Appendix_7_9_Decision_Support_System_File_Layout.xlsx
XLSX spreadsheet 921 KB Posted
- Attached to
- Employee Assistance Program (EAP) and Behavioral Health Organization (BHO) Services - UPDATED
- Solicitation number
- RFP 31786-00188
- Issued by
- Davidson County, Tennessee
About this file
This is a Request for Proposal (RFP) from the State of Tennessee Department of Finance and Administration for Employee Assistance Program (EAP) and Behavioral Health Organization (BHO) services covering three financially independent self-funded public sector insurance plans: the State Plan (147,000 covered lives), Local Education Plan (128,000 covered lives), and Local Government Plan (26,000 covered lives), totaling approximately 300,000 covered lives. The procured services include network administration, utilization management, claims adjudication, call center services, and benefits communication. The RFP was issued on October 8, 2025, with written questions due October 22, 2025, and November 19, 2025. The response deadline is December 19, 2025. Technical evaluations are anticipated to be completed by January 29, 2026, with cost proposal scoring on January 30, 2026, and negotiations scheduled for February 9-11, 2026. The contract term spans 86 months, comprising eight months of implementation, 60 months of service delivery (January 1, 2027, through December 31, 2031), and an 18-month claims runout period.
The compensation structure utilizes a per-employee-per-month (PEPM) administrative fee model. While the state self-funds approximately $976 million in annual medical, pharmacy, and behavioral health claims across all three plans, no specific award value is explicitly stated in the procurement documents. The successful vendor must maintain NCQA accreditation as a Managed Behavioral Healthcare Organization and URAC accreditation for utilization management programs, with performance guarantees and liquidated damages ranging from $1,000 to $75,000 per incident. Contractors must demonstrate financial stability and relevant experience managing large employer populations exceeding 10,000 members with claims adjudication experience exceeding $10 million annually for at least two clients. The incumbent contractor will be responsible for transitioning existing members and services at no additional cost to the state. Additional requirements include carrying $5 million in cyber liability insurance and complying with HIPAA, HITECH, and state security requirements, including annual SOC 2 Type 2 examinations and penetration testing. The state encourages responses from minority-owned, women-owned, service-disabled veteran-owned, and small business enterprises.
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Detail File
| # | Category | Field Description | Facets Data Element | Facets Table | Facets Values / Data Dictionary | Type | Size | Format | Notes |
| 1 | Client | Group Id Number | GRGR_ID | CMC_GRGR_GROUP | N/A | N | 8 | ||
| 2 | Client | Group Description/Name | GRGR_NAME | CMC_GRGR_GROUP | N/A | A | 50 | ||
| 3 | Provider | Provider Entity Type | PRPR_ENTITY | CMC_PRPR_PROV | F - Facility |
G - Provider Group
I - IPA
| P - Practitioner | A | 1 | |||||||
| 4 | Provider | Provider Id Number | PRPR_ID | CMC_CLCL_CLAIM | N/A | A | 12 | ||
| 5 | Provider | Provider Full Name | PRPR_NAME | CMC_PRPR_PROV | N/A | A | 55 | ||
| 6 | Provider | Provider Last Name | PRCP_LAST_NAME | CMC_PRCP_COMM_PRAC | N/A | A | 35 | Only for the Common Practitioner data will be populated | |
| 7 | Provider | Provider First Name | PRCP_FIRST_NAME | CMC_PRCP_COMM_PRAC | N/A | A | 15 | Only for the Common Practitioner data will be populated | |
| 8 | Provider | Provider MI (Middle Initial) | PRCP_MID_INIT | CMC_PRCP_COMM_PRAC | N/A | A | 1 | Only for the Common Practitioner data will be populated | |
| 9 | Provider | Provider Address 1 | PRAD_ADDR1 | CMC_PRAD_ADDRESS | N/A | A | 40 | Primary practice address will be extracted | |
| 10 | Provider | Provider Address 2 | PRAD_ADDR2 | CMC_PRAD_ADDRESS | N/A | A | 40 | Primary practice address will be extracted | |
| 11 | Provider | Provider Address 3 | PRAD_ADDR3 | CMC_PRAD_ADDRESS | N/A | A | 40 | Primary practice address will be extracted | |
| 12 | Provider | Provider City | PRAD_CITY | CMC_PRAD_ADDRESS | N/A | A | 19 | Primary practice address will be extracted | |
| 13 | Provider | Provider State | PRAD_STATE | CMC_PRAD_ADDRESS | N/A | A | 2 | Primary practice address will be extracted | |
| 14 | Provider | Provder County | PRAD_COUNTY | CMC_PRAD_ADDRESS | N/A | A | 20 | Primary practice address will be extracted | |
| 15 | Provider | Provider Zip | PRAD_ZIP | CMC_PRAD_ADDRESS | N/A | A | 11 | Primary practice address will be extracted | |
| 16 | Provider | Provider Fax Number | PRAD_FAX | CMC_PRAD_ADDRESS | N/A | A | 20 | Primary practice address will be extracted | |
| 17 | Provider | Provider Phone No. | PRAD_PHONE | CMC_PRAD_ADDRESS | N/A | N | 20 | Primary practice address will be extracted | |
| 18 | Provider | Provider Type | PRPR_MCTR_TYPE | CMC_PRPR_PROV | Click Here for Values | A | 4 | ||
| 19 | Provider | Provider SSN | PRCP_SSN | CMC_PRCP_COMM_PRAC | N/A | A | 9 | Only for the Common Practitioner SSN will be populated | |
| 20 | Provider | Provider Tax Id | MCTN_ID | CMC_PRPR_PROV | N/A | A | 9 | ||
| 21 | Provider | Provider National Provider Identifier | PRPR_NPI | CMC_PRPR_PROV | N/A | A | 10 | ||
| 22 | Provider | Provider UPIN | PRRG_ID | CMC_PRRG_REG | N/A | A | 15 | Get PRRG_ID where PRRG_MCTR_TYPE =’UPIN’ | |
| 23 | Provider | Provider License | LICN_NO | EDS_PRPR_LICENSE | N/A | A | 15 | Primary License will be populated |
For Common Practitioner: (PRPR_ENTITY = 'P') Link PRCP_ID.CMC_PRPR_PROV with PRPR_ID.EDS_PRPR_LICENSE where
LICN_PRIM_IND = 'Y'
For Facility: (PRPR_ENTITY = 'F') Link PRPR_ID.CMC_PRPR_PROV with PRPR_ID.EDS_PRPR_LICENSE where
LICN_PRIM_IND = 'Y'
24 Provider Provider Medicaid Billing Number PRRG_ID CMC_PRRG_REG N/A A 15 Get PRRG_ID where PRRG_MCTR_TYPE =’MCD1’ Only Primary Medicaid number will be populated 25 Provider Provider Medicare Billing Number PRRG_ID CMC_PRRG_REG N/A A 15 Get PRRG_ID where PRRG_MCTR_TYPE =’MCR1’ Only Primary Medicare number will be populated 26 Provider Provider DEA Number PRRG_ID CMC_PRRG_REG N/A A 15 Get PRRG_ID where PRRG_MCTR_TYPE =’DEA1’ Only Primary Medicare number will be populated
| 27 | Provider | Provider Effective Date | NWPR_EFF_DT | CMC_NWPR_RELATION | N/A | D | 8 | YYYYMMDD | Will be used as earlist Network effective date of the par Provider and blank for nonpar provider |
| 28 | Provider | Provider Termination Date | PRPR_TERM_DT | CMC_PRPR_PROV | N/A | D | 8 | YYYYMMDD | |
| 29 | Provider | Professional History Degree/Position | PRHI_DEGREE | CMC_PRHI_HIST | N/A | A | 15 | ||
| 30 | Provider | Provider Specialty | PRCF_MCTR_SPEC | CMC_PRCF_CERT | Click Here for Values | A | 5 | Primary speciality will be pulled |
If Specialty Code is missing or not available for either Practioner or Facility, the default value "OTHER" will be populated
| 31 | Subscriber | Subscriber Identification Number | SBSB_ID | CMC_SBSB_SUBSC | N/A | A | 9 | ||
| 32 | Subscriber | Subscriber Last Name | SBSB_LAST_NAME | CMC_SBSB_SUBSC | N/A | A | 35 | ||
| 33 | Subscriber | Subscriber First Name | SBSB_FIRST_NAME | CMC_SBSB_SUBSC | N/A | A | 15 | ||
| 34 | Subscriber | Subscriber MI | SBSB_MID_INIT | CMC_SBSB_SUBSC | N/A | A | 1 | ||
| 35 | Subscriber | Subscriber Birth Date | MEME_BIRTH_DT | CMC_MEME_MEMBER | N/A | D | 8 | YYYYMMDD | will be extracted as member DoB where MEME_SFX = '00' |
| 36 | Subscriber | Subscriber Gender | MEME_SEX | CMC_MEME_MEMBER | U-Unknown |
F-Female M-Male
| A | 1 | will be extracted as member gender where MEME_SFX = '00' | |||
| 37 | Subscriber | Subscriber Marital Status | MEME_MARITAL_STATUS | CMC_MEME_MEMBER | <Single space> -Not Assigned |
A-Common Law B-Registered Domestic Partner D-Divorce I-Single K-Unknown M-Married R-Unreported S-Separated U-Unmarried W-Widowed
| X-Legally Separated | A | 1 | will be extracted as member marital status where MEME_SFX = '00' | ||||||
| 38 | Subscriber | Subscriber Zip | SBAD_ZIP | CMC_SBAD_ADDR | N/A | A | 11 | ||
| 39 | Subscriber | Subscriber Social Security Number | MEME_SSN | CMC_MEME_MEMBER | N/A | A | 9 | will be extracted as member SSN where MEME_SFX = '00' | |
| 40 | Subscriber | Subscriber HICN | MEME_HICN | CMC_MEME_MEMBER | N/A | A | 12 | will be extracted as member HICN where MEME_SFX = '00' | |
| 41 | Subscriber | Subscriber Medicaid Number | MEME_MEDCD_NO | CMC_MEME_MEMBER | N/A | A | 20 | will be extracted as member Medicaid Number where MEME_SFX = '00' | |
| 42 | Subscriber | Subscriber Status | Will be derived based on Subscriber's eligibility information | CMC_MEPE_PRCS_ELIG / CMC_CDML_CL_LINE | A - Active | ||||
| T - Terminated | A | 1 | Subscriber Status will be derived based on Subscriber's eligibility information with the claim line service dates. |
For active Subscriber records.
