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L.2.04.411
Lipoproteins are a class of heterogeneous particles of varying sizes and densities containing lipid and protein. These lipoproteins include cholesterol esters and free cholesterol, triglycerides, phospholipids and A, C, and E apoproteins. Total cholesterol comprises all the cholesterol found in various lipoproteins.
Factors that affect blood cholesterol levels include age, sex, body weight, diet, alcohol and tobacco use, exercise, genetic factors, family history, medications, menopausal status, the use of hormone replacement therapy, and chronic disorders such as hypothyroidism, obstructive liver disease, pancreatic disease (including diabetes), and kidney disease.
In many individuals, an elevated blood cholesterol level constitutes an increased risk of developing coronary artery disease. Blood levels of total cholesterol and various fractions of cholesterol, especially low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) are useful in assessing and monitoring treatment for that risk in patients with cardiovascular and related diseases.
The serum LDL concentration may be calculated using the Friedenwald formula (LDL=total cholesterol-HDL-triglcerides/5). This formula is valid only for triglyceride levels less than 400mg/dL. The LDL should be measured directly when the triglyceride level exceeds this value. This calculation may not accurately calculate the LDL in alcoholic patients. These patients may also require direct measurement of the serum LDL.
Blood levels of the above cholesterol components including triglyceride have been separated into desirable, borderline and high-risk categories by the National Heart, Lung, and Blood Institute in their report in 1993. These categories form a useful basis for evaluation and treatment of patients with hyperlipidemia. Therapy to reduce these risk parameters includes diet, exercise and medication, and fat weight loss, which is particularly powerful when combined with diet and exercise.
Related medical policies are –
Screening Lipid Testing
A lipid panel (CPT code 80061) is covered once per calendar year as part of the Healthy You! wellness benefit. Refer to Healthy You! Wellness Procedures medical policy for specific coverage guidelines per age group.
Diagnostic Lipid Testing
A lipid panel or any component of the panel may be considered medically necessary for evaluating atherosclerotic cardiovascular disease for patients meeting any of the following criteria:
As follow-up to the initial screen for coronary heart disease (total cholesterol + HDL cholesterol) when total cholesterol is determined to be high (>240 mg/dL), or borderline-high (200-240 mg/dL) plus two or more coronary heart disease risk factors, or an
HDL cholesterol <35 mg/dL.
When monitoring serum LDL levels, it is usually not necessary to obtain a lipid panel (80061) and a measured LDL-cholesterol (83721) on the same day, unless the serum triglyceride level is greater than 400mg/dl. Consequently, if requested on the same day as a lipid panel, the measured
LDL
is only considered medically necessary if ordered as a reflex test
, to be performed if the triglycerides exceed this value.
Assessment of patients with atherosclerotic cardiovascular disease
Diagnostic evaluation of diseases associated with altered lipid metabolism, such as: nephrotic syndrome, pancreatitis, hepatic disease, and hypothyroidism, and hyperthyroidism
Secondary dyslipidemia, including diabetes mellitus, disorders of gastrointestinal absorption, chronic renal failure
Signs or symptoms of dyslipidemias, such as skin lesions
For patients with severe psoriasis which has not responded to conventional therapy and for which the retinoid etretinate has been prescribed and who have developed hyperlipidemia or hepatic toxicity. Specific examples include erythrodermia and generalized pustular type and psoriasis associated with arthritis.
A diagnostic lipid panel or any component of the panel may be considered medically necessary up to three (3) times per calendar year for monitoring dietary or pharmacologic therapy.
If no dietary or pharmacological therapy is advised, monitoring is considered not medically necessary.
None
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
To monitor the progress of patients on anti-lipid dietary management and pharmacologic therapy for the treatment of elevated blood lipid disorders, total cholesterol, HDL cholesterol and LDL cholesterol may be used. Triglycerides may be obtained if this lipid fraction is also elevated or if the patient is put on drugs (for example, thiazide diuretics, beta-blockers, estrogens, glucocorticoids, and tamoxifen) which may raise the triglyceride level.
