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L.6.01.407
Magnetic resonance imaging (MRI) is a multiplanar imaging method based on an interaction between radiofrequency (RF) electromagnetic fields and certain nuclei in the body (usually hydrogen nuclei) after the body has been placed in a strong magnetic field. MRI differentiates between normal and abnormal tissues, providing a sensitive examination to detect disease. This sensitivity is based on the high degree of inherent contrast due to variations in the magnetic relaxation properties of different tissues, both normal and diseased, and the dependence of the MRI signal on these tissue properties.
MRI is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. The receiver information is processed by a computer, and an image is produced. The image and resolution produced by MRI is quite detailed and can detect tiny changes of structures within the body. For some procedures, contrast agents, such as gadolinium, are used to increase the accuracy of the images.
Cardiac magnetic resonance imaging (MRI) is an established imaging modality, well recognized for its value in the initial assessment and monitoring of a wide range of diseases of the heart and surrounding related structures (e.g., pericardium). Historically, imaging has played a critical role in the diagnosis and evaluation of acquired and congenital cardiac disease, beginning with chest radiography and fluoroscopy and progressing to coronary angiography and cardiac catheterization, echocardiography, and nuclear medicine. All of these modalities have a well established role in patient care. MRI, with appropriately equipped scanners, now can image the coronary arteries, cardiac chambers, valves, myocardium, and pericardium and can assess cardiac function. Thus, MRI has played an increasing role in comprehensive cardiac imaging.
Properly performed and interpreted, MRI not only contributes to diagnosis but also can guide treatment planning, help predict outcome, and increase diagnostic confidence. However, MRI should be performed only for a valid medical reason, and only after careful consideration of alternative imaging modalities. The strengths of MRI and other modalities should be weighed as to their suitability in particular patients and in particular clinical conditions.
Related medical policies are -
Provider Accreditation for MRI – Network Providers
All Network Providers billing the technical component of the MRI must be accredited in MRI by the Intersocietal Accreditation Commission (IAC) or a MRI module by the American College of Radiology (ACR) or RadSite. The professional component of the MRI will be reimbursed based upon the accreditation of the facility as the ACR, IAC or RadSite facility accreditations require that interpreting professional physicians also be accredited.
MRI of the Chest
Magnetic resonance imaging (MRI) of the chest is considered medically necessary for the following indications:
For evaluation of mediastinal or hilar mass of patient with renal failure or allergy to contrast material
For evaluation of myasthenia gravis with suspected thymoma
For evaluation of brachial plexus dysfunction (brachial plexopathy/thoracic outlet syndrome)
For evaluation of an aneurysm or dissection of the thoracic aorta
For evaluation of congenital heart disease and malformations, (e.g., aortic arch anomalies and patent ductus arteriosus (PDA))
For evaluating whether masses invade into specific thoracic structures (e.g., aorta, pulmonary artery, brachial plexus, subclavian vessels, thoracic spine.
To determine the consistency of thoracic masses (cystic vs. solid vs. mixed).
Evaluation of suspected infection or dislocation of the sternoclavicular joint
Evaluation of palpable chest or chest wall mass.
MRI of the Heart
Magnetic resonance imaging (MRI) of the heart is considered medically necessary for the following indications:
First pass perfusion
Stress echocardiography is contraindicated
Stress echocardiography has been performed, however findings were inadequate; there were technical difficulties with interpretation, or results were discordant with previous clinical data
MR compatible ventricular pacing
Evidence of ventricular tachycardia
Severe aortic valve dysfunction
Arrhythmogenic right ventricular dysplasia
Evaluation of myocardial viability
Evaluation of infiltrative disease of the heart
Soft tissue characterization of pericardial or cardiac masses
Severe chronic obstructive pulmonary disease, (COPD) as defined as FEV1 <30% predicted or FEV1 <50% predicted plus respiratory failure or clinical signs of right heart failure. (GOLD classification of COPD)
Congestive heart failure (CHF) with current ejection fraction (EF), 40%
Inability to get an echo window for imaging
Prior thoracotomy, CABG, other surgery when disease of the heart is suspected, prior surgery has been performed and CT is unrevealing
Poorly controlled hypertension (generally above 180 mm Hg systolic (both physical stress and dobutamine stress may exacerbate hypertension during stress echo))
Poorly controlled atrial fibrillation (resting heart rate > 100 bpm on medication)
Inability to exercise requiring pharmacological stress test
Segmental wall motion abnormalities at rest (e.g., due to cardiomyopathy, recent MI, or pulmonary hypertension)
Arrhythmias with stress echocardiography- any member on a type 1C anti- arrhythmic drug (e.g., Flecainide or Propafenone) or considered for treatment with a type 1C anti-arrhythmic drug
Evaluation of congenital heart disease.
Magnetic resonance imaging (MRI) of the chest and heart is considered not medically necessary for all other indications, including when performed for screening purposes in asymptomatic patients (absence of signs, symptoms, or disease).
State Health Plan (SHP) Members: For dates of service on or prior to 12/31/2015, this policy applies to MRI of the chest and cardiac when performed in the emergency room. This policy does not apply to MRI of the chest and cardiac performed in non-emergency room settings. MRI of the chest and cardiac performed in non-emergency room settings require pre-certification by the Plan’s Utilization Review Vendor.
Effective 01/01/2016, this policy applies to MRI of the chest and cardiac performed in all settings for State Health Plan Members.
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
Reimbursement for MRI imaging of the same anatomical area is generally limited to one (1) MRI imaging within a 6-month period. MRI imaging in excess of one (1) within a 6-month period will be subject to medical necessity review. Documentation should include radiology reason for study, radiology comparison study-date and time, radiology comparison study observation, radiology impression, and radiology study recommendation.