MEPE_EFF_DT <= CDML_FROM_DT
MEPE_TERM_DT >= CDML_TO_DT
MEPE_ELIG_IND = 'Y'
| 43 | Member | Member Identification Number | SBSB_ID + MEME_SFX | CMC_SBSB_SUBSC / CMC_MEME_MEMBER | N/A | A | 11 | Concatenate the Subscriber ID (9 char) with Member Suffix (2 Char). SBSB_ID + MEME_SFX | |
| 44 | Member | Member Last Name | MEME_LAST_NAME | CMC_MEME_MEMBER | N/A | A | 35 | ||
| 45 | Member | Member First Name | MEME_FIRST_NAME | CMC_MEME_MEMBER | N/A | A | 15 | ||
| 46 | Member | Member MI | MEME_MID_INIT | CMC_MEME_MEMBER | N/A | A | 1 | ||
| 47 | Member | Member Birth Date | MEME_BIRTH_DT | CMC_MEME_MEMBER | N/A | D | 8 | YYYYMMDD | |
| 48 | Member | Member Gender | MEME_SEX | CMC_MEME_MEMBER | U-Unknown |
F-Female
| M-Male | A | 1 | ||||
| 49 | Member | Member Marital Status | MEME_MARITAL_STATUS | CMC_MEME_MEMBER | <Single space> -Not Assigned |
A-Common Law B-Registered Domestic Partner D-Divorce I-Single K-Unknown M-Married R-Unreported S-Separated U-Unmarried W-Widowed
| X-Legally Separated | A | 1 | ||||||
| 50 | Member | Member Zip | SBAD_ZIP | CMC_SBAD_ADDR | N/A | A | 11 | |
| 51 | Member | Member Social Security Number | MEME_SSN | CMC_MEME_MEMBER | N/A | A | 9 | |
| 52 | Member | Member HICN | MEME_HICN | CMC_MEME_MEMBER | N/A | A | 12 | |
| 53 | Member | Member Medicaid Number | MEME_MEDCD_NO | CMC_MEME_MEMBER | N/A | A | 20 | |
| 54 | Member | Member Status | Will be derived based on Members's eligibility information | CMC_MEPE_PRCS_ELIG / CMC_CDML_CL_LINE | A - Active | |||
| T - Terminated | A | 1 | Member Status will be derived based on Members's eligibility information with the claim line service dates. |
For active Members record:
MEPE_EFF_DT <= CDML_FROM_DT
MEPE_TERM_DT >= CDML_TO_DT
MEPE_ELIG_IND = 'Y'
55 Member Member Relationship to Subscriber MEME_REL CMC_MEME_MEMBER D - Daughter/Child H - Husband/Spouse M - Subscriber/Insured O - Other Dependent S - Son/Child W - Wife/Spouse
| A | 1 | |||||||
| 56 | Member | Member Job Category | MEME_ATTR_VALUE | EDS_MEME_MEMB_ATTR / EDS_MEME_MEMB_ATTR_HIST | N/A | A | 50 | Where MEME_ATTR_NAME = 'JOBCAT'. Data will be extracted based on the lowest (CDML_FROM_DT) date of service for each claim line item. If the data does not exists in EDS_MEME_MEMB_ATTR for the service date the same will be extracted from history table EDS_MEME_MEMB_ATTR_HIST. |
| 57 | Member | Member Job Site | MEME_ATTR_VALUE | EDS_MEME_MEMB_ATTR / EDS_MEME_MEMB_ATTR_HIST | N/A | A | 50 | where MEME_ATTR_NAME = 'JOBSITE'. Data will be extracted based on the lowest (CDML_FROM_DT) date of service for each claim line item. If the data does not exists in EDS_MEME_MEMB_ATTR for the service date the same will be extracted from history table EDS_MEME_MEMB_ATTR_HIST. |
| 58 | Member | Member Division | SGSG_ID + Space + SGSG_NAME | CMC_SGSG_SUB_GROUP | Click Here for Values | A | 55 | SGSG_ID + Space + SGSG_NAME |
| 59 | Member | Member Plan Description | PLDS_DESC | CMC_PLDS_PLAN_DESC | N/A | A | 70 | |
| 60 | Claim Header | Claim identifier | CLCL_ID | CMC_CLCL_CLAIM | N/A | A | 12 | |
| 61 | Claim Header | Patient Account Number | CLCL_PA_ACCT_NO | CMC_CLCL_CLAIM | N/A | A | 35 | |
| 62 | Claim Header | Adjusted Claim Identifier | CLCL_ID_ADJ_FROM | CMC_CLCL_CLAIM | N/A | A | 12 | |
| 63 | Claim Header | Corrected Claim Identifier | CLCL_ID_ADJ_TO | CMC_CLCL_CLAIM | N/A | A | 12 | |
| 64 | Claim Header | Claim Type. Medical, Dental, etc. | CLCL_CL_SUB_TYPE | CMC_CLCL_CLAIM | M - Medical |
H - Hospital F - Healthcare Expense D - Dental
| C - Dependent Care Expense | A | 1 | ||||
| 65 | Claim Header | Claim Status | CLCL_CUR_STS | CMC_CLCL_CLAIM | 02 - Accepted;Batch run completed |
14 - Claim pre - paid;Batch completed 91 - Adjusted processed claim
| 92 - Adjusted prepriced claim | A | 2 | ||
| 66 | Claim Header | Indicators for Adjusted Claims | 0 = Original claims, | |
| 1 = Adjustment and reversal (negative) claims | 0 = Original claims, | |||
| 1 = Adjustment and reversal (negative) claims | A | 1 | Display 0 for original claims and 1for sub-sequent adjustment claims and reversal (negative) claims. 0 = Original claims, |
1 = Adjustment and reversal (negative) claims 67 Claim Header Product Category CSPD_CAT CMC_CLCL_CLAIM D - Dental Product
E - EAP PRODUCT
M - Medical Product (BH Product)
W - WORK/LIFE PRODUCT
H - Hospital Product
| R - Pharmacy Product | A | 1 | |||||||
| 68 | Claim Header | Network Indicator | CLCL_NTWK_IND | CMC_CLCL_CLAIM | I - In network | ||||
| O - Out of network | A | 1 | |||||||
| 69 | Claim Header | Admit Diagnosis Code | IDCD_ID | CMC_CLMD_DIAG | Click Here for Values | A | 11 | Get IDCD_ID where CLMD_TYPE =’AD' |
70 Claim Header Diagnosis Code 1 (Primary) IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’01’
71 Claim Header Diagnosis Code 2 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’02’
72 Claim Header Diagnosis Code 3 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’03’
73 Claim Header Diagnosis Code 4 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’04’
74 Claim Header Diagnosis Code 5 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’05’
75 Claim Header Diagnosis Code 6 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’06’
76 Claim Header Diagnosis Code 7 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’07’
77 Claim Header Diagnosis Code 8 IDCD_ID CMC_CLMD_DIAG Click Here for Values A 11 Get IDCD_ID where CLMD_TYPE =’08’
| 78 | Claim Header | Procedure Code Type (Principal) | CLHI_TYPE | CMC_CLHI_PROC | Click Here for Values | A | 1 | CLHI_TYPE = 'P' - Principal |
| 79 | Claim Header | Procedure Code (Principal) | IPCD_ID | CMC_CLHI_PROC | N/A | A | 8 | Get IPCD_ID where CLHI_TYPE = 'P' and CMC_CLHP_HOSP .CLHP_IPCD_METH =9 ( ICD-9 procedure codes). Consider only first 5 chars of procedure code and include decimal between 2nd and 3rd digit (Eg. 9834 will be 98.34) |
| 80 | Claim Header | Procedure Date (Principal) | CLHI_IP_DT | CMC_CLHI_PROC | N/A | D | 8 | YYYYMMDD | Get respective CLHI_IP_DT by CLHI_TYPE = 'P' |
| 81 | Claim Header | Procedure Code Type (Secondary) | CLHI_TYPE | CMC_CLHI_PROC | P - Principal |
S - Secondary T - Tertiary 4 - Fourth 5 - Fifth
| 6 - Sixth | A | 1 | CLHI_TYPE = 'S' - Secondary | ||||||
| 82 | Claim Header | Procedure Code (Secondary) | IPCD_ID | CMC_CLHI_PROC | N/A | A | 8 | Get IPCD_ID where CLHI_TYPE = 'S' and CMC_CLHP_HOSP .CLHP_IPCD_METH =9 ( ICD-9 procedure codes). Consider only first 5 chars of procedure code and include decimal between 2nd and 3rd digit (Eg. 9834 will be 98.34) |
| 83 | Claim Header | Procedure Date (Secondary) | CLHI_IP_DT | CMC_CLHI_PROC | N/A | D | 8 | YYYYMMDD | Get respective CLHI_IP_DT by CLHI_TYPE = 'S' |
| 84 | Claim Header | Procedure Code Type (Tertiary) | CLHI_TYPE | CMC_CLHI_PROC | P - Principal |
S - Secondary T - Tertiary 4 - Fourth 5 - Fifth
| 6 - Sixth | A | 1 | CLHI_TYPE = 'T' - Tertiary | ||||||
| 85 | Claim Header | Procedure Code (Tertiary) | IPCD_ID | CMC_CLHI_PROC | N/A | A | 8 | Get IPCD_ID where CLHI_TYPE = 'T' and CMC_CLHP_HOSP .CLHP_IPCD_METH =9 ( ICD-9 procedure codes). Consider only first 5 chars of procedure code and include decimal between 2nd and 3rd digit (Eg. 9834 will be 98.34) |
| 86 | Claim Header | Procedure Date (Tertiary) | CLHI_IP_DT | CMC_CLHI_PROC | N/A | D | 8 | YYYYMMDD | Get respective CLHI_IP_DT by CLHI_TYPE = 'T' |