Medically Necessary is defined as those services, treatments, procedures, equipment, drugs, devices, items or supplies furnished by a covered Provider that are required to identify or treat a Member's illness, injury or Mental Health Disorders, and which Company determines are covered under this Benefit Plan based on the criteria as follows in A through D:
A. consistent with the symptoms or diagnosis and treatment of the Member's condition, illness, or injury; and
B. appropriate with regard to standards of good medical practice; and
C. not solely for the convenience of the Member, his or her Provider; and
D. the most appropriate supply or level of care which can safely be provided to Member. When applied to the care of an Inpatient, it further means that services for the Member's medical symptoms or conditions require that the services cannot be safely provided to the Member as an Outpatient.
For the definition of medical necessity, “standards of good medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary.
Investigative is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized as a generally accepted standard of good medical practice for the treatment of the condition being treated and; therefore, is not considered medically necessary. For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting.
05/01/2013: New policy added. Approved by Medical Policy Advisory Committee.
03/17/2014: Added ICD-9 Diagnosis code 706.1 to the Code Reference section. Policy statement unchanged.
05/15/2014: Added ICD-9 codes 070.0-070.9, 570, 571.40-571.49, 571.5, 572.0-572.8, 573.0, 573.3, 573.4, 646.70-646.73, and 751.62 to the Code Reference section.
09/02/2014: Added ICD-9 Diagnosis code 583.9 to the Code Reference section.
05/06/2015: Added ICD-9 diagnosis codes 256.4 and 277.7 to the Code Reference section.
09/01/2015: Code Reference section updated for ICD-10.
05/13/2016: Policy Guidelines updated to add medically necessary and investigative definitions. Code Reference section updated to make the following correction: Z79.894 should be Z79.891.
06/07/2016: Policy number L.2.04.411 added.
07/25/2016: Code Reference section updated to make the following correction: ICD-10 diagnosis code Z91.1 should be Z79.1.
09/16/2016: Code Reference section updated to make correction: ICD-10 diagnosis code E08.0 should be E08.00 and E09.09 should be E09.9.
09/30/2016: Code Reference section updated to add new ICD-10 diagnosis codes: E78.00, E78.01, I16.0 - I16.9, K85.00 - K85.92, K90.49, P05.09, P05.19, and Z83.42.
02/10/2017: Code Reference section updated to correct code description for Z83.42.
09/29/2017: Code Reference section updated to add new ICD-10 diagnosis codes I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84, and I50.89, effective 10/01/2017. Removed deleted ICD-10 diagnosis codes E78.0, K85.0, K85.1, K85.2, K85.3, K85.8, K85.9, and K90.4.
09/29/2020: Code Reference section updated to add new ICD-10 diagnosis codes K74.00, K74.01, K74.02, R74.01, and R74.02, effective 10/01/2020.
09/30/2022: Policy Guidelines updated to change "Nervous/Mental Conditions" to "Mental Health Disorders" and "Medically Necessary" to "medical necessity." Code Reference section updated to add new ICD-10 diagnosis code I20.2, effective 10/01/2022. Removed deleted ICD-10 diagnosis codes K74.0 and R74.0.
11/08/2022: Policy reviewed; no changes.
09/28/2023: Code Reference section updated to add new ICD-10 diagnosis codes E88.810, I1A.0, I24.81, I24.89, I20.89, I25.85, K90.821, K90.822, K90.829, K90.83, N04.20, N04.21, N04.22, N04.29, O26.641, O26.642, O26.643, and O26.649, effective 10/01/2023.
12/01/2023: Policy reviewed; no changes.
12/06/2024: Policy reviewed. Policy statements unchanged. Code Reference section updated to remove deleted ICD-10 diagnosis codes E88.81 and I20.8.
08/22/2025: Code Reference section updated to add ICD-10 diagnosis code B20.
