Z13.1 Encounter for screening for diabetes mellitus
• Z83.3 Family history of diabetes mellitus
• Z86.32 Personal history of gestational diabetes

Frequency

• Initial year: Up to 10 hours of initial training within a continuous 12-month period
• Subsequent years: Up to 2 hours of follow-up training each year after the initial year

Medicare Beneficiary Pays

• Copayment/coinsurance applies
• Deductible applies

Alcohol Misuse Screening and Counseling CPT G0442 and G0443

HCPCS/CPT Codes

• G0442 – Annual alcohol misuse screening, 15 minutes
• G0443 – Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes

Who Is Covered

 

All Medicare beneficiaries are eligible for alcohol screening.

 

Medicare beneficiaries who screen positive (those who misuse alcohol but whose levels or patterns of alcohol consumption do not meet criteria for alcohol dependence) are eligible for counseling if,

• They are competent and alert at the time counseling is provided and
• Counseling is furnished by qualified primary care physicians or other primary care practitioners in a primary care setting

Covered ICD Codes

• F10.282 Alcohol dependence with alcohol-induced sleep disorder
• F10.288 Alcohol dependence with other alcohol-induced disorder
• F10.29 Alcohol dependence with unspecified alcohol-induced disorder
• F10.920 Alcohol use, unspecified with intoxication, uncomplicated
• F10.921 Alcohol use, unspecified with intoxication delirium
• F10.929 Alcohol use, unspecified with intoxication, unspecified
• F10.94 Alcohol use, unspecified with alcohol-induced mood disorder
• F10.950 Alcohol use, unspecified with alcohol-induced psychotic disorder with delusions
• F10.951 Alcohol use, unspecified with alcohol-induced psychotic disorder with hallucinations
• F10.959 Alcohol use, unspecified with alcohol-induced psychotic disorder, unspecified
• F10.96 Alcohol use, unspecified with alcohol-induced persisting amnestic disorder
• F10.97 Alcohol use, unspecified with alcohol-induced persisting dementia
• F10.980 Alcohol use, unspecified with alcohol-induced anxiety disorder
• F10.981 Alcohol use, unspecified with alcohol-induced sexual dysfunction
• F10.982 Alcohol use, unspecified with alcohol-induced sleep disorder
• F10.988 Alcohol use, unspecified with other alcohol-induced disorder
• F10.99 Alcohol use, unspecified with unspecified alcohol-induced disorder
• F12.23 Cannabis dependence with withdrawal
• F12.93 Cannabis use, unspecified with withdrawal
• O99.310 Alcohol use complicating pregnancy, unspecified trimester
• O99.311 Alcohol use complicating pregnancy, first trimester
• O99.312 Alcohol use complicating pregnancy, second trimester
• O99.313 Alcohol use complicating pregnancy, third trimester
• O99.314 Alcohol use complicating childbirth
• O99.315 Alcohol use complicating the puerperium
• R45.88 Nonsuicidal self-harm
• T51.8X2A Toxic effect of other alcohols, intentional self-harm, initial encounter
• T51.8X3A Toxic effect of other alcohols, assault, initial encounter
• T51.8X4A Toxic effect of other alcohols, undetermined, initial encounter
• T51.92XA Toxic effect of unspecified alcohol, intentional self-harm, initial encounter
• T51.93XA Toxic effect of unspecified alcohol, assault, initial encounter
• T51.94XA Toxic effect of unspecified alcohol, undetermined, initial encounter
• Z02.83 Encounter for blood-alcohol and blood-drug test
• Z13.30 Encounter for screening examination for mental health and behavioral disorders, unspecified
• Z13.31 Encounter for screening for depression
• Z13.32 Encounter for screening for maternal depression
• Z13.39 Encounter for screening examination for other mental health and behavioral disorders
• Z63.72 Alcoholism and drug addiction in family
• Z71.41 Alcohol abuse counseling and surveillance of alcoholic
• Z71.42 Counseling for family member of alcoholic
• Z71.84 Encounter for health counseling related to travel
• Z81.1 Family history of alcohol abuse and dependence

Frequency

• Annually for G0442
• For those who screen positive, 4 times per year for G0443

Medicare Beneficiary Pays

• Copayment/coinsurance waived
• Deductible waived

Prostate Cancer Screening CPT G0102 and G0103

HCPCS/CPT Codes

G0102 – Prostate cancer screening; digital rectal examination

• The Physician performs a prostate cancer screening in which he performs a digital rectal examination to assess the male patient’s prostate. 
• To examine the prostate the provider inserts a gloved and lubricated finger into the rectum and checks for hardness, lumps, or any abnormalities. 
• This examination helps detect prostate cancer in its early stages. The provider typically performs this test for the first time at the age of 40 for men at risk of having prostate cancer such as those men with a family history of cancer
• Medicare provides coverage for an annual prostate cancer screening digital rectal examination for men at the age of 50.  