| 87 | Claim Header | Procedure Code Type (Fourth) | CLHI_TYPE | CMC_CLHI_PROC | P - Principal |
S - Secondary T - Tertiary 4 - Fourth 5 - Fifth
| 6 - Sixth | A | 1 | CLHI_TYPE = '4' - Fourth | ||||||
| 88 | Claim Header | Procedure Code (Fourth) | IPCD_ID | CMC_CLHI_PROC | N/A | A | 8 | Get IPCD_ID where CLHI_TYPE = '4' and CMC_CLHP_HOSP .CLHP_IPCD_METH =9 ( ICD-9 procedure codes). Consider only first 5 chars of procedure code and include decimal between 2nd and 3rd digit (Eg. 9834 will be 98.34) |
| 89 | Claim Header | Procedure Date (Fourth) | CLHI_IP_DT | CMC_CLHI_PROC | N/A | D | 8 | YYYYMMDD | Get respective CLHI_IP_DT by CLHI_TYPE = '4' |
| 90 | Claim Header | Procedure Code Type (Fifth) | CLHI_TYPE | CMC_CLHI_PROC | P - Principal |
S - Secondary T - Tertiary 4 - Fourth 5 - Fifth
| 6 - Sixth | A | 1 | CLHI_TYPE = '5' - Fifth | ||||||
| 91 | Claim Header | Procedure Code (Fifth) | IPCD_ID | CMC_CLHI_PROC | N/A | A | 8 | Get IPCD_ID where CLHI_TYPE = '5' and CMC_CLHP_HOSP .CLHP_IPCD_METH =9 ( ICD-9 procedure codes). Consider only first 5 chars of procedure code and include decimal between 2nd and 3rd digit (Eg. 9834 will be 98.34) |
| 92 | Claim Header | Procedure Date (Fifth) | CLHI_IP_DT | CMC_CLHI_PROC | N/A | D | 8 | YYYYMMDD | Get respective CLHI_IP_DT by CLHI_TYPE = '5' |
| 93 | Claim Header | Claim Paid Date | CLCL_PAID_DT | CMC_CLCL_CLAIM | N/A | D | 9 | YYYYMMDD | The source the length is 8, but on the extract it is 9. It was decided not to change it,. |
| 94 | Claim Header | Claim Received Date | CLCL_RECD_DT | CMC_CLCL_CLAIM | N/A | D | 8 | YYYYMMDD | |
| 95 | Claim Header | UB92 Admission Date | CLHP_ADM_DT | CMC_CLHP_HOSP | N/A | D | 8 | YYYYMMDD | |
| 96 | Claim Header | UB92 Admission Hour | CLHP_ADM_HOUR_CD | CMC_CLHP_HOSP | N/A | N | 2 | ||
| 97 | Claim Header | UB92 Admission Source | CLHP_ADM_SOURCE | CMC_CLHP_HOSP | 0 - Transfer from Psych, Substance Abuse or Rehab Hospital |
1 - Physician Referral 2 - Clinic Referral 3 - HMO Referral 4 - Transfer from a Hospital 5 - Transfer from a SNF 6 - Transfer from Another Facility 7 - Emergency Room 8 - Court/Law Enforcement 9 - Information Not Available A - Transfer from Critical Access Hospital B - Transfer from Another HHA C - Readmission to Same HHA
| D - Transfer from inpatient in same facility | A | 1 | ||||
| 98 | Claim Header | UB92 Type of Admission | CLHP_ADM_TYP | CMC_CLHP_HOSP | 1 - Emergency |
2 - Urgent 3 - Elective 4 - Newborn 5 - Trauma 6 - Reserved for nat'l assignment 7 - Reserved for nat'l assignment 8 - Reserved for nat'l assignment
| 9 - Information not available | A | 2 | ||||||
| 99 | Claim Header | UB92 Submitted DRG Code | CLHP_INPUT_AGRG_ID | CMC_CLHP_HOSP | N/A | A | 4 | |
| 100 | Claim Header | UB92 Admitting Physician Identifier | CLHP_PRPR_ID_ADM | CMC_CLHP_HOSP | N/A | A | 17 | |
| 101 | Claim Header | UB92 Bill Classification | CLHP_BILL_CLASS | CMC_CLHP_HOSP | Click Here for values | A | 1 | |
| 102 | Claim Header | UB92 Facility Type | CLHP_FAC_TYPE | CMC_CLHP_HOSP | Click Here for values | A | 2 |
220450: UBH:
Increased from 1 to 2 on 09/05/2011
| 103 | Claim Header | UB92 Medical Record Number | CLHP_MED_REC_NO | CMC_CLHP_HOSP | N/A | A | 17 | |
| 104 | Claim Header | UB92 Bill Frequency | CLHP_FREQUENCY | CMC_CLHP_HOSP | Click Here for Values | A | 1 | |
| 105 | Claim Header | UB92 Discharge Date | CLHP_DC_DT | CMC_CLHP_HOSP | N/A | D | 8 | YYYYMMDD |
| 106 | Claim Header | UB92 Discharge Hour | CLHP_DC_HOUR_CD | CMC_CLHP_HOSP | N/A | N | 2 | |
| 107 | Claim Header | UB92 Discharge Status | CLHP_DC_STAT | CMC_CLHP_HOSP | Click Here for Values | A | 2 | |
| 108 | Claim Header | COB Type | CLCB_COB_TYPE | CMC_CLCB_CL_COB | A - Auto |
C - Commercial F - No Fault G - General Liability H - Homeowners M - Medicare Part A & B N - Medicare Part B Only O - Medicare Part A &/or B plus D S - Subrogation
| W - Workers Compensation | A | 1 | |||||||
| 109 | Claim Header | Claim EOB Explanation Code | CLCL_EOB_EXCD_ID | CMC_CLCL_CLAIM | Click Here for Values | A | 3 | ||
| 110 | Claim Header | Hospital Processing Value Code (Only one) | CLVC_CODE | CMC_CLVC_VAL_CODE | N/A | A | 2 | where CLVC_NUMBER = '39' and CLVC_LETTER = 'A' |
display only one code details
| 111 | Claim Header | Hospital Processing Value Amount (Only one) | CLVC_AMT | CMC_CLVC_VAL_CODE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | where CLVC_NUMBER = '39' and CLVC_LETTER = 'A' |
display only one code details 112 Claim Header Hospital Processing Value Units (Only one) CLVC_VALUE CMC_CLVC_VAL_CODE N/A N 5 where CLVC_NUMBER = '39' and CLVC_LETTER = 'A' display only one code details 113 Claim Header Hospital Specific Condition Codes (Only One) CLHC_COND_CD CMC_CLHC_COND_CODE N/A A 2 where MIN (CLHC_SEQ_NO) - Minimum Seq. Number display only one code details 114 Claim Header UB92 Occurrence Code (Only One) CLHO_OCC_CODE CMC_CLHO_OCC_CODE Click Here for Values A 2 where MIN (CLHO_SEQ_NO) - Minimum Seq. Number display only one code details 115 Claim Header UB92 Occurrence Code From Date (Only One) CLHO_OCC_FROM_DT CMC_CLHO_OCC_CODE N/A D 8 YYYYMMDD where MIN (CLHO_SEQ_NO) - Minimum Seq. Number display only one code details 116 Claim Header UB92 Occurrence Code To Date (Only One) CLHO_OCC_TO_DT CMC_CLHO_OCC_CODE N/A D 8 YYYYMMDD where MIN (CLHO_SEQ_NO) - Minimum Seq. Number display only one code details
| 117 | Claim Header | UB92 Hospital Covered Days | CLHP_COVD_DAYS | CMC_CLHP_HOSP | N/A | N | 5 | ||
| 118 | Claim Header | Claim Total Charge | CLCL_TOT_CHG | CMC_CLCL_CLAIM | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 119 | Claim Header | Primary Carrier Payment Amount | CLCB_COB_AMT | CMC_CLCB_CL_COB | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 120 | Claim Header | Claim Level Patient Paid Amount | CLCL_PA_PAID_AMT | CMC_CLCL_CLAIM | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 121 | Claim Header | Check Number | CKCK_CK_NO | CMC_CKCK_CHECK | N/A | N | 10 | ||
| 122 | Claim Header | Pay Date | CKPY_PAY_DT | CMC_CLCK_CLM_CHECK | N/A | D | 8 | YYYYMMDD | |
| 123 | Claim Header | Claim Interest Amount | 0.00 | 0.00 | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points. Default = 00.0 |
124 Claim Line Current Claim Status CDML_CUR_STS CMC_CDML_CL_LINE A 2 02 - Accepted;Batch run completed 14 - Claim pre - paid;Batch completed 91 - Adjusted processed claim 92 - Adjusted prepriced claim
| 125 | Claim Line | Line item Sequence Number | CDML_SEQ_NO | CMC_CDML_CL_LINE | N/A | N | 3 | |
| 126 | Claim Line | Procedure Code | IPCD_ID | CMC_CDML_CL_LINE | N/A | A | 7 | Consider only first 5 chars of procedure code |
| 127 | Claim Line | Revenue Code | RCRC_ID | CMC_CDML_CL_LINE | Click Here for Values | A | 4 | For Hospital claims only | ||
| 128 | Claim Line | First Procedure Modifier | IPCD_ID | CMC_CDML_CL_LINE | N/A | A | 2 | Substr(IPCD_ID,6,7) : last two chars will be extracted as first procedure modifier | ||
| 129 | Claim Line | Second Procedure Modifier | CDML_IPCD_MOD2 | CMC_CDML_CL_LINE | N/A | A | 2 | |||
| 130 | Claim Line | Third Procedure Modifier | CDML_IPCD_MOD3 | CMC_CDML_CL_LINE | N/A | A | 2 | |||
| 131 | Claim Line | Fourth Procedure Modofier | CDML_IPCD_MOD4 | CMC_CDML_CL_LINE | N/A | A | 2 | |||
| 132 | Claim Line | Explanation of Benefits Explanation Code ID | CDML_EOB_EXCD | CMC_CDML_CL_LINE | Click Here for Values | A | 3 | |||
| 133 | Claim Line | From Date | CDML_FROM_DT | CMC_CDML_CL_LINE | N/A | D | 8 | YYYYMMDD | ||