Additional MRI imaging of the same anatomical area may be appropriate for the following, including, but not limited to: diagnosis, staging or follow-up of cancer, follow-up assessment during or after therapy for known metastases, follow-up of member who have had an operative, interventional or therapeutic procedure (e.g., surgery, embolization), reevaluation due to change in clinical status (e.g., deterioration), new or worsening clinical findings, (e.g., neurologic signs, symptoms), medical intervention which warrants reassessment, reevaluation for treatment planning, follow-up during and after completion of therapy or treatment to assess effectiveness, and evaluation after intervention or surgery.
Re-imaging or additional imaging due to poor contrast enhanced exam or technically limited exam is the responsibility of the imaging provider.
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.
05/19/2014: New policy added. Approved by Radiology Physician Advisory Committee and Medical Policy Advisory Committee. Effective 09/15/2014.
06/30/2014: Policy Exceptions section updated regarding SHP members to state that this policy applies to MRI of the chest and cardiac when performed in the emergency room. This policy does not apply to MRI of the chest and cardiac performed in non-emergency room settings. MRI of the chest and cardiac performed in non-emergency room settings require pre-certification by the Plan’s Utilization Review Vendor.
09/05/2014: Added ICD-9 diagnosis codes 170.2, 200.02, 200.12, 200.22, 200.32, 200.42, 200.52, 200.62, 200.72, 200.82, 201.02, 201.12, 201.22, 201.42, 201.52, 201.62, 201.72, 201.92, 202.02, 202.12, 202.22, 202.32, 202.42, 202.52, 202.62, 202.72, 202.82, 202.92, 213.2, 284.81, 338.12, 338.22, 393, 395.9, 396.9, 416.0, 427.0 - 427.32, 427.41 - 427.9, 428.0 - 428.9, 518.81, 518.83, 518.84, 584.6, 584.9, 585.9, 586, 767.6, 997.1, V13.65, V45.81, V58.73, and V64.1 to the Code Reference section.
09/01/2015: Medical policy revised to add ICD-10 codes.
12/31/2015: Policy Exceptions section updated to state that effective 01/01/2016, this policy applies to MRI of the chest and cardiac performed in all settings for State Health Plan Members.
06/08/2016: Policy number L.6.01.407 added. Policy Guidelines updated to add medically necessary definition.
07/25/2016: Code Reference section updated to make the following correction: ICD-10 diagnosis code Z96.4 should be Z95.4.
09/30/2016: Code Reference section updated to add the following new ICD-10 diagnoses: I16.0 - I16.9, I72.5, Q25.21, Q25.29, Q25.40 - Q25.49, T82.855A - T82.855S, Z98.890, and Z98.891. Revised code descriptions for the following ICD-10 diagnoses: C81.72, C81.42, C81.12, C81.22, C81.32, T82.817A - T82.817S, T82.827A - T82.827S, T82.837A - T82.837S, T82.847A - T82.847S, T82.857A - T82.857S, and T82.867A - T82.867S.
09/29/2017: Code Reference section updated to add new ICD-10 diagnosis codes C96.20, C96.21, C96.22, C96.29, I27.20, I27.21, I27.22, I27.23, I27.24, I27.29, I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84, and I50.89, effective 10/01/2017. Revised code description for ICD-10 diagnosis code I50.1. Removed deleted ICD-10 diagnosis codes Q25.2, Q25.4, and Z98.89 and ICD-9 diagnosis codes 747.11, 747.20, 747.21, and V15.1.
10/01/2018: Code Reference section updated to add new ICD-10 diagnosis code R93.89. Removed deleted ICD-10 diagnosis codes C96.2 and I27.2.
09/23/2019: Code Reference section updated to add new ICD-10 diagnosis codes I48.11, I48.19, I48.20, and I48.21, effective 10/01/2019.
06/26/2020: Code Reference section updated to add new HCPCS codes C9762 and C9763, effective 07/01/2020. Removed deleted ICD-10 diagnosis code R93.8.
09/26/2022: Code Reference section updated to add new ICD-10 diagnosis codes I34.81, I34.89, I47.20, I47.21, I47.29, I71.010, I71.011, I71.012, I71.019, I71.10, I71.11, I71.12, I71.13, I71.20, I71.21, I71.22, I71.23, I71.50, I71.51, I71.52, I71.60, Q21.10, Q21.11, Q21.12, Q21.13, Q21.14, Q21.15, Q21.16, Q21.19, Q21.20, Q21.21, Q21.22, and Q21.23, effective 10/01/2022. Revised code description for ICD-10 diagnosis code C84.42. Removed deleted ICD-10 diagnosis codes I48.1 and I48.2.
11/21/2022: Policy reviewed. Policy statements unchanged. Policy Guidelines updated to change "Nervous/Mental Conditions" to "Mental Health Disorders" and "Medically Necessary" to "medical necessity."
09/27/2023: Code Reference section updated to add new ICD-10 diagnosis codes D48.111, D48.112, I47.10, I47.11, and I47.19. Revised the code description for ICD-10 diagnosis codes I71.51 and I71.52. Effective 10/01/2023.
12/04/2023: Policy reviewed. Policy statements unchanged. Code Reference section updated to remove deleted ICD-10 diagnosis codes I47.2, I71.01, I71.1, I71.2, I71.5, I71.6, Q21.1, and Q21.2.
10/01/2024: Code Reference section updated to add new ICD-10 diagnosis codes Q23.81, Q23.82, and Q23.88. Removed deleted ICD-10 diagnosis codes D48.1 and I47.1.
12/13/2024: Policy reviewed; no changes.
11/01/2025: Added RadSite as an imaging accreditation body.
07/30/2026: Policy reviewed. Policy statements unchanged. Code Reference section updated to remove ICD-9 diagnosis codes. Removed deleted ICD-10 diagnosis code Q23.8.
Radiology Physician Advisory Committee
Medical Policy Advisory Committee
American College of Radiology. ACR Practice Guideline for Performing and Interpreting Magnetic Resonance Imaging (MRI), 2011.
American College of Radiology. ACR-NASCI-SPR Practice Guideline for the Performance and Interpretation of Cardiac Magnetic Resonance Imaging (MRI), 2011.
Magnetic Resonance Imaging (MRI) Brain and Head medical policy, Blue Cross and Blue Shield of Florida
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.
Covered Codes
Code Number | Description |
CPT-4 | |
71550 | Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s) |
71551 | Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s) |
71552 | Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences |
75557 | Cardiac magnetic resonance imaging for morphology and function without contrast material |
75559 | Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging |
75561 | Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences |
75563 | Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging |
75565 | Cardiac magnetic resonance imaging for velocity flow mapping (List separately in addition to code for primary procedure) |
HCPCS | |
C9762 | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with strain imaging |
C9763 | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging |
ICD-10 Procedure | |
ICD-10 Diagnosis | |
C16.0 | Malignant neoplasm of cardia |
C34.00 - C34.02 | Malignant neoplasm of main bronchus |
C34.10 - C34.12 | Malignant neoplasm of upper lobe, bronchus or lung |
C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
C34.30 - C34.32 | Malignant neoplasm of lower lobe, bronchus or lung |
C34.80 - C34.82 | Malignant neoplasm of overlapping sites of bronchus and lung |
C34.90 - C34.92 | Malignant neoplasm of unspecified part of bronchus or lung |
C38.4 | Malignant neoplasm of pleura |
C38.4 | Malignant neoplasm of pleura |
C45.0 | Mesothelioma of pleura |
C37 | Malignant neoplasm of thymus |
C38.0 | Malignant neoplasm of heart |
C45.2 | Mesothelioma of pericardium |
C38.1 | Malignant neoplasm of anterior mediastinum |
C38.2 | Malignant neoplasm of posterior mediastinum |
C38.8 | Malignant neoplasm of overlapping sites of heart, mediastinum and pleura |
C38.3 | Malignant neoplasm of mediastinum, part unspecified |
C39.0 | Malignant neoplasm of upper respiratory tract, part unspecified |
C39.9 | Malignant neoplasm of lower respiratory tract, part unspecified |
C41.2 | Malignant neoplasm of vertebral column |
C41.3 | Malignant neoplasm of ribs, sternum and clavicle |
C47.3 | Malignant neoplasm of peripheral nerves of thorax |
C49.3 | Malignant neoplasm of connective and soft tissue of thorax |
C47.6 | Malignant neoplasm of peripheral nerves of trunk, unspecified |
C49.6 | Malignant neoplasm of connective and soft tissue of trunk, unspecified |
C47.8 | Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system |
C49.8 | Malignant neoplasm of overlapping sites of connective and soft tissue |
C46.50 - C46.52 | Kaposi's sarcoma of lung |
C46.3 | Kaposi's sarcoma of lymph nodes |
C46.7 | Kaposi's sarcoma of other sites |
C76.1 | Malignant neoplasm of thorax |
C77.1 | Secondary and unspecified malignant neoplasm of intrathoracic lymph nodes |
C77.2 | Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes |
C77.8 | Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions |
C77.9 | Secondary and unspecified malignant neoplasm of lymph node, unspecified |
C78.00 - C78.02 | Secondary malignant neoplasm of lung |
C78.1 | Secondary malignant neoplasm of mediastinum |
C78.2 | Secondary malignant neoplasm of pleura |
C78.30 | Secondary malignant neoplasm of unspecified respiratory organ |
C78.39 | Secondary malignant neoplasm of other respiratory organs |
C79.89 | Secondary malignant neoplasm of other specified sites |
C79.9 | Secondary malignant neoplasm of unspecified site |
C80.0 | Disseminated malignant neoplasm, unspecified |
C83.32 | Diffuse large B-cell lymphoma, intrathoracic lymph nodes |
C83.52 | Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes |
C83.72 | Burkitt lymphoma, intrathoracic lymph nodes |
C83.82 | Other non-follicular lymphoma, intrathoracic lymph nodes |
C83.12 | Mantle cell lymphoma, intrathoracic lymph nodes |
C83.32 | Diffuse large B-cell lymphoma, intrathoracic lymph nodes |
C83.82 | Other non-follicular lymphoma, intrathoracic lymph nodes |
C84.62 | Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes |
C84.72 | Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodes |
C83.32 | Diffuse large B-cell lymphoma, intrathoracic lymph nodes |
C85.22 | Mediastinal (thymic) large B-cell lymphoma, intrathoracic lymph nodes |
C83.02 | Small cell B-cell lymphoma, intrathoracic lymph nodes |
C83.82 | Other non-follicular lymphoma, intrathoracic lymph nodes |
C83.92 | Non-follicular (diffuse) lymphoma, unspecified, intrathoracic lymph nodes |
C81.72 | Other Hodgkin lymphoma, intrathoracic lymph nodes |
C81.02 | Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes |
C81.42 | Lymphocyte-rich Hodgkin lymphoma, intrathoracic lymph nodes |
C81.12 | Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes |
C81.22 | Mixed cellularity Hodgkin lymphoma, intrathoracic lymph nodes |
C81.32 | Lymphocyte depleted Hodgkin lymphoma, intrathoracic lymph nodes |
C81.92 | Hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
C82.02 | Follicular lymphoma grade I, intrathoracic lymph nodes |
C82.12 | Follicular lymphoma grade II, intrathoracic lymph nodes |
C82.22 | Follicular lymphoma grade III, unspecified, intrathoracic lymph nodes |
C82.32 | Follicular lymphoma grade IIIa, intrathoracic lymph nodes |
C82.42 | Follicular lymphoma grade IIIb, intrathoracic lymph nodes |
C82.62 | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
C82.82 | Other types of follicular lymphoma, intrathoracic lymph nodes |
C82.92 | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
C84.02 | Mycosis fungoides, intrathoracic lymph nodes |
C84.12 | Sezary disease, intrathoracic lymph nodes |
C96.A | Histiocytic sarcoma |
C91.40 | Hairy cell leukemia not having achieved remission |
C96.0 | Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis |
C96.20, C96.21, C96.22, C96.29 | Malignant mast cell tumor |
C84.42 | Peripheral T-cell lymphoma, not elsewhere classified, intrathoracic lymph nodes |
C82.52 | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
C84.92 | Mature T/NK-cell lymphomas, unspecified, intrathoracic lymph nodes |
C84.A2 | Cutaneous T-cell lymphoma, unspecified, intrathoracic lymph nodes |
C84.Z2 | Other mature T/NK-cell lymphomas, intrathoracic lymph nodes |
C85.12 | Unspecified B-cell lymphoma, intrathoracic lymph nodes |
C85.22 | Mediastinal (thymic) large B-cell lymphoma, intrathoracic lymph nodes |
C85.82 | Other specified types of non-Hodgkin lymphoma, intrathoracic lymph nodes |
C85.92 | Non-Hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
C96.9 | Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified |
C96.Z | Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue |
C7A.00 | Malignant carcinoid tumor of unspecified site |
C7A.090 | Malignant carcinoid tumor of the bronchus and lung |
C7A.091 | Malignant carcinoid tumor of the thymus |
C7A.1 | Malignant poorly differentiated neuroendocrine tumors |
C7A.8 | Other malignant neuroendocrine tumors |
D3A.00 | Benign carcinoid tumor of unspecified site |
D3A.8 | Other benign neuroendocrine tumors |
D3A.090 | Benign carcinoid tumor of the bronchus and lung |
D3A.091 | Benign carcinoid tumor of the thymus |
C7B.00 | Secondary carcinoid tumors, unspecified site |
C7B.09 | Secondary carcinoid tumors of other sites |
C7B.8 | Other secondary neuroendocrine tumors |
D15.2 | Benign neoplasm of mediastinum |
D15.0 | Benign neoplasm of thymus |
D15.1 | Benign neoplasm of heart |
D16.6 | Benign neoplasm of vertebral column |
D17.4 | Benign lipomatous neoplasm of intrathoracic organs |
D36.0 | Benign neoplasm of lymph nodes |
D02.20 - D02.22 | Carcinoma in situ of bronchus and lung |
D02.3 | Carcinoma in situ of other parts of respiratory system |
D02.4 | Carcinoma in situ of respiratory system, unspecified |
D09.3 | Carcinoma in situ of thyroid and other endocrine glands |
D09.8 | Carcinoma in situ of other specified sites |
D09.9 | Carcinoma in situ, unspecified |
D38.1 | Neoplasm of uncertain behavior of trachea, bronchus and lung |
D38.2 | Neoplasm of uncertain behavior of pleura |
D38.3 | Neoplasm of uncertain behavior of mediastinum |
D38.4 | Neoplasm of uncertain behavior of thymus |
D38.5 | Neoplasm of uncertain behavior of other respiratory organs |
D38.6 | Neoplasm of uncertain behavior of respiratory organ, unspecified |
D48.0 | Neoplasm of uncertain behavior of bone and articular cartilage |
D48.111 | Desmoid tumor of chest wall |
D48.112 | Desmoid tumor, intrathoracic |
D48.2 | Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system |
D48.7 | Neoplasm of uncertain behavior of other specified sites |
D48.9 | Neoplasm of uncertain behavior, unspecified |
D49.1 | Neoplasm of unspecified behavior of respiratory system |
D49.2 | Neoplasm of unspecified behavior of bone, soft tissue, and skin |
D49.89 | Neoplasm of unspecified behavior of other specified sites |
E32.1 | Abscess of thymus |
E66.2 | Morbid (severe) obesity with alveolar hypoventilation |
D60.0 - D60.9 | Acquired pure red cell aplasia [erythroblastopenia] |
G89.12 | Acute post-thoracotomy pain |
G89.22 | Chronic post-thoracotomy pain |
G54.0 | Brachial plexus disorders |
G54.3 | Thoracic root disorders, not elsewhere classified |
G54.8 | Other nerve root and plexus disorders |
G55 | Nerve root and plexus compressions in diseases classified elsewhere |
G70.00 - G70.01 | Myasthenia gravis |
G73.3 | Myasthenic syndromes in other diseases classified elsewhere |
I09.2 | Chronic rheumatic pericarditis |
I05.1 | Rheumatic mitral insufficiency |
I05.2 | Rheumatic mitral stenosis with insufficiency |
I06.0 | Rheumatic aortic stenosis |
I06.1 | Rheumatic aortic insufficiency |
I06.2 | Rheumatic aortic stenosis with insufficiency |
I06.8 | Other rheumatic aortic valve diseases |
I06.9 | Rheumatic aortic valve disease, unspecified |
I08.0 | Rheumatic disorders of both mitral and aortic valves |
I08.8 | Other rheumatic multiple valve diseases |
I08.9 | Rheumatic multiple valve disease, unspecified |
I09.9 | Rheumatic heart disease, unspecified |
I09.81 | Rheumatic heart failure |
I09.89 | Other specified rheumatic heart diseases |
I10 | Essential (primary) hypertension |
I11.0 - I11.9 | Hypertensive heart disease |
I13.0 - I13.2 | Hypertensive heart and chronic kidney disease |
I16.0 - I16.9 | Hypertensive crisis |
I15.0 - I15.9 | Secondary hypertension |
N26.2 | Page kidney |
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 |
I24.0 | Acute coronary thrombosis not resulting in myocardial infarction |
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 |
I25.750 - I25.759 | Atherosclerosis of native coronary artery of transplanted heart with angina pectoris |
I25.811 | Atherosclerosis of native coronary artery of transplanted heart without angina pectoris |
I25.3 | Aneurysm of heart |
I25.41 | Coronary artery aneurysm |
I25.42 | Coronary artery dissection |
I25.3 | Aneurysm of heart |
I25.83 | Coronary atherosclerosis due to lipid rich plaque |
I25.84 | Coronary atherosclerosis due to calcified coronary lesion |
I27.0 | Primary pulmonary hypertension |
I27.1 | Kyphoscoliotic heart disease |
I27.20, I27.21, I27.22, I27.23, I27.24, I27.29 | Other secondary pulmonary hypertension |
I27.89 | Other specified pulmonary heart diseases |
I27.81 | Cor pulmonale (chronic) |
I27.9 | Pulmonary heart disease, unspecified |
I28.0 | Arteriovenous fistula of pulmonary vessels |
I28.1 | Aneurysm of pulmonary artery |
I32 | Pericarditis in diseases classified elsewhere |
M32.12 | Pericarditis in systemic lupus erythematosus |
I30.0 - I30.9 | Acute pericarditis |
I33.0 - I33.9 | Acute and subacute endocarditis |
I39 | Endocarditis and heart valve disorders in diseases classified elsewhere |
I41 | Myocarditis in diseases classified elsewhere |
I40.0 - I40.9 | Acute myocarditis |
I31.0 | Chronic adhesive pericarditis |
I31.1 | Chronic constrictive pericarditis |
I31.2 | Hemopericardium, not elsewhere classified |
I31.4 | Cardiac tamponade |
I31.8 | Other specified diseases of pericardium |
I34.0 - I34.9 | Nonrheumatic mitral valve disorders |
I35.0 - I35.9 | Nonrheumatic aortic valve disorders |
I36.0 - I36.9 | Nonrheumatic tricuspid valve disorders |
I37.0 - I37.9 | Nonrheumatic pulmonary valve disorders |
I38 | Endocarditis, valve unspecified |
I39 | Endocarditis and heart valve disorders in diseases classified elsewhere |
M32.11 | Endocarditis in systemic lupus erythematosus |
I42.3 | Endomyocardial (eosinophilic) disease |
I42.1 | Obstructive hypertrophic cardiomyopathy |
I42.2 | Other hypertrophic cardiomyopathy |
I42.8 | Other cardiomyopathies |
I42.4 | Endocardial fibroelastosis |
I42.0 | Dilated cardiomyopathy |
I42.5 | Other restrictive cardiomyopathy |
I42.8 | Other cardiomyopathies |
I42.9 | Cardiomyopathy, unspecified |
I42.6 | Alcoholic cardiomyopathy |
I43 | Cardiomyopathy in diseases classified elsewhere |
I42.7 | Cardiomyopathy due to drug and external agent |
I42.9 | Cardiomyopathy, unspecified |
I47.10 | Supraventricular tachycardia, unspecified |
I47.11 | Inappropriate sinus tachycardia, so stated |
I47.19 | Other supraventricular tachycardia |
I49.2 | Junctional premature depolarization |
I47.0 | Re-entry ventricular arrhythmia |
I47.20 | Ventricular tachycardia, unspecified |
I47.21 | Torsades de pointes |
I47.29 | Other ventricular tachycardia |
I47.9 | Paroxysmal tachycardia, unspecified |
I48.0 | Paroxysmal atrial fibrillation |
I48.11 | Longstanding persistent atrial fibrillation |
I48.19 | Other persistent atrial fibrillation |
I48.20 | Chronic atrial fibrillation, unspecified |
I48.21 | Permanent atrial fibrillation |
I48.3 | Typical atrial flutter |
I48.4 | Atypical atrial flutter |
I48.91 | Unspecified atrial fibrillation |
I48.92 | Unspecified atrial flutter |
I49.01 | Ventricular fibrillation |
I49.02 | Ventricular flutter |
I46.2 | Cardiac arrest due to underlying cardiac condition |
I46.8 | Cardiac arrest due to other underlying condition |
I46.9 | Cardiac arrest, cause unspecified |
I49.1 | Atrial premature depolarization |
I49.3 | Ventricular premature depolarization |
I49.40 - I49.49 | Other and unspecified premature depolarization |
I49.5 | Sick sinus syndrome |
I49.8 | Other specified cardiac arrhythmias |
R00.1 | Bradycardia, unspecified |
I49.9 | Cardiac arrhythmia, unspecified |
I50.20 - I50.23 | Systolic (congestive) heart failure |
I50.30 - I50.33 | Diastolic (congestive) heart failure |
I50.40 - I50.43 | Combined systolic (congestive) and diastolic (congestive) heart failure |
I50.9 | Heart failure, unspecified |
I50.1 | Left ventricular failure, unspecified |
I50.20 - I50.23 | Systolic (congestive) heart failure |
I50.30 - I50.33 | Diastolic (congestive) heart failure |
I50.40 - I50.43 | Combined systolic (congestive) and diastolic (congestive) heart failure |
I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84 I50.89, I50.9 | Heart failure |
I51.4 | Myocarditis, unspecified |
I51.5 | Myocardial degeneration |
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris |
I51.7 | Cardiomegaly |
I97.0 | Postcardiotomy syndrome |
I97.110 - I97.191 | Other postprocedural cardiac functional disturbances |
I23.4 | Rupture of chordae tendineae as current complication following acute myocardial infarction |
I51.1 | Rupture of chordae tendineae, not elsewhere classified |
I23.5 | Rupture of papillary muscle as current complication following acute myocardial infarction |
I51.2 | Rupture of papillary muscle, not elsewhere classified |
I23.1 | Atrial septal defect as current complication following acute myocardial infarction |
I23.2 | Ventricular septal defect as current complication following acute myocardial infarction |
I51.0 | Cardiac septal defect, acquired |
I23.0 | Hemopericardium as current complication following acute myocardial infarction |
I23.3 | Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction |
I23.6 | Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction |
I23.7 | Postinfarction angina |
I23.8 | Other current complications following acute myocardial infarction |
I51.3 | Intracardiac thrombosis, not elsewhere classified |
I51.89 | Other ill-defined heart diseases |
I51.81 | Takotsubo syndrome |
I51.9 | Heart disease, unspecified |
I52 | Other heart disorders in diseases classified elsewhere |
I71.010, I71.011, I71.012, I71.019 | Dissection of thoracic aorta |
I71.03 | Dissection of thoracoabdominal aorta |
I71.10, I71.11, I71.12, I71.13 | Thoracic aortic aneurysm, ruptured |
I71.20, I71.21, I71.22, I71.23 | Thoracic aortic aneurysm, without rupture |
I71.50, I71.51, I71.52 | Thoracoabdominal aortic aneurysm, ruptured |
I71.60 | Thoracoabdominal aortic aneurysm, without rupture, unspecified |
I72.5 | Aneurysm of other precerebral arteries |
I72.8 | Aneurysm of other specified arteries |
I77.0 | Arteriovenous fistula, acquired |
I77.1 | Stricture of artery |
I77.2 | Rupture of artery |
I77.819 | Aortic ectasia, unspecified site |
I77.810 | Thoracic aortic ectasia |
I77.811 | Abdominal aortic ectasia |
I77.812 | Thoracoabdominal aortic ectasia |
I82.0 | Budd-Chiari syndrome |
I82.220 - I82.221 | Embolism and thrombosis of inferior vena cava |
J44.1 | Chronic obstructive pulmonary disease with (acute) exacerbation |
J44.0 - J44.9 | Other chronic obstructive pulmonary disease |
J44.9 | Chronic obstructive pulmonary disease, unspecified |
J85.0 | Gangrene and necrosis of lung |
J85.1 | Abscess of lung with pneumonia |
J85.2 | Abscess of lung without pneumonia |
J85.3 | Abscess of mediastinum |
J84.83 | Surfactant mutations of the lung |
J98.11 | Atelectasis |
J98.19 | Other pulmonary collapse |
J96.00 - J96.02 | Acute respiratory failure |
J96.90 - J96.92 | Respiratory failure, unspecified |
J96.10 - J96.12 | Chronic respiratory failure |
J96.20 - J96.22 | Acute and chronic respiratory failure |
N17.1 | Acute kidney failure with acute cortical necrosis |
N17.9 | Acute kidney failure, unspecified |
N18.9 | Chronic kidney disease, unspecified |
N19 | Unspecified kidney failure |
O90.3 | Peripartum cardiomyopathy |
M46.30 - M46.39 | Infection of intervertebral disc (pyogenic) |
M86.9 | Osteomyelitis, unspecified |
Q20.0 | Common arterial trunk |
Q20.3 | Discordant ventriculoarterial connection |
Q20.1 | Double outlet right ventricle |
Q20.5 | Discordant atrioventricular connection |
Q20.2 | Double outlet left ventricle |
Q20.3 | Discordant ventriculoarterial connection |
Q20.8 | Other congenital malformations of cardiac chambers and connections |
Q21.3 | Tetralogy of Fallot |
Q20.4 | Double inlet ventricle |
Q21.0 | Ventricular septal defect |
Q21.10, Q21.11, Q21.12, Q21.13, Q21.14, Q21.15, Q21.16, Q21.19 | Atrial septal defect |
Q21.20, Q21.21, Q21.22, Q21.23 | Atrioventricular septal defect |
Q20.8 | Other congenital malformations of cardiac chambers and connections |
Q20.6 | Isomerism of atrial appendages |
Q20.8 | Other congenital malformations of cardiac chambers and connections |
Q21.4 | Aortopulmonary septal defect |
Q21.8 | Other congenital malformations of cardiac septa |
Q21.9 | Congenital malformation of cardiac septum, unspecified |
Q22.3 | Other congenital malformations of pulmonary valve |
Q22.0 | Pulmonary valve atresia |
Q22.1 | Congenital pulmonary valve stenosis |
Q22.2 | Congenital pulmonary valve insufficiency |
Q22.4 | Congenital tricuspid stenosis |
Q22.6 | Hypoplastic right heart syndrome |
Q22.8 | Other congenital malformations of tricuspid valve |
Q22.9 | Congenital malformation of tricuspid valve, unspecified |
Q22.5 | Ebstein's anomaly |
Q23.0 | Congenital stenosis of aortic valve |
Q23.1 | Congenital insufficiency of aortic valve |
Q23.2 | Congenital mitral stenosis |
Q23.3 | Congenital mitral insufficiency |
Q23.4 | Hypoplastic left heart syndrome |
Q24.4 | Congenital subaortic stenosis |
Q24.2 | Cor triatriatum |
Q24.3 | Pulmonary infundibular stenosis |
Q24.8 | Other specified congenital malformations of heart |
Q24.5 | Malformation of coronary vessels |
Q24.6 | Congenital heart block |
Q24.0 | Dextrocardia |
Q24.1 | Levocardia |
Q24.8 | Other specified congenital malformations of heart |
Q23.81, Q23.82, Q23.88 | Other congenital malformations of aortic and mitral valves |
Q23.9 | Congenital malformation of aortic and mitral valves, unspecified |
Q24.8 | Other specified congenital malformations of heart |
Q20.9 | Congenital malformation of cardiac chambers and connections, unspecified |
Q24.9 | Congenital malformation of heart, unspecified |
Q25.0 | Patent ductus arteriosus |
Q25.1 | Coarctation of aorta |
Q25.21, Q25.29 | Atresia of aorta |
Q25.40 - Q25.49 | Other congenital malformations of aorta |
Q25.3 | Supravalvular aortic stenosis |
Q25.8 | Other congenital malformations of other great arteries |
Q25.9 | Congenital malformation of great arteries, unspecified |
Q25.5 | Atresia of pulmonary artery |
Q25.71 | Coarctation of pulmonary artery |
Q25.72 | Congenital pulmonary arteriovenous malformation |
Q25.6 | Stenosis of pulmonary artery |
Q25.79 | Other congenital malformations of pulmonary artery |
Q26.9 | Congenital malformation of great vein, unspecified |
Q26.2 | Total anomalous pulmonary venous connection |
Q26.3 | Partial anomalous pulmonary venous connection |
Q26.4 | Anomalous pulmonary venous connection, unspecified |
Q26.0 | Congenital stenosis of vena cava |
Q26.1 | Persistent left superior vena cava |
Q26.8 | Other congenital malformations of great veins |
Q27.0 | Congenital absence and hypoplasia of umbilical artery |
Q27.9 | Congenital malformation of peripheral vascular system, unspecified |
Q27.39 | Arteriovenous malformation, other site |
Q27.8 | Other specified congenital malformations of peripheral vascular system |
Q27.9 | Congenital malformation of peripheral vascular system, unspecified |
Q27.30 | Arteriovenous malformation, site unspecified |
Q27.4 | Congenital phlebectasia |
Q28.0 | Arteriovenous malformation of precerebral vessels |
Q28.1 | Other malformations of precerebral vessels |
Q28.8 | Other specified congenital malformations of circulatory system |
Q28.9 | Congenital malformation of circulatory system, unspecified |
Q31.1 | Congenital subglottic stenosis |
Q31.2 | Laryngeal hypoplasia |
Q31.3 | Laryngocele |
Q31.5 | Congenital laryngomalacia |
Q31.8 | Other congenital malformations of larynx |
Q31.9 | Congenital malformation of larynx, unspecified |
Q32.0 - Q32.4 | Congenital malformations of trachea and bronchus |
Q33.0 | Congenital cystic lung |
Q33.2 | Sequestration of lung |
Q33.3 | Agenesis of lung |
Q33.6 | Congenital hypoplasia and dysplasia of lung |
Q33.9 | Congenital malformation of lung, unspecified |
Q33.1 | Accessory lobe of lung |
Q33.5 | Ectopic tissue in lung |
Q33.8 | Other congenital malformations of lung |
Q34.0 | Anomaly of pleura |
Q34.1 | Congenital cyst of mediastinum |
Q34.8 | Other specified congenital malformations of respiratory system |
Q34.9 | Congenital malformation of respiratory system, unspecified |
Q76.5 | Cervical rib |
Q76.6 | Other congenital malformations of ribs |
Q76.7 | Congenital malformation of sternum |
Q76.8 | Other congenital malformations of bony thorax |
Q76.9 | Congenital malformation of bony thorax, unspecified |
Q77.2 | Short rib syndrome |
Q79.0 | Congenital diaphragmatic hernia |
Q79.1 | Other congenital malformations of diaphragm |
P14.0 | Erb's paralysis due to birth injury |
P14.1 | Klumpke's paralysis due to birth injury |
P14.3 | Other brachial plexus birth injuries |
R59.0 - R59.9 | Enlarged lymph nodes |
R07.9 | Chest pain, unspecified |
R07.2 | Precordial pain |
R07.82 | Intercostal pain |
R07.89 | Other chest pain |
R22.2 | Localized swelling, mass and lump, trunk |
R91.1 | Solitary pulmonary nodule |
R91.8 | Other nonspecific abnormal finding of lung field |
R93.1 | Abnormal findings on diagnostic imaging of heart and coronary circulation |
R93.89 | Abnormal findings on diagnostic imaging of other specified body structures |
R94.2 | Abnormal results of pulmonary function studies |
R94.30 | Abnormal result of cardiovascular function study, unspecified |
R94.31 | Abnormal electrocardiogram [ECG] [EKG] |
R94.39 | Abnormal result of other cardiovascular function study |
R87.618 | Other abnormal cytological findings on specimens from cervix uteri |
R87.619 | Unspecified abnormal cytological findings in specimens from cervix uteri |
R87.629 | Unspecified abnormal cytological findings in specimens from vagina |
R89.7 | Abnormal histological findings in specimens from other organs, systems and tissues |
R68.89 | Other general symptoms and signs |
M99.18 | Subluxation complex (vertebral) of rib cage |
S43.201A - S43.226S | Subluxation and dislocation of sternoclavicular joint |
S26.00XA - S26.00XS | Unspecified injury of heart with hemopericardium |
S26.09XA - S26.09XS | Other injury of heart with hemopericardium |
S26.10XA - S26.10XS | Unspecified injury of heart without hemopericardium |
S26.19XA - S26.19XS | Other injury of heart without hemopericardium |
S26.90XA - S26.90XS | Unspecified injury of heart, unspecified with or without hemopericardium |
S26.99XA - S26.99XS | Other injury of heart, unspecified with or without hemopericardium, initial encounter |
S26.01XA - S26.01XS | Contusion of heart with hemopericardium |
S26.11XA - S26.11XS | Contusion of heart without hemopericardium |
S26.91XA - S26.91XS | Contusion of heart, unspecified with or without hemopericardium |
S26.020A - S26.020S | Mild laceration of heart with hemopericardium |
S26.021A - S26.021S | Moderate laceration of heart with hemopericardium |
S26.12XA - S26.12XS | Laceration of heart without hemopericardium |
S26.92XA - S26.92XS | Laceration of heart, unspecified with or without hemopericardium |
S26.022A - S26.022S | Major laceration of heart with hemopericardium |
S26.12XA - S26.12XS | Laceration of heart without hemopericardium |
S26.92XA - S26.92XS | Laceration of heart, unspecified with or without hemopericardium |
S21.309A - S21.309S | Unspecified open wound of unspecified front wall of thorax with penetration into thoracic cavity |
S26.90XA - S26.90XS | Unspecified injury of heart, unspecified with or without hemopericardium |
S26.91XA - S26.91XS | Contusion of heart, unspecified with or without hemopericardium |
S21.309A - S21.309S | Unspecified open wound of unspecified front wall of thorax with penetration into thoracic cavity |
S26.020A - S26.020S | Mild laceration of heart with hemopericardium |
S26.92XA - S26.92XS | Laceration of heart, unspecified with or without hemopericardium |
S26.021A - S26.021S | Moderate laceration of heart with hemopericardium |
S26.022A - S26.022S | Major laceration of heart with hemopericardium |
S25.00XA - S25.09XS | Injury of thoracic aorta |
S25.20XA - S25.29XS | Injury of superior vena cava |
S26.00XA - S26.99XS | Injury of heart |
S27.0XXA- S27.9XXS | Injury of other and unspecified intrathoracic organs |
S14.3XXA - S14.3XXS | Injury of brachial plexus |
T50.905A - T50.905S | Adverse effect of unspecified drugs, medicaments and biological substances |
T50.995A - T50.995S | Adverse effect of other drugs, medicaments and biological substances |
T50.995A - T50.995S | Adverse effect of other drugs, medicaments and biological substances |
T78.40XA - T78.40XS | Allergy, unspecified |
T78.49XA - T78.49XS | Other allergy |
T82.01XA - T82.09XS | Mechanical complication of heart valve prosthesis |
T82.211A - T82.218S | Mechanical complication of coronary artery bypass graft |
T82.855A - T82.855S | Stenosis of coronary artery stent |
T82.817A - T82.817S | Embolism due to cardiac prosthetic devices, implants and grafts |
T82.827A - T82.827S | Fibrosis due to cardiac prosthetic devices, implants and grafts |
T82.837A - T82.837S | Hemorrhage due to cardiac prosthetic devices, implants and grafts |
T82.847A - T82.847S | Pain due to cardiac prosthetic devices, implants and grafts |
T82.857A - T82.857S | Stenosis of other cardiac prosthetic devices, implants and grafts |
T82.867A - T82.867S | Thrombosis due to cardiac prosthetic devices, implants and grafts |
T82.897A - T82.897S | Other specified complication of cardiac prosthetic devices, implants and grafts |
T82.9XXA - T82.9XXS | Unspecified complication of cardiac and vascular prosthetic device, implant and graft |
T86.20 - T86.298 | Complications of heart transplant |
T86.30 - T86.39 | Complications of heart-lung transplant |
I97.110 - I97.191 | Other postprocedural cardiac functional disturbances |
I97.710 - I97.791 | Intraoperative cardiac functional disturbances |
I97.88 | Other intraoperative complications of the circulatory system, not elsewhere classified |
I97.89 | Other postprocedural complications and disorders of the circulatory system, not elsewhere classified |
Z85.118 | Personal history of other malignant neoplasm of bronchus and lung |
Z85.12 | Personal history of malignant neoplasm of trachea |
Z85.20 | Personal history of malignant neoplasm of unspecified respiratory organ |
Z85.21 | Personal history of malignant neoplasm of larynx |
Z85.238 | Personal history of other malignant neoplasm of thymus |
Z85.29 | Personal history of malignant neoplasm of other respiratory and intrathoracic organs |
Z85.830 | Personal history of malignant neoplasm of bone |
Z87.74 | Personal history of (corrected) congenital malformations of heart and circulatory system |
Z98.890, Z98.891 | Other specified postprocedural states |
Z48.21 | Encounter for aftercare following heart transplant |
Z48.280 | Encounter for aftercare following heart-lung transplant |
Z94.1 | Heart transplant status |
Z94.3 | Heart and lungs transplant status |
Z95.3 | Presence of xenogenic heart valve |
Z95.4 | Presence of other heart-valve replacement |
Z95.2 | Presence of prosthetic heart valve |
Z95.1 | Presence of aortocoronary bypass graft |
Z51.0 | Encounter for antineoplastic radiation therapy |
Z51.11 | Encounter for antineoplastic chemotherapy |
Z51.12 | Encounter for antineoplastic immunotherapy |
Z48.812 | Encounter for surgical aftercare following surgery on the circulatory system |
Z53.01 | Procedure and treatment not carried out due to patient smoking |
Z53.09 | Procedure and treatment not carried out because of other contraindication |
Z09 | Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm |
Z08 | Encounter for follow-up examination after completed treatment for malignant neoplasm |
Z09 | Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm |
Z03.89 | Encounter for observation for other suspected diseases and conditions ruled out |
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