G0103 – Prostate cancer screening; prostate specific antigen test (PSA)

• The Prostate screening examination, the Physician detects the prostate specific antigen, or PSA, level in a patient’s blood. PSA is a protein the prostate gland produces, and he/she may use PSA levels to screen for prostate cancer
• This protein is considered as an indicator for prostate cancer. The Physician collects the blood sample through a venipuncture. This test helps to detect prostate cancer in its early stages. 
• A normal level of PSA in blood level as specified below, 
• For below 50 years of age is less than 2.5
• For age 50 to 60 it is less than 3.5, 
• For age 60 to 70 it is less than 4.5 
• For age above 70 it is 6.6.  
• Medicare provides coverage for an annual prostate cancer screening, or PSA, test for men at the age of 50.

ICD-10 Codes

The specified below ICD codes are covered for CPT G0102 and G0103 but may not be limited and some private payers having specific guidelines.

• D07.5 Carcinoma in situ of prostate
• D29.1 Benign neoplasm of prostate
• D40.0 Neoplasm of uncertain behavior of prostate
• R97.20 Elevated prostate specific antigen [PSA]
• R97.21 Rising PSA following treatment for malignant neoplasm of prostate
• Z12.5 Encounter for screening for malignant neoplasm of prostate
• Z15.03 Genetic susceptibility to malignant neoplasm of prostate
• Z71.84 Encounter for health counseling related to travel
• Z80.42 Family history of malignant neoplasm of prostate
• Z85.46 Personal history of malignant neoplasm of prostate

Who Is Covered

• All male Medicare beneficiaries aged 50 and older (coverage begins the day after their 50th birthday)

Frequency

• Annually for covered Medicare beneficiaries
• Medicare Beneficiary Pays

G0102:

• Co-payment/coinsurance applies
• Deductible applies

G0103:

• Co-payment/coinsurance waived
• Deductible waived

Screening for Cervical Cancer with Human Papillomavirus (HPV) Tests

Human Papillomavirus 

The lab analyst performs the technical steps to detect human papillomavirus through nucleic acid detection and the Nucleic acid probes permit identification of microorganisms based on their DNA or RNA. 

The Nucleic acid quantitation allows assessment of treatment response and the Quantitation refers to measuring the exact amount of a substance. The lab analyst performs this procedure for detection of high risk types of human papillomavirus.

HCPCS/CPT Codes

• G0476 – Infectious agent detection by nucleic acid (DNA or RNA); human papillomavirus (HPV), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test 

ICD-10 Codes

The specified below ICD codes are covered for CPT G0476 but may not be limited and some private payers having specific guidelines.

• B97.7 Papillomavirus as the cause of diseases classified elsewhere
• R85.81 Anal high risk human papillomavirus (HPV) DNA test positive
• R85.82 Anal low risk human papillomavirus (HPV) DNA test positive
• R87.810 Cervical high risk human papillomavirus (HPV) DNA test positive
• R87.811 Vaginal high risk human papillomavirus (HPV) DNA test positive
• R87.820 Cervical low risk human papillomavirus (HPV) DNA test positive
• R87.821 Vaginal low risk human papillomavirus (HPV) DNA test positive
• Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings
• Z01.419 Encounter for gynecological examination (general) (routine) without abnormal findings
• Z01.42 Encounter for cervical smear to confirm findings of recent normal smear following initial abnormal smear
• Z11.51 Encounter for screening for human papillomavirus (HPV)
• Z86.002 Personal history of in-situ neoplasm of other and unspecified genital organs

Who Is Covered

• All asymptomatic female Medicare beneficiaries aged 30 to 65 years

Frequency

• Once every 5 years

Medicare Beneficiary Pays

• Co-payment/coinsurance waived
• Deductible waived