| 134 | Claim Line | To Date | CDML_TO_DT | CMC_CDML_CL_LINE | N/A | D | 8 | YYYYMMDD | ||
| 135 | Claim Line | Capitation Fund Id | CRFD_FUND_ID | CMC_CDML_CL_LINE | N/A | A | 4 | |||
| 136 | Claim Line | Line of Business Identifier | Default to "UBH" | Default to "UBH" | UBH | A | 4 | Default to "UBH" | ||
| 137 | Claim Line | Place of Service Identifier | PSCD_ID | CMC_CDML_CL_LINE | Click Here for Values | A | 2 | |||
| 138 | Claim Line | Place of Service Indicator | CDML_POS_IND | CMC_CDML_CL_LINE | I - Inpatient | |||||
| O - Outpatient | A | 2 | ||||||||
| 139 | Claim Line | Authorization Number | CDML_UMAUTH_ID | CMC_CDML_CL_LINE | N/A | A | 9 | |||
| 140 | Claim Line | Service Identifier | SESE_ID | CMC_CDML_CL_LINE | Click Here for Values | A | 4 | |||
| 141 | Claim Line | Units/days Allowable | CDML_UNITS | CMC_CDML_CL_LINE | N/A | N | 5 | NNNNNN.NN (Positive) |
-NNNNN.NN (Negative) Amount will be displayed with two decimal points
| 142 | Claim Line | Charge Amount | CDML_CHG_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 143 | Claim Line | Allowable Amount | CDML_ALLOW | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 144 | Claim Line | Deductible Amount | CDML_DED_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 145 | Claim Line | Disallow Amount | CDML_DISALL_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 146 | Claim Line | Discount Amount | CDML_DISC_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 147 | Claim Line | Line Item Paid Amount | CDML_PAID_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 148 | Claim Line | Risk Withhold Amount | CDML_RISK_WH_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
149 Claim Line COB/Medicare Type CDCB_COB_TYPE CMC_CDCB_LI_COB A-Auto C-Commercial-Medical D-Commercial-Dental F-No Fault G-General Liability H-Homeowners M-Medicare-A&B N-Medicare-B only S-Subrogation W-Workers Compensation
| X-Other | A | 1 | |||||||
| 150 | Claim Line | COB/Medicare Adjustment Amount | CDCB_ADJ_AMT | CMC_CDCB_LI_COB | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 151 | Claim Line | COB/Medicare Disallow Amount | CDCB _COB_DISALLOW | CMC_CDCB_LI_COB | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 152 | Claim Line | COB/Medicare Paid Amount | CDCB _COB_AMT | CMC_CDCB_LI_COB | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 153 | Claim Line | COB/Medicare Substraction Amount | CDCB_SUBTRACT_AMT | CMC_CDCB_LI_COB | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 154 | Claim Line | Coinsurance Amount | CDML_COINS_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 155 | Claim Line | Copay Amount | CDML_COPAY_AMT | CMC_CDML_CL_LINE | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points |
| 156 | Claim Line | Penalty Amount | 0.00 | 0.00 | N/A | N | 12 | NNNNNNNNN.NN (positive) | |
| -NNNNNNNN.NN (negative) | Amount will be displayed with two decimal points. Default = 00.0 |
| 157 | Claim Line | Claim line Benefit level Indicator | CDML_CL_NTWK_IND | CMC_CDML_CL_LINE | I - In network | ||||
| O - Out of network | A | 1 | |||||||
| 158 | Claim Line | Disallow Explanation Code | CDML_DISALL_EXCD | CMC_CDML_CL_LINE | N/A | A | 3 | ||
| 159 | Claim Line | Filler | N/A | N/A | N/A | A | 1 | FUTURE USE ONLY: This field MUST be only be used for the DOWN AJD_IND value. | |
| 160 | Claim Header | ICD Indicator | CLMF_ICD_IND_PROC | CMC_CLMF_MULT_FUNC | 9 = ICD9 codes used on claim | ||||
| 0 = ICD10 codes used on claim | N | 1 | Indicator will refer to the ICD codes used for this claim, ICD9 or ICD10 DX and PROC | ||||||
| 161 | Claim Line | Adjustment Indicator | IDS_ODS_CLCL_CLAIM | IDS_DOWN_ADJ_IND | The indicator will be set to “Y” if it has an entry in the overpay table. | A | 1 | The indicator will be set to “Y” if it has an entry in the overpay table. |
&"Arial,Bold"&14Standard Facets Extract File Layout &8 Appendix 7.9 &"Arial,Bold"&14&D
Trailer Record
| Data Element | Type | Notes | Format | Details | |
| Record type | AN | Value T (default) | |||
| Hard Coded Value 'T' | |||||
| Total Record Count | N | Count of the total claim line items for medstat vendor | Total # records written to file excluding the trailer record. No need for leading zeros. | ||
| Total Net Payments | N | Sum Paid Amt | Total Payments including period. No need for leading zeros. |
| Start Paid Date | D | Start date | YYYYMMDD |
| End Paid Date | D | End date | YYYYMMDD |
Provider Type
| Provider Type | Description |
| T070 | Agency - Non Therapeutic |
| T075 | Ambulance |
| T078 | Autism/ABA Agency |
| T080 | Clubhouse Agency |
| T090 | Community Mental Health Center |
| T092 | Core Service Agency |
| T095 | DME Durable Medical Equipment |
| T098 | Federally Qualified Health Ctr |
| T100 | Freestanding MH Day Treatment |
| T110 | Freestanding MH IOP |
| T120 | Freestanding SA Day Treatment |
| T130 | Freestanding SA IOP |
| T135 | Freestanding MHSA IOP |
| T140 | General Hospital w Detox |
| T150 | General Hospital w MH |
| T160 | General Hospital w MH & SA |
| T170 | General Hospital w SA |
| T172 | Group Home |
| T174 | Halfway House |
| T175 | Handivan |
| T180 | Home Health Care Agency |
| T182 | Indian Health Service Provider |
| T185 | Laboratory |
| T186 | Lodging/Meals Provider |
| T188 | Medicaid Agency |
| T190 | Methadone Maintenance |
| T195 | Nursing Home |
| T200 | Outpatient Detox Center |
| T205 | Pharmacy |
| T210 | Psychiatric Hospital |
| T220 | Psychiatric Hospital w SA |
| T230 | Psychiatric Residential Fac |
| T232 | Residential Treat Ctr w MH |
| T234 | Residential Treat Ctr w SA |
| T240 | Residential Treat Ctr w MH/SA |
| T241 | Residential Other (Geriatric) |
| T245 | Rural Health Clinic |
| T250 | SA Recovery Home |
| T260 | SA Rehab Facility |
| T270 | SA Residential Facility |
| T272 | Substance Abuse Disorder Detox |
| T275 | Taxi |
| T280 | Transportation Agency |
| T285 | Treatment Foster Care Agency |
| T287 | Tribal Provider |
| T288 | Veterans Admin Facility |
| T290 | Unknown |
| TY10 | Physician Psychiatry |
| TY20 | Physician Addictionology |
| TY25 | Physician Develop Behav Peds |
| TY30 | Psychologist |
| TY33 | Psychologist w Prescript Priv |
| TY35 | Limited License Psychologist |
| TY40 | Social Worker |
| TY45 | Marriage/Family |
| TY50 | Master's Level Counselor |
| TY51 | Board Cert Assist Behav Anlyst |
| TY52 | Board Cert Behavioral Analyst |
| TY54 | Autism Provider |
| TY55 | Nurse w Prescriptive Authority |
| TY60 | Specialty Nurse |
| TY62 | Licensed Practical Nurse |
| TY65 | Alcohol/Drug/Chem Counselor |
| TY70 | Pastoral Counselor |
| TY75 | Physician Assistant, MH |
| TY78 | Non-Ind Licensed MH Clinician |
| TY80 | Other Physician |
| TY85 | Other Licensed MHSA Clinician |
| TY88 | Peer Mentor |
| TY90 | Non-Behavioral Health Clin |
| WY10 | Reporting Only |
| WY20 | School Based |
| ZY10 | ER Physician |
| ZY15 | Pathologist/Radiologist |
| ZY20 | Speech Therapist |
| ZY25 | Nutritionist/Dietary Consultan |
| ZY30 | Acupuncturist |
| ZY35 | DC Chiropractor |
| ZY40 | DPM Podiatrist |
| ZY45 | OD Optometrist |
| ZY50 | DDS Dentist |
| ZY55 | Physician Assistant, Non-MH |
| ZY60 | Physical/Occupational Therap |
| ZY65 | Translator, Foreign Language |
| ZY70 | Translator, Hearing Impaired |
| ZY75 | Foreign Provider |
| ZY80 | Anesthesiologist/CRNA |
| ZY85 | Medical Nurse |