10/01/2025: Code Reference section updated to add new ICD-10 diagnosis codes E11.A, E88.10, E88.11, E88.12, E88.13, E88.14, and E88.19.
Medicare National Coverage Determination 190.23 – Lipids Testing
Novitas LCD L32559 - Lipid Profile/Cholesterol Testing
This may not be a comprehensive list of procedure codes applicable to this policy.
The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document.
Code Number | Description | ||
CPT-4 | |||
80061 | Lipid panel [This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)] | ||
82465 | Cholesterol, serum or whole blood, total | ||
83718 | Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) | ||
83721 | Lipoprotein, direct measurement; LDL cholesterol | ||
84478 | Triglycerides | ||
HCPCS | |||
ICD-9 Procedure | ICD-10 Procedure | ||
ICD-9 Diagnosis | ICD-10 Diagnosis | ||
070.0 - 070.9 | Viral hepatitis | B17.0 - B17.9 | Other acute viral hepatitis |
B19.0 - B19.9 | Unspecified viral hepatitis | ||
B18.0 - B18.9 | Chronic viral hepatitis | ||
B20 | Human immunodeficiency virus [HIV] disease | ||
242.00 - 242.91 | Thyrotoxicosis with or without goiter code range | E05.00 - E05.91 | Thyrotoxicosis code range |
243 | Congenital hypothyroidism | E00.0 - E00.9 | Congenital iodine-deficiency syndrome |
E03.0 | Congenital hypothyroidism with diffuse goiter | ||
E03.1 | Congenital hypothyroidism without diffuse goiter | ||
244.0 | Postsurgical hypothyroidism | E89.0 | Postprocedural hypothyroidism |
244.1 | Other postablative hypothyroidism | ||
244.2 | Iodine hypothyroidism | E03.2 | Hypothyroidism due to medicaments and other exogenous substances |
244.3 | Other iatrogenic hypothyroidism | ||
244.8 | Other specified acquired hypothyroidism | E01.8 | Other iodine-deficiency related thyroid disorders and allied conditions |
E02 | Subclinical iodine-deficiency hypothyroidism | ||
E03.3 | Postinfectious hypothyroidism | ||
E03.8 | Other specified hypothyroidism | ||
244.9 | Unspecified acquired hypothyroidism | E03.9 | Hypothyroidism, unspecified |
245.0 - 245.9 | Thyroiditis code range | E06.0 - E06.9 | Thyroiditis code range |
249.00 - 249.91 | Secondary diabetes mellitus code range | E08.00 - E08.9 | Diabetes mellitus due to underlying condition code range |
E09.00 - E09.9 | Drug or chemical induced diabetes mellitus | ||
E13.00 - E13.9 | Other specified diabetes mellitus | ||
250.00 - 250.93 | Diabetes mellitus code range | E10.10 - E10.9 | Type 1 Diabetes Mellitus code range |
E11.00 - E11.9, E11.A | Type 2 Diabetes Mellitus code range (E11.A New 10/01/2025) | ||
E13.00 - E13.9 | Other specified diabetes mellitus | ||
255.0 | Cushing's syndrome | E24.0 - E24.9 | Cushing's Syndrome code range |
256.4 | Polycystic ovaries | E28.2 | Polycystic ovarian syndrome |
260 | Kwashiorkor | E40 | Kwashiorkor |
E42 | Marasmic kwashiorkor | ||
261 | Nutritional marasmus | E41 | Nutritional marasmu |
262 | Other severe protein-calorie malnutrition | E43 | Unspecified severe protein-calorie malnutrition |
263.0 | Malnutrition of moderate degree | E44 | Moderate protein-calorie malnutrition |
263.1 | Malnutrition of mild degree | E44.1 | Mild protein-calorie malnutrition |
263.8 263.9 | Other protein-calorie malnutrition Unspecified protein-calorie malnutrition | E46 | Unspecified protein-calorie malnutrition |
270.0 | Disturbances of amino-acid transport | E72.00 - E72.09 | Other disorders of amino acids metabolism code range |
271.1 | Galactosemia | E74.20 - E74.29 | Disorders of galactose metabolism code range |
