Table 6A: Selected Diagnoses and Services Rendered
National Look-Alikes Data
72 Awardees
Line | Diagnostic Category | Applicable ICD-10-CM Code | Number of Visits by Diagnosis Regardless of Primacy (a) | Number of Patients with Diagnosis (b) | Visits per Patient |
---|---|---|---|---|---|
Selected Infectious and Parasitic Diseases | |||||
1-2. | Symptomatic/Asymptomatic human immunodeficiency virus (HIV) | B20, B97.35, O98.7-, Z21 | 23,650 | 8,148 | 2.90 |
3. | Tuberculosis | A15- through A19-, O98.01 | 288 | 178 | 1.62 |
4. | Sexually transmitted infections | A50- through A64- (exclude A63.0) | 8,459 | 5,405 | 1.57 |
4a. | Hepatitis B | B16.0 through B16.2, B16.9, B17.0, B18.0, B18.1, B19.10, B19.11, O98.4- | 5,015 | 1,864 | 2.69 |
4b. | Hepatitis C | B17.10, B17.11, B18.2, B19.20, B19.21 | 11,204 | 5,021 | 2.23 |
Selected Diseases of the Respiratory System | |||||
5. | Asthma | J45- | 56,638 | 29,160 | 1.94 |
6. | Chronic lower respiratory diseases | J40- through J44-, J47- | 46,171 | 19,053 | 2.42 |
Selected Other Medical Conditions | |||||
7. | Abnormal breast findings, female | C50.01-, C50.11-, C50.21-, C50.31-, C50.41-, C50.51-, C50.61-, C50.81-, C50.91-, C79.81, D05-, D48.6-, D49.3-, N60-, N63-, R92- | 10,951 | 6,731 | 1.63 |
8. | Abnormal cervical findings | C53-, C79.82, D06-, R87.61-, R87.629, R87.810, R87.820 | 6,998 | 4,251 | 1.65 |
9. | Diabetes mellitus | E08- through E13-, O24- (exclude O24.41-) | 194,357 | 57,121 | 3.40 |
10. | Heart disease (selected) | I01-, I02- (exclude I02.9), I20- through I25-, I27-, I28-, I30- through I52- | 53,923 | 21,404 | 2.52 |
11. | Hypertension | I10- through I16- | 316,927 | 115,027 | 2.76 |
12. | Contact dermatitis and other eczema | L23- through L25-, L30- (exclude L30.1, L30.3, L30.4, L30.5), L58- | 22,560 | 16,362 | 1.38 |
13. | Dehydration | E86- | 1,453 | 1,026 | 1.42 |
14. | Exposure to heat or cold | T33-, T34-, T67-, T68-, T69- | 104 | 78 | 1.33 |
14a. | Overweight and obesity | E66-, Z68- (exclude Z68.1, Z68.20 through Z68.24, Z68.51. Z68.52) | 278,365 | 137,850 | 2.02 |
Selected Childhood Conditions (limited to ages 0 through 17) | |||||
15. | Otitis media and Eustachian tube disorders | H65- through H69- | 22,947 | 15,934 | 1.44 |
16. | Selected perinatal/neonatal medical conditions | A33-, P19-, P22- through P29- (exclude P29.3), P35- through P96- (exclude P54-, P91.6-, P92- , P96.81), R78.81, R78.89 | 3,815 | 2,425 | 1.57 |
17. | Lack of expected normal physiological development (such as delayed milestone, failure to gain weight, failure to thrive); nutritional deficiencies in children only. Does not include sexual or mental development. | E40- through E46-, E50- through E63-, P92-, R62- (exclude R62.7), R63.3 | 23,430 | 14,321 | 1.64 |
Selected Mental Health Conditions and Substance Use Disorders | |||||
18. | Alcohol-related disorders | F10-, G62.1, O99.31 | 29,758 | 8,817 | 3.38 |
19. | Other substance-related disorders (excluding tobacco use disorders) | F11- through F19- (exclude F17-), G62.0, O99.32- | 55,251 | 14,881 | 3.71 |
19a. | Tobacco use disorder | F17-, O99.33 | 63,035 | 30,812 | 2.05 |
20a. | Depression and other mood disorders | F30- through F39- | 218,454 | 64,174 | 3.40 |
20b. | Anxiety disorders, including post-traumatic stress disorder (PTSD) | F06.4, F40- through F42-, F43.0, F43.1-, F93.0 | 186,752 | 57,933 | 3.22 |
20c. | Attention deficit and disruptive behavior disorders | F90- through F91- | 43,057 | 12,403 | 3.47 |
20d. | Other mental disorders, excluding drug or alcohol dependence | F01- through F09- (exclude F06.4), F20- through F29-, F43- through F48- (exclude F43.0- and F43.1-), F50- through F99- (exclude F55-, F84.2, F90-, F91-, F93.0, F98-), O99.34, R45.1, R45.2, R45.5, R45.6, R45.7, R45.81, R45.82, R48.0 | 109,218 | 38,029 | 2.87 |