Provider Specialty
| Specialty Code | Description |
| BC10 | BC ABPN Psychiatry |
| BC20 | BC AOA Psychiarty |
| BC30 | BC ASAM Addiction Medicine |
| BC34 | BC BCBA Behavioral Analyst |
| BC35 | BC BCABA Assoc Behav Analyst |
| BC36 | BC BCD Clin Soc Work (BCD) |
| BC38 | BC BCD Clin Soc Work-Child Fam |
| BC40 | BC Child & Adol Psych & Peds |
| BC50 | BC Family Practice |
| BC60 | BC Internal Medicine |
| BC62 | BC Pediatrics |
| BC67 | AANP Amer Acad of Nurse Pract |
| BC70 | ANCC Adult Psych/MN Nurse Prac |
| BC75 | ANCC Family Psych/MH NursePrac |
| BC80 | ANCC Clin Spec Adult Psych/MH |
| BC85 | ANCC Clin Spec Child/Adol Psy |
| BC90 | ANCC Other |
| BC95 | CEAP Cert Employee Asst Prof |
| BC98 | SAP Substance Abuse Prof |
| BS10 | BCSub ABPN Addiction Psych |
| BS15 | BCSub ABPN Adolescent Psych |
| BS18 | BCSub ABPN Child Psych |
| BS20 | BCSub ABPN Child & Adol Psych |
| BS30 | BCSub ABPN Clinical Neurophys |
| BS40 | BCSub ABPN Forensic Psychiatry |
| BS50 | BCSub ABPN Geriatric Psych |
| BS60 | BCSub ABPN Pain Medicine |
| BS70 | BCSub ABPN Psychosomatic Med |
| BS80 | BCSub AOA Psych Addiction Med |
| BS90 | BCSub ASAM Addiction Medicine |
| BS97 | BCSub Developmental-Behav Peds |
| ECFM | ECFMG none |
| HF05 | FEL Child & Adolscent Psych |
| HF10 | FEL Geriatric Psychiatry |
| HF15 | FEL Addiction Psychiatry |
| HF20 | FEL Clinical Neurophysiology |
| HF25 | FEL Forensic Psychiatry |
| HF30 | FEL Psychiatric Pain Medicine |
| HF35 | FEL Psychosomatic Medicine |
| HF40 | FEL Other |
| HI05 | INTERN General |
| HI10 | INTERN Rotating |
| HI15 | INTERN Other |
| HP10 | HP Beharioval Health |
| HP20 | HP Mental Health |
| HP30 | HP MH/SA |
| HP40 | HP Psychiatry |
| HP50 | HP Psyhology |
| HR05 | RESI Psychiatry |
| HR10 | RESI Pediatrics |
| HR15 | RESI Family Practice |
| HR20 | RESI Internal Medicine |
| HR25 | RESI Other |
| HS05 | SCHOOL Psychology |
| HS10 | SCHOOL Social Work |
| HS15 | SCHOOL Mental Health |
| HS20 | SCHOOL Education Psychology |
| HS25 | SCHOOL Counseling |
| HS30 | SCHOOL Other |
| MEDS | MEDICAL SCHOOL |
| RG10 | REG Psychiatry |
| RG20 | REG Psychology |
| RG30 | REG Social Worker |
| RG40 | REG Specialty Nurse |
| RG50 | REG Facility |
| RG60 | REG Other |
| RG70 | REG None |
| UNDR | UNDERGRADUATE none |
| WORK | WORK HISTORY None |
| OTHER | Missing or not available |
Member Division - Sub Group
| GRGR_ID | GRGR_NAME | SGSG_ID | SGSG_NAME |
| 00111 | Group 1 | 0001 | |
| 00111 | 0002 | ||
| 00111 | 0003 | ||
| 00111 | 0004 | ||
| 00111 | 0005 | ||
| 00111 | 0006 | ||
| 00111 | 0007 | ||
| 00111 | 0008 | ||
| 00111 | 0009 | ||
| 00111 | 0010 | ||
| 00111 | 0011 | ||
| 00111 | 0012 | ||
| 00111 | 0013 | ||
| 00111 | 0014 | ||
| 00111 | 0015 | ||
| 00111 | 0016 | ||
| 00111 | 0017 | ||
| 00222 | Group 2, etc. | 0001 | |
| 00222 | 0002 | ||
| 00222 | 0003 | ||
| 00222 | 0004 | ||
| 00222 | 0005 | ||
| 00222 | 0006 | ||
| 00222 | 0007 | ||
| 00222 | 0008 | ||
| 00222 | 0009 | ||
| 00222 | 0010 | ||
| 00222 | 0011 | ||
| 00222 | 0012 | ||
| 00222 | 0013 | ||
| 00222 | 0014 | ||
| 00222 | 0015 | ||
| 00222 | 0016 | ||
| 00222 | 0017 | ||
| 00222 | 0018 | ||
| 00222 | 0019 | ||
| 00222 | 0020 | ||
| 00222 | 0021 | ||
| 00222 | 0022 | ||
| 00222 | 0023 | ||
| 00222 | 0024 | ||
| 00222 | 0025 | ||
| 00222 | 0026 | ||
| 00222 | 0027 | ||
| 00222 | 0028 | ||
| 00222 | 0029 | ||
| 00222 | 0030 | ||
| 00222 | 0031 |
Diagnosis Codes
| IDCD_ID | IDCD_DESC |
| 0001 | CHOLERA |
| 0010 | CHOLERA VIBRIO CHOLERAE |
| 0011 | CHOLERA VIBRIO CHOLERAE EL TOR |
| 0019 | CHOLERA UNSPEC |
| 002 | TYPHOID AND PARATYPHOID FEVERS |
| 0020 | TYPHOID FEVER |
| 0021 | PARATYPHOID FEVER A |
| 0022 | PARATYPHOID FEVER B |
| 0023 | PARATYPHOID FEVER C |
| 0029 | PARATYPHOID FEVER UNSPEC |
| 003 | OTHER SALMONELLA INFECTIONS |
| 0030 | SALMONELLA GASTROENTERITIS |
| 0031 | SALMONELLA SEPTICEMIA |
| 0032 | LOCALIZED SALMONELLA INFECTIONS |
| 0320 | LOCALIZED SALMONELLA INFECTION UNSP |
| 0321 | SALMONELLA MENINGITIS |
| 0322 | SALMONELLA PNEUMONIA |
| 0323 | SALMONELLA ARTHRITIS |
| 0324 | SALMONELLA OSTEOMYELITIS |
| 0329 | OTHER LOCALIZED SALMONELLA INFECT |
| 0038 | OTHER SALMONELLA INFECT |
| 0039 | SALMONELLA INFECTION UNSPEC |
| 004 | SHIGELLOSIS |
| 0040 | SHIGELLA DYSENTERIAE |
| 0041 | SHIGELLA FLEXNERI |
| 0042 | SHIGELLA BOYDII |
| 0043 | SHIGELLA SONNEI |
| 0048 | OTHER SHIGELLA INFECTIONS |
| 0049 | SHIGELLOSIS UNSPEC |
| 005 | OTHER FOOD POISONING (BACTERIAL) |
| 0050 | STAPHYLOCOCCAL FOOD POISONING |
| 0051 | BOTULISM FOOD POISONING |
| 0052 | FOOD POISONING CLOSTRIDIUM PERFRING |
| 0053 | FOOD POISONING OTHER CLOSTRIDIA |
| 0054 | FOOD POISONING VIBRIO PARAHAEMOLYT |
| 0058 | OTHER BACTERIAL FOOD POISONING |
| 0581 | FOOD POISONING VIBRIO VULNIFICUS |
| 0589 | OTHER BACTERIAL FOOD POISONING |
| 0059 | FOOD POISONING UNSPEC |
| 006 | AMEBIASIS |
| 0060 | ACUTE AMEBIC DYSENTERY WO ABSCESS |
| 0061 | CHRON INTESTIN AMEBIASIS WO ABSCESS |
| 0062 | AMEBIC NONDYSENTERIC COLITIS |
| 0063 | AMEBIC LIVER ABSCESS |
| 0064 | AMEBIC LUNG ABSCESS |
| 0065 | AMEBIC BRAIN ABSCESS |
| 0066 | AMEBIC SKIN ULCERATION |
| 0068 | AMEBIC INFECTION OTHER SITES |
| 0069 | AMEBIASIS UNSPEC |
| 007 | OTHER PROTOZOAL INTESTINAL DISEASE |
| 0070 | BALANTIDIASIS |
| 0071 | GIARDIASIS |
| 0072 | COCCIDIOSIS |
| 0073 | INTESTINAL TRICHOMONIASIS |
| 0074 | CRYPTOSPORIDIOSIS |
| 0075 | CYCLOSPORIASIS |
| 0078 | OTHER PROTOZOAL INTESTINAL DISEASES |
| 0079 | UNSPEC PROTOZOAL INTESTINAL DISEASE |
| 008 | INTESTINAL INFECTIONS OT ORGANISMS |
| 0080 | INTESTINAL INFECTION DUE TO E COLI |
| 0800 | UNS INTESTINAL INFECT E COLI |
| 0801 | INTESTINAL INFEC ENTEROPATH E COLI |
| 0802 | INTESTINAL INFEC ENTEROTOX E COLI |
| 0803 | INTESTINAL INFEC ENTEROINVAS E COLI |
| 0804 | INTESTINAL INFEC ENTEROHEMOR E COLI |
| 0809 | OTH INTESTINAL E COLI INFECS |
| 0081 | INTEST INFECT AZ PARACOLN BACILLI |
| 0082 | INTESTINAL INFEC AEROBACTER AEROGEN |
| 0083 | INTESTINAL INFECT PROTEUS |
| 0084 | INTESTINAL INFECTION OTHER BACTERIA |
| 0841 | INTESTINAL INFEC STAPHYLOCOCCUS |
| 0842 | INTESTINAL INFEC PSEUDOMONAS |
| 0843 | INTESTINAL INFEC CAMPYLOBACTER |
| 0844 | INTESTINAL INFEC YERSINIA ENTEROCOL |
| 0845 | INTESTINAL INFEC CLOSTRIDIUM DIFF |
| 0846 | INTESTINAL INFEC OTHER ANAEROBES |
| 0847 | INTESTIN INFEC OTHER GRAM NEG BACT |
| 0849 | INTESTINAL INFEC OTHER BACTERIA |
| 0085 | UNS BACTERIAL ENTERITIS |
| 0086 | ENTERITIS DUE TO SPECIFIED VIRUS |
| 0861 | ENTERITIS ROTAVIRUS |
| 0862 | ENTERITIS ADENOVIRUS |
| 0863 | ENTERITIS NORWALK VIRUS |
| 0864 | ENTERITIS OTH SMALL ROUND VIRUSES |
| 0865 | ENTERITIS CALCIVIRUS |
| 0866 | ENTERITIS ASTROVIRUS |
| 0867 | ENTERITIS ENTEROVIRUS |
| 0869 | OTH VIRAL ENTERITIS |
| 0088 | ENTERITIS OTHER VIRAL ORGANISM |
| 009 | ILL-DEFINED INTESTINAL INFECTIONS |
| 0090 | INFECTIOUS ENTERITIS |
| 0091 | ENTERITIS INFECT ORIGIN |
| 0092 | INFECTIOUS DIARRHEA |
| 0093 | DIARRHEA PRESUMED INFECTIOUS ORIGIN |
| 0010 | PRIMARY TUBERCULOUS INFECTION |
| 0100 | PRIMARY TUBERCULOUS COMPLEX |
| 1000 | PRIMARY TB COMPLEX UNS EXAM |
| 1001 | PRIMARY TB COMPLEX NO EXAM |
| 1002 | PRIMARY TB COMPLEX EXAM UNKN |
| 1003 | PRIMARY TB COMPLEX MICRO DX |
| 1004 | PRIMARY TB COMPLEX CULT DX |
| 1005 | PRIMARY TB COMPLEX HISTO DX |
| 1006 | PRIMARY TB COMPLEX OTHER TEST |
| 0101 | TUBERCULOUS PLEURISY PRIMARY TB |
| 1010 | TB PLEURISY PRIMARY PROGTB UNS EXAM |