272.0 - 272.9 | Disorders of lipoid metabolism code range | E71.30 | Disorder of fatty-acid metabolism, unspecified |
E75.21 | Fabry (-Anderson) disease | ||
E75.22 | Gaucher disease | ||
E75.240 - E75.249 | Niemann-Pick disease | ||
E75.3 | Sphingolipidosis, unspecified | ||
E75.5 | Other lipid storage disorders | ||
E75.6 | Lipid storage disorder, unspecified | ||
E77.0 - E77.9 | Disorders of glycoprotein metabolism code range | ||
E78.00 - E78.9 | Disorders of lipoprotein metabolism and other lipidemias code range | ||
E88.1, E88.10, E88.11, E88.12, E88.13, E88.14, E88.19 | Lipodystrophy, not elsewhere classified(E88.10, E88.11, E88.12, E88.13, E88.14, E88.19 New 10/01/2025) (Deleted 09/30/2025) | ||
E88.2 | Lipomatosis, not elsewhere classified | ||
E88.89 | Other specified metabolic disorders | ||
277.30 - 277.39 | Amyloidosis code range | E85.0 - E85.9 | Amyloidosis code range |
277.7 | Dysmetabolic Syndrome X | E88.810 | Metabolic syndrome |
362.10 - 362.16 | Other background retinopathy and retinal vascular changes code range | H35.00 - H35.059, H35.071 - H35.079 | Other retinal disorders |
362.30 - 362.34 | Retinal vascular occlusion code range | G45.3 | Amaurosis fugax |
H34.00 - H34.03 | Transient retinal artery occlusion | ||
H34.10 - H34.13 | Central retinal artery occlusion | ||
H34.211 - H34.239 | Other retinal artery disorders | ||
H34.9 | Unspecified retinal vascular occlusion | ||
362.82 | Retinal exudates and deposits | H35.89 | Other specified retinal disorders |
371.41 | Senile corneal changes | H18.411 - H18.419 | Arcus senilis code range |
374.51 | Xanthelasma of eyelid | H02.60 - H02.66 | Xanthelasma of eyelid |
379.22 | Crystalline deposits in vitreous | H43.20 - H43.23 | Crystalline deposits in vitreous body |
388.00 | Degenerative and vascular disorders unspecified | H93.091 - H93.099 | Unspecified degenerative and vascular disorders of ear |
388.02 | Transient ischemic deafness | H93.011 - H93.019 | Transient ischemic deafness |
401.0 - 401.9 | Essential hypertension code range | I10 | Essential (primary) hypertension |
402.00 - 402.91 | Hypertensive heart disease code range | I11.0 - I11.9 | Hypertensive heart disease |
403.00 - 403.91 | Hypertensive chronic kidney disease code range | I12.0 - I12.9 | Hypertensive chronic kidney disease |
404.00 - 404.93 | Hypertensive heart and chronic kidney disease code range | I13.0 - I13.2 | Hypertensive heart and chronic kidney disease |
405.01 - 405.99 | Secondary hypertension code range | I15.0 - I15.9 | Secondary hypertension |
I1A.0 | Resistant hypertension | ||
I16.0 - I16.9 | Hypertensive crisis | ||
410.00 - 410.92 | Acute myocardial infarction code range | I21.01 - I21.4 | ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction |
I22.0 - I22.9 | Subsequent ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction | ||
411.0 - 411.89 | Other acute and subacute forms of ischemic heart disease code range | I20.0 | Unstable angina |
I20.2 | Refractory angina pectoris | ||
I24.0 - I24.9, I24.81, I24.89 | Other acute ischemic heart disease | ||
412 | Old myocardial infarction | I25.2 | Old myocardial infarction |
413.0 | Angina decubitus | I20.89 | Other forms of angina pectoris |
413.1 | Prinzmetal angina | I20.1 | Angina pectoris with documented spasm |
413.9 | Other and unspecified angina pectoris | I20.9 | Angina pectoris, unspecified |
414.00 - 414.07 | Coronary atherosclerosis code range | I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris |
I25.110 - I25.119 | Atherosclerotic heart disease of native coronary artery with angina pectoris | ||
I25.700 - I25.799 | Atherosclerosis of coronary artery bypass graft(s) and coronary artery of transplanted heart with angina pectoris | ||
I25.810 - I25.812 | Atherosclerosis of other coronary vessels without angina pectoris | ||
414.10 | Aneurysm of heart (wall) | I25.3 | Aneurysm of heart |
414.19 | Other aneurysm of heart | ||
414.11 | Aneurysm of coronary vessels | I25.41 | Coronary artery aneurysm |
414.12 | Dissection of coronary artery | I25.42 | Coronary artery dissection |
414.3 | Coronary atherosclerosis due to lipid rich plaque | I25.83 | Coronary atherosclerosis due to lipid rich plaque |
414.4 | Coronary atherosclerosis due to calcified coronary lesion | I25.84 | Coronary atherosclerosis due to calcified coronary lesion |
414.8 | Other specified forms of chronic ischemic heart disease | I25.5 | Ischemic cardiomyopathy |
I25.6 | Silent myocardial ischemia | ||
I25.85 | Chronic coronary microvascular dysfunction | ||
I25.89 | Other forms of chronic ischemic heart disease | ||
I25.9 | Chronic ischemic heart disease, unspecified | ||
414.9 | Chronic ischemic heart disease unspecified | I25.9 | Chronic ischemic heart disease, unspecified |
428.0 - 428.9 | Heart failure code range | I50.1-I50.9, I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84, I50.89 | Heart Failure code range |
429.2 429.9 | Cardiovascular disease unspecified Heart disease unspecified | I25.10, I51.9, I52 | Atherosclerotic heart disease of native coronary artery without angina pectoris |
431 | Intracerebral hemorrhage | I61.0 - I61.9 | Nontraumatic intracerebral hemorrhage |
433.00 - 433.91 | Occlusion and stenosis of precerebral arteries code range | I63.00 - I63.09 | Cerebral infarction due to thrombosis of precerebral arteries |
I63.10 - I63.19 | Cerebral infarction due to embolism of precerebral arteries | ||
I63.20 - I63.29 | Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries | ||
I63.59 | Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery | ||
I65.01-I65.9 | Occlusion and stenosis of precerebral arteries, not resulting in cerebral infarction | ||
434.00 - 434.91 | Occlusion of cerebral arteries code range | I63.30-I63.39 | Cerebral infarction due to thrombosis of cerebral arteries |
I63.40-I63.9 | Cerebral infarction due to embolism of cerebral arteries | ||
I66.01-I66.9 | Occlusion and stenosis of cerebral arteries, not resulting in cerebral infarction | ||
435.0 - 435.9 | Transient cerebral ischemia code range | G45.0 | Vertebro-basilar artery syndrome |
G45.1 | Carotid artery syndrome (hemispheric) | ||
G45.2 | Multiple and bilateral precerebral artery syndromes | ||
G45.8 | Other transient cerebral ischemic attacks and related syndromes | ||
G45.9 | Transient cerebral ischemic attack, unspecified | ||
G46.0 | Middle cerebral artery syndrome | ||
G46.1 | Anterior cerebral artery syndrome | ||
G46.2 | Posterior cerebral artery syndrome | ||
I67.841 | Reversible cerebrovascular vasoconstriction syndrome | ||
I67.848 | Other cerebrovascular vasospasm and vasoconstriction | ||
437.0 | Cerebral atherosclerosis | I67.2 | Cerebral atherosclerosis |
437.1 | Other generalized ischemic cerebrovascular disease | I67.81 | Acute cerebrovascular insufficiency |
I67.82 | Cerebral ischemia | ||
I67.89 | Other cerebrovascular disease | ||
437.5 | Moyamoya disease | I67.5 | Moyamoya disease |
438.0 - 438.9 | Late effects of cerebrovascular disease code range | I69.00 - I69.998 | Sequelae of nontraumatic subarachnoid hemorrhage |
