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POMS Section DI 28085.125

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TN 5 (02-05)

DI 28085.125 Coding Lists

A. Adult Listing Impairment Codes

Use for any condition that meets or equals part A of the listing of impairments.

Find listing is met/equaled and use code shown for that listing.

Listing

Diagnostic Category

Impairment
Code

Musculoskeletal (01)

  

1.02

Other and Unspecified Arthropathies

7160

1.03

Osteoarthrosis and Allied Disorders

7150

1.04

Disorders of Back (discogenic and degenerative)

7240

1.04B

Arachnoiditis

3210

1.05

Late Effects of Musculoskeletal and Connective Tissue Injuries (amputation)

9050

1.06

Fractures of Lower Limb

8270

1.07

Fractures of Upper Limb

8180

1.08

Open Wound of Upper Limb (Soft Tissue Injury)

8840

1.08

Open Wound of Lower Limb (Soft Tissue Injury)

8940

1.08

Burns (NOS)

9490

Special Senses and Speech (02)

  

2.02

Retinal Detachments and Defects

3610

2.02

Glaucoma

3650

2.02

Cataract

3660

2.02

Blindness and Low Vision

3690

2.03

Visual Disturbances

3680

2.04

Visual Disturbances

3680

2.07

Vertiginous Syndromes and Other Disorders of Vestibular System

3860

2.08

Deafness

3890

2.09

Loss of Voice

7840

Respiratory (03)

  

3.02

Chronic Pulmonary Insufficiency

4960

3.03

Asthma

4930

3.04

Cystic Fibrosis

2770

3.06

Pneumoconiosis

5050

3.07

Bronchiectasis

4940

3.08

Mycobacterial, Mycotic, and Other Chronic Persistent Infections of the Lung

1170

3.09

Cor Pulmonale secondary to Chronic Pulmonary Vascular Hypertension

4160

3.10

Sleep-related Breathing Disorders

7800

3.11

Lung Transplant

3250

Cardiovascular (04)

  

4.02

Chronic Heart Failure

4280

4.04

Ischemic Heart Disease

4140

4.05

Recurrent Arrhythmias

4270

4.06

Symptomatic Congenital Heart Disease

7460

4.09

Heart Transplant

3750

4.10

Aneurysm of Aorta or Major Branches

4410

4.11

Chronic Venous Insufficiency

4590

4.12

Peripheral Arterial Disease

4430

Digestive (05)

  

5.02

Gastrointestinal hemorrhaging from any cause

5780

5.05

Chronic Liver Disease

5710

5.06

Inflammatory Bowel Disease (IBD)

5550

5.07

Short Bowel Syndrome (SBS)

5793

5.08

Weight loss due to any digestive disorder

2630

5.09

Liver Transplantation

4750

Genitourinary (06)

  

6.02

Chronic Renal Failure

5850

6.06

Nephrotic Syndrome

5810

Hematological Disorders (07)

  

7.02

Other Anemias

2850

7.05

Hereditary Hemolytic Anemias (Including all Sickle Cell)

2820

7.06

Purpura and Other Hemorrhagic Conditions

2870

7.07

Disease of Capillaries (Hereditary Telangiectasia)

4480

7.08

Coagulation Defects (Including Hemophilia)

2860

7.09

Polycythemia Vera

2380

7.10

Other Diseases of Blood and Blood-Forming Organs

2890

7.15

Diseases of White Blood Cells

2880

7.17

Aplastic Anemia

2840

Skin Disorders (08)

  

8.02

Ichthyosis

6950

8.03

Bullous Disease

6940

8.04

Chronic Infection of the Skin or Mucous Membranes

1170

8.05

Dermatitis

6960

8.06

Hidradenitis Suppurativa

7050

8.07

Genetic Photosensitivity Disorders

7590

8.08

Burns

9480

Endocrine (09)

  

9.02

All Disorders of Thyroid Gland (Except Malignant Neoplasm)

2460

9.03

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2520

9.04

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2520

9.05

All Disorders of Pituitary Gland (Except Malignant Neoplasm)

2530

9.06

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2550

9.08

Diabetes Mellitus

2500

9.08A

Diabetic Neuropathy

3570

9.08B

Diabetic Acidosis

2760

9.08C

Other Retinal Disorder (Diabetic Retinopathy)

3620

Impairments That Affect Multiple Body Systems (10)

  

10.06

Non-mosaic Down Syndrome

7580

Neurological (11)

  

11.02

Epilepsy (Major Motor Seizures)

3450

11.03

Epilepsy (Minor Motor Seizures)

3450

11.04

Late Effects of Cerebrovascular Disease

4380

11.05

Benign Neoplasm of Brain and Other Parts of Nervous System

2250

11.06

Parkinson’s Disease

3320

11.07

Cerebral Palsy

3430

11.08

Other Diseases of Spinal Cord

3360

11.08

Fracture of Vertebral Column with Spinal Cord Lesion

8060

11.09

Multiple Sclerosis

3400

11.10

Anterior Horn Cell Disease (Amyotrophic Lateral Sclerosis)

3350

11.11

Late Effects of Acute Poliomyelitis

1380

11.12

Myoneural Disorders

3580

11.13

Muscular Dystrophies and Other Myopathies

3590

11.14

Peripheral Neuropathy

3570

11.16

Deficiency Anemias

2810

11.17

Other Cerebral Degenerations

3310

11.18

Late Effects of Injuries to the Nervous System

9070

11.19

Other Diseases of Spinal Cord

3360

Mental Disorders (12)

  

12.02

Organic Mental Disorders

2940

12.03

Schizophrenic, Paranoid and Other Psychotic Disorders

2950

12.04

Affective Disorders

2960

12.05

Mental Retardation

3180

12.06

Anxiety Related Disorders

3000

12.07

Somatoform Disorders

3060

12.08

Personality Disorders

3010

12.09

Substance Addiction Disorder Alcohol

3030

12.09

Substance Addiction Disorder Drug

3040

**

Borderline Intellectual Functioning

3195*

 

*Borderline intellectual functioning must not be coded as 3180 (under mental retardation.

