2022 ICD-10-CM Code Placement on the Prioritized List of ... - Oregon

2022 ICD-10-CM Code Placement on the Prioritized List of Health Services - Health Evidence Review

Commission

ICD10 Code

A79.82

Code Description

Anaplasmosis [A. phagocytophilum]

C56.3

Malignant neoplasm of bilateral

ovaries

Secondary malignant neoplasm of

bilateral ovaries

Anaplastic large cell lymphoma, ALKnegative, brea

C79.63

C84.7A

Recommended Placement

268 RICKETTSIAL AND OTHER

ARTHROPOD-BORNE DISEASES

238 CANCER OF OVARY

238 CANCER OF OVARY

158 NON-HODGKIN'S LYMPHOMAS

Treatment: MEDICAL THERAPY

163 NON-HODGKIN'S LYMPHOMAS

Treatment: BONE MARROW

TRANSPLANT

194 HEREDITARY ANEMIAS,

HEMOGLOBINOPATHIES, AND

DISORDERS OF THE SPLEEN

194 HEREDITARY ANEMIAS,

HEMOGLOBINOPATHIES, AND

DISORDERS OF THE SPLEEN

653 CARDIOVASCULAR CONDITIONS

WITH NO OR MINIMALLY EFFECTIVE

TREATMENTS OR NO TREATMENT

NECESSARY

D55.21

Anemia due to pyruvate kinase

deficiency

D55.29

Anemia due to other disorders of

glycolytic enzyme

D75.838

Other thrombocytosis

D75.839

Thrombocytosis, unspecified

653 CARDIOVASCULAR CONDITIONS

WITH NO OR MINIMALLY EFFECTIVE

TREATMENTS OR NO TREATMENT

NECESSARY

D89.44

Hereditary alpha tryptasemia

652 ENDOCRINE AND METABOLIC

CONDITIONS WITH NO OR MINIMALLY

EFFECTIVE TREATMENTS OR NO

TREATMENT NECESSARY

E75.244

Niemann-Pick disease type A/B

F32.A

Depression, unspecified

60 METABOLIC DISORDERS

99 END STAGE RENAL DISEASE

71,292,345,377 Dysfunction lines

203 DEPRESSION AND OTHER MOOD

DISORDERS, MILD OR MODERATE

F78.A1

SYNGAP1-related intellectual disability 71,292,345,377 Dysfunction lines

F78.A9

Other genetic related intellectual

disability

Acute flaccid myelitis

G04.82

Page 1 of 11

71,292,345,377 Dysfunction lines

71,292,345,377 Dysfunction lines

535 VIRAL, SELF-LIMITING

ENCEPHALITIS, MYELITIS AND

ENCEPHALOMYELITIS

2022 ICD-10-CM Code Placement on the Prioritized List of Health Services - Health Evidence Review

Commission

ICD10 Code

G44.86

G92.00

G92.01

Code Description

Cervicogenic headache

Immune effector cell-associated

neurotoxicity syndrome, grade

unspecified

Immune effector cell-associated

neurotoxicity syndrome, grade 1

Recommended Placement

540 TENSION HEADACHE

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

313 DISORDERS INVOLVING THE

IMMUNE SYSTEM

71,292,345,377 Dysfunction lines

71,292,345,377 Dysfunction lines

71,292,345,377 Dysfunction lines

G92.02

Immune effector cell-associated

neurotoxicity syndrome, grade 2

G92.03

Immune effector cell-associated

neurotoxicity syndrome, grade 3

G92.04

Immune effector cell-associated

neurotoxicity syndrome, grade 4

G92.05

Immune effector cell-associated

neurotoxicity syndrome, grade 5

G92.8

G92.9

Other toxic encephalopathy

Unspecified toxic encephalopathy

I5A

Non-ischemic myocardial injury (non- INFORMATIONAL DIAGNOSES

traumatic)

Esophageal polyp

638 BENIGN NEOPLASMS OF DIGESTIVE

SYSTEM

Esophagogastric junction polyp

638 BENIGN NEOPLASMS OF DIGESTIVE

SYSTEM

Other specified disease of esophagus 56 ULCERS, GASTRITIS, DUODENITIS,

AND GI HEMORRHAGE

K22.81

K22.82

K22.89

K31.A0

Gastric intestinal metaplasia,

unspecified

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A11

Gastric intestinal metaplasia without

dysplasia, involving the antrum

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A12

Gastric intestinal metaplasia without 528 DISORDERS OF FUNCTION OF

dysplasia, involving the body (corpus) STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

Page 2 of 11

2022 ICD-10-CM Code Placement on the Prioritized List of Health Services - Health Evidence Review

Commission

ICD10 Code

K31.A13

Code Description

Gastric intestinal metaplasia without

dysplasia, involving the fundus

Recommended Placement

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A14

Gastric intestinal metaplasia without

dysplasia, involving the cardia

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A15

Gastric intestinal metaplasia without

dysplasia, involving multiple sites

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A19

Gastric intestinal metaplasia without

dysplasia, unspecified site

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A21

Gastric intestinal metaplasia with low 528 DISORDERS OF FUNCTION OF

grade dysplasia

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A22

Gastric intestinal metaplasia with high 528 DISORDERS OF FUNCTION OF

grade dysplasia

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

K31.A29

Gastric intestinal metaplasia with

dysplasia, unspecified

528 DISORDERS OF FUNCTION OF

STOMACH AND OTHER FUNCTIONAL

DIGESTIVE DISORDERS

L24.A0

Irritant contact dermatitis due to

friction or contact with body fluids,

unspecified

Irritant contact dermatitis due to

saliva

455 URINARY INCONTINENCE

L24.A2

Irritant contact dermatitis due to

fecal, urinary or dual incontinence

455 URINARY INCONTINENCE

L24.A9

Irritant contact dermatitis due friction 455 URINARY INCONTINENCE

or contact with other specified body

fluids

L24.A1

Page 3 of 11

71 EUROLOGICAL DYSFUNCTION IN

BREATHING, EATING, SWALLOWING,

BOWEL, OR BLADDER CONTROL

CAUSED BY CHRONIC CONDITIONS;

ATTENTION TO OSTOMIES

2022 ICD-10-CM Code Placement on the Prioritized List of Health Services - Health Evidence Review

Commission

ICD10 Code

L24.B0

Code Description

Irritant contact dermatitis related to

unspecified stoma or fistula

Recommended Placement

71 EUROLOGICAL DYSFUNCTION IN

BREATHING, EATING, SWALLOWING,

BOWEL, OR BLADDER CONTROL

CAUSED BY CHRONIC CONDITIONS;

ATTENTION TO OSTOMIES

L24.B1

Irritant contact dermatitis related to

digestive stoma or fistula

71 EUROLOGICAL DYSFUNCTION IN

BREATHING, EATING, SWALLOWING,

BOWEL, OR BLADDER CONTROL

CAUSED BY CHRONIC CONDITIONS;

ATTENTION TO OSTOMIES

L24.B2

Irritant contact dermatitis related to

respiratory stoma or fistula

71 EUROLOGICAL DYSFUNCTION IN

BREATHING, EATING, SWALLOWING,

BOWEL, OR BLADDER CONTROL

CAUSED BY CHRONIC CONDITIONS;

ATTENTION TO OSTOMIES

L24.B3

Irritant contact dermatitis related to

fecal or urinary stoma or fistula

71 EUROLOGICAL DYSFUNCTION IN

BREATHING, EATING, SWALLOWING,

BOWEL, OR BLADDER CONTROL

CAUSED BY CHRONIC CONDITIONS;

ATTENTION TO OSTOMIES

M31.10

M31.11

Thrombotic microangiopathy,

unspecified

Hematopoietic stem cell

transplantation-associated thrombotic

microangiopathy [HSCT-TMA]

175 POLYARTERITIS NODOSA AND

ALLIED CONDITIONS

285 COMPLICATIONS OF A PROCEDURE

ALWAYS REQUIRING TREATMENT

M31.19

Other thrombotic microangiopathy

M35.05

M35.06

M35.07

M35.08

175 POLYARTERITIS NODOSA AND

ALLIED CONDITIONS

Sjogren syndrome with inflammatory 330 SYSTEMIC SCLEROSIS; SJOGREN'S

arthritis

SYNDROME

Sjogren syndrome with peripheral

330 SYSTEMIC SCLEROSIS; SJOGREN'S

nervous system involvement

SYNDROME

Sjogren syndrome with central

nervous system involvement

Sjogren syndrome with

gastrointestinal involvement

Page 4 of 11

330 SYSTEMIC SCLEROSIS; SJOGREN'S

SYNDROME

330 SYSTEMIC SCLEROSIS; SJOGREN'S

SYNDROME

2022 ICD-10-CM Code Placement on the Prioritized List of Health Services - Health Evidence Review

Commission

ICD10 Code

M35.0A

Code Description

Sjogren syndrome with glomerular

disease

M35.0B

Sjogren syndrome with vasculitis

M35.0C

Sjogren syndrome with dental

involvement

M45.A0

Non-radiographic axial

spondyloarthritis of unspecified sites

in spine

M45.A1

Non-radiographic axial

spondyloarthritis of occipito-atlantoaxial region

M45.A2

Non-radiographic axial

spondyloarthritis of cervical region

M45.A3

Non-radiographic axial

spondyloarthritis of cervicothoracic

region

M45.A4

Non-radiographic axial

spondyloarthritis of thoracic region

M45.A5

Non-radiographic axial

spondyloarthritis of thoracolumbar

region

Page 5 of 11

Recommended Placement

59 END STAGE RENAL DISEASE

Treatment MEDICAL THERAPY

INCLUDING DIALYSIS

99 END STAGE RENAL DISEASE

Treatment RENAL TRANSPLANT

330 SYSTEMIC SCLEROSIS; SJOGREN'S

SYNDROME

330 SYSTEMIC SCLEROSIS; SJOGREN'S

SYNDROME

53 PREVENTIVE DENTAL SERVICES

330 SYSTEMIC SCLEROSIS; SJOGREN'S

SYNDROME

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

402 CONDITIONS OF THE BACK AND

SPINE

529 CONDITIONS OF THE BACK AND

SPINE WITHOUT URGENT SURGICAL

INDICATIONS

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