440.0 - 440.9 | Atherosclerosis code range | I70.0 - I70.92 | Atherosclerosis code range |
441.00 - 441.9 | Aortic aneurysm and dissection code range | I71.00 - I71.9 | Aortic aneurysm and dissection |
I79.0 | Aneurysm of aorta in diseases classified elsewhere | ||
442.0 | Aneurysm of artery of upper extremity | I72.1 | Aneurysm of artery of upper extremity |
442.1 | Aneurysm of renal artery | I72.2 | Aneurysm of iliac artery |
442.2 | Aneurysm of iliac artery | I72.3 | Aneurysm of iliac artery |
444.01 | Saddle embolus of abdominal aorta | I74.01 | Saddle embolus of abdominal aorta |
444.09 | Other arterial embolism and thrombosis of abdominal aorta | I74.09 | Other arterial embolism and thrombosis of abdominal aorta |
I74.10 | Embolism and thrombosis of unspecified parts of aorta | ||
I74.19 | Embolism and thrombosis of other parts of aorta | ||
444.1 | Embolism and thrombosis of thoracic aorta | I74.11 | Embolism and thrombosis of thoracic aorta |
444.21 | Arterial embolism and thrombosis of upper extremity | I74.2 | Embolism and thrombosis of arteries of the upper extremities |
444.22 | Arterial embolism and thrombosis of lower extremity | I74.3 | Embolism and thrombosis of arteries of the lower extremities |
I74.4 | Embolism and thrombosis of arteries of extremities, unspecified | ||
444.81 | Embolism and thrombosis of iliac artery | I74.5 | Embolism and thrombosis of iliac artery |
444.89 | Embolism and thrombosis of other artery | I74.8 | Embolism and thrombosis of other arteries |
444.9 | Embolism and thrombosis of unspecified artery | I74.9 | Embolism and thrombosis of unspecified artery |
557.1 | Chronic vascular insufficiency of intestine | K55.1 | Chronic vascular disorders of intestine |
570 | Acute and subacute necrosis of liver | K72.00 | Acute and subacute hepatic failure without coma |
K72.01 | Acute and subacute hepatic failure with coma | ||
K76.2 | Central hemorrhagic necrosis of liver | ||
571.40 - 571.49 | Chronic hepatitis | K73.0 - K73.9 | Chronic hepatitis, not elsewhere classified |
571.5 | Cirrhosis of liver without mention of alcohol | K74.00, K74.01, K74.02 | Hepatic fibrosis |
K74.60 | Unspecified cirrhosis of liver | ||
K74.69 | Other cirrhosis of liver | ||
571.8 | Other chronic nonalcoholic liver disease | K76.0 | Fatty (change of) liver, not elsewhere classified |
571.9 | Unspecified chronic liver disease without alcohol | K74.1 | Hepatic sclerosis |
K74.2 | Hepatic fibrosis with hepatic sclerosis | ||
572.0 - 572.8 | Central hemorrhagic necrosis of liver | K75.0 - K75.9 | Other inflammatory liver disease |
573.0 | Chronic passive congestion of liver | K76.1 | Chronic passive congestion of liver |
573.3 | Unspecified hepatitis | K71.0 - K71.9 | Toxic liver disease |
K76.4 | Peliosis hepatis | ||
573.4 | Hepatic infarction | K76.3 | Infarction of liver |
573.5 | Hepatopulmonary syndrome | K76.81 | Hepatopulmonary syndrome |
573.8 | Other specified disorders of liver | K76.89 | Other specified diseases of liver |
573.9 | Unspecified disorder of liver | K76.9 | Liver disease, unspecified |
K90.49 | Malabsorption due to intolerance, not elsewhere classified | ||
577.0 - 577.9 | Diseases of pancreas code range | K85.00 - K85.92 | Acute pancreatitis |
K86.0 - K86.9 | Other diseases of pancreas | ||
K87 | Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere | ||
579.3 | Other and unspecified postsurgical nonabsorption | K91.2 | Postsurgical malabsorption, not elsewhere classified |