 
 

**In the event that borderline intellectual functioning is determined to be of listing level severity, the appropriate listed impairment category on which to find equivalence must be based on consideration of all the manifestations in the particular claim.

 

Malignant Neoplastic Diseases (13)

  

13.02

Soft Tissue Tumors of Head and Neck

1950

13.03

Malignant Neoplasm of Skin

1730

13.04

Malignant Neoplasm of Connective and Other
Soft Tissue

1710

13.05

Lymphoma

2020

13.06

Leukemia

2070

13.07

Multiple Myeloma

2030

13.08

Malignant Neoplasm of Salivary Glands

1420

13.09

Malignant Neoplasm of Thyroid Gland

1930

13.10

Malignant Neoplasm of Breast

1740

13.11

Malignant Neoplasm of Skeletal System

1780

13.12

Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa

1700

13.13

Malignant Neoplasm of Nervous System

1910

13.14

Malignant Neoplasm of Trachea, Bronchus, or Lung

1620

13.15

Malignant Neoplasm of Pleura

1630

13.15

Malignant Neoplasm of Mediastinum

1640

13.16

Malignant Neoplasm of Esophagus

1500

13.16

Malignant Neoplasm of Stomach

1510

13.17

Malignant Neoplasm of Small Intestine, Including Duodenum

1520

13.18

Malignant Neoplasm of Colon, Rectum or Anus

1530

13.19

Malignant Neoplasm of Liver and Intrahepatic Bile Ducts

1550

13.19

Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts

1560

13.20

Malignant Neoplasm of Pancreas

1570

13.21

Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters

1890

13.22

Malignant Neoplasm of Bladder

1880

13.23

Malignant Neoplasm of Uterus

1790

13.23

Malignant Neoplasm of Vulva

1840

13.23

Malignant Neoplasm of Ovary and Other Uterine Adnexa

1830

13.24

Malignant Neoplasm of Prostate

1850

13.25

Malignant Neoplasm of Testis

1860

13.26

Malignant Neoplasm of Penis

1870

13.27

Malignant Neoplasm of Unspecified Site

1990

13.28

Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation

0420

Immune System Disorders (14)

  

14.02

Systemic Lupus Erythematosus

7100

14.03

Systemic Vasculitis

4460

14.04

Systemic Sclerosis (Scleroderma)

7100

14.05

Polymyositis and Dermatomyositis

7100

14.06

Undifferentiated and Mixed Connective Tissue Disease

7100

14.07

Immune Deficiency Disorders, Excluding HIV Infection

2790

14.08

Human Immunodeficiency Virus (HIV) Infection

0430

14.09

Inflammatory Arthritis

7140

14.09C

Ankylosing Spondylitis or Other Spondyloarthropathies

7200

14.10

Sjögren's Syndrome

7100

B. Childhood Listing Impairment Codes

  • Use for any condition that meets part B of the Listing of Impairments. Also, use in "equals" cases to show the impairment code for the listing being equaled.

  • Find the listing which is met/equaled and use the code shown for that listing.

Listing

Diagnostic Category

Impairment
Code

Musculoskeletal (01)

  

101.02

Other and Unspecified Arthropathies

7160

101.03

Osteoarthrosis and Allied Disorders

7150

101.04

Fracture of Vertebral Column with Spinal Cord Lesion

8060

Curvature of Spine

7370

101.05

Late Effects of Musculoskeletal and Connective Tissue Injuries (amputation)

9050

101.06

Fractures of Lower Limb

8270

101.07

Fractures of Upper Limb

8180

101.08

Open Wound of Upper Limb (Soft Tissue Injury)

8840

101.08

Open Wound of Lower Limb (Soft Tissue Injury)

8940

101.08

Burns (NOS)

9490

Special Senses (02)

  

102.02

Blindness and Low Vision

3690

102.03

Visual Disturbances

3680

102.04

Visual Disturbances

3680

102.08

Deafness

3890

Respiratory (03)

  

103.02

Chronic Pulmonary Insufficiency

4960

103.03

Asthma

4930

103.04

Cystic Fibrosis

2770

103.05

Lung Transplant

3250

Cardiovascular (04)

  

104.02

Chronic Heart Failure

4280

104.05

Recurrent Arrhythmias

4270

104.06

Congenital Heart Disease

7460

104.09

Heart Transplant

3750

104.13

Rheumatic Heart Disease

3910

Digestive (05)

  

105.02

Gastronintestinal hemorrhaging from any cause

5780

105.05

Chronic Liver Disease

5710

105.06

Inflammatory Bowel Disease

5550

105.07

Short Bowel Syndrome (SBS)

5793

105.08

Malnutrition

2630

105.09

Liver Transplantation

4750

105.10

Need for supplemental daily enteral feeding vvia a gastrostomy

5799

Genitourinary (06)

  

106.02

Chronic Renal Failure

5850

106.06

Nephrotic Syndrome

5810

106.07

Congenital Anomalies of Urinary System

7530

Hematological Disorders (07)

  

107.03

Hereditary Hemolytic Anemias

2820

107.05

Hereditary Hemolytic Anemia (Sickle Cell)

2820

107.06

Purpura and Other Hemorrhagic Conditions

2870

107.08

Coagulation Defects (Including Hemophilia)

2860

Skin Disorders (08)

  

108.02

Ichthyosis

6950

108.03

Bullous Disease

6940

108.04

Chronic Infections of the Skin or Mucous Membranes

1170

108.05

Dermatitis

6960

108.06

Hidradenitis Suppurativa

7050

108.07

Genetic Photosensitivity Disorders

7590

108.08

Burns

9480

Endocrine (09)

  

109.02

All Disorders of Thyroid Gland (Except Malignant Neoplasm)

2460

109.03

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2520

109.04

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2520

109.05

All Disorders of Pituitary Gland (Except Malignant Neoplasm)

