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Table 6A: Selected Diagnoses and Services Rendered

Indiana Data

X

26 Awardees

Line Diagnostic Category Applicable ICD-10-CM Code or Value Set Object Identifier (OID) 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 OID: 2.16.840.1.113883.3.464.1003.120.12.1003 2,606 1,326 1.97
3. Tuberculosis A15- through A19-, O98.0-, Z86.15, Z22.7 OID: 2.16.840.1.113762.1.4.1146.451 1,205 820 1.47
4. Sexually transmitted infections (gonococcal infections and venereal diseases) A50- through A64-, A69.0, A69.1, A69.8, A69.9 OID: 2.16.840.1.113883.3.464.1003.112.11.1003 5,839 4,374 1.33
4a. Hepatitis B B16.0 through B16.2, B16.9, B17.0, B18.0, B18.1, B19.1- OID: 2.16.840.1.113883.3.464.1003.110.12.1025 795 447 1.78
4b. Hepatitis C B17.1-, B18.2, B19.2- OID: 2.16.840.1.113762.1.4.1146.153 3,616 2,239 1.62
4c. Novel coronavirus (SARS-CoV-2) disease U07.1 OID: 2.16.840.1.113762.1.4.1248.139, 2.16.840.1.113762.1.4.1200.151 6,635 6,205 1.07
4d. Long COVID U09.9 OID: 2.16.840.1.113762.1.4.1222.1391 406 332 1.22
Selected Diseases of the Respiratory System
5. Asthma J45- OID: 2.16.840.1.113883.3.526.3.362 53,579 33,866 1.58
6. Chronic lower respiratory diseases J40 (count J40 only when code U07.1 is not present), J41- through J44-, J47-, J4A- 38,971 20,422 1.91
6a. Acute respiratory illness due to novel coronavirus (SARS-CoV-2) disease J12.82, J12.89, J20.8, J40, J22, J98.8, J80 (count codes listed only when code U07.1 is also present) OID: 2.16.840.1.113762.1.4.1029.374 102 99 1.03
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- through N65-, R92- 12,013 9,613 1.25
8. Abnormal cervical findings C53-, C79.82, D06-, N87.0, N87.1, N87.9, R87.61- (exclude R87.615 and R87.616), R87.629, R87.810, R87.820 5,161 3,667 1.41
9. Diabetes mellitus E08- through E13-, O24- (exclude O24.41-) OID: 2.16.840.1.113762.1.4.1219.35 178,799 63,958 2.80
10. Heart disease (selected) I01-, I02- (exclude I02.9), I20- through I25-, I27-, I28-, I30- through I52-, Q24- 34,630 19,776 1.75
11. Hypertension I10- through I16-, O10-, O11- OID: 2.16.840.1.113762.1.4.1222.1547 (Includes all codes other than O11-) 267,257 118,320 2.26
12. Contact dermatitis and other eczema H01.13-, L20.89, L23- through L25-, L30- (exclude L30.1, L30.3, L30.4, L30.5), L58- 25,869 21,445 1.21
13. Dehydration E86- 815 751 1.09
14. Exposure to heat or cold T33-, T34-, T67-, T68-, T69-, W92-, W93-, X30-, X31-, X32- 144 130 1.11
14a. Overweight and obesity E66-, Z68- (exclude Z68.1, Z68.20 through Z68.24, Z68.51, Z68.52) 230,421 127,912 1.80
Selected Childhood Conditions (limited to ages 0 through 17)
15. Otitis media and Eustachian tube disorders H65- through H69-, H72- 28,755 20,299 1.42
16. Selected perinatal/neonatal medical conditions A33, P19-, P22- through P29- (exclude P29.3-), P35- through P96- (exclude P54-, P91.6-, P92-, P96.81), Q86- 4,866 3,219 1.51
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- (exclude R63.39) 19,251 13,431 1.43
Selected Mental Health Conditions and Substance Use Disorders
18. Alcohol-related disorders F10-, G62.1, K70-, O99.31- 37,219 11,069 3.36
19. Other substance-related disorders (excluding tobacco use disorders) F11- through F19- (exclude F17-), G62.0, O99.32- 75,628 18,111 4.18
19a. Tobacco use disorder F17-, O99.33-, Z72.0 64,029 36,837 1.74
20a. Depression and other mood disorders F30- through F39- 339,955 90,539 3.75
20b. Anxiety disorders, including post-traumatic stress disorder (PTSD) F06.4, F40- through F42-, F43.0, F43.1-, F43.8-, F93.0 382,433 105,861 3.61
20c. Attention deficit and disruptive behavior disorders F90- through F91- 128,812 34,404 3.74
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-, F64-, F84.2, F90-, F91-, F93.0, F98-), 099.34-, R45.1, R45.2, R45.5, R45.6, R45.7, R45.81, R45.82, R48.0 150,946 58,611 2.58
20e. Human trafficking T74.5- through T74.6-, T76.5- through T76.6-, Z04.81, Z04.82, Z62.813, Z91.42 82 44 1.86