K90.821 | Short bowel syndrome with colon in continuity | ||
K90.822 | Short bowel syndrome without colon in continuity | ||
K90.829 | Short bowel syndrome, unspecified | ||
K90.83 | Intestinal failure | ||
579.8 | Other specified intestinal malabsorption | K90.89 | Other intestinal malabsorption |
581.0 - 581.9 | Nephrotic syndrome code range | N04.0 - N04.9 | Nephrotic syndrome |
583.9 | Nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney | N05.9 | Unspecified nephritic syndrome with unspecified morphologic changes |
N07.9 | Hereditary nephropathy, not elsewhere classified with unspecified morphologic lesions | ||
N15.9 | Renal tubulo-interstitial disease, unspecified | ||
584.5 | Acute kidney failure with lesion of tubular necrosis | N17.0 | Acute kidney failure with tubular necrosis |
585.4 | Chronic kidney disease, stage IV (severe) | N18.4 | Chronic kidney disease, stage 4 (severe) |
585.5 | Chronic kidney disease, stage v | N18.5 | Chronic kidney disease, stage 5 |
585.6 | End stage renal disease | N18.6 | End stage renal disease |
585.9 | Chronic kidney disease, unspecified | N18.9 | Chronic kidney disease, unspecified |
588.0 | Renal osteodystrophy | N25.0 | Renal osteodystrophy |
588.1 | Nephrogenic diabetes insipidus | N25.1 | Nephrogenic diabetes insipidus |
588.81 | Secondary hyperparathyroidism (of renal origin) | N25.81 | Secondary hyperparathyroidism of renal origin |
588.9 | Unspecified disorder resulting from impaired renal function | N25.9 | Disorder resulting from impaired renal tubular function, unspecified |
646.70 | Liver and biliary tract disorders in pregnancy, unspecified as to episode of care or not applicable | O26.619 | Liver and biliary tract disorders in pregnancy, unspecified trimester |
646.71 | Liver and biliary tract disorders in pregnancy, delivered, with or without mention of antepartum condition | O26.62 | Liver and biliary tract disorders in childbirth |
646.73 | Liver and biliary tract disorders in pregnancy, antepartum condition or complication | O26.611 | Liver and biliary tract disorders in pregnancy, first trimester |
O26.612 | Liver and biliary tract disorders in pregnancy, second trimester | ||
O26.613 | Liver and biliary tract disorders in pregnancy, third trimester | ||
O26.641, O26.642, O26.643, O26.649 | Intrahepatic cholestasis of pregnancy | ||
648.10 | Thyroid dysfunction of mother complicating pregnancy childbirth or the puerperium unspecified as to episode of care | O99.280 | Endocrine, nutritional and metabolic diseases complicating pregnancy, unspecified trimester |
648.11 | Thyroid dysfunction of mother with delivery | O99.281 | Endocrine, nutritional and metabolic diseases complicating pregnancy, first trimester |
O99.282 | Endocrine, nutritional and metabolic diseases complicating pregnancy, second trimester | ||
O99.283 | Endocrine, nutritional and metabolic diseases complicating pregnancy, third trimester | ||
O99.284 | Endocrine, nutritional and metabolic diseases complicating childbirth | ||
648.12 | Thyroid dysfunction of mother with delivery with postpartum complication | O90.5 | Postpartum thyroiditis |
O99.285 | Endocrine, nutritional and metabolic diseases complicating the puerperium | ||
648.14 | Postpartum thyroid dysfunction | ||
648.13 | Antepartum thyroid dysfunction | O99.281 | Endocrine, nutritional and metabolic diseases complicating pregnancy, first trimester |
O99.282 | Endocrine, nutritional and metabolic diseases complicating pregnancy, second trimester | ||