| 1011 | TB PLEURISY PRIMARY PROGTB NO EXAM |
| 1012 | TB PLEURISY PRIMARY PROGTB EXAM UNK |
| 1013 | TB PLEURISY PRIMARY PROGTB MICRO DX |
| 1014 | TB PLEURISY PRIMARY PROGTB CULT DX |
| 1015 | TB PLEURISY PRIMARY PROGTB HISTO DX |
| 1016 | TB PLEURISY PRIMARY PROGTB OTH TEST |
| 0108 | OTHER PRIMARY PROGRESSIVE TB |
| 1080 | OTH PRIMARY PROGRESSIVE TB UNS EXAM |
| 1081 | OTH PRIMARY PROGRESSIVE TB NO EXAM |
| 1082 | OTH PRIMARY PROGRESSIVE TB EXAM UNK |
| 1083 | OTH PRIMARY PROGRESSIVE TB MICRO DX |
| 1084 | OTH PRIMARY PROGRESSIVE TB CULT DX |
| 1085 | OTH PRIMARY PROGRESSIVE TB HISTO DX |
| 1086 | OTH PRIMARY PROGRESSIVE TB OTH TEST |
| 0109 | PRIMARY TB INFECTION UNSPECIFIED |
| 1090 | UNS PRIMARY TB INFECTION UNS EXAM |
| 1091 | UNS PRIMARY TB INFECTION NO EXAM |
| 1092 | UNS PRIMARY TB INFECTION EXAM UNKN |
| 1093 | UNS PRIMARY TB INFECTION MICRO DX |
| 1094 | UNS PRIMARY TB INFECTION CULT DX |
| 1095 | UNS PRIMARY TB INFECTION HISTO DX |
| 1096 | UNS PRIMARY TB INFECTION OTH TEST |
| 0011 | PULMONARY TUBERCULOSIS |
| 0110 | TUBERCULOSIS OF LUNG INFILTRATIVE |
| 1100 | TB OF LUNG INFILTRATIVE UNS EXAM |
| 1101 | TB OF LUNG INFILTRATIVE NO EXAM |
| 1102 | TB OF LUNG INFILTRATIVE EXAM UNKN |
| 1103 | TB OF LUNG INFILTRATIVE MICRO DX |
| 1104 | TB OF LUNG INFILTRATIVE CULT DX |
| 1105 | TB OF LUNG INFILTRATIVE HISTO DX |
| 1106 | TB OF LUNG INFILTRATIVE OTH TEST |
| 0111 | TUBERCULOSIS OF LUNG NODULAR |
| 1110 | TB OF LUNG NODULAR UNS EXAM |
| 1111 | TB OF LUNG NODULAR NO EXAM |
| 1112 | TB OF LUNG NODULAR EXAM UNKN |
| 1113 | TB OF LUNG NODULAR MICRO DX |
| 1114 | TB OF LUNG NODULAR CULT DX |
| 1115 | TB OF LUNG NODULAR HISTO DX |
| 1116 | TB OF LUNG NODULAR OTHER TEST |
| 0112 | TUBERCULOSIS OF LUNG W CAVITATION |
| 1120 | TB OF LUNG W CAVITATION UNS EXAM |
| 1121 | TB OF LUNG W CAVITATION NO EXAM |
| 1122 | TB OF LUNG W CAVITATION EXAM UNKN |
| 1123 | TB OF LUNG W CAVITATION MICRO DX |
| 1124 | TB OF LUNG W CAVITATION CULT DX |
| 1125 | TB OF LUNG W CAVITATION HISTO DX |
| 1126 | TB OF LUNG W CAVITATION OTH TEST |
| 0113 | TUBERCULOSIS OF BRONCHUS |
| 1130 | TB OF BRONCHUS UNS EXAM |
| 1131 | TB OF BRONCHUS NO EXAM |
| 1132 | TB OF BRONCHUS EXAM UNKN |
| 1133 | TB OF BRONCHUS MICRO DX |
| 1134 | TB OF BRONCHUS CULT DX |
| 1135 | TB OF BRONCHUS HISTO DX |
| 1136 | TB OF BRONCHUS OTHER TEST |
| 0114 | TUBERCULOUS FIBROSIS OF LUNG |
| 1140 | TB FIBROSIS LUNG UNS EXAM |
| 1141 | TB FIBROSIS LUNG NO EXAM |
| 1142 | TB FIBROSIS LUNG EXAM UNKN |
| 1143 | TB FIBROSIS LUNG MICRO DX |
| 1144 | TB FIBROSIS LUNG CULT DX |
| 1145 | TB FIBROSIS LUNG HISTO DX |
| 1146 | TB FIBROSIS LUNG OTHER TEST |
| 0115 | TUBERCULOUS BRONCHIECTASIS |
| 1150 | TB BRONCHIECTASIS UNS EXAM |
| 1151 | TB BRONCHIECTASIS NO EXAM |
| 1152 | TB BRONCHIECTASIS EXAM UNKN |
| 1153 | TB BRONCHIECTASIS MICRO DX |
| 1154 | TB BRONCHIECTASIS CULT DX |
| 1155 | TB BRONCHIECTASIS HISTO DX |
| 1156 | TB BRONCHIECTASIS OTHER TEST |
| 0116 | TUBERCULOUS PNEUMONIA (ANY FORM) |
| 1160 | TB PNEUMONIA UNS EXAM |
| 1161 | TB PNEUMONIA NO EXAM |
| 1162 | TB PNEUMONIA EXAM UNKN |
| 1163 | TB PNEUMONIA MICRO DX |
| 1164 | TB PNEUMONIA CULT DX |
| 1165 | TB PNEUMONIA HISTO DX |
| 1166 | TB PNEUMONIA OTHER TEST |
| 0117 | TUBERCULOUS PNEUMOTHORAX |
| 1170 | TB PNEUMOTHORAX UNS EXAM |
| 1171 | TB PNEUMOTHORAX NO EXAM |
| 1172 | TB PNEUMOTHORAX EXAM UNKN |
| 1173 | TB PNEUMOTHORAX MICRO DX |
| 1174 | TB PNEUMOTHORAX CULT DX |
| 1175 | TB PNEUMOTHORAX HISTO DX |
| 1176 | TB PNEUMOTHORAX OTHER TEST |
| 0118 | OTHER SPECIFIED PULMONARY TB |
| 1180 | OTHER PULMONARY TB UNS EXAM |
| 1181 | OTHER PULMONARY TB NO EXAM |
| 1182 | OTHER PULMONARY TB EXAM UNKN |
| 1183 | OTHER PULMONARY TB MICRO DX |
| 1184 | OTHER PULMONARY TB CULT DX |
| 1185 | OTHER PULMONARY TB HISTO DX |
| 1186 | OTHER PULMONARY TB OTHER TEST |
| 0119 | UNSPEC PULMONARY TUBERCULOSIS |
| 1190 | UNS PULMONARY TB UNS EXAM |
| 1191 | UNS PULMONARY TB NO EXAM |
| 1192 | UNS PULMONARY TB EXAM UNKN |
| 1193 | UNS PULMONARY TB MICRO DX |
| 1194 | UNS PULMONARY TB CULT DX |
| 1195 | UNS PULMONARY TB HISTO DX |
| 1196 | UNS PULMONARY TB OTHER TEST |
| 0012 | OTHER RESPIRATORY TUBERCULOSIS |
| 0120 | TUBERCULOUS PLEURISY |
| 1200 | TB PLEURISY UNS EXAM |
| 1201 | TB PLEURISY NO EXAM |
| 1202 | TB PLEURISY EXAM UNKN |
| 1203 | TB PLEURISY MICRO DX |
| 1204 | TB PLEURISY CULT DX |
| 1205 | TB PLEURISY HISTO DX |
| 1206 | TB PLEURISY OTHER TEST |
| 0121 | TB OF INTRATHORACIC LYMPH NODES |
| 1210 | TB OF INTRATHORACIC NODES UNS EXAM |
| 1211 | TB OF INTRATHORACIC NODES NO EXAM |
| 1212 | TB OF INTRATHORACIC NODES EXAM UNKN |
| 1213 | TB OF INTRATHORACIC NODES MICRO DX |
| 1214 | TB OF INTRATHORACIC NODES CULT DX |
| 1215 | TB OF INTRATHORACIC NODES HISTO DX |
| 1216 | TB OF INTRATHORACIC NODES OTH TEST |
| 0122 | ISOLATED TRACHEAL/BRONCHIAL TB |
| 1220 | ISOLATED TRACH/BRONCH TB UNS EXAM |
| 1221 | ISOLATED TRACH/BRONCH TB NO EXAM |
| 1222 | ISOLATED TRACH/BRONCH TB EXAM UNKN |
| 1223 | ISOLATED TRACH/BRONCH TB MICRO DX |
| 1224 | ISOLATED TRACH/BRONCH TB CULT DX |
| 1225 | ISOLATED TRACH/BRONCH TB HISTO DX |
| 1226 | ISOLATED TRACH/BRONCH TB OTH TEST |
| 0123 | TUBERCULOUS LARYNGITIS |
| 1230 | TB LARYNGITIS UNS EXAM |
| 1231 | TB LARYNGITIS NO EXAM |
| 1232 | TB LARYNGITIS EXAM UNKN |
| 1233 | TB LARYNGITIS MICRO DX |
| 1234 | TB LARYNGITIS CULT DX |
| 1235 | TB LARYNGITIS HISTO DX |
| 1236 | TB LARYNGITIS OTHER TEST |
| 0128 | OTHER SPECIFIED RESPIRATORY TB |
| 1280 | OTHER RESPIRATORY TB UNS EXAM |
| 1281 | OTHER RESPIRATORY TB NO EXAM |
| 1282 | OTHER RESPIRATORY TB EXAM UNKN |
| 1283 | OTHER RESPIRATORY TB MICRO DX |
| 1284 | OTHER RESPIRATORY TB CULT DX |
| 1285 | OTHER RESPIRATORY TB HISTO DX |
| 1286 | OTHER RESPIRATORY TB OTHER TEST |
| 0013 | TUBERCULOSIS OF MENINGES AND CNS |
| 0130 | TUBERCULOUS MENINGITIS |
| 1300 | TB MENINGITIS UNS EXAM |
| 1301 | TB MENINGITIS NO EXAM |
| 1302 | TB MENINGITIS EXAM UNKN |
| 1303 | TB MENINGITIS MICRO DX |
| 1304 | TB MENINGITIS CULT DX |
| 1305 | TB MENINGITIS HISTO DX |
| 1306 | TB MENINGITIS OTHER TEST |
| 0131 | TUBERCULOMA OF MENINGES |
| 1310 | TUBERCULOMA OF MENINGES UNS EXAM |
| 1311 | TUBERCULOMA OF MENINGES NO EXAM |
| 1312 | TUBERCULOMA OF MENINGES EXAM UNKN |
| 1313 | TUBERCULOMA OF MENINGES MICRO DX |
| 1314 | TUBERCULOMA OF MENINGES CULT DX |
| 1315 | TUBERCULOMA OF MENINGES HISTO DX |
| 1316 | TUBERCULOMA OF MENINGES OTH TEST |
| 0132 | TUBERCULOMA OF BRAIN |
| 1320 | TUBERCULOMA OF BRAIN UNS EXAM |
| 1321 | TUBERCULOMA OF BRAIN NO EXAM |
| 1322 | TUBERCULOMA OF BRAIN EXAM UNKN |
| 1323 | TUBERCULOMA OF BRAIN MICRO DX |
| 1324 | TUBERCULOMA OF BRAIN CULT DX |
| 1325 | TUBERCULOMA OF BRAIN HISTO DX |
| 1326 | TUBERCULOMA OF BRAIN OTH TEST |
| 0133 | TUBERCULOUS ABSCESS OF BRAIN |
| 1330 | TB ABSCESS OF BRAIN UNS EXAM |
| 1331 | TB ABSCESS OF BRAIN NO EXAM |
| 1332 | TB ABSCESS OF BRAIN EXAM UNKN |
| 1333 | TB ABSCESS OF BRAIN MICRO DX |
| 1334 | TB ABSCESS OF BRAIN CULT DX |
| 1335 | TB ABSCESS OF BRAIN HISTO DX |
| 1336 | TB ABSCESS OF BRAIN OTHER TEST |
| 0134 | TUBERCULOMA OF SPINAL CORD |
| 1340 | TUBERCULOMA OF SPINAL CORD UNS EXAM |
| 1341 | TUBERCULOMA OF SPINAL CORD NO EXAM |
| 1342 | TUBERCULOMA OF SPINAL CORD EXAM UNK |
| 1343 | TUBERCULOMA OF SPINAL CORD MICRO DX |
| 1344 | TUBERCULOMA OF SPINAL CORD CULT DX |
| 1345 | TUBERCULOMA OF SPINAL CORD HISTO DX |
| 1346 | TUBERCULOMA OF SPINAL CORD OTH TEST |