2530

109.06

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2550

109.07

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2550

109.08

Diabetes Mellitus

2500

109.09

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2550

109.10

All Disorders of Pituitary Gland (Except Malignant Neoplasm)

2530

109.11

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2550

109.12

Hypoglycemia

2510

109.13

Chromosomal Anomalies

7580

Impairments That Affect Multiple Body Systems (10)

  

110.06

Non-mosaic Down Syndrome

7580

110.08A

Anencephalus and Catastrophic Congenital Abnormality or Disease

7400

110.08B

Cerebral Degeneration Usually Manifest in Childhood

3300

Neurological (11)

  

111.02A&B

Epilepsy (Major Motor Seizures)

3450

111.03

Epilepsy (Minor Motor Seizures)

3450

111.05

Benign Neoplasm of Brain and Other Parts of Nervous System

2250

111.06

Other Disorders of Nervous System

3490

111.07

Cerebral Palsy

3430

111.08

Spina Bifida (Meningomyelocele)

7410

111.09

Loss of Voice (Communication Impairment)

7840

Mental Disorders (12)

  

112.02

Organic Mental Disorders

2940

112.03

Schizophrenic, Delusional (Paranoid), Schizoaffective, and Other Psychotic Disorders

2950

112.04

Mood Disorders

2960

112.05

Mental Retardation

3180

112.06

Anxiety Disorders

3000

112.07

Somatoform Disorders

3060

112.07

Eating and Tic Disorders

3070

112.08

Personality Disorders

3010

112.09

Psychoactive Substance Dependence Disorders, Alcohol

3030

112.09

Psychoactive Substance Dependence Disorders, Drugs

3040

112.10

Autistic Disorders and other Pervasive Development Disorders

2990

112.11

Attention Deficit Hyperactivity Disorders

3140

112.12

Developmental and Emotional Disorders of Newborn and Younger Infants

3150

112.12

Speech and Language Delays

3153

**

*Borderline intellectual functioning must not be coded as 3180 (under mental retardation

 
 

**In the event that borderline intellectual functioning is determined to be of listing level severity, the appropriate listed impairment category on which to find medical equivalence must be based on consideration of all cognitive and/or behavioral manifestations in the particular claim.

 
 

NOTE: Listing codes are shown for some childhood mental impairments above to show listings that might be appropriate if the impairment is of listing level severity. Because there is no listing specifically for these mental impairments, they cannot meet a listing.

 

Malignant Neoplastic Diseases (13)

  

113.03

Malignant Neoplasms of Unspecified Site

1990

113.05

Lymphoma

2020

113.06

Leukemia

2070

113.09

Malignant Neoplasm of Thyroid

1930

113.12

Malignant Neoplasms of Eye

1900

113.13

Malignant Neoplasms of Nervous System

1910

113.21

Neuroblastoma

1920

Immune System Disorders (14)

  

114.02

Systemic Lupus Erythematosus

7100

114.03

Systemic Vasculitis

4460

114.04

Systemic Sclerosis (Scleroderma)

7100

114.05

Polymyositis and Dermatomyositis

7100

114.06

Undifferentiated and Mixed Connective Tissue Disease

7100

114.07

Immune Deficiency Disorders, Excluding HIV Infection

2790

114.08

Human Immunodeficiency Virus (HIV) Infection

0430

114.09

Inflammatory Arthritis

7140

114.09C

Ankylosing Spondylitis or Other Spondyloarthropathies

7200

114.10

Sjögren's Syndrome

7100

Growth Impairment (19)

  

100.02, 03

Birthweight Between 1200 and2000 Grams and small for Gestational Age

7649

100.02, 03

Birthweight Under 1200 Grams

7650

100.02

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

7830

100.03

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

7830

C. General List of Impairment Codes

  • Use the following list for any impairment that does not meet or equal a Listings of Impairments (Part A or B) or for special diagnostic situations.

  • Find the body system for the impairment, determine diagnostic category most appropriate to the impairment (including special/other), and use code shown for that category.

Impairment
Codes

Diagnostic Categories

Musculoskeletal (01)

 

7150

Osteoarthrosis and Allied Disorders

7160

Other and Unspecified Arthropathies

7240

Disorders of Back (Discogenic and Degenerative)

3210

Arachnoiditis

7280

Disorders of Muscle, Ligament and Fascia

7300

Osteomyelitis, Periostitis and Other Infections Involving Bone

7330

Other Disorders of Bone and Cartilage (Osteoporosis)

7370

Curvature of Spine

7830

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

8030

Fracture of Skull Without Intracranial Injury

8060

Fracture of Vertebral Column with Spinal Cord Lesion

8180

Fractures of Upper Limb

8270

Fractures of Lower Limb

8290

Other Fractures of Bones

8390

Dislocations--All Types

8480

Sprains and Strains--All Types

8840

Open Wound of Upper Limb (Soft Tissue Injury)

8940

Open Wound of Lower Limb (Soft Tissue Injury)

9050

Late Effects of Musculoskeletal and Connective Tissue Injuries (Amputation)

9490

Burns

Special Senses and Speech (02)

 

3610

Retinal Detachments and Defects

3620

Other Retinal Disorders (Including Diabetic Retinopathy)

3650

Glaucoma

3660

Cataract

3680

Visual Disturbances

3690

Blindness and Low Vision

3780

Strabismus and Other Disorders of Eye Movements

3860

Vertiginous Syndromes and Other Disorders of Vestibular System

3880

Other Disorders of Ear

3890

Deafness

7840

Loss of Voice

Respiratory (03)

 

0110

Pulmonary Tuberculosis

1170

Mycobacterial, Mycotic and Other Chronic Infections of the Lung

1350

Sarcoidosis

2770

Cystic Fibrosis

4160

Cor Pulmonale Secondary to Chronic Pulmonary Vascular Hypertension

4910

Chronic Bronchitis

4920

Emphysema

4930

Asthma

4940

Bronchiectasis

4960

Chronic Pulmonary Insufficiency (COPD)

5010

Asbestosis

5050

Pneumoconiosis

7800

Sleep Related Breathing Disorders

5190

Other Disorders of the Respiratory System

Cardiovascular (04)

 

0930

Cardiovascular Syphilis

3910

Rheumatic Fever with Heart Involvement

3950

Diseases of Aortic Valve

3980

Other Rheumatic Heart Disease

4010

Essential Hypertension

4020

Hypertensive Vascular Disease

4030

Hypertensive Vascular and Renal Disease

4100

Acute Myocardial Infarction

4130

Angina Pectoris Without Ischemic Heart Disease

4140

Chronic Ischemic Heart Disease With or Without Angina

4160

Chronic Pulmonary Heart Disease (Cor Pulmonale)

4240

Valvular Heart Disease or Other Stenotic Defects, or Valvular Regurgitation

4250

Cardiomyopathy

4270

Cardiac Dysrhythmias

4280

Heart Failure

4410

Aortic Aneurysm

4430

Peripheral Vascular (Arterial) Disease

4510

Phlebitis and Thrombophlebitis

4540

Varicose Veins of Lower Extremities

4590

Other Diseases of Circulatory System

7460

Congenital Anomalies of Heart

Digestive (05)

 

1360

Other Infectious and Parasitic Disorders

2630

Malnutrition (Weight Loss)

4750

Liver Transplantation

5300

Diseases of Esophagus

5330

Peptic Ulcer (Gastric or Duodenal)

5350

Gastritis and Duodenitis

5530

Hernias

5550

Inflammatory Bowel Disease (IBD)

5690

Other Disorders of Gastrointestinal System

5710

Chronic Liver Disease

5780

Gastrointestinal Hemorrhage

5793

Short Bowel Syndrome (SBS)

5799

Need for supplemental daily enteral feeding via a gastrostomy

7500

Congenital Anomalies of Upper Alimentary Tract

Genitourinary (06)

 

5810

Nephrotic Syndrome

5850

Chronic Renal Failure

5990

Other Disorders of the Urinary Tract

6080

Disorders of the Male Genital Organs

6290

Disorders of the Female Genital Organs

7530

Congenital Anomalies of Urinary System

Hematological Disorders (07)

 

2380

Polycythemia Vera

2790

Immune Deficiency Disorders, Excluding HIV Infection

2810

Deficiency Anemias

2820

Hereditary Hemolytic Anemias (Including All Sickle Cell)

2840

Aplastic Anemia

2850

Other Anemias

2860

Coagulation Defects (Including Hemophilia)

2870

Purpura and Other Hemorrhagic Conditions

2880

Diseases of White Blood Cells

2890

Other Diseases of Blood and Blood-Forming Organs

4480

Diseases of Capillaries (Hereditary Telangiectasia)

Skin Disorders (08)

 

1170

Chronic Infections of the Skin or Mucous Membranes

6940

Bullous Disease

6950

Ichthyosis

6960

Dermatitis

7050

Hidradenitis Suppurativa

7090

Other Disorders of the Skin and Subcutaneous Tissues

7590

Genetic Photosensitivity Disorders

9480

Burns

Endocrine (09)

 

2460

All Disorders of Thyroid Gland (Except Malignant Neoplasm)

2500

Diabetes Mellitus

2510

Hypoglycemia

2520

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2530

All Disorders of the Pituitary Gland (Except Malignant Neoplasm)

2550

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2760

Diabetic Acidosis

3570

Diabetic and Other Peripheral Neuropathy

3620

Other Retinal Disorder (Diabetic Retinopathy)

4430

Peripheral Vascular (Arterial) Disease

7580

Chromosomal Anomalies

Impairments That Affect Multiple Body Systems (10)

 

3300

Cerebral Degenerations Usually Manifest in Childhood

7400

Anencephalus and Catastrophic Congenital Abnormality or Disease

7580

Non-mosaic Down Syndrome

Neurological (11)

 

0940

Neurosyphilis (Tabes Dorsalis)

1380

Late Effects of Acute Poliomyelitis

2250

Benign Neoplasm of Brain and Other Parts of Nervous System

2810

Deficiency Anemias

3300

Cerebral Degenerations Usually Manifest in Childhood

3310

Other Cerebral Degenerations

3320

Parkinson"s Disease

3350

Anterior Horn Cell Disease (Including Amyotrophic Lateral Sclerosis)

3360

Other Diseases of Spinal Cord

3370

Disorders of Autonomic Nervous System

3400

Multiple Sclerosis

3430

Cerebral Palsy

3450

Epilepsy

3460

Migraine

3490

Other Disorders of the Nervous System

3540

Carpal Tunnel Syndrome

3570

Diabetic and Other Peripheral Neuropathy

3580

Myoneural Disorders

3590

Muscular Dystrophies and Other Myopathies

4380

Late Effects of Cerebrovascular Disease

7410

Spina Bifida

7840

Loss of Voice

8060

Fracture of Vertebral Column with Spinal Cord Lesion

8540

Intracranial Injury

9070

Late Effects of Injuries to the Nervous System

Mental Disorders (12)

 

2940

Organic Mental Disorders (Chronic Brain Syndrome)

2950

Schizophrenic, Paranoid and Other Functional Psychotic Disorders

2960

Affective Disorders

2990

Autism and Other Pervasive Developmental Disorders

3000

Anxiety Related Disorders

3010

Personality Disorders

3030

Substance Addiction Disorders (Alcohol)

3040

Substance Addiction Disorders (Drug)

3060

Somatoform Disorders

3070

Eating and Tic Disorders

3140

Attention Deficit Hyperactivity Disorders

3150

Development and Emotional Disorders of Newborns and Younger Infants

3152

Learning Disorder

3153

Speech and Language Delays

3180

Mental Retardation

3195

Borderline Intellectual Functioning

 

*Borderline intellectual functioning must not be coded as 3180 (under mental retardation)

Malignant Neoplastic Diseases (13)

 

0420

Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation

1410

Malignant Neoplasm of Tongue

1420

Malignant Neoplasm of Salivary Glands

1500

Malignant Neoplasm of Esophagus

1510

Malignant Neoplasm of Stomach

1520

Malignant Neoplasm of Small Intestine, Including Duodenum

1530

Malignant Neoplasm of Colon, Rectum or Anus

1550

Malignant Neoplasm of Liver and Intrahepatic Bile Ducts

1560

Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts

1570

Malignant Neoplasm of Pancreas

1590

Malignant Neoplasm of Other and Ill-Defined Sites Within the Digestive Organs and Peritoneum (Abdomen)

1620

Malignant Neoplasm of Trachea, Bronchus, or Lung

1630

Malignant Neoplasm of Pleura

1640

Malignant Neoplasm of Mediastinum

1700

Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa

1710

Malignant Neoplasm of Connective and Other Soft Tissue

1720

Malignant Melanoma of Skin

1730

Malignant Neoplasms of Skin

1740

Malignant Neoplasm of Breast

1780

Malignant Neoplasm of Skeletal System

1790

Malignant Neoplasm of Uterus

1830

Malignant Neoplasm of Ovary and Other Uterine Adnexa

1840

Malignant Neoplasm of Vulva

1850

Malignant Neoplasm of Prostate

1860

Malignant Neoplasm of Testis

1870

Malignant Neoplasm of Penis

1880

Malignant Neoplasm of Bladder

1890

Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters

1900

Malignant Neoplasm of Eye

1910

Malignant Neoplasm of Nervous System

1920

Neuroblastoma

1930

Malignant Neoplasm of Thyroid Gland

1940

Malignant Neoplasm of Other Endocrine Glands and Related Structures

1950

Soft Tissue Tumors of Head and Neck

1980

Secondary Malignant Neoplasms (Metastatic Neoplasms of Distant Sites Other Than Regional Lymph Nodes)

1990

Malignant Neoplasms of Unspecified Site

2020

Lymphoma

2030

Multiple Myeloma

2070

Leukemia

2390

Neoplasm of Unspecified or Unknown Nature

2730

Macroglobulinemia or Heavy Chain Disease

Immune System Disorders (14)

 

2790

Immune Deficiency Disorders, Excluding HIV Infection

4460

Periarteritis Nodosa and Allied Conditions (Systemic Vasculitis)

7100

Diffuse Diseases of Connective Tissue (including Systemic Lupus Erythematosus, Systemic Sclerosis (Scleroderma), Polymyositis and Dermatomyositis, Undifferentiated and Mixed Connective Tissue Disease, Sjögren's Syndrome)

0430

Symptomatic Human Immunodeficiency Virus (HIV) Infection

0440

Asymptomatic Human Immunodeficiency Virus (HIV) Infection

2740

Gout

7140

Inflammatory Arthritis

7200

Ankylosing Spondylitis or Other Spondyloarthropathies

Growth Impairment (19)

 

7649

Birthweight Between 1200 and2000 Grams and Small For Gestational Age

7650

Birthweight Under 1200 Grams

7830

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

Special/Other (20)

 

0000

None Established (No Medical Evidence in File)

6490

None Established (Medical Evidence in File But Insufficient to Establish Diagnosis)

2480

Diagnosis Established--No Predetermined List Code of Medical Nature Applicable

2780

Obesity

7590

Other Congenital Anomalies

8690

Internal Injury

89790

Other Open Wounds, Except Limbs

9339

Chronic Fatigue Syndrome (CFS)

D. List of Symptomatic HIV Infection

Whenever symptomatic HIV (code 0430) is used as the primary diagnosis, the secondary diagnosis should be the manifestation of HIV. Select the most appropriate code from the following list as the secondary diagnosis code. If the manifestation of HIV is not included in this list select the most appropriate code from the preceding General list of Impairment Codes.

Diagnosis (Secondary)

Impairment Code

Anemia

2850

Aspergillosis

1170

Bacterial infections, multiple or current

0410

Bone infection

7300

Brain atrophy

3310

Candidiasis

1120

Carcinoma of the Cervix

1800

Cardiomyopathy

4250

Coccidioidomycosis

1140

Condyloma caused by the human papillomavirus

0780

Cryptococcosis

1170

Cryptosporidiosis

0070

Cytomegalovirus Disease

0780

Diarrhea

5580

Eczema

6920

Endocarditis

4240

Genital ulcerative disease, female

6290

Genital ulcerative disease, male

6080

Granulocytopenia

2880

Growth disturbance

7830

Hepatitis

5730

Herpes Simple

0540

Herpes Zoster

0530

Histoplasmosis

1150

HIV encephalopathy

3480

HIV wasting syndrome

2630

Impaired brain growth

7420

Isosporiasis

0070

Joint Infection

7110

Kaposi’s Sarcoma

1760

Leukoencephalopathy

0460

Lymphoid interstital pneumonia (LIP)

5160

Lymphoma

2000

Meningitis

3220

Microcephaly

7420

Microsporidiosis

1360

Mucormycosis

1170

Mycobacterium infection avium intracellulare, caused by M. Kansasii, or M. tuberculosis (except pulmonary tuberculosis)

0310

Nephropathy

5830

Neurological conditions

3490

Neurosyphilis

0940

Nocardiosis

0390

Pancreatitis

5770

Pelvic inflammatory disease

6140

Peripheral neuropathy

3560

Pneumocystis Pneumonia (PCP)

1360

Pneumocystis Infection, extra pulmonary

1360

Pneumonia (non-PCP)

4860

Psoriasis

6960

Pulmonary lymphoid hyperplasia (PLH)

2850

Pulmonary tuberculosis

0110

Salmonella Bacteremia

0030

Sepsis

0380

Septic Arthritis

7110

Sinusitis

4730

Squamous Cell Carcinoma of the Anal Canal or Anal Margin

1540

Strongyloidiasis

1270

Syphilis

0970

Thrombocytopenia

2870

Toxoplasmosis

1300

Vulvovaginal candida

1120

E. Impairment Codes In Numeric Sequence

See DI 28086.021 and DI 28086.022.

Impairment
Codes

Body System

Diagnostic Categories

0000

20

None Established (No Medical Evidence in File)

0030

14

Salmonella Bacteremia (Secondary Diagnosis for HIV-0430)

0070

14

Cryptosporidiosis (Secondary Diagnosis for HIV-0430)

 

14

Isosporiasis (Secondary Diagnosis for HIV-0430)

0110

03

Pulmonary Tuberculosis

0310

14

Mycobacterium infection avium intracellulare, caused by M. Kansasii, or M. tuberculosis (except pulmonary tuberculosis) (Secondary Diagnosis for HIV-0430)

0380

14

Sepsis (Secondary Diagnosis for HIV-0430)

0390

14

Nocardiosis (Secondary Diagnosis for HIV-0430)

0410

14

Bacterial Infections, Multiple or Recurrent (Secondary Diagnosis for HIV-0430)

0420

13

Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation

0430

14

Symptomatic Human Immunodeficiency Virus (HIV) Infection

0440

14

Asymptomatic Human Immunodeficiency Virus (HIV) Infection

0460

14

Leukoencephalopathy (Secondary Diagnosis for HIV-0430)

0530

14

Herpes Zoster (Secondary Diagnosis for HIV-0430)

0540

14

Herpes Simplex (Secondary Diagnosis for HIV-0430)

0780

14

Condyloma Caused by the Human Papillomavirus (Secondary Diagnosis for HIV-0430)

 

14

Cytomegalovirus Disease (Secondary Diagnosis for HIV-0430)

0930

04

Cardiovascular Syphilis

0940

11

Neurosyphilis (Tabes Dorsalis)

0940

14

Neurosyphilis (Secondary Diagnosis for HIV-0430)

0970

14

Syphilis (Secondary Diagnosis for HIV-0430)

1120

14

Candidiasis (Secondary Diagnosis for HIV-0430)

 

14

Vulvovaginal Candida (Secondary Diagnosis for HIV-0430)

1140

14

Coccidiodomycosis (Secondary Diagnosis for HIV-0430)

1150

14

Histoplasmosis (Secondary Diagnosis for HIV-0430)

1170

03

Mycobacterial, Mycotic and Other Chronic Infections of the Lung

 

08

Chronic Infections of the Skin or Mucous Membranes

 

14

Aspergillosis (Secondary Diagnosis for HIV-0430)

 

14

Cryptococcosis (Secondary Diagnosis for HIV-0430)

 

14

Mucormycosis (Secondary Diagnosis for HIV-0430)

1270

14

Strongyloidiasis (Secondary Diagnosis for HIV-0430)

1300

14

Toxoplasmosis (Secondary Diagnosis for HIV-0430)

1350

03

Sarcoidosis

1360

05

Other Infectious and Parasitic Disorders

 

14

Microsporidiosis (Secondary Diagnosis for HIV-0430)

 

14

Pneumocystis Infection, extra-pulmonary (Secondary Diagnosis for HIV-0430)

 

14

Pneumocystis Pneumonia (PCP) (Secondary Diagnosis for HIV-0430)

1380

11

Late Effects of Acute Poliomyelitis

1410

13

Malignant Neoplasm of Tongue

1420

13

Malignant Neoplasm of Salivary Glands

1500

13

Malignant Neoplasm of Esophagus

1510

13

Malignant Neoplasm of Stomach

1520

13

Malignant Neoplasm of Small Intestine, Including Duodenum

1530

13

Malignant Neoplasm of Colon, Rectum or Anus

1540

14

Squamous Cell Carcinoma of the Anal Canal or Anal Margin (Secondary Diagnosis for HIV-0430)

1550

13

Malignant Neoplasm of Liver and Intrahepatic Bile Ducts

1560

13

Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts

1570

13

Malignant Neoplasm of Pancreas

1590

13

Malignant Neoplasm of Other and Ill-Defined Sites Within the Digestive Organs and Peritoneum (Abdomen)

1620

13

Malignant Neoplasm of Trachea, Bronchus, or Lung

1630

13

Malignant Neoplasm of Pleura

1640

13

Malignant Neoplasm of Mediastinum

1700

13

Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa

1710

13

Malignant Neoplasm of Connective and Other Soft Tissue

1720

13

Malignant Melanoma of Skin

1730

13

Malignant Neoplasm of Skin

1740

13

Malignant Neoplasm of Breast

1760

14

Kaposi’s Sarcoma (Secondary Diagnosis for HIV-0430)

1780

13

Malignant Neoplasm of Skeletal System

1790

13

Malignant Neoplasm of Uterus

1800

14

Carcinoma of the Cervix (Secondary Diagnosis for HIV-0430)

1830

13

Malignant Neoplasm of Ovary and Other Uterine Adnexa

1840

13

Malignant Neoplasm of Vulva

1850

13

Malignant Neoplasm of Prostate

1860

13

Malignant Neoplasm of Testis

1870

13

Malignant Neoplasm of Penis

1880

13

Malignant Neoplasm of Bladder

1890

13

Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters

1900

13

Malignant Neoplasm of Eye

1910

13

Malignant Neoplasm of Nervous System

1920

13

Neuroblastoma

1930

13

Malignant Neoplasm of Thyroid Gland

1940

13

Malignant Neoplasm of Other Endocrine Glands and Related Structures

1950

13

Soft Tissue Tumors of Head and Neck

1980

13

Secondary Malignant Neoplasms (Metastatic Neoplasms of Distant Sites Other Than Regional Lymph Nodes)

1990

13

Malignant Neoplasm of Unspecified Site

2000

14

Lymphoma (Secondary Diagnosis for HIV-0430)

2020

13

Lymphoma

2030

13

Multiple Myeloma

2070

13

Leukemia

2250

11

Benign Neoplasm of Brain and Other Parts of Nervous System

2380

07

Neoplasm of Uncertain Behavior of Other Sites and Tissues (Polycythemia Vera)

2390

13

Neoplasm of Unspecified or Unknown Nature

2460

09

All Disorders of Thyroid Gland (Except Malignant Neoplasm)

2480

20

Diagnosis Established--No Predetermined List Code of Medical Nature Applicable

2500

09

Diabetes Mellitus

2510

09

Hypoglycemia

2520

09

All Disorders of Parathyroid Gland (Except Malignant Neoplasm)

2530

09

All Disorders of the Pituitary Gland (Except Malignant Neoplasm)

2550

09

All Disorders of Adrenal Glands (Except Malignant Neoplasm)

2630

05

Malnutrition (Weight Loss)

 

14

HIV Wasting Syndrome (Secondary Diagnosis for HIV-0430)

2720

04

Hyperlipidemia

2730

13

Macroglobulinemia or Heavy Chain Disease

2740

14

Gout

2760

09

Diabetic Acidosis

2770

03

Cystic Fibrosis

2780

20

Obesity

2790

07

Immune Deficiency Disorders, Excluding HIV Infection

2790

14

Immune Deficiency Disorders, Excluding HIV Infection

2810

07

Deficiency Anemias

 

11

Deficiency Anemias (such as Pernicious Anemia)

2820

07

Hereditary Hemolytic Anemias (Including All Sickle Cell)

2840

07

Aplastic Anemia

2850

07

Other Anemias

2850

14

Anemia (Secondary Diagnosis for HIV-0430)

 

14

Pulmonary Lymphoid Hyperplasia (PLH) (Secondary Diagnosis for HIV-0430)

2860

07

Coagulation Defects (Including Hemophilia)

2870

07

Purpura and Other Hemorrhagic Conditions

 

14

Thrombocytopenia (Secondary Diagnosis for HIV-0430)

2880

07

Diseases of White Blood Cells

 

14

Granulocytopenia (Secondary Diagnosis for HIV-0430)

2890

07

Other Diseases of Blood and Blood-Forming Organs

2940

12

Organic Mental Disorders (Chronic Brain Syndrome)

2950

12

Schizophrenic, Paranoid and Other Functional Psychotic Disorders

2960

12

Affective/Mood Disorders

2990

12

Autism and Other Pervasive Developmental Disorders

3000

12

Anxiety Disorders

3010

12

Personality Disorders

3030

12

Substance Addiction/Dependence Disorders (Alcohol)

3040

12

Substance Addiction/Dependence Disorders (Drug)

3060

12

Somatoform Disorders

3070

12

Eating and Tic Disorders

3120

12

Conduct Disorder

3138

12

Oppositional/Defiant Disorder

3140

12

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

3150

12

Development and Emotional Disorders of Newborns and Younger Infants

3152

12

Learning Disorder

3153

12

Speech and Language Delays

3180

12

Mental Retardation

3195

12

Borderline Intellectual Functioning *

*Borderline intellectual functioning must not be coded as 3180 (under mental retardation)

3210

01

Arachnoiditis

3220

14

Meningitis (Secondary Diagnosis for HIV-0430)

3250

03

Lung Transplant

3300

10

Cerebral Degenerations Usually Manifest in Childhood

 

11

Cerebral Degenerations Usually Manifest in Childhood

3310

11

Other Cerebral Degenerations

 

14

Brain Atrophy (Secondary Diagnosis for HIV-0430)

3320

11

Parkinson’s Disease

3350

11

Anterior Horn Cell Disease (Including Amyotrophic Lateral Sclerosis)

3360

11

Other Diseases of Spinal Cord

3370

11

Disorders of Autonomic Nervous System

3400

11

Multiple Sclerosis

3430

11

Cerebral Palsy

3450

11

Epilepsy

3460

11

Migraine

3480

14

HIV Encephalopathy (Secondary Diagnosis for HIV-0430)

3490

11

Other Disorders of the Nervous System

 

14

Neurological Conditions (Secondary Diagnosis for HIV-0430)

3540

11

Carpal Tunnel Syndrome

3560

14

Peripheral Neuropathy (Secondary Diagnosis for HIV-0430)

3570

09

Diabetic Neuropathy

 

11

Peripheral Neuropathy

3580

11

Myoneural Disorders

3590

11

Muscular Dystrophies and Other Myopathies

3610

02

Retinal Detachments and Defects

3620

02

Other Retinal Disorders (Including Diabetic Retinopathy)

 

09

Other Retinal Disorders (Diabetic Retinopathy)

3650

02

Glaucoma

3660

02

Cataract

3680

02

Visual Disturbances

3690

02

Blindness and Low Vision

3750

04

Cardiac Transplantation

3780

02

Strabismus and Other Disorders of Eye Movements

3860

02

Vertiginous Syndromes and Other Disorders of Vestibular System

3880

02

Other Disorders of Ear

3890

02

Deafness

3910

04

Rheumatic Fever with Heart Involvement

3950

04

Diseases of Aortic Valve

3980

04

Other Rheumatic Heart Disease

4010

04

Essential Hypertension

4020

04

Hypertensive Cardiovascular Disease

4030

04

Hypertensive Vascular and Renal Disease

4100

04

Acute Myocardial Infarction

4130

04

Angina Pectoris Without Ischemic Heart Disease

4140

04

Chronic Ischemic Heart Disease With or Without Angina

4160

03

Cor Pulmonale Secondary to Chronic Pulmonary Vascular Hypertension

 

04

Chronic Pulmonary Heart Disease (Cor Pulmonale)

4240

04

Valvular Heart Disease or Other Stenotic Defects or Valvular Regurgitation

 

14

Endocarditis (Secondary Diagnosis for HIV-0430)

4250

04

Cardiomyopathy

4270

04

Cardiac Dysrhythmias (Arrhythmias)

4280

04

Heart Failure

4380

11

Late Effects of Cerebrovascular Disease

4410

04

Aneurysm of Aorta or Major Branches

4430

04

Peripheral Vascular (Arterial) Disease

4460

04

Kawasaki Syndrome

 

14

Periarteritis Nodosa and Allied Conditions (Systemic Vasculitis)

4480

07

Diseases of Capillaries (Hereditary Telangiectasia)

4510

04

Phlebitis and Thrombophlebitis

4540

04

Varicose Veins of Lower Extremities

4590

04

Other Diseases of Circulatory System (Venous Insufficiency)

4730

14

Sinusitis (Secondary Diagnosis for HIV-0430)

4750

05

Liver Transplant

4860

14

Pneumonia (non-PCP) (Secondary Diagnosis for HIV-0430)

4910

03

Chronic Bronchitis

4920

03

Emphysema

4930

03

Asthma

4940

03

Bronchiectasis

4960

03

Chronic Pulmonary Insufficiency (COPD)

5010

03

Asbestosis

5050

03

Pneumoconiosis

5160

14

Lymphoid Interstitial Pneumonia (LIP) (Secondary Diagnosis for HIV-0430)

5190

03

Other Disorders of the Respiratory System

5300

05

Diseases of Esophagus

5330

05

Peptic Ulcer (Gastric or Duodenal)

5350

05

Gastritis and Duodenitis

5530

05

Hernias

5550

05

Inflammatory bowel disease (IBD)

5580

14

Diarrhea (Secondary Diagnosis for HIV-0430)

5690

05

Other Disorders of Gastrointestinal System

5710

05

Chronic liver disease

5730

14

Hepatitis (Secondary Diagnosis for HIV-0430)

5770

14

Pancreatitis (Secondary Diagnosis for HIV-0430)

5780

05

Gastrointestinal hemorrhaging from any cause

5793

05

Short bowel syndrome (SBS)

5799

05

Need for supplemental daily enteral feeding via a gastrostomy

5810

06

Nephrotic Syndrome

5830

14

Nephropathy (Secondary Diagnosis for HIV-0430)

5850

06

Chronic Renal Failure

5990

06

Other Disorders of the Urinary Tract

6080

06

Disorders of the Male Genital Organs

 

14

Genital Ulcerative Disease, Male (Secondary Diagnosis for HIV-0430)

6140

14

Pelvic Inflammatory Disease (Secondary Diagnosis for HIV-0430)

6290

06

Disorders of the Female Genital Organs

 

14

Genital Ulcerative Disease, Female (Secondary Diagnosis for HIV-0430)

6490

20

None Established (Medical Evidence in File But Insufficient to Establish Diagnosis)

6920

14

Eczema (Secondary Diagnosis for HIV-0430)

6940

08

Bullous Disease

6950

08

Ichthyosis

6960

08

Dermatitis

 

14

Psoriasis (Secondary Diagnosis for HIV-0430)

7050

08

Hidradenitis Suppurativa

7090

08

Other Disorders of the Skin and Subcutaneous Tissues

7100

14

Diffuse Diseases of Connective Tissue (including Systemic Lupus Erythematosus, Systemic Sclerosis (Scleroderma), Polymyositis and Dermatomyositis, Undifferentiated and Mixed Connective Tissue Disease, Sjögren's Syndrome)

7110

14

Joint Infection (Secondary Diagnosis for HIV-0430)

7110

14

Septic Arthritis (Secondary Diagnosis for HIV-0430)

7140

14

Inflammatory Arthritis

7150

01

Osteoarthrosis and Allied Disorders

7160

01

Other and Unspecified Arthropathies

7200

14

Ankylosing Spondylitis or Other Spondyloarthropathies

7240

01

Disorders of Back (Discogenic and Degenerative)

7280

01

Disorders of Muscle, Ligament and Fascia

7300

01

Osteomyelitis, Periostitis and Other Infections Involving Bone

7300

14

Bone Infection (Secondary Diagnosis for HIV-0430)

7330

01

Other Disorders of Bone and Cartilage (Osteoporosis)

7370

01

Curvature of Spine

7400

10

Anencephalus and Catastrophic Congenital Abnormality or Disease

7410

11

Spina Bifida (Meningomyelocele)

7420

14

Impaired Brain Growth (Secondary Diagnosis for HIV-0430)

 

14

Microcephaly (Secondary Diagnosis for HIV-0430)

7460

04

Congenital Heart Disease

7500

05

Congenital Anomalies of Upper Alimentary Tract

7530

06

Congenital Anomalies of Urinary System

7580

09

Chromosomal Anomalies (Turner’s Syndrome)

 

10

Non-mosaic Down Syndrome

7590

08

Genetic Photosensitivity Disorders

 

20

Other Congenital Anomalies

7600

10

Multiple Body Dysfunction

7649

19

Birthweight Between1200 and2000 Grams and Small For Gestational Age

7650

19

Birthweight Under1200 Grams

7800

03

Sleep-Related Breathing Disorders

7830

01

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

 

14

Growth Disturbance (Secondary Diagnosis for HIV-0430)

 

19

Malnutrition, Marasmus, Failure to Thrive (Growth Impairment)

78840

02

Loss of Voice

 

11

Loss of Voice

8030

01

Fracture of Skull Without Intracranial Injury

8060

01

Fracture of Vertebral Column with Spinal Cord Lesion

 

11

Fracture of Vertebral Column with Spinal Cord Lesion

8180

01

Fractures of Upper Limb

8270

01

Fractures of Lower Limb

8290

01

Other Fractures of Bones

8390

01

Dislocations--All Types

8480

01

Sprains and Strains--All Types

8540

11

Intracranial Injury

8690

20

Internal Injury

8790

20

Other Open Wounds, Except Limbs

8840

01

Open Wound of Upper Limb (Soft Tissue Injury)

8940

01

Open Wound of Lower Limb (Soft Tissue Injury)

9050

01

Late Effects of Musculoskeletal and Connective Tissue Injuries (Amputation)

9070

11

Late Effects of Injuries to the Nervous System

9330

20

Chronic Fatigue Syndrome (CFS)

9480

08

Burns

9490

01

Burns (NOS)




To Link to this section - Use this URL:
http:/policy.ssa.gov/poms.nsf/links/0428085125

DI 28085.125 - Coding Lists - 10/22/2008