20f. Intimate partner violence T74.11-, T74.21-, T74.31-, Z69.11 330 215 1.53
Line Diagnostic Category Applicable ICD-10-CM, CPT-4/I/II/PLA, or HCPCS 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 78,320 71,666 1.09
21a. Hepatitis B test CPT-4: 80074, 86704 through 86707, 87340, 87341, 87350, 87912 28,192 26,915 1.05
21b. Hepatitis C test CPT-4: 80074, 86803, 86804, 87520 through 87522, 87902 59,108 57,033 1.04
21c. Novel coronavirus (SARS-CoV-2) diagnostic test CPT-4: 87426, 87428, 87635, 87636, 87637, 87811 HCPCS: U0001, U0002, U0003, U0004, U0005 CPT PLA: 0202U, 0223U, 0225U, 0240U, 0241U 38,578 31,941 1.21
21d. Novel coronavirus (SARS-CoV-2) antibody test ICD-10: Z01.84 CPT-4: 86318, 86328, 86408, 86409, 86413, 86769 CPT PLA: 0224U, 0226U 258 243 1.06
21e. Pre-Exposure Prophylaxis (PrEP)-associated management of all patients on PrEP ICD-10: Z29.81 1,642 817 2.01
22. Mammogram ICD-10: Z12.31 CPT-4: 77062, 77063, 77065, 77066, 77067 HCPCS: G0279 27,924 26,548 1.05
23. Pap test ICD-10: R87.619, R87.629, Z01.41-, Z01.42, Z12.4 (exclude Z01.411 and Z01.419) CPT-4: 88141 through 88153, 88155, 88164 through 88167, 88174, 88175 HCPCS: G0123, G0143, G0144, G0145, G0146, G0147, G0148, P3000 38,590 37,063 1.04
24. Selected immunizations: hepatitis A; haemophilus influenzae B (Hib); pneumococcal, diphtheria, tetanus, pertussis (DTaP) (DTP) (DT); measles, mumps, rubella (MMR); poliovirus; varicella; hepatitis B CPT-4: 90632, 90633, 90634, 90636, 90644, 90645, 90646, 90647, 90648, 90669, 90670, 90671, 90677, 90696, 90697, 90698, 90700, 90701, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90712, 90713, 90714, 90715, 90716, 90720, 90721, 90723, 90730, 90731, 90732, 90739, 90740, 90743, 90744, 90745, 90746, 90747, 90748, 90759 136,814 98,940 1.38
24a. Seasonal flu vaccine CPT-4: 90630, 90653 through 90662, 90672, 90673, 90674, 90682, 90685 through 90688, 90694, 90724, 90756 97,162 89,422 1.09
24b. Coronavirus (SARS-CoV-2) vaccine CPT-4: 90480, 91304, 91318, 91319, 91320, 91321, 91322 Codes listed include those available as of the release date of this manual. 18,783 18,055 1.04
25. Contraceptive management ICD-10: Z30- 60,539 34,371 1.76
26. Health supervision of infant or child (ages 0 through 11) CPT-4: 99381 through 99383, 99391 through 99393, ICD-10: Z00.1 -, Z76.1.Z76.2 190,609 116,850 1.63
26a. Childhood lead test screening (9 to 72 months) ICD-10: Z13.88, CPT-4: 83655 17,938 16,257 1.10
26b. Screening, Brief Intervention, and Referral to Treatment (SBIRT) CPT-4: 99408, 99409, HCPCS: G0396, G0397, G0443, H0050 14,574 8,143 1.79
26c. Smoke and tobacco use cessation counseling CPT-4: 99406, 99407, HCPCS: S9075 207,746 99,373 2.09
26d. Comprehensive and intermediate eye exams CPT-4: 92002, 92004, 92012, 92014 20,186 19,084 1.06
26e. Childhood development screenings and evaluations (limited to patients who are less than 18 years of age) CPT-4: 96110, 96112, 96113, 96127 ICD-10: Z13.4- 50,121 35,881 1.40
Line Service Category Applicable ADA Code Number of Visits (a) Number of Patients (b) Visits per Patient
Selected Dental Services
27. Emergency services CDT: D0140, D9110 21,049 19,345 1.09
28. Oral exams CDT: D0120, DO145, D0150, D0160, D0170, D0171, D0180 77,361 63,474 1.22
29. Prophylaxis–adult or child CDT: D1110, D1120 54,124 41,603 1.30
30. Sealants CDT: D1351 6,583 5,391 1.22
31. Fluoride treatment–adult or child CDT: D1206, D1208, CPT-4: 99188 38,999 31,113 1.25
32. Restorative services CDT: D21xx through D29xx 42,872 24,966 1.72
33. Oral surgery (extractions and other surgical procedures) CDT: D7xxx 15,015 11,256 1.33
34. Rehabilitative services (Endo, Perio, Prostho, Ortho) CDT: D3xxx, D4xxx, D5xxx, D6xxx, D8xxx 25,042 15,131 1.66

Footnotes

'-' Data cannot be calculated or has been suppressed for confidentiality purposes.

Cells that are shaded blue represent data that was not reported or null values.

View Detailed UDS Footnotes

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