| 0135 | TUBERCULOUS ABSCESS OF SPINAL CORD |
| 1350 | TB ABSCESS OF SPINAL CORD UNS EXAM |
| 1351 | TB ABSCESS OF SPINAL CORD NO EXAM |
| 1352 | TB ABSCESS OF SPINAL CORD EXAM UNKN |
| 1353 | TB ABSCESS OF SPINAL CORD MICRO DX |
| 1354 | TB ABSCESS OF SPINAL CORD CULT DX |
| 1355 | TB ABSCESS OF SPINAL CORD HISTO DX |
| 1356 | TB ABSCESS OF SPINAL CORD OTH TEST |
| 0136 | TUBERCULOUS ENCEPHALITIS/MYELITIS |
| 1360 | TB ENCEPHALITIS/MYELITIS UNS EXAM |
| 1361 | TB ENCEPHALITIS/MYELITIS NO EXAM |
| 1362 | TB ENCEPHALITIS/MYELITIS EXAM UNKN |
| 1363 | TB ENCEPHALITIS/MYELITIS MICRO DX |
| 1364 | TB ENCEPHALITIS/MYELITIS CULT DX |
| 1365 | TB ENCEPHALITIS/MYELITIS HISTO DX |
| 1366 | TB ENCEPHALITIS/MYELITIS OTH TEST |
| 0138 | OTHER TUBERCULOSIS OF CNS |
| 1380 | OTHER TB CENT NERV SYS UNS EXAM |
| 1381 | OTHER TB CENT NERV SYS NO EXAM |
| 1382 | OTHER TB CENT NERV SYS EXAM UNKN |
| 1383 | OTHER TB CENT NERV SYS MICRO DX |
| 1384 | OTHER TB CENT NERV SYS CULT DX |
| 1385 | OTHER TB CENT NERV SYS HISTO DX |
| 1386 | OTHER TB CENT NERV SYS OTH TEST |
| 0139 | UNSPEC TB CENTRAL NERVOUS SYSTEM |
| 1390 | UNS TB CENT NERV SYS UNS EXAM |
| 1391 | UNS TB CENT NERV SYS NO EXAM |
| 1392 | UNS TB CENT NERV SYS EXAM UNKN |
| 1393 | UNS TB CENT NERV SYS MICRO DX |
| 1394 | UNS TB CENT NERV SYS CULT DX |
| 1395 | UNS TB CENT NERV SYS HISTO DX |
| 1396 | UNS TB CENT NERV SYS OTHER TEST |
| 0014 | TB INTESTINE/PERITONEUM/MESENTERIC |
| 0140 | TUBERCULOUS PERITONITIS |
| 1400 | TB PERITONITIS UNS EXAM |
| 1401 | TB PERITONITIS NO EXAM |
| 1402 | TB PERITONITIS EXAM UNKN |
| 1403 | TB PERITONITIS MICRO DX |
| 1404 | TB PERITONITIS CULT DX |
| 1405 | TB PERITONITIS HISTO DX |
| 1406 | TB PERITONITIS OTHER TEST |
| 0148 | OT TB INTESTINE/PERITONEUM/MESENTER |
| 1480 | OTH TB PERIT/MESEN GLAND UNS EXAM |
| 1481 | OTH TB PERIT/MESEN GLANDS NO EXAM |
| 1482 | OTH TB PERIT/MESEN GLAND EXAM UNKN |
| 1483 | OTH TB PERIT/MESEN GLAND MICRO DX |
| 1484 | OTH TB PERIT/MESEN GLAND CULT DX |
| 1485 | OTH TB PERIT/MESEN GLAND HISTO DX |
| 1486 | OTH TB PERIT/MESEN GLAND OTH TEST |
| 0015 | TUBERCULOSIS OF BONES AND JOINTS |
| 0150 | TUBERCULOSIS OF VERTEBRAL COLUMN |
| 1500 | TB OF VERTEBRAL COLUMN UNS EXAM |
| 1501 | TB OF VERTEBRAL COLUMN NO EXAM |
| 1502 | TB OF VERTEBRAL COLUMN EXAM UNKN |
| 1503 | TB OF VERTEBRAL COLUMN MICRO DX |
| 1504 | TB OF VERTEBRAL COLUMN CULT DX |
| 1505 | TB OF VERTEBRAL COLUMN HISTO DX |
| 1506 | TB OF VERTEBRAL COLUMN OTH TEST |
| 0151 | TUBERCULOSIS OF HIP |
| 1510 | TB OF HIP UNS EXAM |
| 1511 | TB OF HIP NO EXAM |
| 1512 | TB OF HIP EXAM UNKN |
| 1513 | TB OF HIP MICRO DX |
| 1514 | TB OF HIP CULT DX |
| 1515 | TB OF HIP HISTO DX |
| 1516 | TB OF HIP OTHER TEST |
| 0152 | TUBERCULOSIS OF KNEE |
| 1520 | TB OF KNEE UNS EXAM |
| 1521 | TB OF KNEE NO EXAM |
| 1522 | TB OF KNEE EXAM UNKN |
| 1523 | TB OF KNEE MICRO DX |
| 1524 | TB OF KNEE CULT DX |
| 1525 | TB OF KNEE HISTO DX |
| 1526 | TB OF KNEE OTHER TEST |
| 0155 | TUBERCULOSIS OF LIMB BONES |
| 1550 | TB OF LIMB BONES UNS EXAM |
| 1551 | TB OF LIMB BONES NO EXAM |
| 1552 | TB OF LIMB BONES EXAM UNKN |
| 1553 | TB OF LIMB BONES MICRO DX |
| 1554 | TB OF LIMB BONES CULT DX |
| 1555 | TB OF LIMB BONES HISTO DX |
| 1556 | TB OF LIMB BONES OTHER TEST |
| 0156 | TUBERCULOSIS OF MASTOID |
| 1560 | TB OF MASTOID UNS EXAM |
| 1561 | TB OF MASTOID NO EXAM |
| 1562 | TB OF MASTOID EXAM UNKN |
| 1563 | TB OF MASTOID MICRO DX |
| 1564 | TB OF MASTOID CULT DX |
| 1565 | TB OF MASTOID HISTO DX |
| 1566 | TB OF MASTOID OTHER TEST |
| 0157 | TUBERCULOSIS OF OTHER BONE |
| 1570 | TB OF OTHER BONE UNS EXAM |
| 1571 | TB OF OTHER BONE NO EXAM |
| 1572 | TB OF OTHER BONE EXAM UNKN |
| 1573 | TB OF OTHER BONE MICRO DX |
| 1574 | TB OF OTHER BONE CULT DX |
| 1575 | TB OF OTHER BONE HISTO DX |
| 1576 | TB OF OTHER BONE OTH TEST |
| 0158 | TUBERCULOSIS OF OTHER JOINT |
| 1580 | TB OF OTHER JOINT UNS EXAM |
| 1581 | TB OF OTHER JOINT NO EXAM |
| 1582 | TB OF OTHER JOINT EXAM UNKN |
| 1583 | TB OF OTHER JOINT MICRO DX |
| 1584 | TB OF OTHER JOINT CULT DX |
| 1585 | TB OF OTHER JOINT HISTO DX |
| 1586 | TB OF OTHER JOINT OTH TEST |
| 0159 | TB OF UNSPECIFIED BONES AND JOINTS |
| 1590 | TB OF UNS BONES/JOINTS UNS EXAM |
| 1591 | TB OF UNS BONES/JOINTS NO EXAM |
| 1592 | TB OF UNS BONES/JOINTS EXAM UNKN |
| 1593 | TB OF UNS BONES/JOINTS MICRO DX |
| 1594 | TB OF UNS BONES/JOINTS CULT DX |
| 1595 | TB OF UNS BONES/JOINTS HISTO DX |
| 1596 | TB OF UNS BONES/JOINTS OTHER TEST |
| 0016 | TB OF GENITOURINARY SYSTEM |
| 0160 | TUBERCULOSIS OF KIDNEY |
| 1600 | TB OF KIDNEY UNS EXAM |
| 1601 | TB OF KIDNEY NO EXAM |
| 1602 | TB OF KIDNEY EXAM UNKN |
| 1603 | TB OF KIDNEY MICRO DX |
| 1604 | TB OF KIDNEY CULT DX |
| 1605 | TB OF KIDNEY HISTO DX |
| 1606 | TB OF KIDNEY OTHER TEST |
| 0161 | TUBERCULOSIS OF BLADDER |
| 1610 | TB OF BLADDER UNS EXAM |
| 1611 | TB OF BLADDER NO EXAM |
| 1612 | TB OF BLADDER EXAM UNKN |
| 1613 | TB OF BLADDER MICRO DX |
| 1614 | TB OF BLADDER CULT DX |
| 1615 | TB OF BLADDER HISTO DX |
| 1616 | TB OF BLADDER OTHER TEST |
| 0162 | TUBERCULOSIS OF URETER |
| 1620 | TB OF URETER UNS EXAM |
| 1621 | TB OF URETER NO EXAM |
| 1622 | TB OF URETER EXAM UNKN |
| 1623 | TB OF URETER MICRO DX |
| 1624 | TB OF URETER CULT DX |
| 1625 | TB OF URETER HISTO DX |
| 1626 | TB OF URETER OTHER TEST |
| 0163 | TB OF OTHER URINARY ORGANS |
| 1630 | TB OF OTH URINARY ORGANS UNS EXAM |
| 1631 | TB OF OTH URINARY ORGANS NO EXAM |
| 1632 | TB OF OTH URINARY ORGANS EXAM UNKN |
| 1633 | TB OF OTH URINARY ORGANS MICRO DX |
| 1634 | TB OF OTH URINARY ORGANS CULT DX |
| 1635 | TB OF OTH URINARY ORGANS HISTO DX |
| 1636 | TB OF OTH URINARY ORGANS OTH TEST |
| 0164 | TUBERCULOSIS OF EPIDIDYMIS |
| 1640 | TB OF EPIDIDYMIS UNS EXAM |
| 1641 | TB OF EPIDIDYMIS NO EXAM |
| 1642 | TB OF EPIDIDYMIS EXAM UNKN |
| 1643 | TB OF EPIDIDYMIS MICRO DX |
| 1644 | TB OF EPIDIDYMIS CULT DX |
| 1645 | TB OF EPIDIDYMIS HISTO DX |
| 1646 | TB OF EPIDIDYMIS OTHER TEST |
| 0165 | TB OF OTHER MALE GENITAL ORGANS |
| 1650 | TB OF OTH MALE GEN ORGANS UNS EXAM |
| 1651 | TB OF OTH MALE GEN ORGANS NO EXAM |
| 1652 | TB OF OTH MALE GEN ORGANS EXAM UNKN |
| 1653 | TB OF OTH MALE GEN ORGANS MICRO DX |
| 1654 | TB OF OTH MALE GEN ORGANS CULT DX |
| 1655 | TB OF OTH MALE GEN ORGANS HISTO DX |
| 1656 | TB OF OTH MALE GEN ORGANS OTH TEST |
| 0166 | TB OOPHORITIS AND SALPINGITIS |
| 1660 | TB OOPHORITIS/SALPINGITIS UNS EXAM |
| 1661 | TB OOPHORITIS/SALPINGITIS NO EXAM |
| 1662 | TB OOPHORITIS/SALPINGITIS EXAM UNKN |
| 1663 | TB OOPHORITIS/SALPINGITIS MICRO DX |
| 1664 | TB OOPHORITIS/SALPINGITIS CULT DX |
| 1665 | TB OOPHORITIS/SALPINGITIS HISTO DX |
| 1666 | TB OOPHORITIS/SALPINGITIS OTH TEST |
| 0167 | TB OF OTHER FEMALE GENITAL ORGANS |
| 1670 | TB OF OTH FEM GEN ORGANS UNS EXAM |
| 1671 | TB OF OTH FEM GEN ORGANS NO EXAM |
| 1672 | TB OF OTH FEM GEN ORGANS EXAM UNKN |
| 1673 | TB OF OTH FEM GEN ORGANS MICRO DX |
| 1674 | TB OF OTH FEM GEN ORGANS CULT DX |
| 1675 | TB OF OTH FEM GEN ORGANS HISTO DX |
| 1676 | TB OF OTH FEM GEN ORGANS OTH TEST |
| 0169 | GENITOURINARY TB UNSPECIFIED |
| 1690 | UNS GENITOURINARY TB OF UNS EXAM |
| 1691 | UNS GENITOURINARY TB OF NO EXAM |
| 1692 | UNS GENITOURINARY TB OF EXAM UNKN |
| 1693 | UNS GENITOURINARY TB OF MICRO DX |
| 1694 | UNS GENITOURINARY TB OF CULT DX |
| 1695 | UNS GENITOURINARY TB OF HISTO DX |