O99.283 | Endocrine, nutritional and metabolic diseases complicating pregnancy, third trimester | ||
696.0 | Psoriatic arthropathy | L40.50 - L40.59 | Arthropathic psoriasis |
696.1 | Other psoriasis and similar disorders | L40.0 | Psoriasis vulgaris |
L40.1 | Generalized pustular psoriasis | ||
L40.2 | Acrodermatitis continua | ||
L40.3 | Pustulosis palmaris et plantaris | ||
L40.4 | Guttate psoriasis | ||
L40.8 | Other psoriasis | ||
L40.9 | Psoriasis, unspecified | ||
706.1 | Other acne | L70.0 | Acne vulgaris |
L70.1 | Acne conglobata | ||
L70.3 | Acne tropica | ||
L70.4 | Infantile acne | ||
L70.5 | Acne excoriee des jeunes filles | ||
L70.8 | Other acne | ||
L70.9 | Acne, unspecified | ||
L73.0 | Acne keloid | ||
751.61 | Biliary atresia congenital | Q44.2 | Atresia of bile ducts |
Q44.3 | Congenital stenosis and stricture of bile ducts | ||
751.62 | Congenital cystic disease of liver | Q44.6 | Cystic disease of liver |
P05.09 | Newborn light for gestational age, 2500 grams and over | ||
P05.19 | Newborn small for gestational age, other | ||
764.10 - 764.19 | "Light-for-dates" with signs of fetal malnutrition code range | P05.00 - P05.08 | Newborn light for gestational age |
P05.10 - P05.18 | Newborn small for gestational age | ||
786.50 | Unspecified chest pain | R07.9 | Chest pain, unspecified |
786.51 | Precordial pain | R07.2 | Precordial pain |
786.59 | Other chest pain | R07.82 | Intercostal pain |
R07.89 | Other chest pain | ||
789.1 | Hepatomegaly | R16.0 | Hepatomegaly, not elsewhere classified |
790.4 | Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase (LDH) | R74.01, R74.02 | Nonspecific elevation of levels of transaminase or lactic acid dehydrogenase [LDH] |
790.5 | Other nonspecific abnormal serum enzyme levels | R74.8 | Abnormal levels of other serum enzymes |
R74.9 | Abnormal serum enzyme level, unspecified | ||
790.6 | Other abnormal blood chemistry | R78.71- R78.79 | Finding of abnormal level of heavy metals in blood |
R78.89 | Finding of other specified substances, not normally found in blood | ||
R79.0 | Abnormal level of blood mineral | ||
R79.89 | Other specified abnormal findings of blood chemistry | ||
R79.9 | Abnormal finding of blood chemistry, unspecified | ||
793.4 | Nonspecific (abnormal) findings on radiological and other examination of gastrointestinal tract | R93.3 | Abnormal findings on diagnostic imaging of other parts of digestive tract |
987.9 | Toxic effect of unspecified gas fume or vapor | T59.91XA, T59.92XA, T59.93XA, T59.94XA | Toxic effect of unspecified gases, fumes and vapors, initial encounter |
996.81 | Complications of transplanted kidney | T86.10 - T86.19 | Complications of kidney transplant |
Z83.42 | Family history of familial hypercholesterolemia | ||
V42.0 | Kidney replaced by transplant | Z48.22 | Encounter for aftercare following kidney transplant |
Z94.0 | Kidney transplant status | ||
V42.7 | Liver replaced by transplant | Z94.4 | Liver transplant status |
V58.63 | Long-term (current) use of antiplatelets/antithrombotics | Z79.02 | Long term (current) use of antithrombotics/antiplatelets |
V58.64 | Long-term (current) use of nonsteroidal anti-inflammatories | Z79.1 | Long term (current) use of non-steroidal anti-inflammatories (NSAID) |
V58.69 | Long-term (current) use of other medications | Z79.891 | Long term (current) use of opiate analgesic |
Z79.899 | Other long term (current) drug therapy |
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