Line | Service Category | Applicable ICD-10-CM Code or CPT4/II Code | Number of Visits (a) | Number of Patients (b) | Visits per Patient |
---|---|---|---|---|---|
Selected Diagnostic Tests/Screening/Preventive Services | |||||
21. | HIV test | CPT-4: 86689, 86701 through 86703, 87389 through 87391, 87534 through 87539, 87806 | 32,652 | 25,782 | 1.27 |
21a. | Hepatitis B test | CPT-4: 86704 through 86707, 87340, 87341, 87350 | 12,375 | 11,234 | 1.10 |
21b. | Hepatitis C test | CPT-4: 86803, 86804, 87520 through 87522 | 14,004 | 12,755 | 1.10 |
22. | Mammogram | CPT-4: 77052, 77057, 77065, 77066, 77067 OR ICD-10: Z12.31 | 25,131 | 21,854 | 1.15 |
23. | Pap test | CPT-4: 88141 through 88153, 88155, 88164 through 88167, 88174, 88175 OR ICD-10: Z01.41-, Z01.42, Z12.4(exclude Z01.411 and Z01.419) | 31,421 | 29,723 | 1.06 |
24. | Selected immunizations: hepatitis A; haemophilus influenzae B (HiB); pneumococcal, diphtheria, tetanus, pertussis (DTaP) (DTP) (DT); mumps, measles, rubella (MMR); poliovirus; varicella; hepatitis B | CPT-4: 90632, 90633, 90634, 90636, 90643, 90644, 90645, 90646, 90647, 90648, 90669, 90670, 90696, 90697, 90698, 90700, 90701, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90712, 90713, 90714, 90715, 90716, 90718, 90720, 90721, 90723, 90730, 90731, 90732, 90740, 90743, 90744, 90745, 90746, 90747, 90748 | 100,116 | 73,720 | 1.36 |
24a. | Seasonal flu vaccine | CPT-4: 90630, 90653 through 90657, 90661, 90662, 90672, 90673, 90674, 90682, 90685 through 90688, 90749, 90756 | 97,579 | 90,431 | 1.08 |
25. | Contraceptive management | ICD-10: Z30- | 50,601 | 29,775 | 1.70 |
26. | Health supervision of infant or child (ages 0 through 11) | CPT-4: 99381 through 99383, 99391 through 99393 | 113,878 | 73,986 | 1.54 |
26a. | Childhood lead test screening (9 to 72 months) | ICD-10: Z13.88 CPT-4: 83655 | 8,034 | 7,383 | 1.09 |
26b. | Screening, Brief Intervention, and Referral to Treatment (SBIRT) | CPT-4: 99408, 99409 HCPCS: G0396, G0397, H0050 | 4,170 | 3,918 | 1.06 |
26c. | Smoke and tobacco use cessation counseling | CPT4: 99406, 99407 OR HCPCS: S9075 OR CPTII: 4000F, 4001F, 4004F | 43,426 | 26,287 | 1.65 |
26d. | Comprehensive and intermediate eye exams | CPT4: 92002, 92004, 92012, 92014 | 5,995 | 5,702 | 1.05 |
Line | Service Category | Applicable ADA Code | Number of Visits (a) | Number of Patients (b) | Visits per Patient |
---|---|---|---|---|---|
Selected Dental Services | |||||
27. | Emergency services | ADA: D9110 | 5,801 | 4,814 | 1.21 |
28. | Oral exams | ADA: D0120, D0140, D0145, D0150, D0160, D0170, D0171, D0180 | 49,108 | 41,165 | 1.19 |
29. | Prophylaxis–adult or child | ADA: D1110, D1120 | 36,285 | 28,760 | 1.26 |
30. | Sealants | ADA: D1351 | 4,246 | 3,544 | 1.20 |
31. | Fluoride treatment–adult or child | ADA: D1206, D1208 CPT-4: 99188 | 24,220 | 20,426 | 1.19 |
32. | Restorative services | ADA: D21xx through D29xx | 29,934 | 15,067 | 1.99 |
33. | Oral surgery (extractions and other surgical procedures) | ADA: D7xxx | 8,087 | 5,473 | 1.48 |
34. | Rehabilitative services (Endo, Perio, Prostho, Ortho) | ADA: D3xxx, D4xxx,D5xxx , D6xxx, D8xxx | 13,249 | 6,206 | 2.13 |
Source of codes:
- ICD-10-CM (2019) – National Center for Health Statistics (NCHS)
- CPT (2019) – American Medical Association (AMA)
- Code on Dental Procedures and Nomenclature CDT Code (2019) – Dental Procedure Codes. American Dental Association (ADA)
Note: “X” in a code denotes any number including the absence of a number in that place.
“–” (Dashes) in a code indicate that additional characters are required.
ICD10CM codes all have at least four digits. These codes are not intended to reflect if a code is billable or not. Instead they are used to point out that other codes in the series are to be
considered.