| 1696 | UNS GENITOURINARY TB OF OTH TEST |
| 0017 | TUBERCULOSIS OF OTHER ORGANS |
| 0170 | TB SKIN AND SUBCUTANEOUS TISSUE |
| 1700 | TB OF SKIN/SUBQ CELLULAR UNS EXAM |
| 1701 | TB OF SKIN SUBQ CELLULAR NO EXAM |
| 1702 | TB OF SKIN SUBQ CELLULAR EXAM UNKN |
| 1703 | TB OF SKIN SUBQ CELLULAR MICRO DX |
| 1704 | TB OF SKIN SUBQ CELLULAR CULT DX |
| 1705 | TB OF SKIN SUBQ CELLULAR HISTO DX |
| 1706 | TB OF SKIN SUBQ CELLULAR OTH TEST |
| 0171 | ERYTHEMA NODOSUM W REACTION IN TB |
| 1710 | TB ERYTHEMA NOD W HYPSENS UNS EXAM |
| 1711 | TB ERYTHEMA NOD W HYPSENS NO EXAM |
| 1712 | TB ERYTHEMA NOD W HYPSENS EXAM UNKN |
| 1713 | TB ERYTHEMA NOD W HYPSENS MICRO DX |
| 1714 | TB ERYTHEMA NOD W HYPSENS CULT DX |
| 1715 | TB ERYTHEMA NOD W HYPSENS HISTO DX |
| 1716 | TB ERYTHEMA NOD W HYPSENS OTH TEST |
| 0172 | TB OF PERIPHERAL LYMPH NODES |
| 1720 | TB PERIPHERAL LYMPH NODES UNS EXAM |
| 1721 | TB PERIPHERAL LYMPH NODES NO EXAM |
| 1722 | TB PERIPHERAL LYMPH NODES EXAM UNKN |
| 1723 | TB PERIPHERAL LYMPH NODES MICRO DX |
| 1724 | TB PERIPHERAL LYMPH NODES CULT DX |
| 1725 | TB PERIPHERAL LYMPH NODES HISTO DX |
| 1726 | TB PERIPHERAL LYMPH NODES OTH TEST |
| 0173 | TUBERCULOSIS OF EYE |
| 1730 | TB OF EYE UNSPEC |
| 1731 | TB OF EYE NO EXAM |
| 1732 | TB OF EYE EXAM UNKN |
| 1733 | TB OF EYE MICRO DX |
| 1734 | TB OF EYE CULT DX |
| 1735 | TB OF EYE HISTO DX |
| 1736 | TB OF EYE OT TEST |
| 0174 | TUBERCULOSIS OF EAR |
| 1740 | TB OF EAR UNSPEC |
| 1741 | TB OF EAR NO EXAM |
| 1742 | TB OF EAR EXAM UNKN |
| 1743 | TB OF EAR MICRO DX |
| 1744 | TB OF EAR CULT DX |
| 1745 | TB OF EAR HISTO DX |
| 1746 | TB OF EAR OT TEST |
| 0175 | TUBERCULOSIS OF THYROID GLAND |
| 1750 | TB OF THYROID GLAND UNS EXAM |
| 1751 | TB OF THYROID GLAND NO EXAM |
| 1752 | TB OF THYROID GLAND EXAM UNKN |
| 1753 | TB OF THYROID GLAND MICRO DX |
| 1754 | TB OF THYROID GLAND CULT DX |
| 1755 | TB OF THYROID GLAND HISTO DX |
| 1756 | TB OF THYROID GLAND OTHER TEST |
| 0176 | TUBERCULOSIS OF ADRENAL GLANDS |
| 1760 | TB OF ADRENAL GLANDS UNS EXAM |
| 1761 | TB OF ADRENAL GLANDS NO EXAM |
| 1762 | TB OF ADRENAL GLANDS EXAM UNKN |
| 1763 | TB OF ADRENAL GLANDS MICRO DX |
| 1764 | TB OF ADRENAL GLANDS CULT DX |
| 1765 | TB OF ADRENAL GLANDS HISTO DX |
| 1766 | TB OF ADRENAL GLANDS OTHER TEST |
| 0177 | TUBERCULOSIS OF SPLEEN |
| 1770 | TB OF SPLEEN UNS EXAM |
| 1771 | TB OF SPLEEN NO EXAM |
| 1772 | TB OF SPLEEN EXAM UNKN |
| 1773 | TB OF SPLEEN MICRO DX |
| 1774 | TB OF SPLEEN CULT DX |
| 1775 | TB OF SPLEEN HISTO DX |
| 1776 | TB OF SPLEEN OTHER TEST |
| 0178 | TUBERCULOSIS OF ESOPHAGUS |
| 1780 | TB OF ESOPHAGUS UNS EXAM |
| 1781 | TB OF ESOPHAGUS NO EXAM |
| 1782 | TB OF ESOPHAGUS EXAM UNKN |
| 1783 | TB OF ESOPHAGUS MICRO DX |
| 1784 | TB OF ESOPHAGUS CULT DX |
| 1785 | TB OF ESOPHAGUS HISTO DX |
| 1786 | TB OF ESOPHAGUS OTHER TEST |
| 0179 | TB OF OTHER SPECIFIED ORGANS |
| 1790 | TB OF OTHER ORGANS UNS EXAM |
| 1791 | TB OF OTHER ORGANS NO EXAM |
| 1792 | TB OF OTHER ORGANS EXAM UNKN |
| 1793 | TB OF OTHER ORGANS MICRO DX |
| 1794 | TB OF OTHER ORGANS CULT DX |
| 1795 | TB OF OTHER ORGANS HISTO DX |
| 1796 | TB OF OTHER ORGANS OTH TEST |
| 0018 | MILIARY TUBERCULOSIS |
| 0180 | ACUTE MILIARY TUBERCULOSIS |
| 1800 | ACUTE MILIARY TB UNS EXAM |
| 1801 | ACUTE MILIARY TB NO EXAM |
| 1802 | ACUTE MILIARY TB EXAM UNKN |
| 1803 | ACUTE MILIARY TB MICRO DX |
| 1804 | ACUTE MILIARY TB CULT DX |
| 1805 | ACUTE MILIARY TB HISTO DX |
| 1806 | ACUTE MILIARY TB OTHER TEST |
| 0188 | OTHER SPEC MILIARY TUBERCULOSIS |
| 1880 | OTHER MILIARY TB UNS EXAM |
| 1881 | OTHER MILIARY TB NO EXAM |
| 1882 | OTHER MILIARY TB EXAM UNKN |
| 1883 | OTHER MILIARY TB MICRO DX |
| 1884 | OTHER MILIARY TB CULT DX |
| 1885 | OTHER MILIARY TB HISTO DX |
| 1886 | OTHER MILIARY TB OTH TEST |
| 0189 | UNSPECIFIED MILIARY TUBERCULOSIS |
| 1890 | UNS MILIARY TB UNS EXAM |
| 1891 | UNS MILIARY TB NO EXAM |
| 1892 | UNS MILIARY TB EXAM UNKN |
| 1893 | UNS MILIARY TB MICRO DX |
| 1894 | UNS MILIARY TB CULT DX |
| 1895 | UNS MILIARY TB HISTO DX |
| 1896 | UNS MILIARY TB OTHER TEST |
| 0020 | PLAGUE |
| 0200 | BUBONIC PLAGUE |
| 0201 | CELLULOCUTANEOUS PLAGUE |
| 0202 | SEPTICEMIC PLAGUE |
| 0203 | PRIMARY PNEUMONIC PLAGUE |
| 0204 | SECONDARY PNEUMONIC PLAGUE |
| 0205 | PNEUMONIC PLAGUE UNSPEC |
| 0208 | OTHER TYPES PLAGUE |
| 0209 | PLAGUE UNSPEC |
| 0021 | TULAREMIA |
| 0210 | ULCEROGLANDULAR TULAREMIA |
| 0211 | ENTERIC TULAREMIA |
| 0212 | PULMONARY TULAREMIA |
| 0213 | OCULOGLANDULAR TULAREMIA |
| 0218 | OTHER TULAREMIA |
| 0219 | UNSPEC TULAREMIA |
| 0022 | ANTHRAX |
| 0220 | CUTANEOUS ANTHRAX |
| 0221 | PULMONARY ANTHRAX |
| 0222 | GASTROINTESTINAL ANTHRAX |
| 0223 | ANTHRAX SEPTICEMIA |
| 0228 | OTHER MANIFESTATIONS ANTHRAX |
| 0229 | ANTHRAX UNSPEC |
| 0023 | BRUCELLOSIS |
| 0230 | BRUCELLA MELITENSIS |
| 0231 | BRUCELLA ABORTUS |
| 0232 | BRUCELLA SUIS |
| 0233 | BRUCELLA CANIS |
| 0238 | OTHER BRUCELLOSIS |
| 0239 | BRUCELLOSIS UNSPEC |
| 0024 | GLANDERS |
| 0025 | MELIOIDOSIS |
| 0026 | RAT-BITE FEVER |
| 0260 | SPIRILLARY FEVER |
| 0261 | STREPTOBACILLARY FEVER |
| 0269 | UNSPEC RAT-BITE FEVER |
| 0027 | OTHER ZOONOTIC BACTERIAL DISEASES |
| 0270 | LISTERIOSIS |
| 0271 | ERYSIPELOTHRIX INFECTION |
| 0272 | PASTEURELLOSIS |
| 0278 | OTHER ZOONOTIC BACTERIAL DISEASES |
| 0279 | UNS ZOONOTIC BACTERIAL DISEASES |
| 0030 | LEPROSY |
| 0300 | LEPROMATOUS LEPROSY |
| 0301 | TUBERCULOID LEPROSY |
| 0302 | INDETERMINATE LEPROSY |
| 0303 | BORDERLINE LEPROSY |
| 0308 | OTHER LEPROSY |
| 0309 | LEPROSY UNSPEC |
| 0031 | DISEASES DUE TO OTHER MYCOBACTERIA |
| 0310 | PULMONARY DISEASES OTHER MYCOBACT |
| 0311 | CUTANEOUS DISEASES OTHER MYCOBACT |
| 0312 | DISSEMINATED MYCOBACTERIUM |
| 0318 | OTHER MYCOBACTERIAL DISEASES |
| 0319 | UNSPEC DISEASES MYCOBACTERIA |
| 0032 | DIPHTHERIA |
| 0320 | FAUCIAL DIPHTHERIA |
| 0321 | NASOPHARYNGEAL DIPHTHERIA |
| 0322 | ANTERIOR NASAL DIPHTHERIA |
| 0323 | LARYNGEAL DIPHTHERIA |
| 0328 | OTHER SPECIFIED DIPHTHERIA |
| 3281 | CONJUNCTIVAL DIPHTHERIA |
| 3282 | DIPHTHERITIC MYOCARDITIS |
| 3283 | DIPHTHERITIC PERITONITIS |
| 3284 | DIPHTHERITIC CYSTITIS |
| 3285 | CUTANEOUS DIPHTHERIA |
| 3289 | OTHER DIPHTHERIA |
| 0329 | DIPHTHERIA UNSPEC |
| 0033 | WHOOPING COUGH |
| 0330 | BORDETELLA PERTUSSIS |
| 0331 | BORDETELLA PARAPERTUSSIS |
| 0338 | WHOOPING COUGH OTHER ORGANISM |
| 0339 | WHOOPING COUGH UNS ORGANISM |
| 0034 | STREP SORE THROAT AND SCARLET FEVER |
| 0340 | STREPTOCOCCAL SORE THROAT |
| 0341 | SCARLET FEVER |
| 0035 | ERYSIPELAS |
| 0036 | MENINGOCOCCAL INFECTION |
| 0360 | MENINGOCOCCAL MENINGITIS |
| 0361 | MENINGOCOCCAL ENCEPHALITIS |
| 0362 | MENINGOCOCCEMIA |
| 0363 | WATERHOUSE-FRIDERICHSEN SYNDROME |
| 0364 | MENINGOCOCCAL CARDITIS |
| 3640 | UNS MENINGOCOCCAL CARDITIS |
| 3641 | MENINGOCOCCAL PERICARDITIS |
| 3642 | MENINGOCOCCAL ENDOCARDITIS |
| 3643 | MENINGOCOCCAL MYOCARDITIS |
| 0368 | OTHER MENINGOCOCCAL INFECTIONS |
| 3681 | MENINGOCOCCAL OPTIC NEURITIS |
| 3682 | MENINGOCOCCAL ARTHROPATHY |
| 3689 | OTHER MENINGOCOCCAL INFECTION |
| 0369 | UNS MENINGOCOCCAL INFECTION |
| 0037 | TETANUS |
| 0038 | SEPTICEMIA |
| 0380 | STREPTOCOCCAL SEPTICEMIA |
| 0381 | STAPHYLOCOCCAL SEPTICEMIA |
| 3810 | UNS STAPHYLOCOCCAL SEPTICEMIA |
| 3811 | METH SUSCEPTIBLE STAPH SEPTICEMIA |
| 3812 | METH RESISTANT STAPH SEPTICEMIA |
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .