PhilHealth Circular No. 0035, s.2013 Annex 1 List of Medical Case Rates

ANNEX 1.
LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE

P91.3 P91.4 P91.6 P91.8 P91.9 J36
DESCRIPTION
Neonatal cerebral irritability Neonatal cerebral depression Hypoxic ischemic encephalopathy of newborn
GROUP
ABNORMAL SENSORIUM IN THE NEWBORN ABNORMAL SENSORIUM IN THE NEWBORN ABNORMAL SENSORIUM IN THE NEWBORN
Case Rate 12,000 12,000 12,000 12,000 12,000 10,000
Professional Fee 3,600 3,600 3,600 3,600 3,600 3,000
Health Care Institution Fee 8,400 8,400 8,400 8,400 8,400 7,000
Other specified disturbances of cerebral status of newborn ABNORMAL SENSORIUM IN THE NEWBORN Disturbance of cerebral status of newborn, unspecified Peritonsillar abscess; Abscess of tonsil; Peritonsillar cellulitis; Quinsy Other diseases of larynx; Abscess of larynx; Cellulitis of larynx; Disease NOS of larynx; Necrosis of larynx; Pachyderma of larynx; Perichondritis of larynx; Ulcer of larynx Retropharyngeal and parapharyngeal abscess; Peripharyngeal abscess Other abscess of pharynx; Cellulitis of pharynx; Nasopharyngeal abscess Other diseases of pharynx; Cyst of pharynx or nasopharynx; Oedema of pharynx or nasopharynx Abscess of lung with pneumonia Abscess of lung without pneumonia; Abscess of lung NOS Abscess of mediastinum Pyothorax with fistula Pyothorax without fistula; Abscess of pleura; Abscess of thorax; Empyema; Pyopneumothorax Cholera due to Vibrio cholerae 01, biovar cholerae Cholera due to Vibrio cholerae 01, biovar eltor Cholera, unspecified Shigellosis due to Shigella dysenteriae; Group A shigellosis [Shiga-Kruse dysentery] Shigellosis due to Shigella flexneri;Group B shigellosis Shigellosis due to Shigella boydii; Group C shigellosis Shigellosis due to Shigella sonnei; Group D shigellosis Other shigellosis Shigellosis, unspecified; ; Bacillary dysentery NOS Enteropathogenic Escherichia coli infection Enterotoxigenic Escherichia coli infection Enteroinvasive Escherichia coli infection Enterohaemorrhagic Escherichia coli infection Other intestinal Escherichia coli infections Campylobacter enteritis Enteritis due to Yersinia enterocolitica Enterocolitis due to Clostridium difficile; Foodborne intoxication by Clostridium difficile; Pseudomembranous colitis Other specified bacterial intestinal infections Bacterial intestinal infection, unspecified. Bacterial enteritis NOS Foodborne staphylococcal intoxication Foodborne Clostridium perfringens [Clostridium welchii] intoxication. Enteritis necroticans. Pig-bel Foodborne Vibrio parahaemolyticus intoxication Foodborne Bacillus cereus intoxication Other specified bacterial foodborne intoxications Bacterial foodborne intoxication, unspecified Balantidiasis; Balantidial dysentery Giardiasis [lambliasis] Cryptosporidiosis Isosporiasis; Infection due to Isospora belli and Isospora hominis; Intestinal coccidiosis; Isosporosis Other specified protozoal intestinal diseases; Intestinal trichomoniasis; Sarcocystosis; Sarcosporidiosis Protozoal intestinal disease, unspecified;Flagellate diarrhoea; Protozoal colitis; Protozoal diarrhoea; Protozoal dysentery Rotaviral enteritis Acute gastroenteropathy due to Norwalk agent; Small round structured virus enteritis Adenoviral enteritis Other viral enteritis Viral intestinal infection, unspecified; Viral enteritis NOS; Viral gastroenteritis NOS; Viral gastroenteropathy NOS Other specified intestinal infections Infectious diarrhea Acute gastroenteritis Gastroenteritis and colitis due to radiation Toxic gastroenteritis and colitis ABNORMAL SENSORIUM IN THE NEWBORN ABSCESS OF RESPIRATORY TRACT
J38.7
ABSCESS OF RESPIRATORY TRACT
10,000
3,000
7,000
J39.0 J39.1 J39.2 J85.1 J85.2 J85.3 J86.0 J86.9 A00.0 A00.1 A00.9 A03.0 A03.1 A03.2 A03.3 A03.8 A03.9 A04.0 A04.1 A04.2 A04.3 A04.4 A04.5 A04.6 A04.7 A04.8 A04.9 A05.0 A05.2 A05.3 A05.4 A05.8 A05.9 A07.0 A07.1 A07.2 A07.3 A07.8
ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS
10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000
3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800
7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200
A07.9 A08.0 A08.1 A08.2 A08.3 A08.4 A08.5 A09.0 A09.9 K52.0 K52.1
ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS
6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000
1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800
4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200
Page 1 of 111
ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE
K52.2 K52.8
DESCRIPTION
Allergic and dietetic gastroenteritis and colitis; Food hypersensitivity gastroenteritis or colitis Other specified noninfective gastroenteritis and colitis; Eosinophilic gastritis or gastroenteritis Noninfective gastroenteritis and colitis, unspecified; Diarrhoea specified as noninfective, or NOS in countries where the conditions can be presumed to be of noninfectious origin; Enteritis specified as noninfective, or NOS in countries where the conditio Irritable bowel syndrome with diarrhoea Acute renal failure with tubular necrosis; Tubular necrosis NOS; Acute Tubular necrosis ; Renal Tubular necrosis Acute renal failure with acute cortical necrosis; Cortical necrosis NOS; Acute Cortical necrosis ; Renal Cortical necrosis
GROUP
ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS
Case Rate 6,000 6,000
Professional Fee 1,800 1,800
Health Care Institution Fee 4,200 4,200
K52.9
ACUTE GASTROENTERITIS
6,000
1,800
4,200
K58.0 N17.0
ACUTE GASTROENTERITIS ACUTE RENAL FAILURE
6,000 19,300
1,800 5,790
4,200 13,510
N17.1
ACUTE RENAL FAILURE
19,300
5,790
13,510
N17.2 N17.8 N17.9 O08.4
Acute renal failure with medullary necrosis; Medullary papillary necrosis, NOS; Acute medullary papillary necrosis; ACUTE RENAL FAILURE Renal medullary papillary necrosis Other acute renal failure Acute renal failure, unspecified; ACUTE RENAL FAILURE ACUTE RENAL FAILURE
19,300 19,300 19,300 19,300
5,790 5,790 5,790 5,790
13,510 13,510 13,510 13,510
Renal failure following abortion and ectopic and molar pregnancy; Oliguria Acute renal failure; Oliguria renal ACUTE RENAL FAILURE shutdown; Oliguria renal tubular necrosis; Oliguria Uraemia Adult respiratory distress syndrome; Adult hyaline membrane disease Other adverse food reactions, not elsewhere classified Angioneurotic oedema; Giant urticaria; Quinke's oedema ADULT RESPIRATORY DISTRESS SYNDROME ALLERGIC REACTIONS ALLERGIC REACTIONS
J80 T78.1 T78.3 T78.4 T78.8 T78.9
32,000 6,200 6,200 6,200 6,200 6,200
9,600 1,860 1,860 1,860 1,860 1,860
22,400 4,340 4,340 4,340 4,340 4,340
T88.7
A06.4 A06.0 A06.1 A06.2 A06.3 A06.7 A06.8 E85.8 T78.0 T78.2 T88.6 D50.0 D50.1 D50.8 D50.9 D51.0 D51.8 D51.9 D52.1 D52.9 D53.0 D53.1 D53.2 D53.8
Allergy, unspecified; Allergic reaction NOS; Hypersensitivity ALLERGIC REACTIONS NOS; Idiosyncracy NOS Other adverse effects, not elsewhere classified ALLERGIC REACTIONS Adverse effect, unspecified ALLERGIC REACTIONS Unspecified adverse effect of drug or medicament; Adverse effect of correct drug or medicament properly ALLERGIC REACTIONS administered; Allergic reactiion to correct drug or medicament properly administered; Hypersensitivity to correct drug or medicament properly administe Amoebic liver abscess; Hepatic amoebiasis AMOEBIASIS, HEPATIC Acute amoebic dysentery; Acute amoebiasis; Intestinal AMOEBIASIS, NONHEPATIC amoebiasis NOS Chronic intestinal amoebiasis AMOEBIASIS, NONHEPATIC Amoebic nondysenteric colitis AMOEBIASIS, NONHEPATIC Amoeboma of intestine; Amoeboma NOS AMOEBIASIS, NONHEPATIC Cutaneous amoebiasis AMOEBIASIS, NONHEPATIC Amoebic Appendicitis AMOEBIASIS, NONHEPATIC Other amyloidosis; Localized amyloidosis AMYLOIDOSIS Anaphylactic shock due to adverse food reaction ANAPHYLACTIC SHOCK Anaphylactic shock, unspecified; Allergic shock NOS; ANAPHYLACTIC SHOCK Anaphylactic reaction NOS; Anaphylaxis NOS Anaphylactic shock due to adverse effect of correct drug or ANAPHYLACTIC SHOCK medicament properly administered Iron deficiency anaemia secondary to blood loss (chronic); ANEMIA Posthaemorrhagic anaemia (chronic) Sideropenic dysphagia; Kelly-Paterson syndrome; PlummerANEMIA Vinson syndrome Other iron deficiency anaemias ANEMIA Iron deficiency anaemia, unspecified ANEMIA Vitamin B12 deficiency anaemia due to intrinsic factor deficiency; Addison Anaemia; Biermer Anaemia; ANEMIA CongenitalPernicious Anaemia; Congenital intrinsic factor deficiency Other vitamin B12 deficiency anaemias ANEMIA Vitamin B12 deficiency anaemia, unspecified ANEMIA Drug-induced folate deficiency anaemia ANEMIA Folate deficiency anaemia, unspecified; Folic acid ANEMIA deficiency anaemia NOS Protein deficiency anaemia; Amino-acid deficiency ANEMIA anaemia; Orotaciduric anaemia Other megaloblastic anaemias, not elsewhere classified; ANEMIA Megaloblastic anaemia NOS Scorbutic anaemia ANEMIA Other specified nutritional anaemias; Anaemia associated with deficiency of copper; Anaemia associated with ANEMIA deficiency of molybdenum; Anaemia associated with deficiency of zinc Nutritional anaemia, unspecified; Simple chronic anaemia Anaemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency; Favism; G6PD deficiency anaemia ANEMIA ANEMIA
6,200
1,860
4,340
10,000 6,000 6,000 6,000 6,000 6,000 6,000 11,100 7,600 7,600 7,600 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000
3,000 1,800 1,800 1,800 1,800 1,800 1,800 3,330 2,280 2,280 2,280 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000
7,000 4,200 4,200 4,200 4,200 4,200 4,200 7,770 5,320 5,320 5,320 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000
D53.9 D55.0
10,000 10,000
3,000 3,000
7,000 7,000
Page 2 of 111
ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION
Anaemia due to other disorders of glutathione metabolism; Anaemia due to enzyme deficiencies, except G6PD, related to the hexose monophosphate [HMP] shunt pathway; Anaemia due to haemolytic nonspherocytic hereditary, type I Anaemia due to disorders of glycolytic enzymes; Haemolytic nonspherocytic hereditary Anaemia, type II; Hexokinase deficiency Anaemia; Pyruvate kinase [PK] deficiency Anaemia; Triose-phosphate isomerase deficiency Anaemia Other anaemias due to enzyme disorders Anaemia due to enzyme disorder, unspecified Mediterranean anaemia; Mediterranean anaemia with other haemoglobinopathy; Thalassaemia minor with other haemoglobinopathy; Thalassaemia mixed with other haemoglobinopathy; Sickle-cell anaemia with crisis; Hb-SS disease with crisis
GROUP
Case Rate
Professional Fee
Health Care Institution Fee
D55.1
ANEMIA
10,000
3,000
7,000
D55.2
ANEMIA
10,000
3,000
7,000
D55.8 D55.9 D56.9
ANEMIA ANEMIA ANEMIA
10,000 10,000 10,000
3,000 3,000 3,000
7,000 7,000 7,000
D57.0 D57.1 D57.3 D57.8 D58.0 D58.1
ANEMIA
10,000 10,000 10,000 10,000 10,000 10,000
3,000 3,000 3,000 3,000 3,000 3,000
7,000 7,000 7,000 7,000 7,000 7,000
Sickle-cell anaemia without crisis; Sickle-cell anaemia NOS; ANEMIA Sickle-cell disease NOS ; Sickle-cell disorder NOS Sickle-cell trait; Hb-S trait ; Heterozygous Haemoglobin S Other sickle-cell disorders Hereditary spherocytosis; Acholuric (familial) jaundice; Congenital (spherocytic) haemolytic icterus; MinkowskiChauffard syndrome Hereditary elliptocytosis; Congenital Elliptocytosis; Congenital Ovalocytosis; Hereditary Ovalocytosis ANEMIA ANEMIA ANEMIA ANEMIA
D58.2
Other haemoglobinopathies; Abnormal haemoglobin NOS; Congenital Heinz body anaemia; Hb-C Disease; Hb-C ANEMIA Disease; Hb-D Disease; Hb-E Disease; Haemoglobinopathy NOS; Unstable haemoglobin haemolytic disease Other specified hereditary haemolytic anaemias; Stomatocytosis Hereditary haemolytic anaemia, unspecified; Acquired haemolytic anaemia Drug-induced autoimmune haemolytic anaemia Other autoimmune haemolytic anaemias; Autoimmune haemolytic disease, cold type; (Autoimmune haemolytic disease, warm type; Chronic cold haemagglutinin disease; Cold agglutinin disease; Cold agglutinin haemoglobinuria; Secondary symptomatic Haemolytic a ANEMIA ANEMIA ANEMIA
10,000
3,000
7,000
D58.8 D58.9 D59.0
10,000 10,000 10,000
3,000 3,000 3,000
7,000 7,000 7,000
D59.1
ANEMIA
10,000
3,000
7,000
D59.2 D59.4 D59.5
Drug-induced nonautoimmune haemolytic anaemia; DrugANEMIA induced enzyme deficiency anaemia Other nonautoimmune haemolytic anaemias; Mechanical ANEMIA Haemolytic anaemia; Microangiopathic Haemolytic anaemia; Toxic Haemolytic anaemia Paroxysmal nocturnal haemoglobinuria [MarchiafavaANEMIA Micheli] Haemoglobinuria due to haemolysis from other external causes; Haemoglobinuria from exertion; Haemoglobinuria ANEMIA march; Haemoglobinuria paroxysmal cold Other acquired haemolytic anaemias Acquired haemolytic anaemia, unspecified; Chronic Idiopathic haemolytic anaemia Transient acquired pure red cell aplasia Constitutional aplastic anaemia; Congenital Pure red cell Aplasia; Pure red cell Aplasia of infants; Primary Pure red cell Aplasia; Blackfan-Diamond syndrome; Familial hypoplastic anaemia; Fanconi's anaemia; Pancytopenia with malformations Drug-induced aplastic anaemia Aplastic anaemia due to other external agents Idiopathic aplastic anaemia Other specified aplastic anaemias Aplastic anaemia, unspecified; Hypoplastic anaemia NOS; Medullary hypoplasia; Panmyelophthisis Acute posthaemorrhagic anaemia Anaemia in neoplastic disease Anaemia in other chronic diseases classified elsewhere Hereditary sideroblastic anaemia; Sex-linked hypochromic sideroblastic anaemia Secondary sideroblastic anaemia due to disease Secondary sideroblastic anaemia due to drugs and toxins Other sideroblastic anaemias; Sideroblastic anaemia NOS; pyridoxine-responsive NEC Sideroblastic anaemia ANEMIA ANEMIA ANEMIA
10,000 10,000 10,000
3,000 3,000 3,000
7,000 7,000 7,000
D59.6 D59.8 D59.9 D60.1
10,000 10,000 10,000 10,000
3,000 3,000 3,000 3,000
7,000 7,000 7,000 7,000
D61.0
ANEMIA
10,000
3,000
7,000
D61.1 D61.2 D61.3 D61.8 D61.9 D62 D63.0* D63.8* D64.0 D64.1 D64.2 D64.3
ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA
10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000
3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000
7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000
Page 3 of 111
D64.8 D64.9 M00.16 M00.19 M00.29 M00.82 M00.90 M00.91 M00.93 M00.94 M00.95 M00.96 M00.97 M00.98 M00.99 M02.39 M06.19 M08.29 M02.99 M05.99 M06.01 M06.09 M06.36 M06.45 M06.49 M06.81 M06.86 M06.87 M06.89 M06.90 M06.91 M06.93 M06.94 M06.95 M06.96 M06.97 M06.98 M06.99 M08.06 M08.07
DESCRIPTION
Other specified anaemias; Infantile pseudoleukaemia; Leukoerythroblastic anaemia Anaemia, unspecified Pneumococcal arthritis and polyarthritis, Lower leg Pneumococcal arthritis and polyarthritis, Site unspecified Other streptococcal arthritis and polyarthritis, Site unspecified Arthritis and polyarthritis due to other specified bacterial agents upper arm Pyogenic arthritis, unspecified; Infective arthritis NOS multiple sites Pyogenic arthritis, unspecified; Infective arthritis NOS shoulder region Pyogenic arthritis, unspecified; Infective arthritis NOS forearm Pyogenic arthritis, unspecified; Infective arthritis NOS hand Pyogenic arthritis, unspecified; Infective arthritis NOS pelvic region and thigh Pyogenic arthritis, unspecified; Infective arthritis NOS lower leg Pyogenic arthritis, unspecified; Infective arthritis NOS ankle and foot Pyogenic arthritis, unspecified; Infective arthritis NOS other sites Pyogenic arthritis, unspecified; Infective arthritis NOS site unspecified Reiter's disease, site unspecified Adult-onset Still's disease, site unspecified Juvenile arthritis with systemic onset; Still's disease NOS site unspecified Reactive arthropathy, unspecified, site unspecified Seropositive rheumatoid arthritis, unspecified, site unspecified Seronegative rheumatoid arthritis, shoulder region Seronegative rheumatoid arthritis, site unspecified Rheumatoid nodule, lower leg Inflammatory polyarthropathy, pelvic region and thigh Inflammatory polyarthropathy, site unspecified Other specified rheumatoid arthritis, shoulder region Other specified rheumatoid arthritis, lower leg Other specified rheumatoid arthritis, ankle and foot Other specified rheumatoid arthritis, site unspecified Rheumatoid arthritis, unspecified, multiple sites Rheumatoid arthritis, unspecified, shoulder region Rheumatoid arthritis, unspecified, forearm Rheumatoid arthritis, unspecified, hand Rheumatoid arthritis, unspecified, pelvic region and thigh Rheumatoid arthritis, unspecified, lower leg Rheumatoid arthritis, unspecified, ankle and foot Rheumatoid arthritis, unspecified, other sites Rheumatoid arthritis, unspecified, site unspecified Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis with or without rheumatoid factor lower leg ANEMIA
GROUP
Case Rate 10,000 10,000 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000
Professional Fee 3,000 3,000 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100
Health Care Institution Fee 7,000 7,000 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900
ANEMIA ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS
Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis ARTHRITIS NONINFECTIOUS with or without rheumatoid factor ankle and foot Juvenile rheumatoid arthritis; Juvenile rheumatoid arthritis ARTHRITIS NONINFECTIOUS with or without rheumatoid factor site unspecified Juvenile ankylosing spondylitis site unspecified Other juvenile arthritis lower leg Other juvenile arthritis site unspecified Juvenile arthritis, unspecified shoulder region Juvenile arthritis, unspecified lower leg Juvenile arthritis, unspecified site unspecified ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS
M08.09 M08.19 M08.86 M08.89 M08.91 M08.96 M08.99 M10.00 M10.01 M10.02 M10.03 M10.04 M10.05 M10.06 M10.07 M10.08 M10.09 M10.10 M10.29
7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000
2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100
4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900
Idiopathic gout; Gouty bursitis; Primary gout multiple sites ARTHRITIS NONINFECTIOUS Urate tophus of heart shoulder region Urate tophus of heart upper arm Idiopathic gout; Gouty bursitis; Primary gout forearm Urate tophus of heart hand Urate tophus of heart pelvic region and thigh Idiopathic gout; Gouty bursitis; Primary gout lower leg Urate tophus of heart ankle and foot Urate tophus of heart other sites Urate tophus of heart site unspecified Lead-induced gout multiple sites Drug-induced gout site unspecified ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS
Page 4 of 111
M10.30 M10.36 M10.39 M10.40 M10.49 M10.90 M10.91 M10.92 M10.93 M10.94 M10.96 M10.97 M10.98 M10.99 M11.89 M11.90 M11.99 M12.26 M12.39 M12.50 M12.52 M12.53 M12.54 M12.55 M12.56 M12.57 M12.58 M12.59 M12.86 M12.89 M13.00 M13.01 M13.02 M13.06 M13.09 M13.13 M13.16 M13.17 M13.18 M13.80 M13.81 M13.85 M13.86 M13.87 M13.88 M13.89 M13.90 M13.91 M13.92 M13.93 M13.94 M13.95 M13.96 M13.97 M13.98 M13.99 A92.0 A92.1 A92.2 A92.8 A93.1 A93.8
DESCRIPTION
Gout due to impairment of renal function multiple sites Gout due to impairment of renal function lower leg Gout due to impairment of renal function site unspecified Other secondary gout multiple sites Other secondary gout site unspecified Gout, unspecified multiple sites Gout, unspecified shoulder region Gout, unspecified upper arm Gout, unspecified forearm Gout, unspecified hand Gout, unspecified lower leg Gout, unspecified ankle and foot Gout, unspecified other sites Gout, unspecified site unspecified Other specified crystal arthropathies site unspecified Crystal arthropathy, unspecified multiple sites Crystal arthropathy, unspecified site unspecified Villonodular synovitis (pigmented) lower leg Palindromic rheumatism site unspecified Traumatic arthropathy multiple sites Traumatic arthropathy upper arm Traumatic arthropathy forearm Traumatic arthropathy hand Traumatic arthropathy pelvic region and thigh Traumatic arthropathy lower leg Traumatic arthropathy ankle and foot Traumatic arthropathy other sites Traumatic arthropathy site unspecified Other specific arthropathies, not elsewhere classified; Transient arthropathy lower leg Other specific arthropathies, not elsewhere classified; Transient arthropathy site unspecified Polyarthritis, unspecified multiple sites Polyarthritis, unspecified shoulder region Polyarthritis, unspecified upper arm Polyarthritis, unspecified lower leg Polyarthritis, unspecified site unspecified Monoarthritis, not elsewhere classified forearm Monoarthritis, not elsewhere classified lower leg Monoarthritis, not elsewhere classified ankle and foot Monoarthritis, not elsewhere classified other sites Other specified arthritis; Allergic arthritis multiple sites Other specified arthritis; Allergic arthritis shoulder region
GROUP
ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS
Case Rate 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 8,100 8,100 8,100 8,100 8,100 8,100
Professional Fee 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,430 2,430 2,430 2,430 2,430 2,430
Health Care Institution Fee 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 5,670 5,670 5,670 5,670 5,670 5,670
Other specified arthritis; Allergic arthritis pelvic region and ARTHRITIS NONINFECTIOUS thigh Other specified arthritis; Allergic arthritis lower leg ARTHRITIS NONINFECTIOUS Other specified arthritis; Allergic arthritis ankle and foot Other specified arthritis; Allergic arthritis other sites Other specified arthritis; Allergic arthritis site unspecified Arthritis, unspecified; Arthropathy NOS multiple sites Arthritis, unspecified; Arthropathy NOS shoulder region Arthritis, unspecified; Arthropathy NOS upper arm Arthritis, unspecified; Arthropathy NOS forearm Arthritis, unspecified; Arthropathy NOS hand Arthritis, unspecified; Arthropathy NOS pelvic region and thigh Arthritis, unspecified; Arthropathy NOS lower leg Arthritis, unspecified; Arthropathy NOS ankle and foot Arthritis, unspecified; Arthropathy NOS other sites Arthritis, unspecified; Arthropathy NOS site unspecified Chikungunya virus disease; Chikungunya (haemorrhagic) fever O'nyong-nyong fever ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER
Venezuelan equine fever; Venezuelan equine encephalitis; ARTHROPOD BORNE VIRAL FEVER Venezuelan encephalomyelitis virus disease Other specified mosquito-borne viral fevers Sandfly fever; Pappataci fever; Phlebotomus fever Other specified arthropod-borne viral fevers; Piry virus disease; Vesicular stomatitis virus disease [Indiana fever] ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER
A94 M15.0
Unspecified arthropod-borne viral fever; Unspecified arthropod-borne viral fever; Arboviral fever NOS; Arbovirus ARTHROPOD BORNE VIRAL FEVER infection NOS Primary generalized (osteo)arthrosis ARTHROSIS
8,100 7,000
2,430 2,100
5,670 4,900
Page 5 of 111
M15.2 M15.3 M15.4 M15.8 M15.9 M16.0 M16.1 M16.2 M16.3 M16.9 M17.0 M17.1 M17.2 M17.3 M17.5 M17.9 M18.0 M18.9 M19.00 M19.02 M19.05 M19.06 M19.08 M19.09 M19.10 M19.11 M19.12 M19.19 M19.21 M19.29 M19.81 M19.86 M19.87 M19.88 M19.89 M19.90 M19.91 M19.92 M19.93 M19.94 M19.95 M19.96 M19.97 M19.98 M19.99 J45.00
DESCRIPTION
Bouchard's nodes (with arthropathy) Secondary multiple arthrosis; Post-traumatic polyarthrosis Erosive (osteo)arthrosis Other polyarthrosis Polyarthrosis, unspecified; Generalized osteoarthritis NOS Primary coxarthrosis, bilateral Other primary coxarthrosis; Primary coxarthrosis NOS; Primary coxarthrosis unilateral Coxarthrosis resulting from dysplasia, bilateral Other dysplastic coxarthrosis; Dysplastic coxarthrosis NOS; Dysplastic coxarthrosis unilateral Coxarthrosis, unspecified Primary gonarthrosis, bilateral Other primary gonarthrosis; Primary gonarthrosis NOS; Primary gonarthrosis unilateral Post-traumatic gonarthrosis, bilateral Other post-traumatic gonarthrosis; Post-traumatic gonarthrosis NOS; Post-traumatic gonarthrosis unilateral Other secondary gonarthrosis; Secondary gonarthrosis NOS; Secondary gonarthrosis unilateral Gonarthrosis, unspecified Primary arthrosis of first carpometacarpal joints, bilateral Arthrosis of first carpometacarpal joint, unspecified Primary arthrosis of other joints; Primary arthrosis NOSmultiple sites Primary arthrosis of other joints; Primary arthrosis NOSupper arm Primary arthrosis of other joints; Primary arthrosis NOSpelvic region and thigh Primary arthrosis of other joints; Primary arthrosis NOSlower leg Primary arthrosis of other joints; Primary arthrosis NOSother sites Primary arthrosis of other joints; Primary arthrosis NOSsite unspecified Post-traumatic arthrosis of other joints; Post-traumatic arthrosis NOS multiple sites Post-traumatic arthrosis of other joints; Post-traumatic arthrosis NOS shoulder region Post-traumatic arthrosis of other joints; Post-traumatic arthrosis NOS upper arm Post-traumatic arthrosis of other joints; Post-traumatic arthrosis NOS site unspecified Other secondary arthrosis; Secondary arthrosis NOS shoulder region Other secondary arthrosis; Secondary arthrosis NOS site unspecified Other specified arthrosis shoulder region Other specified arthrosis lower leg Other specified arthrosis ankle and foot Other specified arthrosis other sites Other specified arthrosis site unspecified Arthrosis, unspecified multiple sites Arthrosis, unspecified shoulder region Arthrosis, unspecified upper arm Arthrosis, unspecified forearm Arthrosis, unspecified hand Arthrosis, unspecified pelvic region and thigh Arthrosis, unspecified lower leg Arthrosis, unspecified ankle and foot Arthrosis, unspecified other sites Arthrosis, unspecified site unspecified Predominantly allergic asthma; Allergic bronchitis NOS; Allergic rhinitis with asthma; Atopic asthma; Extrinsic allergic asthma; Hay fever with asthma; in Acute Exacerbation Nonallergic asthma; Idiosyncratic asthma; Intrinsic nonallergic asthma, in Acute Exacerbation Mixed asthma, in Acute Exacerbation Bronchial Asthma in Acute Exacerbation Status asthmaticus; Acute severe asthma Pulmonary collapse; Atelectasis; Collapse of lung; Brock's syndrome Panniculitis affecting regions of neck and back occipitoatlanto-axial region Panniculitis affecting regions of neck and back lumbar region Panniculitis affecting regions of neck and back sacral and sacrococcygeal region ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS
GROUP
Case Rate 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 9,000
Professional Fee 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,100 2,700
Health Care Institution Fee 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 4,900 6,300
ASTHMA IN ACUTE EXACERBATION
J45.10 J45.80 J45.90 J46 J98.1 M54.01 M54.06 M54.08
ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ATELECTASIS BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA
9,000 9,000 9,000 9,000 13,800 6,400 6,400 6,400
2,700 2,700 2,700 2,700 4,140 1,920 1,920 1,920
6,300 6,300 6,300 6,300 9,660 4,480 4,480 4,480
Page 6 of 111
Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS Multiple sites in spine Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS occipito-atlanto-axial region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS cervical region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS thoracic region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS thoracolumbar region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS lumbar region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS lumbosacral region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS sacral and sacrococcygeal region Radiculopathy; Brachial Neuritis or radiculitis NOS; Lumbar Neuritis or radiculitis NOS; Lumbosacral; thoracic Neuritis or radiculitis NOS ; Radiculitis NOS site unspecified Cervicalgia Cervicalgia Multiple sites in spine Cervicalgia cervical region Cervicalgia lumbar region Sciatica Sciatica Multiple sites in spine Sciatica occipito-atlanto-axial region Sciatica thoracolumbar region Sciatica lumbar region Sciatica lumbosacral region Sciatica sacral and sacrococcygeal region Sciatica site unspecified Lumbago with sciatica Lumbago with sciatica occipito-atlanto-axial region Lumbago with sciatica thoracic region Lumbago with sciatica lumbar region Lumbago with sciatica sacral and sacrococcygeal region Lumbago with sciatica site unspecified Low back pain; Loin pain; Low back strain; Lumbago NOS Low back pain; Loin pain; Low back strain; Lumbago NOS Multiple sites in spine Low back pain; Loin pain; Low back strain; Lumbago NOS occipito-atlanto-axial region Low back pain; Loin pain; Low back strain; Lumbago NOS cervical region Other dorsalgia thoracic region Other dorsalgia sacral and sacrococcygeal region Dorsalgia, unspecified; Backache NOS occipito-atlanto-axial region Dorsalgia, unspecified; Backache NOS cervicothoracic region Dorsalgia, unspecified; Backache NOS lumbar region Dorsalgia, unspecified; Backache NOS lumbosacral region Dorsalgia, unspecified; Backache NOS sacral and sacrococcygeal region Dorsalgia, unspecified; Backache NOS site unspecified Uninhibited neuropathic bladder, not elsewhere classified Reflex neuropathic bladder, not elsewhere classified
GROUP
Case Rate
Professional Fee 1,920
Health Care Institution Fee 4,480
M54.10
BACK PAIN, RADICULOPATHY, SCIATICA
6,400
M54.11
6,400
1,920
4,480
M54.12
6,400
1,920
4,480
M54.14
6,400
1,920
4,480
M54.15
6,400
1,920
4,480
M54.16
6,400
1,920
4,480
M54.17
6,400
1,920
4,480
M54.18
6,400
1,920
4,480
M54.19 M54.2 M54.20 M54.22 M54.26 M54.3 M54.30 M54.31 M54.35 M54.36 M54.37 M54.38 M54.39 M54.4 M54.41 M54.44 M54.46 M54.48 M54.49 M54.5 M54.50 M54.51 M54.52 M54.84 M54.88 M54.91 M54.93 M54.96 M54.97 M54.98 M54.99 N31.0 N31.1
BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BACK PAIN, RADICULOPATHY, SCIATICA BLADDER DYSFUNCTION BLADDER DYSFUNCTION
6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 9,000 9,000
1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 2,700 2,700
4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 6,300 6,300
N31.2
Flaccid neuropathic bladder, not elsewhere classified; Atonic Motor Neuropathic bladder; Sensory Atonic Motor BLADDER DYSFUNCTION Neuropathic bladder; Autonomous Neuropathic bladder ; Nonreflex Neuropathic bladder
9,000
2,700
6,300
Page 7 of 111
N31.8 N31.9 N32.9 N39.3 N39.4 R32 A05.1 G93.5
DESCRIPTION
Other neuromuscular dysfunction of bladder Neuromuscular dysfunction of bladder, unspecified; Neurogenic bladder dysfunction NOS Bladder disorder, unspecified Stress incontinence Other specified urinary incontinence; Overflow incontinence, Reflex incontinence, Urge incontinence Unspecified urinary incontinence; Enuresis NOS Botulism; Classical foodborne intoxication due to Clostridium botulinum Compression of brain; [compression, Herniation] of brain (stem) Inflammatory disorders of breast; Acute abscess of non puerperal areola; Acute abscess nonpuerperal breast; Chronic abscess of nonpuerperal areola; Chronic abscess of nonpuerperal breast; Carbuncle of breast; Acute mastitis nonpuerperal, NOS; Acute inf Infection of nipple associated with childbirth; Gestational abscess of nipple; Puerperal abscess of nipple Abscess of breast associated with childbirth; Mammary abscess gestational or puerperal; Purulent mastitis gestational or puerperal; Subareolar abscess gestational or puerperal Nonpurulent mastitis associated with childbirth; Lymphangitis of breast gestational or puerperal; Mastitis NOS gestational or puerperal; Interstitial mastitis gestational or puerperal; Parenchymatous mastitis gestational or puerperal Retracted nipple associated with childbirth Cracked nipple associated with childbirth; Fissure of nipple, gestational or puerperal Malignant neoplasm of Nipple and areola, breast Malignant neoplasm of Central portion of breast Malignant neoplasm of Upper-inner quadrant of breast Malignant neoplasm of Lower-inner quadrant of breast Malignant neoplasm of Upper-outer quadrant of breast Malignant neoplasm of Axillary tail of breast Malignant neoplasm of Overlapping lesion of breast Malignant neoplasm of Breast, unspecified Pemphigus vulgaris Pemphigus vegetans Pemphigus foliaceus Pemphigus erythematosus; Senear-Usher syndrome Other pemphigus Pemphigus, unspecified Acquired keratosis follicularis Transient acantholytic dermatosis [Grover] Acantholytic disorder, unspecified Bullous pemphigoid Cicatricial pemphigoid; Benign mucous membrane pemphigoid Chronic bullous disease of childhood; Juvenile dermatitis herpetiformis Acquired epidermolysis bullosa Other pemphigoid Dermatitis herpetiformis; Duhring's disease
GROUP
BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BOTULISM BRAIN HERNIATION
Case Rate 9,000 9,000 9,000 9,000 9,000 9,000 4,800 22,400
Professional Fee 2,700 2,700 2,700 2,700 2,700 2,700 1,440 6,720
Health Care Institution Fee 6,300 6,300 6,300 6,300 6,300 6,300 3,360 15,680
N61
BREAST INFECTIONS
7,900
2,370
5,530
O91.0
BREAST INFECTIONS
7,900
2,370
5,530
O91.1
BREAST INFECTIONS
7,900
2,370
5,530
O91.2
BREAST INFECTIONS
7,900
2,370
5,530
O92.0 O92.1 C50.0 C50.1 C50.2 C50.3 C50.4 C50.6 C50.8 C50.9 L10.0 L10.1 L10.2 L10.4 L10.8 L10.9 L11.0 L11.1 L11.9 L12.0 L12.1 L12.2 L12.3 L12.8 L13.0 L13.1 L13.9 T20.4 T21.0 T21.2 T21.5 T21.6 T22.2 T22.5 T22.6 T23.2 T23.4 T24.2 T24.5 T24.6 T25.2
BREAST INFECTIONS BREAST INFECTIONS BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS
7,900 7,900 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 12,000 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500
2,370 2,370 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,600 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550
5,530 5,530 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950
Subcorneal pustular dermatitis; Sneddon-Wilkinson disease BULLOUS DISORDERS Bullous disorder, unspecified Corrosion of unspecified degree of head and neck Burn of unspecified degree of trunk Burn of second degree of trunk Corrosion of first degree of trunk Corrosion of second degree of trunk Burn of second degree of shoulder and upper limb, except wrist and hand Corrosion of first degree of shoulder and upper limb, except wrist and hand Corrosion of second degree of shoulder and upper limb, except wrist and hand Burn of second degree of wrist and hand Corrosion of unspecified degree of wrist and hand Burn of second degree of hip and lower limb, except ankle and foot Corrosion of first degree of hip and lower limb, except ankle and foot Corrosion of second degree of hip and lower limb, except ankle and foot Burn of second degree of ankle and foot BULLOUS DISORDERS BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A
Page 8 of 111
T25.5 T26.0 T26.4 T26.9 T27.3 T27.7 T28.9 T29.1 T30.0 T30.2 T30.3 T30.4 T30.5 T30.6 T30.7 T31.0 T31.1 T32.0 T32.1 T34.1 T35.0 T35.1 T20.2 T20.3 T20.6 T22.3 T23.3 T23.6 T23.7 T24.3 T24.7 T25.3 T26.1 T26.2 T26.3 T26.6 T27.0 T27.2 T28.0 T28.1 T28.2 T28.3 T28.5 T28.6 T28.7 T28.8 T29.2 T29.3 T29.6 T31.2 T31.3 T31.4 T31.5 T32.2 T32.3 T32.4 T34.9 T21.3 T31.6 T31.7 T31.8 T31.9 T32.9 I47.0
DESCRIPTION
Corrosion of first degree of ankle and foot Burn of eyelid and periocular area Burn of eye and adnexa, part unspecified Corrosion of eye and adnexa, part unspecified Burn of respiratory tract, part unspecified Corrosion of respiratory tract, part unspecified Corrosion of other and unspecified internal organs Burns of multiple regions, no more than first-degree burns mentioned Burn of unspecified body region, unspecified degree; Burn NOS Burn of second degree, body region unspecified; Secodndegree burn NOS Burn of third degree, body region unspecified; Third-degree burn NOS Corrosion of unspecified body region, unspecified degree; Corrosion NOS Corrosion of first degree, body region unspecified; Firstdegree corrosion NOS Corrosion of second degree, body region unspecified; Second-degree corrosion NOS Corrosion of third degree, body region unspecified; Thriddegree corrosion NOS Burns involving less than 10% of body surface Burns involving 10-19% of body surface Corrosions involving less than 10% of body surface Corrosions involving 10-19% of body surface Frostbite with tissue necrosis of neck Superficial frostbite involving multiple body regions; Multiple superficial frosbite NOS Frostbite with tissue necrosis involving multiple body regions; Multiple frosbite with tissue necrosis NOS Burn of second degree of head and neck Burn of third degree of head and neck Corrosion of second degree of head and neck Burn of third degree of shoulder and upper limb, except wrist and hand Burn of third degree of wrist and hand Corrosion of second degree of wrist and hand Corrosion of third degree of wrist and hand Burn of third degree of hip and lower limb, except ankle and foot Corrosion of third degree of hip and lower limb, except ankle and foot Burn of third degree of ankle and foot Burn of cornea and conjunctival sac Burn with resulting rupture and destruction of eyeball Burn of other parts of eye and adnexa Corrosion of cornea and conjunctival sac Burn of larynx and trachea Burn of other parts of respiratory tract; Thoracic cavity Burn of mouth and pharynx Burn of oesophagus Burn of other parts of alimentary tract Burn of internal genitourinary organs Corrosion of mouth and pharynx Corrosion of oesophagus Corrosion of other parts of alimentary tract Corrosion of internal genitourinary organs Burns of multiple regions, no more than second-degree burns mentioned Burns of multiple regions, at least one burn of third degree mentioned Corrosions of multiple regions, no more than seconddegree corrosions mentioned Burns involving 20-29% of body surface Burns involving 30-39% of body surface Burns involving 40-49% of body surface Burns involving 50-59% of body surface Corrosions involving 20-29% of body surface Corrosions involving 30-39% of body surface Corrosions involving 40-49% of body surface BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B
GROUP
Case Rate 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 16,100 16,100 16,100 16,100 16,100 16,100 12,200
Professional Fee 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 4,830 4,830 4,830 4,830 4,830 4,830 3,660
Health Care Institution Fee 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 11,270 11,270 11,270 11,270 11,270 11,270 8,540
Frostbite with tissue necrosis of other and unspecified sites; Frosbite with tissue necrosis NOS; Frosbite with tissue BURN B of leg NOS; Frosbite with tissue necrosis of trunk NOS Burn of third degree of trunk Burns involving 60-69% of body surface Burns involving 70-79% of body surface Burns involving 80-89% of body surface Burns involving 90% or more of body surface Corrosions involving 90% or more of body surface Re-entry ventricular arrhythmia BURN C BURN C BURN C BURN C BURN C BURN C CARDIAC ARRHYTHMIA
Page 9 of 111
Supraventricular tachycardia; Atrial Paroxysmal tachycardia; Atrioventricular [AV] Paroxysmal tachycardia; Junctional Paroxysmal tachycardia; Nodal Paroxysmal tachycardia Ventricular tachycardia Paroxysmal tachycardia, unspecified; Bouveret (-Hoffmann) syndrome ATRIAL FIBRILLATION AND FLUTTER Ventricular fibrillation and flutter Atrial premature depolarization; Atrial premature beats Junctional premature depolarization Ventricular premature depolarization Other and unspecified premature depolarization; Ectopic beats; Extrasystoles; Extrasystolic arrhythmias; Premature beats NOS; Premature contractions Sick sinus syndrome; Tachycardia-bradycardia syndrome
GROUP
Case Rate
Professional Fee 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660
Health Care Institution Fee 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540
I47.1 I47.2 I47.9 I48 I49.0 I49.1 I49.2 I49.3 I49.4
CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA
12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200
I49.5 I49.8 I49.9 I42.0 I42.1 I42.2 I42.3 I42.4 I42.5 I42.6 I42.7 I42.8 I42.9 P29.0 P29.1 P29.2 P29.4 P29.8 G83.4 A46 A48.0 L03.0 L03.1 L03.2 L03.3
CARDIAC ARRHYTHMIA
12,200 12,200 12,200 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 22,700 22,700 22,700 22,700 22,700 8,800 9,600 9,600 9,600 9,600 9,600 9,600
3,660 3,660 3,660 4,020 4,020 4,020 4,020 4,020 4,020 4,020 4,020 4,020 4,020 6,810 6,810 6,810 6,810 6,810 2,640 2,880 2,880 2,880 2,880 2,880 2,880
8,540 8,540 8,540 9,380 9,380 9,380 9,380 9,380 9,380 9,380 9,380 9,380 9,380 15,890 15,890 15,890 15,890 15,890 6,160 6,720 6,720 6,720 6,720 6,720 6,720
Other specified cardiac arrhythmias; Coronary sinus rhythm CARDIAC ARRHYTHMIA disorder; Ectopic rhythm disorder; nodal rhythm disorder Cardiac arrhythmia, unspecified; Cardiac arrhythmia NOS Dilated cardiomyopathy; Congestive cardiomyopathy Obstructive hypertrophic cardiomyopathy; Hypertrophic subaortic stenosis Other hypertrophic cardiomyopathy; Nonobstructive hypertrophic cardiomyopathy Endomyocardial (eosinophilic) disease; Endomyocardial (tropical) fibrosis; Lffler's endocarditis Endocardial fibroelastosis; Congenital cardiomyopathy Other restrictive cardiomyopathy Alcoholic cardiomyopathy Cardio myopathy due to drugs and other external agents Other cardiomyopathies Cardio myopathy, unspecified; Primary cardiomyopathy NOS; Secondary cardiomyopathy NOS Neonatal cardiac failure Neonatal cardiac dysrhythmia Neonatal hypertension Transient myocardial ischaemia of newborn CARDIAC ARRHYTHMIA CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN
Other cardiovascular disorders originating in the perinatal period Cauda equina syndrome; Neurogenic bladder due to cauda CAUDA EQUINA SYNDROME equina syndrome Excludes: cord bladder NOS (G95.8) Erysipelas CELLULITIS Gas gangrene; Clostridial cellulitis; Clostridial myonecrosis CELLULITIS Cellulitis of finger and toe; Infection of nail; Onychia; Paronychia; Perionychia Cellulitis of other parts of limb, Axilla; Cellulitis of Hip;Cellulitis of Shoulder Cellulitis of face Cellulitis of trunk;Cellulitis of Abdominal wall;Cellulitis of Back [any part]; Cellulitis of Chest wall;Cellulitis of Groin;Cellulitis of Perineum;Cellulitis of Umbilicus Cellulitis of other sites; Cellulitis of Head [any part, except face];Cellulitis of Scalp Cellulitis, unspecified Eosinophilic cellulitis [Wells] Spastic cerebral palsy; Congenital spastic paralysis (cerebral); Spastic tetraplegic cerebral palsy Spastic diplegia; Spastic cerebral palsy NOS Infantile hemiplegia Dyskinetic cerebral palsy; Athetoid cerebral palsy; Dystonic cerebral palsy Ataxic cerebral palsy Other infantile cerebral palsy; Mixed cerebral palsy syndromes Infantile cerebral palsy, unspecified; Cerebral palsy NOS Primary biliary cirrhosis; Chronic nonsupparative destructive cholangitis CELLULITIS CELLULITIS CELLULITIS CELLULITIS
L03.8 L03.9 L98.3 G80.0 G80.1 G80.2 G80.3 G80.4 G80.8 G80.9 K74.3
CELLULITIS CELLULITIS CELLULITIS CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CHOLANGITIS
9,600 9,600 9,600 9,500 9,500 9,500 9,500 9,500 9,500 9,500 13,200
2,880 2,880 2,880 2,850 2,850 2,850 2,850 2,850 2,850 2,850 3,960
6,720 6,720 6,720 6,650 6,650 6,650 6,650 6,650 6,650 6,650 9,240
Page 10 of 111
K80.3 K80.0 K80.1 K80.4
DESCRIPTION
Calculus of bile duct with cholangitis; Any condition listed in K80.5 with cholangitis Calculus of gallbladder with acute cholecystitis; Any condition listed in K80.2 with acute cholecystitis Calculus of gallbladder with other cholecystitis; Any condition listed in K80.2 with chronic cholecystitis; Cholecystitis with cholelithiasis NOS Calculus of bile duct with cholecystitis; Any condition listed in K80.5 with cholecystitis (with cholangitis) CHOLANGITIS CHOLECYSTITIS CHOLECYSTITIS CHOLECYSTITIS
GROUP
Case Rate 13,200 11,300 11,300 11,300
Professional Fee 3,960 3,390 3,390 3,390
Health Care Institution Fee 9,240 7,910 7,910 7,910
K81.0
Acute cholecystitis; Abscess of gallbladder without calculus; Angiocholecystitis without calculus; Acute emphysematous cholecystitis without calculus; Gangrenous cholecystitis CHOLECYSTITIS without calculus; Supparative cholecystitis without calculus; Empyema of gallbl Chronic cholecystitis Other cholecystitis Trisomy 21, meiotic nondisjunction Trisomy 21, translocation Down's syndrome, unspecified; Trisomy 21 NOS Trisomy 18, meiotic nondisjunction Trisomy 18, translocation Edwards' syndrome, unspecified Patau's syndrome, unspecified Trisomy and partial trisomy of autosomes, unspecified Whole chromosome monosomy, mosaicism (mitotic nondisjunction) Chromosome replaced with ring or dicentric Deletion of short arm of chromosome 5; Cri-du-chat syndrome Other deletions of part of a chromosome; Angelman syndrome Deletions with other complex rearrangements Deletion from autosomes, unspecified CHOLECYSTITIS CHOLECYSTITIS CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES
11,300
3,390
7,910
K81.1 K81.8 Q90.0 Q90.2 Q90.9 Q91.0 Q91.2 Q91.3 Q91.7 Q92.9 Q93.1 Q93.2 Q93.4 Q93.5 Q93.7 Q93.9 Q95.9 Q96.9 Q97.9 Q98.4 Q99.2 Q99.8 N18.0 N18.8 N18.9 N19 J44.0
11,300 11,300 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 14,500 14,500 14,500 14,500 12,200
3,390 3,390 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 4,350 4,350 4,350 4,350 3,660
7,910 7,910 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 10,150 10,150 10,150 10,150 8,540
Balanced rearrangement and structural marker, unspecified CHROMOSOMAL ABNORMALITIES Turner's syndrome, unspecified Sex chromosome abnormality, female phenotype, unspecified Klinefelter's syndrome, unspecified Fragile X chromosome; Fragile X syndrome Other specified chromosome abnormalities End-stage renal disease Other chronic renal failure Chronic renal failure, unspecified; Uraemia NOS Unspecified renal failure Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with acute lower respiratory infection Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with acute exacerbation, unspecified Chronic asthmatic (obstructive) bronchitis NOS; Chronic emphysematous bronchitis NOS; Chronic obstructive bronchitis NOS Chronic obstructive pulmonary disease, unspecified; Chronic obstructive airway disease NOS; Chronic obstructive lung disease NOS CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
J44.1
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
12,200
3,660
8,540
J44.8
12,200
3,660
8,540
J44.9
12,200
3,660
8,540
Q35.0 Q35.1 Q35.3 Q35.5 Q35.7 Q35.8 Q35.9 Q36.0 Q36.1 Q36.9 Q37.0 Q37.1 Q37.2 Q37.3 Q37.4 Q37.5 Q37.8 Q37.9 F01.0
CLEFT HARD PALATE, BILATERAL; BILATERAL FISSURE OF CLEFT LIP AND PALATE HARD PALATE; BILATERAL PALATOSCHISIS OF HARD PALATE Cleft hard palate Cleft soft palate Cleft hard palate with cleft soft palate Cleft uvula CLEFT PALATE, UNSPECIFIED, BILATERAL Cleft palate, unspecified Cleft lip, bilateral Cleft lip, median Cleft lip, unilateral; Cleft lip NOS Cleft hard palate with bilateral cleft lip Cleft hard palate with unilateral cleft lip; Cleft hard palate with cleft lip NOS Cleft soft palate with bilateral cleft lip Cleft soft palate with unilateral cleft lip; Cleft soft palate with cleft lip NOS Cleft hard and soft palate with bilateral cleft lip Cleft hard and soft palate with unilateral cleft lip; Cleft hard and soft palate with cleft lip NOS Unspecified cleft palate with bilateral cleft lip Unspecified cleft palate with unilateral cleft lip; Cleft palate with cleft lip NOS Vascular dementia of acute onset CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE COGNITIVE DYSFUNCTION
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 8,200
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,460
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,740
Page 11 of 111
R41.0 R41.3 R54 D34 D35.0 D35.1 D35.2 D35.3 D35.4 D35.9 D16.0 D16.1 D16.2 D16.3 D16.4 D16.5 D16.6 D16.7 D16.8 D16.9 D12.0 D12.1 D12.3 D12.4 D12.5 D12.6
DESCRIPTION
GROUP
Case Rate 8,200 8,200 8,200 12,000 12,000 12,000 12,000 12,000 12,000 12,000 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 8,700 8,700 8,700 8,700 8,700 8,700
Disorientation, unspecified; Confusion NOS COGNITIVE DYSFUNCTION Other amnesia; Amnesia NOS COGNITIVE DYSFUNCTION Senility; Old age without mention of psychosis; Senescence COGNITIVE DYSFUNCTION without mention of psychosis; Senile asthenia; Senile debility COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of thyroid gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Adrenal gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Parathyroid gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Pituitary gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Craniopharyngeal duct ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Pineal gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Endocrine gland, unspecified ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Scapula and long bones of upper limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Short bones of upper limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm ofLong bones of lower limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Short bones of lower limb BONES Benign neoplasm of Bones of skull and face; Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE neoplasm of Superior Maxilla; Benign neoplasm of Orbital BONES bone COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Lower jaw bone BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Vertebral column BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Ribs, sternum and clavicle BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Pelvic bones, sacrum and coccyx BONES Benign neoplasm of Bone and articular cartilage, COMPLICATIONS OF BENIGN NEOPLASMS OF THE unspecified BONES Benign neoplasm of Caecum;Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Ileocaecal valve DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Appendix DIGESTIVE SYSTEM Benign neoplasm of Transverse colon; Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Hepatic flexure; Benign neoplasm of Splenic flexure DIGESTIVE SYSTEM Benign neoplasm of Descending colon Benign neoplasm of Sigmoid colon Benign neoplasm of Colon, unspecified; Adenomatosis of colon; Benign neoplasm of Large intestine NOS; Hereditary Polyposis of colon Benign neoplasm of Rectosigmoid junction; Adenomatosis of colon; Benign neoplasm of Large intestine NOS; Hereditary Polyposis of colon Benign neoplasm of Rectum COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM
Professional Fee 2,460 2,460 2,460 3,600 3,600 3,600 3,600 3,600 3,600 3,600 3,150 3,150 3,150 3,150 3,150 3,150 3,150 3,150 3,150 3,150 2,610 2,610 2,610 2,610 2,610 2,610
Health Care Institution Fee 5,740 5,740 5,740 8,400 8,400 8,400 8,400 8,400 8,400 8,400 7,350 7,350 7,350 7,350 7,350 7,350 7,350 7,350 7,350 7,350 6,090 6,090 6,090 6,090 6,090 6,090
D12.7 D12.8 D12.9 D13.0 D13.1 D13.2 D13.3 D13.4 D13.5 D13.6 D13.7
8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700
2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610
6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090
COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Anus and anal canal DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Oesophagus DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Stomach DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Duodenum DIGESTIVE SYSTEM Benign neoplasm of Other and unspecified parts of small COMPLICATIONS OF BENIGN NEOPLASMS OF THE intestine DIGESTIVE SYSTEM Benign neoplasm of Liver; Benign neoplasm of Intrahepatic COMPLICATIONS OF BENIGN NEOPLASMS OF THE bile ducts DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Extrahepatic bile ducts DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Pancreas DIGESTIVE SYSTEM Benign neoplasm of Endocrine pancreas; Benign neoplasm COMPLICATIONS OF BENIGN NEOPLASMS OF THE of Islet cell tumour; Benign neoplasm of Islets of DIGESTIVE SYSTEM Langerhans Benign neoplasm of Ill-defined sites within the digestive COMPLICATIONS OF BENIGN NEOPLASMS OF THE system; Benign neoplasm of Digestive system NOS; Benign DIGESTIVE SYSTEM neoplasm of Intestine NOS; Benign neoplasm of Spleen Benign lipomatous neoplasm of intra-abdominal organs COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM
D13.9
8,700
2,610
6,090
D17.5
8,700
2,610
6,090
Page 12 of 111
D17.6 D17.7 D20.0 D20.1 D21.4 D25.0 D25.1 D25.2 D25.9 D26.0 D26.1 D26.7 D26.9 D27 D28.0 D28.1
DESCRIPTION
Benign lipomatous neoplasm of spermatic cord Benign lipomatous neoplasm of other sites; Benign lipomatous neoplasm of Peritoneum; Benign lipomatous neoplasm of Retroperitoneum Benign neoplasm of of soft tissue of Retroperitoneum Benign neoplasm of of soft tissue of Peritoneum Benign neoplasm of Connective and other soft tissue of abdomen Submucous leiomyoma of uterus Intramural leiomyoma of uterus Subserosal leiomyoma of uterus Leiomyoma of uterus, unspecified Other Benign neoplasm of Cervix uteri Other Benign neoplasm of Corpus uteri Other Benign neoplasm of Other parts of uterus Other Benign neoplasm of Uterus, unspecified Benign neoplasm of ovary Benign neoplasm of Vulva Benign neoplasm of Vagina Benign neoplasm of Uterine tubes and ligaments; Benign neoplasm of Fallopian Tubes; Benign neoplasm of Uterine Broad Ligament; Benign neoplasm of Uterine round ligament Benign neoplasm of Other specified female genital organs Benign neoplasm of Female genital organ, unspecified Benign neoplasm of Penis Benign neoplasm of Prostate Benign neoplasm of Testis Benign neoplasm of Scrotum; Benign neoplasm of Skin of scrotum Benign neoplasm of Cerebral meninges Benign neoplasm of Spinal meninges Benign neoplasm of Meninges, unspecified; Meningioma NOS Benign neoplasm of Brain, supratentorial; Benign neoplasm of Cerebral ventricle; Benign neoplasm of Cerebrum; Benign neoplasm of Frontal lobe; Benign neoplasm of Occipital lobe; Benign neoplasm of Parietal lobe; Benign neoplasm of Temporal lobe Benign neoplasm of Brain, infratentorial; Benign neoplasm of Brain stem; Benign neoplasm of Cerebellum; Benign neoplasm of Fourth ventricle Benign neoplasm of Brain, unspecified
GROUP
COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM
Case Rate 8,700 8,700 8,700 8,700 8,700 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600
Professional Fee 2,610 2,610 2,610 2,610 2,610 2,880 2,880 2,880 2,880 2,880 2,880 2,880 2,880 2,880 2,880 2,880
Health Care Institution Fee 6,090 6,090 6,090 6,090 6,090 6,720 6,720 6,720 6,720 6,720 6,720 6,720 6,720 6,720 6,720 6,720
D28.2
9,600
2,880
6,720
D28.7 D28.9 D29.0 D29.1 D29.2 D29.4 D32.0 D32.1 D32.9
9,600 9,600 7,700 7,700 7,700 7,700 14,800 14,800 14,800
2,880 2,880 2,310 2,310 2,310 2,310 4,440 4,440 4,440
6,720 6,720 5,390 5,390 5,390 5,390 10,360 10,360 10,360
D33.0
14,800
4,440
10,360
D33.1 D33.2 D33.3 D33.4 D33.7 D33.9 D36.1 D10.0
COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM
14,800 14,800 14,800 14,800 14,800 14,800 14,800 9,500
4,440 4,440 4,440 4,440 4,440 4,440 4,440 2,850
10,360 10,360 10,360 10,360 10,360 10,360 10,360 6,650
D10.1
D10.3
COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM Benign neoplasm of Cranial nerves; Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Olfactory bulb NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Spinal cord NERVOUS SYSTEM Benign neoplasm of Other specified parts of central COMPLICATIONS OF BENIGN NEOPLASMS OF THE nervous system NERVOUS SYSTEM Benign neoplasm of Central nervous system, unspecified; COMPLICATIONS OF BENIGN NEOPLASMS OF THE Central Nervous system NOS NERVOUS SYSTEM Benign neoplasm of Peripheral nerves and autonomic COMPLICATIONS OF BENIGN NEOPLASMS OF THE nervous system NERVOUS SYSTEM Benign neoplasm of Lip; Benign neoplasm of frenulum of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Lip; Benign neoplasm of Inner aspect of lip; Benign ORAL CAVITY, PHARYNX, LARYNX, SALIVARY neoplasm of Mucosa of Lip; Vermilion border of Lip GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Tongue;Benign neoplasm of Lingual ORAL CAVITY, PHARYNX, LARYNX, SALIVARY tonsil GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Other and unspecified parts of mouth; ORAL CAVITY, PHARYNX, LARYNX, SALIVARY Benign neoplasm of Minor salivary gland NOS GLANDS
9,500
2,850
6,650
9,500
2,850
6,650
Page 13 of 111
Benign neoplasm of Nasopharynx; Benign neoplasm of Pharyngeal tonsil; Benign neoplasm of Posterior margin of septum and choanae Benign neoplasm of Hypopharynx
GROUP
COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY, PHARYNX, LARYNX, SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES
Case Rate 9,500
D10.6
D10.7
9,500
2,850
6,650
D10.9
Benign neoplasm of Pharynx, unspecified
9,500
2,850
6,650
D11.0
Benign neoplasm of Parotid gland
9,500
2,850
6,650
D11.7
Benign neoplasm of Other major salivary glands
9,500
2,850
6,650
D11.9
Benign neoplasm of Major salivary gland, unspecified Benign neoplasm of Larynx; Benign neoplasm of suprahyoid portion of Epiglottis Benign neoplasm of Trachea Benign neoplasm of Kidney Benign neoplasm of Renal pelvis Benign neoplasm of Bladder; Benign neoplasm of Urethral orifice of bladder; Benign neoplasm of ureteric orifice of bladder Benign neoplasm of Urethra Benign neoplasm of Urinary organ, unspecified; Benign neoplasm of Urinary system NOS Cardiac septal defect, acquired; Acquired atrial septal defect old; Acquired auricular septal defect old ; Acquired ventricular septal defect old Rupture of chordae tendineae, not elsewhere classified Rupture of papillary muscle, not elsewhere classified Intra cardiac thrombosis, notel sewhere classified; Old Apical thrombosis; Old Atrial thrombosis; Old Auricular thrombosis; Old Venticular thrombosis Myocarditis, unspecified; Myocardial fibrosis; Myocarditis NOS; Chronic interstitial myocarditis Myocardial degeneration; Fatty Degeneration of heart or myocardium fatty; Senile Degeneration of heart or myocardium; Myocardial disease Other ill-defined heart diseases; Acute carditis; Chronic Carditis; Acute pancarditis; Chronic pancarditis Haemangioma, any site; Angioma NOS Lymphangioma, any site Benign neoplasm of Bronchus and lung Benign neoplasm of Respiratory system, unspecified Benign neoplasm of Thymus Benign neoplasm of Heart Benign neoplasm of Mediastinum Benign neoplasm of Intrathoracic organ, unspecified Benign lipomatous neoplasm of intrathoracic organs Benign neoplasm of Connective and other soft tissue of thorax; Benign neoplasm of Connective and other soft tissue of Axilla; Benign neoplasm of Connective and other soft tissue of Diaphragm; Benign neoplasm of Connective and other soft tissue of Great v Late Symptomatic neurosyphilis; Tabes dorsalis Neurosyphilis, unspecified; Syphilitic Gumma of central nervous system NOS; Late Syphilis of central nervous system NOS; Syphiloma of central nervous system NOS Other symptomatic late syphilis
9,500
2,850
6,650
D14.1
9,500
2,850
6,650
D14.2 D30.0 D30.1 D30.3 D30.4 D30.9 I51.0 I51.1 I51.2 I51.3 I51.4 I51.5
9,500 8,300 8,300 8,300 8,300 8,300 14,400 14,400 14,400 14,400 14,400 14,400
2,850 2,490 2,490 2,490 2,490 2,490 4,320 4,320 4,320 4,320 4,320 4,320
6,650 5,810 5,810 5,810 5,810 5,810 10,080 10,080 10,080 10,080 10,080 10,080
I51.8 D18.0 D18.1 D14.3 D14.4 D15.0 D15.1 D15.2 D15.9 D17.4
COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEMANGIOMA AND LYMPHANGIOMA COMPLICATIONS OF HEMANGIOMA AND LYMPHANGIOMA COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES
14,400 9,000 9,000 10,100 10,100 10,100 10,100 10,100 10,100 10,100
4,320 2,700 2,700 3,030 3,030 3,030 3,030 3,030 3,030 3,030
10,080 6,300 6,300 7,070 7,070 7,070 7,070 7,070 7,070 7,070
D21.3
10,100
3,030
7,070
A52.1
5,500
1,650
3,850
A52.3
5,500
1,650
3,850
A52.7
5,500
1,650
3,850
Page 14 of 111
Latent syphilis, unspecified as early or late; Latent syphilis NOS; Positive serological reaction for syphilis Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess; Gonococcal Bartholin's gland abscess GONOCOCCAL PELVIPERITONITIS AND OTHER GONOCOCCAL GENITOURINARY INFECTIONS Gonococcal septicaemia; Gonococcal skin lesions Chlamydial lymphogranuloma (venereum); Climatic or tropical bubo ; Durand-Nicolas-Favre disease; Esthiomene; Lymphogranuloma inguinale Chlamydial infection of pelviperitoneum and other genitourinary organs; Trichomoniasis Air embolism (traumatic) Fat embolism (traumatic) Traumatic secondary and recurrent haemorrhage Post-traumatic wound infection, not elsewhere classified Traumatic shock; immediate shock following injury; Delayed shock following injury Traumatic anuria; Crush syndrome; Renal failure following crushing Traumatic ischaemia of muscle; Compartment syndrome; Volkmann's ischaemic contracture Traumatic subcutaneous emphysema Other early complications of trauma
GROUP
COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA
Case Rate 5,500
A53.0
A54.1 A54.2 A54.8 A55 A56.1 A59 T79.0 T79.1 T79.2 T79.3 T79.4 T79.5 T79.6 T79.7 T79.8 E25.0 P61.2 P61.3 P61.4 D64.4 D74.0 Q80.2 Q80.9 Q81.2 Q81.8 Q81.9 Q82.0 Q82.2 Q82.3 Q82.4
5,500 5,500 5,500 5,500 5,500 5,500 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 7,800 15,200 15,200 15,200 4,000 4,000 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800
1,650 1,650 1,650 1,650 1,650 1,650 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,340 4,560 4,560 4,560 1,200 1,200 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540
3,850 3,850 3,850 3,850 3,850 3,850 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 5,460 10,640 10,640 10,640 2,800 2,800 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260
Congenital adrenogenital disorders associated with enzyme deficiency; Congenital adrenal hyperplasia; 21-Hydroxylase CONGENITAL ANDROGENITAL DISORDER deficiency; Salt-losing congenital adrenal hyperplasia Anaemia of prematurity Congenital anaemia from fetal blood loss Other congenital anaemias, not elsewhere classified; Congenital anaemia NOS Congenital dyserythropoietic anaemia; Congenital Dyshaematopoietic anaemia Congenital methaemoglobinaemia Lamellar ichthyosis; Collodion baby Congenital ichthyosis, unspecified Epidermolysis bullosa dystrophica Other epidermolysis bullosa Epidermolysis bullosa, unspecified Hereditary lymphoedema Mastocytosis; Urticaria pigmentosa Incontinentia pigmenti Ectodermal dysplasia (anhidrotic) Other specified congenital malformations of skin; Abnormal palmar creases; Accessory skin tags; Benign familial pemphigus [Hailey-Hailey]; Cutis laxa (hyperelastica); Dermatoglyphic anomalies; Inherited keratosis palmaris et plantaris; Keratosis follicula Other specified congenital malformations of integument; Aplasia cutis congenita Developmental ovarian cyst CONGENITAL ANEMIA CONGENITAL ANEMIA CONGENITAL ANEMIA CONGENITAL BLOOD DISORDERS CONGENITAL BLOOD DISORDERS CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES
Q82.8
CONGENITAL DERMATOLOGIC DISEASES
11,800
3,540
8,260
Q84.8 Q50.1 Q50.3 Q50.4 Q50.5
CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT
11,800 9,300 9,300 9,300 9,300
3,540 2,790 2,790 2,790 2,790
8,260 6,510 6,510 6,510 6,510
Other congenital malformations of ovary; Accessory ovary; CONGENITAL DISORDERS OF THE FEMALE GENITAL Congenital malformation of ovary NOS; Ovarian streak TRACT Embryonic cyst of fallopian tube; Fimbrial cyst Embryonic cyst of broad ligament; Cyst epoophoron; Gartner's duct Cyst; Parovarian Cyst Other congenital malformations of fallopian tube and broad ligament; Absence of fallopian tube or broad ligament; Accessory of fallopian tube or broad ligament; Atresia of fallopian tube or broad ligament; Congenital malformation of fallopian tube or bro Agenesis and aplasia of uterus; Congenital absence of uterus Congenital malformation of uterus and cervix, unspecified Unstable hip; Dislocatable hip; Subluxatable hip Plagiocephaly CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM
Q50.6
9,300
2,790
6,510
Q51.0 Q51.9 Q65.6 Q67.3
9,300 9,300 5,300 5,300
2,790 2,790 1,590 1,590
6,510 6,510 3,710 3,710
Q67.4
Other congenital deformities of skull, face and jaw; Depressions in skull; Deviation of nasal septum, congenital; CONGENITAL DISORDERS OF THE Hemifacial atrophy or hypertrophy; Squashed or bent nose, MUSCULOSKELETAL SYSTEM congenital
5,300
1,590
3,710
Page 15 of 111
Q67.6 Q67.7
DESCRIPTION
Pectus excavatum; Congenital funnel chest Pectus carinatum; Congenital pigeon chest Congenital deformity of sternocleidomastoid muscle; Congenital, sternomastoid torticollis; Contracture of sternocleidomastoid muscle; Sternomastoid tumour, congenital Congenital scoliosis due to congenital bony malformation; Hemivertebra fusion or failure of segmentation with scoliosis Osteogenesis imperfecta; Fragilitas ossium Osteopetrosis; Albers-Schnberg syndrome Other specified osteochondrodysplasias; Osteopoikilosis Osteochondrodysplasia, unspecified; Chondrodystrophy NOS; Osteodystrophy NOS Other congenital malformation syndromes with other skeletal changes Atresia of oesophagus without fistula; Atresia of oesophagus NOS Atresia of oesophagus with tracheo-oesophageal fistula; Atresia of oesophagus with broncho-oesophageal fistula Congenital tracheo-oesophageal fistula without atresia; Congenital tracheo-oesophageal fistula NOS Diverticulum of oesophagus; Oesophageal pouch Congenital malformation of oesophagus, unspecified Congenital hypertrophic pyloric stenosis; Congenital or infantile constriction of pylorus; Congenital or infantile hypertrophy of pylorus; Congenital or infantile spasm of pylorus; Congenital or infantile stenosis of pylorus; Congenital or infantile stric Congenital hiatus hernia; Displacement of cardia through oesophageal hiatus Other specified congenital malformations of stomach; Congenital displacement of stomach; Congenital diverticulum of stomach; Congenital hourglass stomach; Duplication of stomach; Megalogastria; Microgastria Congenital malformation of upper alimentary tract, unspecified; Congenital anomaly NOS of upper alimentary tract; Congenital deformity NOS of upper alimentary tract Congenital absence, atresia and stenosis of duodenum Congenital absence, atresia and stenosis of jejunum; Apple peel syndrome; Imperforate jejunum Congenital absence, atresia and stenosis of ileum Congenital absence, atresia and stenosis of small intestine, part unspecified; Congenital absence, atresia and stenosis of intestine NOS Congenital absence, atresia and stenosis of rectum with fistula Congenital absence, atresia and stenosis of rectum without fistula; Imperforate rectum Congenital absence, atresia and stenosis of anus with fistula Congenital absence, atresia and stenosis of anus without fistula; Imperforate anus Congenital absence, atresia and stenosis of large intestine, part unspecified Meckel's diverticulum; Persistent omphalomesenteric duct; Persistent vitelline duct Hirschsprung's disease; Aganglionosis; Congenital (aganglionic) megacolon Other congenital functional disorders of colon; Congenital dilatation of colon Congenital malformations of intestinal fixation; Congenital anomalous omental adhesions [bands] ; Congenital peritoneal adhesions [bands]; Jackson's membrane; Malrotation of colon; Failure of rotation of caecum and colon; Incomplete rotation of caecum a Duplication of intestine Ectopic anus Congenital fistula of rectum and anus Persistent cloaca; Cloaca NOS
GROUP
CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS
Case Rate 5,300 5,300
Q68.0
5,300
1,590
3,710
Q76.3 Q78.0 Q78.2 Q78.8 Q78.9 Q87.5 Q39.0 Q39.1 Q39.2 Q39.6 Q39.9
5,300 5,300 5,300 5,300 5,300 5,300 11,300 11,300 11,300 11,300 11,300
1,590 1,590 1,590 1,590 1,590 1,590 3,390 3,390 3,390 3,390 3,390
3,710 3,710 3,710 3,710 3,710 3,710 7,910 7,910 7,910 7,910 7,910
Q40.0
CONGENITAL GASTROINTESTINAL DISORDERS
11,300
3,390
7,910
Q40.1
11,300
3,390
7,910
Q40.2
11,300
3,390
7,910
Q40.9
11,300
3,390
7,910
Q41.0 Q41.1 Q41.2 Q41.9 Q42.0 Q42.1 Q42.2 Q42.3 Q42.9 Q43.0 Q43.1 Q43.2
CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS
11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300
3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390
7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910
Q43.3
11,300
3,390
7,910
Q43.4 Q43.5 Q43.6 Q43.7
CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS
11,300 11,300 11,300 11,300
3,390 3,390 3,390 3,390
7,910 7,910 7,910 7,910
Page 16 of 111
Other specified congenital malformations of intestine; Congenital blind loop syndrome; Congenital diverticulitis, colon; Congenital diverticulum, intestine; Dolichocolon; Megaloappendix; Megaloduodenum; Microcolon; Transposition of appendix; Transpositio
GROUP
Case Rate
Professional Fee
Q43.8
11,300
3,390
7,910
Q43.9 Q44.0 Q44.1 Q44.2 Q44.3 Q44.4 Q44.5 Q44.6 Q44.7
Congenital malformation of intestine, unspecified CONGENITAL GASTROINTESTINAL DISORDERS Agenesis, aplasia and hypoplasia of gallbladder; Congenital CONGENITAL GASTROINTESTINAL DISORDERS absence of gallbladder Other congenital malformations of gallbladder; Congenital malformation of gallbladder NOS; Intrahepatic gallbladder Atresia of bile ducts Congenital stenosis and stricture of bile ducts Choledochal cyst Other congenital malformations of bile ducts; Accessory hepatic duct; Congenital malformation of bile duct NOS; Biliary duct Duplication; Cystic duct Duplication Cystic disease of liver; Fibrocystic disease of liver CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS
11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,300
3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,390
7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910 7,910
Other congenital malformations of liver; Accessory liver; Alagille's syndrome; Congenital absence of liver; Congenital CONGENITAL GASTROINTESTINAL DISORDERS hepatomegaly; Congenital malformation of liver NOS Agenesis, aplasia and hypoplasia of pancreas; Congenital absence of pancreas Other specified congenital malformations of digestive system; Absence of alimentary tract NOS, complete; Absence of alimentary tract NOS, partial; Duplication of digestive organs NOS; Malposition, congenital of digestive organs NOS Congenital malformation of digestive system, unspecified; Congenital anomaly NOS of digestive system ; Congenital deformity NOS of digestive system Congenital diaphragmatic hernia Other congenital malformations of diaphragm; Absence of diaphragm; Congenital malformation of diaphragm NOS; Eventration of diaphragm Exomphalos; Omphalocele Gastroschisis Prune belly syndrome Other congenital malformations of abdominal wall Common arterial trunk; Persistent truncus arteriosus Double outlet right ventricle; Taussig-Bing syndrome Double outlet left ventricle Discordant ventriculoarterial connection; Dextrotransposition of aorta; Transposition of great vessels (complete) Double inlet ventricle; Common ventricle; Cor triloculare biatriatum; Single ventricle Discordant atrioventricular connection; Corrected transposition; Laevotransposition; Ventricular inversion Congenital malformation of cardiac chambers and connections, unspecified Ventricular septal defect Atrial septal defect; Coronary sinus defect; Patent or persistent foramen ovale; Patent or persistent ostium secundum defect (type II); Sinus venosus defect Atrioventricular septal defect; Common atrioventricular canal; Endocardial cushion defect; Ostium primum atrial septal defect (type I) Tetralogy of Fallot; Ventricular septal defect with pulmonary stenosis or atresia, dextroposition of aorta and hypertrophy of right ventricle. Aortopulmonary septal defect; Aortic septal defect; Aortopulmonary window Other congenital malformations of cardiac septa; Eisenmenger's defect; Pentalogy of Fallot Congenital malformation of cardiac septum, unspecified; Septal (heart) defect NOS Pulmonary valve atresia Congenital pulmonary valve stenosis Congenital pulmonary valve insufficiency; Congenital pulmonary valve regurgitation Congenital tricuspid stenosis; Tricuspid atresia Ebstein's anomaly Hypoplastic right heart syndrome Other congenital malformations of tricuspid valve Congenital stenosis of aortic valve; Congenital aortic atresia; Congenital aortic stenosis Congenital insufficiency of aortic valve; Bicuspid aortic valve; Congenital aortic insufficiency CONGENITAL GASTROINTESTINAL DISORDERS
Q45.0
11,300
3,390
7,910
Q45.8
11,300
3,390
7,910
Q45.9 Q79.0 Q79.1 Q79.2 Q79.3 Q79.4 Q79.5 Q20.0 Q20.1 Q20.2 Q20.3 Q20.4 Q20.5 Q20.9 Q21.0 Q21.1
CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,300 11,300 11,300 11,300 11,300 11,300 11,300 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600
3,390 3,390 3,390 3,390 3,390 3,390 3,390 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480
7,910 7,910 7,910 7,910 7,910 7,910 7,910 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120
Q21.2
CONGENITAL HEART DISEASES
11,600
3,480
8,120
Q21.3 Q21.4 Q21.8 Q21.9 Q22.0 Q22.1 Q22.2 Q22.4 Q22.5 Q22.6 Q22.8 Q23.0 Q23.1
CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120
Page 17 of 111
Q23.2 Q23.3
DESCRIPTION
GROUP
Case Rate 11,600 11,600
Q23.4
Congenital mitral stenosis; Congenital mitral atresia CONGENITAL HEART DISEASES Congenital mitral insufficiency CONGENITAL HEART DISEASES Hypoplastic left heart syndrome; Atresia, or marked hypoplasia of aortic orifice or valve, with hypoplasia of ascending aorta and defective development of left ventricle CONGENITAL HEART DISEASES (with mitral valve stenosis or atresia). Other congenital malformations of aortic and mitral valves CONGENITAL HEART DISEASES Congenital malformation of aortic and mitral valves, unspecified Dextrocardia Cor triatriatum Pulmonary infundibular stenosis Congenital subaortic stenosis Malformation of coronary vessels; Congenital coronary (artery) aneurysm Congenital heart block Other specified congenital malformations of heart; Congenital diverticulum of left ventricle; Congenital malformation of myocardium; Congenital malformation of pericardium; Malposition of heart; Uhl's disease Congenital malformation of heart, unspecified; Congenital anomaly NOS of heart; Congenital disease NOS of heart Patent ductus arteriosus; Patent ductus Botallo; Persistent ductus arteriosus Coarctation of aorta; Preductal coarctation of aorta; Postductal coarctation of aorta Atresia of aorta Stenosis of aorta; Supravalvular aortic stenosis CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,600
3,480
8,120
Q23.8 Q23.9 Q24.0 Q24.2 Q24.3 Q24.4 Q24.5 Q24.6
11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120
Q24.8
11,600
3,480
8,120
Q24.9 Q25.0 Q25.1 Q25.2 Q25.3
CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120
Q25.4
Other congenital malformations of aorta; Absence of aorta; Aplasia of aorta; Congenital aneurysm of aorta; Congenital dilatation of aorta; Aneurysm of sinus of valsalva (rupture); CONGENITAL HEART DISEASES Double aortic arch [vascular ring or aorta]; Hypoplasia of aorta; Persisten Atresia of pulmonary artery Stenosis of pulmonary artery Other congenital malformations of pulmonary artery; aberrant pulmonary artery; agenesis of pulmonary artery; aneurysm, congenital of pulmonary artery; anomaly of pulmonary artery; hypoplasia of pulmonary artery; pulmonary arteriovenous aneurysm Other congenital malformations of great arteries Congenital malformation of great arteries, unspecified Congenital stenosis of vena cava; Congenital stenosis of inferior vena cava; Congenital stenosis ofsuperior vena cava Total anomalous pulmonary venous connection Anomalous pulmonary venous connection, unspecified CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,600
3,480
8,120
Q25.5 Q25.6
11,600 11,600
3,480 3,480
8,120 8,120
Q25.7
11,600
3,480
8,120
Q25.8 Q25.9 Q26.0 Q26.2 Q26.4
CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES
11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120
Q26.8
Other congenital malformations of great veins; Absence of inferior vena cava ; Absence of superior vena cava ; Azygos CONGENITAL HEART DISEASES continuation of inferior vena cava; Persistent left posterior cardinal vein; Scimitar syndrome Congenital malformation of great vein, unspecified; Anomaly of inferior vena cava NOS; Anomaly of superior vena cava NOS Congenital iodine-deficiency syndrome, neurological type; Endemic cretinism, neurological type Congenital hypothyroidism with diffuse goitre; Nontoxic congenital Goitre NOS; Nontoxic ongenital parenchymatous Goitre Congenital hypothyroidism without goitre; Aplasia of thyroid (with myxoedema); Congenital atrophy of thyroid; Congenital hypothyroidism NOS Anencephaly; Acephaly; Acrania; Amyelencephaly; Hemicephaly; Hemicephaly Frontal encephalocele Nasofrontal encephalocele Occipital encephalocele Encephalocele of other sites Microcephaly; Hydromicrocephaly; Micrencephalon CONGENITAL HEART DISEASES CONGENITAL HYPOTHYROIDISM CONGENITAL HYPOTHYROIDISM
11,600
3,480
8,120
Q26.9 E00.0 E03.0
11,600 9,900 9,900
3,480 2,970 2,970
8,120 6,930 6,930
E03.1 Q00.0 Q01.0 Q01.1 Q01.2 Q01.8 Q02
CONGENITAL HYPOTHYROIDISM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM
9,900 13,000 13,000 13,000 13,000 13,000 13,000
2,970 3,900 3,900 3,900 3,900 3,900 3,900
6,930 9,100 9,100 9,100 9,100 9,100 9,100
Page 18 of 111
Malformations of aqueduct of Sylvius; Anomaly of aqueduct of sylvius; Obstruction, congenital of aqueduct of sylvius; Stenosis of aqueduct of sylvius Atresia of foramina of Magendie and Luschka; DandyWalker syndrome Congenital malformations of corpus callosum; Agenesis of corpus callosum Holoprosencephaly Other reduction deformities of brain; Absence of part of brain; Agenesis of part of brain; Aplasia of part of brain; Hypoplasia of part of brain ; Agyria; Hydranencephaly; Lissencephaly; Microgyria; Pachygyria Septo-optic dysplasia Congenital cerebral cysts; Porencephaly; Schizencephaly Other specified congenital malformations of brain; Macrogyria Congenital malformation of brain, unspecified; Congenital anomaly NOS of brain; Congenital deformity NOS of brain; Congenital disease of lesion NOS of brain; Congenital multiple anomalis NOS of brain Thoracic spina bifida with hydrocephalus; Dorsal spina bifida with hydrocephalus; Thoracolumbar spina bifida with hydrocephalus Lumbar spina bifida with hydrocephalus; Lumbosacral spina bifida with hydrocephalus Unspecified spina bifida with hydrocephalus Thoracic spina bifida without hydrocephalus; Dorsal NOS spina bifida; Thoracolumbar NOS spina bifida Lumbar spina bifida without hydrocephalus; Lumbosacral spina bifida NOS Sacral spina bifida without hydrocephalus Spina bifida, unspecified Amyelia Diastematomyelia Hydromyelia; Hydrorachis Other specified congenital malformations of spinal cord
GROUP
CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM
Case Rate 13,000 13,000 13,000 13,000
Q03.0 Q03.1 Q04.0 Q04.2
Q04.3
13,000
3,900
9,100
Q04.4 Q04.6 Q04.8
13,000 13,000 13,000
3,900 3,900 3,900
9,100 9,100 9,100
Q04.9
13,000
3,900
9,100
Q05.1 Q05.2 Q05.4 Q05.6 Q05.7 Q05.8 Q05.9 Q06.0 Q06.2 Q06.4 Q06.8
CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM
13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000
3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900
9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100
Q06.9
Congenital malformation of spinal cord, unspecified; Congenital anomaly NOS of spinal cord or meninges; CONGENITAL MALFORMATIONS OF THE Congenital deformity NOS of spinal cord or meninges; BRAIN/NERVOUS SYSTEM Congenital disease or lesion NOS of spinal cord or meninges Arnold-Chiari syndrome Congenital malformation of nervous system, unspecified; Congenital anomaly NOS of nervous system; Congenital deformity NOS of nervous system; Congenital disease or lesion NOS of nervous system Arthrogryposis multiplex congenita Craniosynostosis; Acrocephaly; ]Imperfect fusion of skull; Oxycephaly; Trigonocephaly Craniofacial dysostosis; Crouzon's disease Hypertelorism Mandibulofacial dysostosis; Franceschetti Syndrome; Treacher Collins Syndrome Other specified congenital malformations of skull and face bones; Absence of skull bone, congenital; Congenital deformity of forehead; Platybasia Congenital malformation of skull and face bones, unspecified; Congenital anomaly of face bones NOS; Congenital anomaly of skull NOS Spina bifida occulta Other congenital malformations of spine, not associated with scoliosis; Congenital absence of vertebra unspecified or not associated with scoliosis; Congenital fusion of spine unspecified or not associated with scoliosis; Congenital kyphosis unspecified o CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM
13,000
3,900
9,100
Q07.0
13,000
3,900
9,100
Q07.9
13,000
3,900
9,100
Q74.3 Q75.0 Q75.1 Q75.2 Q75.4 Q75.8
13,000 13,000 13,000 13,000 13,000 13,000
3,900 3,900 3,900 3,900 3,900 3,900
9,100 9,100 9,100 9,100 9,100 9,100
Q75.9 Q76.0
13,000 13,000
3,900 3,900
9,100 9,100
Q76.4
CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM
13,000
3,900
9,100
Page 19 of 111
Q32.0
DESCRIPTION
Congenital tracheomalacia
GROUP
CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT
Case Rate 21,700
Q32.4
Other congenital malformations of bronchus; Absence of bronchus; Agenesis of bronchus; Atresia of bronchus; CONGENITAL MALFORMATIONS OF THE LOWER Congenital malformation NOS of bronchus; Diverticulum of RESPIRATORY TRACT bronchus; Congenital malformations of lung] of bronchus Congenital cystic lung; Congenital honeycomb lung; Congenital cystic lung disease; Congenital polycystic lung disease Sequestration of lung Agenesis of lung; Absence of lung, lobe Congenital bronchiectasis Hypoplasia and dysplasia of lung Congenital cyst of mediastinum Other specified congenital malformations of respiratory system; Atresia of nasopharynx Congenital malformation of respiratory system, unspecified; Congenital absence of respiratory organ ; Congenital anomaly NOS of respiratory organ Choanal atresia; Absence of anterior nares; Absence of posterior nares; congenital stenosis of anterior nares; Congenital stenosis of posterior nares Agenesis and underdevelopment of nose; Congenital absence of nose Fissured, notched and cleft nose Laryngocele Congenital laryngomalacia Other congenital malformations of larynx; Absence of cricoid cartilage, epiglottis, glottis, larynx or thyroid cartilage; Agenesis of cricoid cartilage, epiglottis, glottis, larynx or thyroid cartilage; Atresia of cricoid cartilage, epiglottis, glottis, Congenital malformation of larynx, unspecified Macroglossia Congenital malformations of palate, not elsewhere classified; Absence of uvula; Congenital malformation of palate NOS; High arched palate Other congenital malformations of mouth; Congenital malformation of mouth NOS Other congenital malformations of pharynx; Congenital malformation of pharynx NOS Coloboma of lens Spherophakia Other congenital corneal malformations; Congenital malformation of cornea NOS; Microcornea; Peter's anomaly Congenital malformation of vitreous humour; Congenital vitreous opacity Congenital malformation of retina; Congenital retinal aneurysm Congenital malformation of posterior segment of eye, unspecified CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE, UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS
21,700
6,510
15,190
Q33.0 Q33.2 Q33.3 Q33.4 Q33.6 Q34.1 Q34.8 Q34.9
21,700 21,700 21,700 21,700 21,700 21,700 21,700 21,700
6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510
15,190 15,190 15,190 15,190 15,190 15,190 15,190 15,190
Q30.0 Q30.1 Q30.2 Q31.3 Q31.5
11,000 11,000 11,000 11,000 11,000
3,300 3,300 3,300 3,300 3,300
7,700 7,700 7,700 7,700 7,700
Q31.8
11,000
3,300
7,700
Q31.9 Q38.2 Q38.5 Q38.6 Q38.8 Q12.2 Q12.4 Q13.4 Q14.0 Q14.1 Q14.9
11,000 4,000 4,000 4,000 4,000 4,300 4,300 4,300 4,300 4,300 4,300
3,300 1,200 1,200 1,200 1,200 1,290 1,290 1,290 1,290 1,290 1,290
7,700 2,800 2,800 2,800 2,800 3,010 3,010 3,010 3,010 3,010 3,010
Q15.0
Congenital glaucoma; Buphthalmos; Glaucoma of newborn; Hydrophthalmos; Keratoglobus, congenital, with glaucoma; CONGENITAL OPHTHALMOLOGIC DISORDERS Macrocornea with glaucoma; Macrophthalmos in congenital glaucoma; Megalocornea with glaucoma Other specified congenital malformations of eye Congenital malformation of eye, unspecified; Congenital anomaly NOS of eye; Congenital deformity NOS of eye Congenital renal failure; Uraemia of newborn Renal agenesis, unilateral Renal agenesis, bilateral Renal agenesis, unspecified Renal hypoplasia, unilateral Renal hypoplasia, unspecified Potter's syndrome Congenital single renal cyst; Congenital cyst of kidney; Single cyst of kidney Polycystic kidney, autosomal recessive; Polycystic kidney, infantile type CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS
4,300
1,290
3,010
Q15.8 Q15.9 P96.0 Q60.0 Q60.1 Q60.2 Q60.3 Q60.5 Q60.6 Q61.0 Q61.1
4,300 4,300 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100
1,290 1,290 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730
3,010 3,010 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370
Page 20 of 111
Q61.2 Q61.3 Q61.4 Q61.5 Q61.8 Q61.9 Q62.0 Q62.7 Q63.0 Q63.1 Q63.2 Q63.3 Q63.8
DESCRIPTION
Polycystic kidney, autosomal dominant; Polycystic kidney, adult type Polycystic kidney, unspecified Renal dysplasia Medullary cystic kidney; Sponge kidney NOS Other cystic kidney diseases; Fibrocystic kidney; Fibrocystic renal degeneration or disease Cystic kidney disease, unspecified; Meckel-Gruber syndrome Congenital hydronephrosis Congenital vesico-uretero-renal reflux Accessory kidney Lobulated, fused and horseshoe kidney Ectopic kidney; Congenital displaced kidney; Malrotation of kidney Hyperplastic and giant kidney Other specified congenital malformations of kidney; Congenital renal calculi Early cutaneous congenital syphilis: , Early mucocutaneous congenital syphilis, Early visceral congenital syphilis; Early congenital syphilitic laryngitis; Early congenital syphilitic oculopathy; Early congenital syphilitic osteochondropathy; Ear Early congenital syphilis, unspecified; Congenital syphilis NOS less than two years after birth. Late congenital neurosyphilis [juvenile neurosyphilis]; Dementia paralytica juvenilis; Juvenile general paresis ; Juvenile tabes dorsalis; Juvenile taboparetic neurosyphilis Other late congenital syphilis, symptomatic; Syphilitic saddle nose Congenital syphilis, unspecified Atresia and stenosis of ureter; Congenital occlusion of ureter; Congenital occlusion of ureteropelvic junction; Congenital occlusion of ureterovesical orifice; Impervious ureter Congenital megaloureter; Congenital dilatation of ureter Other obstructive defects of renal pelvis and ureter; Congenital ureterocele
GROUP
CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS
Case Rate 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100
Professional Fee 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730
Health Care Institution Fee 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370
A50.0
CONGENITAL SYPHILIS
12,800
3,840
8,960
A50.2
CONGENITAL SYPHILIS
12,800
3,840
8,960
A50.4
CONGENITAL SYPHILIS
12,800
3,840
8,960
A50.5 A50.9 Q62.1
CONGENITAL SYPHILIS CONGENITAL SYPHILIS CONGENITAL URINARY TRACT DISORDERS
12,800 12,800 9,100
3,840 3,840 2,730
8,960 8,960 6,370
Q62.2 Q62.3 Q62.5
CONGENITAL URINARY TRACT DISORDERS CONGENITAL URINARY TRACT DISORDERS
9,100 9,100 9,100
2,730 2,730 2,730
6,370 6,370 6,370
Duplication of ureter; Accessory of ureter, Double of ureter CONGENITAL URINARY TRACT DISORDERS Malposition of ureter; Deviation of ureter or ureteric orifice; Displacement of ureter or ureteric orifice; Ectopic of ureter of ureteric orifice; Implantation, anomalous of ureter or ureteric orifice Exstrophy of urinary bladder; Ectopia vesicae; Extroversion of bladder Congenital posterior urethral valves Other atresia and stenosis of urethra and bladder neck; Congenital bladder neck obstruction; Congenital stricture of urethra; Congenital stricture of urinary meatus; Congenital stricture of vesicourethral orifice; Impervious urethra Malformation of urachus; Cyst of urachus; Patent urachus; Prolapse of urachus
Q62.6
CONGENITAL URINARY TRACT DISORDERS
9,100
2,730
6,370
Q64.1 Q64.2
CONGENITAL URINARY TRACT DISORDERS CONGENITAL URINARY TRACT DISORDERS
9,100 9,100
2,730 2,730
6,370 6,370
Q64.3
9,100
2,730
6,370
Q64.4
9,100
2,730
6,370
Q64.7
Other congenital malformations of bladder and urethra; Accessory bladder; Accessory urethra; Congenital hernia of bladder; Congenital malformation of bladder or urethra CONGENITAL URINARY TRACT DISORDERS NOS; Congenital prolapse of bladder (mucosa); Congenital prolapse of urethra; Congenit Other specified congenital malformations of urinary system CONGENITAL URINARY TRACT DISORDERS Congenital malformation of urinary system, unspecified; Congenital anomaly NOS of urinary system; Congenital deformity NOS of urinary system Congenital renal artery stenosis Peripheral arteriovenous malformation; Arteriovenous aneurysm Other specified congenital malformations of peripheral vascular system; Aberrant subclavian artery; Absence of artery or vein NEC; Atresia of artery or vein NEC; Congenital aneurysm (peripheral); Congenital stricture, artery; Congenital varix Congenital malformation of peripheral vascular system, unspecified; Anomaly of artery or vein NOS Arteriovenous malformation of precerebral vessels; Congenital arteriovenous precerebral aneurysm (nonruptured) Other malformations of precerebral vessels; Congenital malformation of precerebral vessels NOS; Congenital precerebral aneurysm (nonruptured) CONGENITAL URINARY TRACT DISORDERS CONGENITAL VASCULAR DISEASES CONGENITAL VASCULAR DISEASES
9,100
2,730
6,370
Q64.8 Q64.9 Q27.1 Q27.3
9,100 9,100 12,000 12,000
2,730 2,730 3,600 3,600
6,370 6,370 8,400 8,400
Q27.8
CONGENITAL VASCULAR DISEASES
12,000
3,600
8,400
Q27.9 Q28.0
CONGENITAL VASCULAR DISEASES CONGENITAL VASCULAR DISEASES
12,000 12,000
3,600 3,600
8,400 8,400
Q28.1
CONGENITAL VASCULAR DISEASES
12,000
3,600
8,400
Page 21 of 111
ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP
Case Rate Professional Fee 3,600 Health Care Institution Fee 8,400
Q28.2
Arteriovenous malformation of cerebral vessels; Arteriovenous malformation of brain NOS; CONGENITAL VASCULAR DISEASES Congenital arteriovenous cerebral aneurysm (nonruptured) Other malformations of cerebral vessels; Congenital cerebral aneurysm, nonruptured; Congenital malformation of cerebral vessels NOS Polyarteritis nodosa Polyarteritis with lung involvement [Churg-Strauss]; Allergic granulomatous angiitis Juvenile polyarteritis Mucocutaneous lymph node syndrome [Kawasaki] Other conditions related to polyarteritis nodosa; Polyangiitis overlap syndrome Hypersensitivity angiitis; Goodpasture's syndrome Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura Lethal midline granuloma Wegener's granulomatosis; Necrotizing respiratory granulomatosis Aortic arch syndrome [Takayasu] Other giant cell arteritis Other specified necrotizing vasculopathies; Hypocomplementaemic vasculitis Necrotizing vasculopathy, unspecified Juvenile dermatomyositis Other dermatomyositis Polymyositis Dermatopolymyositis, unspecified Progressive systemic sclerosis CR(E)ST syndrome; Combination of calcinosis, Raynaud's phenomenon, (o)esophageal dysfunction, sclerodactyly, telangiectasia Systemic sclerosis induced by drugs and chemicals Systemic sclerosis, unspecified SICCA SYNDROME [SJGREN] CONGENITAL VASCULAR DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES
12,000
Q28.3 M30.0 M30.1 M30.2 M30.3 M30.8 M31.0 M31.1 M31.2 M31.3 M31.4 M31.6 M31.8 M31.9 M33.0 M33.1 M33.2 M33.9 M34.0 M34.1 M34.2 M34.9 M35.0 M35.1 M35.2 M35.3 M35.4 M35.8 M35.9 G50.0 G50.8 G51.0 G51.1 G51.3 G51.4 G51.8 G51.9 G52.0 G52.1 G52.2 G52.7 G52.8 H46 H47.0 J05.0 E24.0 E24.1 E24.2 E24.3 E24.8 E24.9 E84.0 E84.1 E84.8 E84.9
12,000 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 8,200 9,500 9,500 9,500 9,500 9,500 9,500 7,300 7,300 7,300 7,300
3,600 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,460 2,850 2,850 2,850 2,850 2,850 2,850 2,190 2,190 2,190 2,190
8,400 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,740 6,650 6,650 6,650 6,650 6,650 6,650 5,110 5,110 5,110 5,110
Other overlap syndromes; Mixed connective tissue disease CONNECTIVE TISSUE DISEASES Behet's disease Polymyalgia rheumatica Diffuse (eosinophilic) fasciitis Other specified systemic involvement of connective tissue Systemic involvement of connective tissue, unspecified; Systemic Autoimmune disease NOS; Collagen (vascular) disease NOS Trigeminal neuralgia; Syndrome of paroxysmal facial pain; Tic douloureux Other disorders of trigeminal nerve Bell's palsy; Facial palsy Geniculate ganglionitis Clonic hemifacial spasm Facial myokymia Other disorders of facial nerve Disorder of facial nerve, unspecified Disorders of olfactory nerve; Disorder of 1st cranial nerve CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER
Disorders of glossopharyngeal nerve; Disorder of 9th CRANIAL NERVE DISORDER cranial nerve; Glossopharyngeal neuralgia Disorders of vagus nerve; Disorder of pneumogastric [10th] CRANIAL NERVE DISORDER nerve Disorders of multiple cranial nerves; Polyneuritis cranialis Disorders of other specified cranial nerves Optic neuritis; Optic neuropathy, except ischaemic; Optic papillitis; Retrobulbar neuritis NOS Disorders of optic nerve, not elsewhere classified; Compression of optic nerve; Haemorrhage in optic nerve sheath; Ischaemic optic neuropathy Acute obstructive laryngitis [croup]; Obstructive laryngitis NOS CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CROUP
Pituitary-dependent Cushing's disease; Overproduction of CUSHING'S SYNDROME pituitary ACTH; Pituitary-dependent hyperadrenocorticism Nelson's syndrome Drug-induced Cushing's syndrome Ectopic ACTH syndrome Other Cushing's syndrome Cushing's syndrome, unspecified Cystic fibrosis with pulmonary manifestations Cystic fibrosis with intestinal manifestations Cystic fibrosis with other manifestations; Cystic fibrosis with combined manifestations Cystic fibrosis, unspecified CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CYSTIC FIBROSIS CYSTIC FIBROSIS CYSTIC FIBROSIS CYSTIC FIBROSIS
Page 22 of 111
G30.0 G30.1 G30.8 G30.9+F00.9* G31.0 G31.1
DESCRIPTION
Alzheimer's disease with early onset Alzheimer's disease with late onset Other Alzheimer's disease Dementia in alzheimer's disease, unspecified Circumscribed brain atrophy; Pick's disease; Progressive isolated aphasia Senile degeneration of brain, not elsewhere classified
GROUP
DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM
Case Rate 10,000 10,000 10,000 10,000 10,000 10,000
G31.2
Degeneration of nervous system due to alcohol; Alcoholic cerebellar ataxia; Alcoholic cerebellar degeneration; DEGENERATIVE DISEASES OF CENTRAL NERVOUS Alcoholic cerebral degeneration; Alcoholic encephalopathy; SYSTEM Dysfunction of autonomic nervous system due to alcohol Other specified degenerative diseases of nervous system; Grey-matter degeneration [Alpers]; Lewy body (ies) dementia; Lewy body (ies) disease; Subacute necrotizing encephalopathy [Leigh] Other specified degenerative disorders of nervous system in diseases classified elsewhere Multiple sclerosis; Multiple sclerosis NOS; Multiple sclerosis of brain stem; Multiple sclerosis of cord; Multiple sclerosis, disseminated; Multiple sclerosis, generalized Neuromyelitis optica [Devic]; Demyelination in optic neuritis Acute and subacute haemorrhagic leukoencephalitis [Hurst] Other specified acute disseminated demyelination Acute disseminated demyelination, unspecified Diffuse sclerosis; Periaxial encephalitis; Schilder's disease Central demyelination of corpus callosum Central pontine myelinolysis Acute transverse myelitis in demyelinating disease of central nervous system; Acute transverse myelitis NOS Subacute necrotizing myelitis Other specified demyelinating diseases of central nervous system Demyelinating disease of central nervous system, unspecified Dengue without warning signs Dengue with warning signs Severe dengue Diabetes insipidus Nephrogenic diabetes insipidus Insulin-dependent diabetes mellitus with coma; Brittle diabetes (mellitus) with coma; Juvenile-onset diabetes (mellitus) withcoma ; Ketosis-prone diabetes (mellitus) with coma; Type I diabetes (mellitus) with coma; DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DENGUE FEVER DENGUE FEVER DENGUE, SEVERE DIABETES INSIPIDUS DIABETES INSIPIDUS
10,000
3,000
7,000
G31.8
10,000
3,000
7,000
G32.8*
10,000
3,000
7,000
G35
11,600
3,480
8,120
G36.0 G36.1 G36.8 G36.9 G37.0 G37.1 G37.2 G37.3 G37.4 G37.8 G37.9 A90 A91.1 A91.3 E23.2 N25.1
11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 10,000 10,000 16,000 10,100 10,100
3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,000 3,000 4,800 3,030 3,030
8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 7,000 7,000 11,200 7,070 7,070
E10.0
DIABETES MELLITUS WITH COMA OR KETOSIS
15,800
4,740
11,060
E10.1
E11.0
Insulin-dependent diabetes mellitus with acididosis/ ketoacidosis without mention of coma; Diabetic acididosis DIABETES MELLITUS WITH COMA OR KETOSIS without mention of coma; Diabetic ketoacidosis without mention of coma; Non-insulin-dependent diabetes mellitus with coma; Nonobese diabetes (mellitus) With coma ; Obese diabetes mellitus With coma ; Adult-onset diabetes mellitus With DIABETES MELLITUS WITH COMA OR KETOSIS coma ; Maturity-onset diabetes mellitus With coma ; Nonketotic diabetes mellitus With com Non-insulin-dependent diabetes mellitus with ketoacidosis without mention of coma; ; Nonobese diabetes (mellitus) With ketoacidosis without mention of coma; Obese DIABETES MELLITUS WITH COMA OR KETOSIS diabetes mellitus With ketoacidosis without mention of coma; Adult-onset diabetes mellitu Malnutrition-related diabetes mellitus with coma; Insulindependent malnutrition-related diabetes mellitus with coma ; Non-insulin-dependent malnutrition-related diabetes mellitus with coma Other specified diabetes mellitus with coma Other specified diabetes mellitus with acididosis/ ketoacidosis without mention of coma
15,800
4,740
11,060
15,800
4,740
11,060
E11.1
15,800
4,740
11,060
E12.0 E13.0 E13.1
DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS
15,800 15,800 15,800
4,740 4,740 4,740
11,060 11,060 11,060
Page 23 of 111
E14.0 E14.1 E10.5 E10.6 E10.7 E10.8
DESCRIPTION
Unspecified diabetes mellitus; diabetes NOS with coma Unspecified diabetes mellitus; diabetes NOS with acididosis/ ketoacidosis without mention of coma Insulin-dependent diabetes mellitus with Diabetic gangrene/ ulcer INSULIN-DEPENDENT DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Insulin-dependent diabetes mellitus with multiple complications Insulin-dependent diabetes mellitus with unspecified complications Non-insulin-dependent diabetes mellitus with Diabetic gangrene/ ulcer; Nonobese diabetes (mellitus) with Diabetic gangrene/ ulcer; Obese diabetes mellitus with Diabetic gangrene/ ulcer; Adult-onset diabetes mellitus with Diabetic gangrene/ ulcer; Mat NON-INSULIN-DEPENDENT DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Non-insulin-dependent diabetes mellitus with multiple complications ; Nonobese diabetes (mellitus) With multiple complications ; Obese diabetes mellitus With multiple complications ; Adult-onset diabetes mellitus With multiple complications ; Matur Malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer; Insulin-dependent malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer; Noninsulin-dependent malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer MALNUTRITION-RELTAED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Malnutrition-related diabetes mellitus with unspecified complications; Insulin-dependent malnutrition-related diabetes mellitus with unspecified complications; Noninsulin-dependent malnutrition-related diabetes mellitus with unspecified complicati Other specified diabetes mellitus with Diabetic gangrene/ ulcer OTHER SPECIFIED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Unspecified diabetes mellitus; diabetes NOS with Diabetic gangrene/ ulcer UNSPECIFIED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Unspecified diabetes mellitus; diabetes NOS with multiple complications Pharyngeal diphtheria; Diphtheritic membranous angina; Tonsillar diphtheria Cutaneous diphtheria Diphtheria, unspecified Agranulocytosis; Agranulocytic angina; Infantile genetic agranulocytosis; Kostmann's disease; Neutropenia NOS; Congenital Neutropenia; Cyclic Neutropenia; Drug-induced Neutropenia; Periodic Neutropenia; Primary Splenic Neutropenia; Toxic Neutropenia; Functional disorders of polymorphonuclear neutrophils; Cell membrane receptor complex [CR3] defect; Chronic (childhood) granulomatous disease; Congenital dysphagocytosis; Progressive septic granulomatosis; Other disorders of white blood cells Genetic anomalies of leukocytes; Alder Granulation Anomaly or Syndrome; Alder Granulocyte Anomaly or Syndrome; May-Hegglin Granulation Anomaly or Syndrome; May-Hegglin Granulocyte Anomaly or Syndrome; Pelger-Hut Granulocyte Anomaly or Syndrome; P Other specified disorders of white blood cells; Lymphocytic Leukaemoid reaction; Monocytic Leukaemoid reaction; Myelocytic Leukaemoid reaction; Leukocytosis; Symptomatic Lymphocytosis; Lymphopenia; Symptomatic Monocytosis; Chronic congestive splenomegaly
GROUP
DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS
Case Rate 15,800 15,800 12,600 12,600 12,600 12,600
E11.5
DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS
12,600
3,780
8,820
E11.6
12,600
3,780
8,820
E11.7
12,600
3,780
8,820
E12.5
DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS
12,600
3,780
8,820
E12.6
12,600
3,780
8,820
E12.8
12,600
3,780
8,820
E13.5 E13.6 E14.5 E14.6 E14.7 A36.0 A36.3 A36.9
DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIPHTHERIA DIPHTHERIA DIPHTHERIA
12,600 12,600 12,600 12,600 12,600 8,700 8,700 8,700
3,780 3,780 3,780 3,780 3,780 2,610 2,610 2,610
8,820 8,820 8,820 8,820 8,820 6,090 6,090 6,090
D70
DISEASES OF BLOOD AND BLOOD FORMING ORGANS
12,100
3,630
8,470
D71
12,100
3,630
8,470
D72.0
12,100
3,630
8,470
D72.8
12,100
3,630
8,470
D73.2 D73.3 D73.4 D73.5
DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING Abscess of spleen ORGANS DISEASES OF BLOOD AND BLOOD FORMING Cyst of spleen ORGANS Infarction of spleen; Nontraumatic Splenic rupture; Torsion DISEASES OF BLOOD AND BLOOD FORMING of spleen ORGANS
12,100 12,100 12,100 12,100
3,630 3,630 3,630 3,630
8,470 8,470 8,470 8,470
Page 24 of 111
D73.8 D74.9 D75.0
DESCRIPTION
Other diseases of spleen; Fibrosis of spleen NOS; Perisplenitis; Splenitis NOS Methaemoglobinaemia, unspecified
GROUP
DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING ORGANS
Case Rate 12,100 12,100 12,100
Professional Fee 3,630 3,630 3,630
Health Care Institution Fee 8,470 8,470 8,470
D75.1
D75.2 D75.8 D76.0 D76.1 D76.2 D76.3 K20 K22.0
K22.1
K22.2 K22.3 K22.4 K22.6 K22.7 K22.8 K22.9 H60.1 H60.2 H60.3 H60.4 H83.0 H83.8 H68.1 H69.9 H70.0 H70.1 H70.2 H70.8 H70.9 H71 H73.0 H73.1 H73.8 H73.9 H74.8 H74.9 K09.0
Familial erythrocytosis; Benign Polycythaemia; Familial Polycythaemia Secondary polycythaemia; Acquired Polycythaemia due to erythropoietin; Acquired Polycythaemia due to fall in DISEASES OF BLOOD AND BLOOD FORMING plasma volume; Acquired Polycythaemia due to high ORGANS altitude; Acquired Polycythaemia due to stress; Emotional Polycythaemia; Hypoxaemic Polycytha DISEASES OF BLOOD AND BLOOD FORMING Essential thrombocytosis ORGANS DISEASES OF BLOOD AND BLOOD FORMING Other specified diseases of blood and blood-forming organs ORGANS DISEASES OF BLOOD AND BLOOD FORMING Langerhans' cell histiocytosis, not elsewhere classified ORGANS Haemophagocytic lymphohistiocytosis; Eosinophilic DISEASES OF BLOOD AND BLOOD FORMING granuloma; Hand-Schller-Christian disease; Chronic ORGANS Histiocytosis X DISEASES OF BLOOD AND BLOOD FORMING Haemophagocytic syndrome, infection-associated ORGANS Other histiocytosis syndromes; Reticulohistiocytoma (giantDISEASES OF BLOOD AND BLOOD FORMING cell); Sinus histiocytosis with massive lymphadenopathy; ORGANS Xanthogranuloma Oesophagitis; Abscess of oesophagus; Oesophagitis NOS; DISEASES OF ESOPHAGUS Chemical oesophagitis; Peptic oesophagitis Achalasia of cardia; Achalasia NOS; Cardiospasm DISEASES OF ESOPHAGUS Ulcer of oesophagus; Erosion of oesophagus; Ulcer of oesophagus NOS; Ulcer of oesophagus due to ingestion of DISEASES OF ESOPHAGUS chemicals; Ulcer of oesophagus due to ingestion of drugs and medicaments; Fungal ulcer of oesophagus; Peptic ulcer of oesophagus Oesophageal obstruction; Compression of oesophagus; DISEASES OF ESOPHAGUS Constriction of oesophagus; Stenosis of oesophagus; Stricture of oesophagus; Perforation of oesophagus; Rupture of oesophagus DISEASES OF ESOPHAGUS Dyskinesia of oesophagus; Corksrew oesophagus; Diffuse DISEASES OF ESOPHAGUS oesophageal spasm; Spasm of oesophagus Gastro-oesophageal laceration-haemorrhage syndrome; DISEASES OF ESOPHAGUS Mallory-Weiss syndrome Barrett's esophagus; Barret's disease; Barett's syndrome Other specified diseases of oesophagus; Haemorrhage of oesophagus NOS Disease of oesophagus, unspecified Cellulitis of external ear; Cellulitis of auricle; Cellulitis of external auditory canal Malignant otitis externa Other infective otitis externa; diffuse Otitis externa ; Haemorrhagic Otitis externa ; Swimmer's ear Cholesteatoma of external ear; Keratosis obturans of external ear (canal) Labyrinthitis Other specified diseases of inner ear Obstruction of Eustachian tube; Compression of Eustachian tube; Stenosis of Eustachian tube; Stricture of Eustachian tube Eustachian tube disorder, unspecified Acute mastoiditis; Abscess of mastoid; Empyema of mastoid Chronic mastoiditis; Caries of mastoid; Fistula of mastoid Petrositis; Acute inflammation of petrous bone; Chronic inflammation of petrous bone Other mastoiditis and related conditions Mastoiditis, unspecified Cholesteatoma of middle ear; Cholesteatoma tympani; Perforation of tympanic membrane; Persistent posttraumatic perforation of ear drum; Postinflammatory perforation of ear drum Acute myringitis; Acute tympanitis; Bullous myringitis Chronic myringitis; Chronic tympanitis Other specified disorders of tympanic membrane Disorder of tympanic membrane, unspecified Other specified disorders of middle ear and mastoid Disorder of middle ear and mastoid, unspecified Developmental odontogenic cysts; Dentigerous cyst; Eruption Cyst; Follicular cyst; Gingival cyst; Lateral periodontal cyst; Primordial cyst; Keratocyst DISEASES OF ESOPHAGUS DISEASES OF ESOPHAGUS DISEASES OF ESOPHAGUS DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF INNER EAR DISEASES OF INNER EAR DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
12,100
3,630
8,470
12,100 12,100 12,100 12,100 12,100 12,100 8,300 8,300
3,630 3,630 3,630 3,630 3,630 3,630 2,490 2,490
8,470 8,470 8,470 8,470 8,470 8,470 5,810 5,810
8,300
2,490
5,810
8,300 8,300 8,300 8,300 8,300 8,300 8,300 9,000 9,000 9,000 9,000 6,200 6,200 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 10,400 8,300
2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,700 2,700 2,700 2,700 1,860 1,860 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 3,120 2,490
5,810 5,810 5,810 5,810 5,810 5,810 5,810 6,300 6,300 6,300 6,300 4,340 4,340 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 7,280 5,810
K09.1
Developmental (nonodontogenic) cysts of oral region; Cyst DISEASES OF ORAL CAVITY, SALIVARY GLANDS, of globulomaxillary; Cyst of incisive canal; Cyst of median AND JAW palatal; Cyst of nasopalatine; Cyst of palatine papilla
8,300
2,490
5,810
Page 25 of 111
Other cysts of jaw; Cyst of jaw NOS; Aneurysmal cyst of jaw; Haemorrhagic cyst of jaw; Traumatic cyst of jaw Other cysts of oral region, not elsewhere classified; Dermoid cyst of mouth; Epidermoid cyst of mouth; Lymphoepithelial cyst of mouth; Epstein's pearl; Nasoalveolar cyst; Nasolabial cyst Cyst of oral region, unspecified Developmental disorders of jaws; Latent bone cyst of jaw; Stafne's cyst; Torus mandibularis; Torus palatinus Giant cell granuloma, central; Giant cell granuloma NOS
GROUP
DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW
Case Rate 8,300
K09.2
K09.8
8,300
2,490
5,810
K09.9 K10.0 K10.1
8,300 8,300 8,300
2,490 2,490 2,490
5,810 5,810 5,810
K10.2
K10.3
DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW Inflammatory conditions of jaws; Acute osteitis of jaw; Chronic osteitis of jaw; Supparative osteitis of jaw; Acute DISEASES OF ORAL CAVITY, SALIVARY GLANDS, neonatal osteomyelitis of jaw; Chronic neonatal AND JAW osteomyelitis of jaw; Supparative neonatal osteomyelitis of jaw; Acute osteoradionecrosis o DISEASES OF ORAL CAVITY, SALIVARY GLANDS, Alveolitis of jaws; Alveolar osteitis; Dry socket AND JAW Other specified diseases of jaws; Cherubism of jaw; Exostosis of jaw; Fibrous dysplasia of jaw; Unilateral condylar hyperplasia; Unilateral condylar hypoplasia Sialoadenitis Abscess of salivary gland Fistula of salivary gland Sialolithiasis; Calculus of salivary gland or duct; Stone of salivary gland or duct Mucocele of salivary gland; Mucous extravasation cyst of salivary gland; Mucous retention cyst of salivary gland; Ranula Other diseases of salivary glands; Benign lymphoepithelial lesion of salivary gland; Mikulicz' disease; Necrotizing sialometaplasia; Sialectasia; Stenosis of salivary duct; Stricture of salivary duct Disease of salivary gland, unspecified; Sialoadenopathy NOS Cellulitis and abscess of mouth; Cellulitis of floor of mouth; Submandibular abscess Granuloma and granuloma-like lesions of oral mucosa; Eosinophilic granuloma of oral mucosa; Granuloma pyogenicum of oral mucosa; Verrucous xanthoma of oral mucosa Other and unspecified lesions of oral mucosa; Focal oral mucinosis Adult hypertrophic pyloric stenosis; Pyloric stenosis NOS Hourglass stricture and stenosis of stomach Pylorospasm, not elsewhere classified Gastric diverticulum Obstruction of duodenum; Constriction of duodenum; Stenosis of duodenum; Stricture of duodenum; Chronic duodenal ileus Fistula of stomach and duodenum; Gastrocolic fistula; Gastrojejunocolic fistula Polyp of stomach and duodenum Other specified diseases of stomach and duodenum; Achlorhydria; Gastroptosis; Hourglass contraction of stomach Secondary biliary cirrhosis Biliary cirrhosis, unspecified Calculus of gallbladder without cholecystitis; Cholecystolithiasis unspecified or without cholecystitis; Cholelithiasis unspecified or without cholecystitis; Recurrent colic of gallbladder unspecified or without cholecystitis; Impacted gallstone of cystic Calculus of bile duct without cholangitis or cholecystitis; Choledocholithiasis unspecified or without cholangitis or cholecystitis; Impacted gallstone of bile duct NOS unspecified or without cholangitis or cholecystitis; Impacted gallstone of common duct Other cholelithiasis DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF ORAL CAVITY, SALIVARY GLANDS, AND JAW DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT
8,300
2,490
5,810
8,300
2,490
5,810
K10.8
8,300
2,490
5,810
K11.2 K11.3 K11.4 K11.5 K11.6
8,300 8,300 8,300 8,300 8,300
2,490 2,490 2,490 2,490 2,490
5,810 5,810 5,810 5,810 5,810
K11.8
8,300
2,490
5,810
K11.9 K12.2
8,300 8,300
2,490 2,490
5,810 5,810
K13.4
8,300
2,490
5,810
K13.7 K31.1 K31.2 K31.3 K31.4 K31.5 K31.6 K31.7 K31.8 K74.4 K74.5
8,300 6,600 6,600 6,600 6,600 6,600 6,600 6,600 6,600 9,800 9,800
2,490 1,980 1,980 1,980 1,980 1,980 1,980 1,980 1,980 2,940 2,940
5,810 4,620 4,620 4,620 4,620 4,620 4,620 4,620 4,620 6,860 6,860
K80.2
DISEASES OF THE GALLBLADDER AND BILIARY TRACT
9,800
2,940
6,860
K80.5
9,800
2,940
6,860
K80.8
9,800
2,940
6,860
Page 26 of 111
Obstruction of gallbladder; Occlusion of cystic duct of gallbladder without calculus; Stenosis of cystic duct or gallbladder without calculus; Stricture of cystic duct or gallbladder without calculus Hydrops of gallbladder; Mucocele of gallbladder Perforation of gallbladder; Rupture of cystic duct or gallbladder Fistula of gallbladder; Cholecystocolic fistula; Cholecystoduodenal fistula Cholesterolosis of gallbladder; Strawberry gallbladder Other specified diseases of gallbladder; Adhesions of cystic duct or gallbladder; Atrophy of cystic duct or gallbladder; Cyst of cystic duct or gallbladder; Dyskinesia of cystic duct or gallbladder; Hypertrophy of cystic duct or gallbladder; Nonfunctionin Cholangitis; Cholangitis NOS; Ascending cholangitis; Primary cholangitis; Recurrent cholangitis; Sclerosing cholangitis; Secondary cholangitis; Stenosing cholangitis; Suppurative cholangitis Obstruction of bile duct; Occlusion of bile duct without calculus; Stenosis of bile duct without calculus; Stricture of bile duct without calculus Fistula of bile duct; Choledochoduodenal fistula Spasm of sphincter of Oddi Biliary cyst Other specified diseases of biliary tract; Adhesions of bile duct; Atrophy of bile duct; Hypertrophy of bile duct; Ulcer of bile duct Acute pancreatitis; Abscess of pancreas; Acute necrosis of pancreas; Infective necrosis of pancreas; Pancreatitis NOS; Acute recurrent pancreatitis; Haemorrhagic pancreatitis; Subacute pancreatitis; Supparative pancreatitis Idiopathic acute pancreatitis Biliary acute pancreatitis; Gallstone pancreatitis Alcohol-induced acute pancreatitis Other acute pancreatitis
GROUP
Case Rate
K82.0
DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT
9,800
K82.1 K82.2 K82.3 K82.4
9,800 9,800 9,800 9,800
2,940 2,940 2,940 2,940
6,860 6,860 6,860 6,860
K82.8
9,800
2,940
6,860
K83.0
DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT
9,800
2,940
6,860
K83.1 K83.3 K83.4 K83.5 K83.8
9,800 9,800 9,800 9,800 9,800
2,940 2,940 2,940 2,940 2,940
6,860 6,860 6,860 6,860 6,860
K85
DISEASES OF THE PANCREAS
12,600
3,780
8,820
K85.0 K85.1 K85.2 K85.8 K85.9 K86.0 K86.1 K86.2 K86.3
DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS
12,600 12,600 12,600 12,600 12,600 12,600 12,600 12,600 12,600
3,780 3,780 3,780 3,780 3,780 3,780 3,780 3,780 3,780
8,820 8,820 8,820 8,820 8,820 8,820 8,820 8,820 8,820
Acute pancreatitis, unspecified; Other diseases of pancreas DISEASES OF THE PANCREAS Alcohol-induced chronic pancreatitis Other chronic pancreatitis; Chronic pancreatitis NOS; Infectious chronic pancreatitis; Recurrent chronic pancreatitis; Relapsing chronic pancreatitis Cyst of pancreas Pseudocyst of pancreas DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS
K86.8
Other specified diseases of pancreas; Atrophy of pancreas; Calculus of pancreas; Cirrhosis of pancreas; Fibrosis of DISEASES OF THE PANCREAS pancreas; Pancreatic infantilism; Pancreatic necrosis NOS; Aseptic pancreatic necrosis; Fat necrosis of pancreas Other specified diseases of pulmonary vessels; Rupture of pulmonary vessel; Stenosis of pulmonary vessel; Stricture of pulmonary vessel Dissection of aorta [anypart]; Dissecting aneurysm of aorta (ruptured) [any part] Aortic aneurysm of unspecified site without mention of rupture; Aneurysm of aorta; Dilatation of aorta; Hyaline necrosis of aorta Embolism and thrombosis of abdominal aorta; Aortic bifurcation syndrome; Leriche's syndrome Embolism and thrombosis of other and unspecified parts of aorta Embolism and thrombosis of arteries of upper extremities Embolism and thrombosis of arteries of lower extremities Embolism and thrombosis of arteries of extremities, unspecified; Peripheral arterial embolism Embolism and thrombosis of iliac artery Embolism and thrombosis of other arteries Embolism and thrombosis of unspecified artery Coeliac artery compression syndrome Arteritis, unspecified; Aortitis NOS; Endarteritis NOS Other specified disorders of arteries and arterioles Oesophageal varices with bleeding Compression of vein; Stricture of vein; Inferior Vena cava syndrome; Superior vena cava syndrome DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM
12,600
3,780
8,820
I28.8 I71.0 I71.9 I74.0 I74.1 I74.2 I74.3 I74.4 I74.5 I74.8 I74.9 I77.4 I77.6 I77.8 I85.0 I87.1
13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100 13,100
3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930 3,930
9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170 9,170
Page 27 of 111
Disseminated chorioretinal inflammation; Disseminated chorioretinitis; Disseminated choroiditis; Disseminated retinitis; Disseminated retinochoroiditis Other chorioretinal inflammations; Harada's disease Choroidal haemorrhage and rupture; Choroidal haemorrhage NOS; Choroidal haemorrhage expulsive Postmenopausal osteoporosis with pathological fracture
GROUP
Case Rate
Professional Fee 1,380 1,380 1,380 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,430
Health Care Institution Fee 3,220 3,220 3,220 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,670
H30.1 H30.8 H31.3 M80.0 M80.1 M80.3 M81.0 M81.08 M81.1 M81.4 M81.40 M81.55 M81.58 M81.6 M81.8 M81.88 M81.89 M81.9 M81.95 M81.98 M83.2 M83.4 M83.8 M83.87 M83.89 M83.9 M83.99 M85.0 M85.1 M85.2 M85.5 M85.55 M85.6 M85.63 M85.65 M85.8 M85.88 M89.38 E75.2
DISODERS OF CHOROID AND RETINA DISODERS OF CHOROID AND RETINA DISODERS OF CHOROID AND RETINA DISORDER OF BONE DENSITY AND STRUCTURE
4,600 4,600 4,600 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 8,100
Postoophorectomy osteoporosis with pathological fracture DISORDER OF BONE DENSITY AND STRUCTURE Postsurgical malabsorption osteoporosis with pathological fracture Postmenopausal osteoporosis Postmenopausal osteoporosis Other Postoophorectomy osteoporosis Drug-induced osteoporosis Drug-induced osteoporosis Multiple site Idiopathic osteoporosis Pelvic region and thigh Idiopathic osteoporosis Other Localized osteoporosis [Lequesne] Other osteoporosis; Senile osteoporosis Other osteoporosis; Senile osteoporosis Other Other osteoporosis; Senile osteoporosis Site unspecified Osteoporosis, unspecified Osteoporosis, unspecified Pelvic region and thigh Osteoporosis, unspecified Other Adult osteomalacia due to malabsorption; Postsurgical malabsorption osteomalacia in adults Aluminium bone disease Other adult osteomalacia Other adult osteomalacia Ankle and foot Other adult osteomalacia Site unspecified Adult osteomalacia, unspecified Adult osteomalacia, unspecified Site unspecified Fibrous dysplasia (monostotic) Skeletal fluorosis Multiple site Hyperostosis of skull Aneurysmal bone cyst Aneurysmal bone cyst Pelvic region and thigh Other cyst of bone Other cyst of bone Forearm Other cyst of bone Pelvic region and thigh Other specified disorders of bone density and structure; Hyperostosis of bones, except skull Other specified disorders of bone density and structure; Hyperostosis of bones, except skull Other Hypertrophy of bone Other Other sphingolipidosis; Fabry(-Anderson) Disease; Gaucher Disease; Krabbe Disease; Niemann-Pick Disease; Faber's syndrome; Metachromatic leukodystrophy; Sulfatase deficiency Neuronal ceroid lipofuscinosis; Batten Disease; Bielschowsky-Jansky Disease; Kufs Disease; pielmeyer-Vogt Disease Other lipid storage disorders; Cerebrotendinous cholesterosis [van Bogaert-Scherer-Epstein]; Wolman's disease Lipid storage disorder, unspecified Postmenopausal bleeding Primary hyperaldosteronism; Conn's syndrome; Primary aldosteronism due to adrenal hyperplasia (bilateral) Secondary hyperaldosteronism Other hyperaldosteronism; Bartter's syndrome Hyperaldosteronism, unspecified; Other disorders of adrenal gland Primary adrenocortical insufficiency; Addison's disease; Autoimmune adrenalitis Addisonian crisis; Adrenal crisis; Adrenocortical crisis Drug-induced adrenocortical insufficiency Other and unspecified adrenocortical insufficiency; Adrenal haemorrhage; Adrenal infarction; Adrenocortical insufficiency NOS; Hypoaldosteronism Other specified disorders of adrenal gland; Abnormality of cortisol-binding globulin Classical phenylketonuria Other hyperphenylalaninaemias Disorders of tyrosine metabolism; Alkaptonuria; Hypertyrosinaemia; Ochronosis; Tyrosinaemia; Tyrosinosis DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF LIPID STORAGE
E75.4
DISORDER OF LIPID STORAGE
8,100
2,430
5,670
E75.5 E75.6 N95.0 E26.0 E26.1 E26.8 E26.9 E27.1 E27.2 E27.3 E27.4 E27.8 E70.0 E70.1 E70.2
DISORDER OF LIPID STORAGE DISORDER OF LIPID STORAGE DISORDERS ASSOCIATED WITH MENOPAUSE DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM
8,100 8,100 6,000 9,900 9,900 9,900 9,900 9,900 9,900 9,900 9,900 9,900 10,600 10,600 10,600
2,430 2,430 1,800 2,970 2,970 2,970 2,970 2,970 2,970 2,970 2,970 2,970 3,180 3,180 3,180
5,670 5,670 4,200 6,930 6,930 6,930 6,930 6,930 6,930 6,930 6,930 6,930 7,420 7,420 7,420
Page 28 of 111
Albinism; OcularAlbinism; Oculocutaneous Albinism Chediak(-Steinbrinck)-Higashi Syndrome; Cross Syndrome; Hermansky-Pudlak Syndrome Other disorders of aromatic amino-acid metabolism; Disorders of histidine metabolism; Disorders of tryptophan metabolism Maple-syrup-urine disease Other disorders of branched-chain amino-acid metabolism; Hyperleucine-isoleucinaemia; Hypervalinaemia; Isovaleric acidaemia; Methylmalonic acidaemia; Propionic acidaemia Disorders of fatty-acid metabolism; Adrenoleukodystrophy [Addison-Schilder]; Muscle carnitine palmityltransferase deficiency Disorders of amino-acid transport; Cystinosis; Cystinuria; Fanconi(-de Toni)(-Debr) syndrome; Hartnup's disease; Lowe's syndrome Disorders of urea cycle metabolism; Argininaemia; Argininosuccinic aciduria; Citrullinaemia; Hyperammonaemia Disorders of lysine and hydroxylysine metabolism Disorders of glycine metabolism; Hyperhydroxyprolinaemia; Hyperprolinaemia (type I) , Hyperprolinaemia type II; Non-ketotic hyperglycinaemia; Sarcosinaemia Congenital lactase deficiency
GROUP
Case Rate 10,600
E70.3
DISORDERS OF AMINO ACID METABOLISM
E70.8 E71.0 E71.1
DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM
10,600 10,600 10,600
3,180 3,180 3,180
7,420 7,420 7,420
E71.3
10,600
3,180
7,420
E72.0
10,600
3,180
7,420
E72.2 E72.3 E72.5 E73.0
DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF CARBOHYDRATE METABOLISM
10,600 10,600 10,600 5,800
3,180 3,180 3,180 1,740
7,420 7,420 7,420 4,060
E74.0
Glycogen storage disease; Cardiac glycogenosis; Andersen Disease; Cori Disease; Forbes Disease; Hers Disease; DISORDERS OF CARBOHYDRATE METABOLISM McArdle Disease; Pompe Disease; Tauri Disease; von Gierke Disease; Liver phosphorylase deficiency Disorders of fructose metabolism; Essential fructosuria; Fructose-1,6-diphosphatase deficiency; Hereditary fructose DISORDERS OF CARBOHYDRATE METABOLISM intolerance Disorders of galactose metabolism; Galactokinase DISORDERS OF CARBOHYDRATE METABOLISM deficiency; Galactosaemia Other disorders of intestinal carbohydrate absorption; Glucose-galactose malabsorption; Sucrase deficiency Other specified disorders of carbohydrate metabolism Other disorders of glycoprotein metabolism Mucopolysaccharidosis, type I; Hurler Syndrome; HurlerScheie Syndrome; Scheie Syndrome Mucopolysaccharidosis, type II; Hunter's syndrome DISORDERS OF CARBOHYDRATE METABOLISM DISORDERS OF CARBOHYDRATE METABOLISM DISORDERS OF GLYCOPROTEIN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM
5,800
1,740
4,060
E74.1 E74.2 E74.3 E74.8 E77.8 E76.0 E76.1
5,800 5,800 5,800 5,800 10,600 10,900 10,900
1,740 1,740 1,740 1,740 3,180 3,270 3,270
4,060 4,060 4,060 4,060 7,420 7,630 7,630
E76.2
Other mucopolysaccharidoses; -Glucuronidase deficiency; Mucopolysaccharidosis, type III; Mucopolysaccharidosis IV, DISORDERS OF GLYCOSAMINOGLYCAN Mucopolysaccharidosis VI, Mucopolysaccharidosis VII; METABOLISM Mild Maroteaux-Lamy Syndrome; Severe Maroteaux-Lamy Syndrome; Morquio-like Syndrome; Mucopolysaccharidosis, unspecified Other disorders of glucosaminoglycan metabolism DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM
10,900
3,270
7,630
E76.3 E76.8
10,900 10,900
3,270 3,270
7,630 7,630
E78.0
Pure hypercholesterolaemia; Familial hypercholesterolaemia; Fredrickson's hyperlipoproteinaemia, type Iia; DISORDERS OF LIPOPROTEIN METABOLISM Hyperbetalipoproteinaemia; Hyperlipidaemia, group A; Lowdensity-lipoprotein-type [LDL] hyperlipoproteinaemia Pure hyperglyceridaemia; Endogenous hyperglyceridaemia; Fredrickson's hyperlipoproteinaemia, type IV; Hyperlipidaemia, group B; Hyperprebetalipoproteinaemia'; DISORDERS OF LIPOPROTEIN METABOLISM Very-low-density-lipoprotein-type [VLDL] hyperlipoproteinaemia Mixed hyperlipidaemia; Broad- or floatingbetalipoproteinaemia; Fredrickson's hyperlipoproteinaemia, type IIb; Fredrickson's DISORDERS OF LIPOPROTEIN METABOLISM hyperlipoproteinaemia type III; Hyperbetalipoproteinaemia with prebetalipoproteinaemia; Hypercholesterolaemia with endogenous hype Hyperchylomicronaemia; Fredrickson's hyperlipoproteinaemia, type I; Fredrickson's DISORDERS OF LIPOPROTEIN METABOLISM hyperlipoproteinaemia, type V; Hyperlipidaemia, group D; Mixed hyperglyceridaemia Other hyperlipidaemia; Familial combined hyperlipidaemia DISORDERS OF LIPOPROTEIN METABOLISM
6,600
1,980
4,620
E78.1
6,600
1,980
4,620
E78.2
6,600
1,980
4,620
E78.3
6,600
1,980
4,620
E78.4
6,600
1,980
4,620
Page 29 of 111
Lipoprotein deficiency; Abetalipoproteinaemia; High-density lipoprotein deficiency; Hypoalphalipoproteinaemia; Familial Hypobetalipoproteinaemia; Lecithin cholesterol acyltransferase deficiency; Tangier disease Other disorders of lipoprotein metabolism Disorders of copper metabolism; Menkes' kinky hair disease; Menkes' steely hair disease; Wilson's disease Disorders of iron metabolism; Haemochromatosis
GROUP
Case Rate
Professional Fee
E78.6
DISORDERS OF LIPOPROTEIN METABOLISM
6,600
1,980
4,620
E78.8 E83.0 E83.1 E83.2
DISORDERS OF LIPOPROTEIN METABOLISM DISORDERS OF MINERAL METABOLISM DISORDERS OF MINERAL METABOLISM
6,600 7,300 7,300 7,300
1,980 2,190 2,190 2,190
4,620 5,110 5,110 5,110
Disorders of zinc metabolism; Acrodermatitis enteropathica DISORDERS OF MINERAL METABOLISM Disorders of phosphorus metabolism; Acid phosphatase deficiency; Familial hypophosphataemia; DISORDERS OF MINERAL METABOLISM Hypophosphatasia; Vitamin-D-resistant osteomalacia; Vitamin-D-resistant rickets Disorders of magnesium metabolism; Hypermagnesaemia; DISORDERS OF MINERAL METABOLISM Hypomagnesaemia Disorders of calcium metabolism; Familial hypocalciuric hypercalcaemia; Idiopathic hypercalciuria DISORDERS OF MINERAL METABOLISM
E83.3
7,300
2,190
5,110
E83.4 E83.5 E83.8 H05.0 H05.2 E80.0 E80.2 E80.4 E80.5 E80.6 E79.8 E20.0 E20.8 E20.9 E21.0 E21.4 E21.5 E22.2
7,300 7,300 7,300 9,500 9,500 9,800 9,800 9,800 9,800 9,800 7,000 9,300 9,300 9,300 9,300 9,300 9,300 11,800
2,190 2,190 2,190 2,850 2,850 2,940 2,940 2,940 2,940 2,940 2,100 2,790 2,790 2,790 2,790 2,790 2,790 3,540
5,110 5,110 5,110 6,650 6,650 6,860 6,860 6,860 6,860 6,860 4,900 6,510 6,510 6,510 6,510 6,510 6,510 8,260
Other disorders of mineral metabolism DISORDERS OF MINERAL METABOLISM Acute inflammation of orbit; Abscess of orbit;Cellulitis of orbit; Osteomyelitis of orbit; Periostitis of orbit, Tenonitis of DISORDERS OF ORBIT orbit Exophthalmic conditions; Displacement of globe (lateral) DISORDERS OF ORBIT NOS; Haemorrhage of orbit; Oedema of orbit Hereditary erythropoietic porphyria; Congenital erythropoietic porphyria; Erythropoietic protoporphyria Other porphyria; Hereditary coproporphyria Porphyria NOS; Acute intermittent (hepatic) Porphyria Gilbert's syndrome Crigler-Najjar syndrome Other disorders of bilirubin metabolism; Dubin-Johnson syndrome; Rotor's syndrome Other disorders of purine and pyrimidine metabolism; Hereditary xanthinuria Idiopathic hypoparathyroidism Other hypoparathyroidism Hypoparathyroidism, unspecified; Parathyroid tetany Primary hyperparathyroidism; Hyperplasia of parathyroid; Osteitis fibrosa cystica generalisata [von Recklinghausen's disease of bone] Other specified disorders of parathyroid gland Disorder of parathyroid gland, unspecified Syndrome of inappropriate secretion of antidiuretic hormone DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PURINE AND PYRIMIDINE METABOLISM DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PITUITARY GLAND
E23.0
Hypopituitarism; Fertile eunuch syndrome; Hypogonadotropic hypogonadism; Idiopathic growth hormone deficiency; Isolated deficiency of gonadotropin; DISORDERS OF THE PITUITARY GLAND Isolated deficiency of growth hormone; Isolated deficiency of pituitary hormone; Kallmann's syndrome; Lorai Vitreous prolapse Vitreous haemorrhage Purulent endophthalmitis; Panophthalmitis; Vitreous abscess Other endophthalmitis; Parasitic endophthalmitis NOS; Sympathetic uveitis Degenerated conditions of globe; Absolute glaucoma; Atrophy of globe; Phthisis bulbi Disseminated intravascular coagulation [defibrination syndrome]; Acquired Afibrinogenaemia; Consumption coagulopathy; Diffuse or disseminated intravascular coagulation [DIC] ; Acquired Fibrinolytic haemorrhage; Fibrinolytic Purpura; Purpura fulminans; Disseminated intravascular coagulation of fetus and newborn; Defibrination syndrome of fetus or newborn Adult osteochondrosis of spine Spondylolysis cervical region Spondylolysis cervicothoracic region Spondylolysis thoracic region Spondylolysis lumbar region Spondylolysis lumbosacral region Spondylolysis site unspecified Spondylolisthesis Multiple sites in spine Spondylolisthesis cervical region Spondylolisthesis thoracolumbar region Spondylolisthesis lumbar region Spondylolisthesis lumbosacral region DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE
11,800
3,540
8,260
H43.0 H43.1 H44.0 H44.1 H44.5
10,400 10,400 10,400 10,400 10,400
3,120 3,120 3,120 3,120 3,120
7,280 7,280 7,280 7,280 7,280
D65
DISSEMINATED INTRAVASCULAR COAGULATION
32,000
9,600
22,400
P60 M42.1 M43.02 M43.03 M43.04 M43.06 M43.07 M43.09 M43.10 M43.12 M43.15 M43.16 M43.17
DISSEMINATED INTRAVASCULAR COAGULATION DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES
32,000 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600
9,600 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280
22,400 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320
Page 30 of 111
M43.18 M43.19 M43.22 M43.26 M43.27 M43.29 M43.42 M43.49 M43.60 M43.62 M43.64 M43.66 M43.68 M43.69 M43.8 M43.82 M43.85 M43.86 M43.87 M43.88 M43.89 M43.9 M43.94 M43.95 M43.96 M43.97 M43.99 M53.0 M53.1 M53.12 M53.19 M53.2 M53.22 M53.24 M53.26 M53.27 M53.28 M53.29 M53.3 M53.38 M53.8 M53.86 M53.87 M53.89 M53.9 M53.92 M53.95 M54 T75.1 O00.0 O00.1 O00.2 O00.8 O00.9 O36.7 T75.0 T75.4
DESCRIPTION
Spondylolisthesis sacral and sacrococcygeal region Spondylolisthesis site unspecified Other fusion of spine; Ankylosis of spinal joint cervical region Other fusion of spine; Ankylosis of spinal joint lumbar region Other fusion of spine; Ankylosis of spinal joint lumbosacral region Other fusion of spine; Ankylosis of spinal joint site unspecified Other recurrent atlantoaxial subluxation cervical region Other recurrent atlantoaxial subluxation site unspecified Torticollis Multiple sites in spine Torticollis cervical region Torticollis thoracic region Torticollis lumbar region Torticollis sacral and sacrococcygeal region Torticollis site unspecified Other specified deforming dorsopathies Other specified deforming dorsopathies cervical region Other specified deforming dorsopathies thoracolumbar region Other specified deforming dorsopathies lumbar region DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES
GROUP
Case Rate 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,600 7,100 7,800 7,800 7,800 7,800 7,800 7,800 5,400 5,400
Professional Fee 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,280 2,130 2,340 2,340 2,340 2,340 2,340 2,340 1,620 1,620
Health Care Institution Fee 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 5,320 4,970 5,460 5,460 5,460 5,460 5,460 5,460 3,780 3,780
Other specified deforming dorsopathies lumbosacral region DORSOPATHIES Other specified deforming dorsopathies sacral and sacrococcygeal region Other specified deforming dorsopathies site unspecified Deforming dorsopathy, unspecified; Curvature of spine NOS Deforming dorsopathy, unspecified; Curvature of spine NOS thoracic region Deforming dorsopathy, unspecified; Curvature of spine NOS thoracolumbar region Deforming dorsopathy, unspecified; Curvature of spine NOS lumbar region Deforming dorsopathy, unspecified; Curvature of spine NOS lumbosacral region Deforming dorsopathy, unspecified; Curvature of spine NOS site unspecified Cervicocranial syndrome; Posterior cervical sympathetic syndrome Cervicobrachial syndrome Cervicobrachial syndrome cervical region Cervicobrachial syndrome site unspecified Spinal instabilities Spinal instabilities cervical region Spinal instabilities thoracic region Spinal instabilities lumbar region Spinal instabilities lumbosacral region Spinal instabilities sacral and sacrococcygeal region Spinal instabilities site unspecified Coccygodynia Coccygodynia sacral and sacrococcygeal region Other specified dorsopathies Other specified dorsopathies lumbar region Other specified dorsopathies lumbosacral region Other specified dorsopathies site unspecified Dorsopathy, unspecified Dorsopathy, unspecified cervical region Dorsopathy, unspecified thoracolumbar region Dorsalgia Drowning and nonfatal submersion; Immersion; Swimmer's cramp Abdominal pregnancy Tubal pregnancy; Fallopian pregnancy; Rupture of fallopian tube due to pregnancy Ovarian pregnancy Other ectopic pregnancy; Cervical pregnancy; Cornual pregnancy; Intraligamentous pregnancy; Mural pregnancy Ectopic pregnancy, unspecified Maternal care for viable fetus in abdominal pregnancy Effects of lightning; Shock from lightning; Struck by lightning NOS Effects of electric current; Electrocution; Shock from electric current DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DROWNING ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ELECTRICAL SHOCK ELECTRICAL SHOCK
Page 31 of 111
J43.0 J43.1 J43.2 J43.8
DESCRIPTION
MacLeod's syndrome; Unilateral emphysema; Unilateral transparency of lung Panlobular emphysema; Panacinar emphysema Centrilobular emphysema Other emphysema Emphysema, unspecified; Lung emphysema NOS; Pulmonary emphysema NOS; Bullous lung emphysema; Bullous pulmonary emphysema; Vesicular lung emphysema; Vesucular pulmonary emphysema; Emphysematous bleb Interstitial emphysema; Mediastinal emphysema Compensatory emphysema Human immunodeficiency virus [HIV] disease resulting in encephalopathy; Human immunodeficiency virus [HIV] dementia Toxic encephalopathy Anoxic brain damage, not elsewhere classified Hypertensive encephalopathy Endometriosis of uterus; Adenomyosis Endometriosis of ovary Endometriosis of fallopian tube Endometriosis of pelvic peritoneum Endometriosis of rectovaginal septum and vagina Endometriosis of intestine Other endometriosis Endometriosis, unspecified Acute epiglottitis; Epiglottitis NOS Localization-related focal idiopathic epilepsy and epileptic syndromes with seizures of localized onset; Localizationrelated partial idiopathic epilepsy and epileptic syndromes with seizures of localized onset; Benign childhood epilepsy with centrotempor Localization-related focal symptomatic epilepsy and epileptic syndromes with simple partial seizures; Localization-related partial symptomatic epilepsy and epileptic syndromes with simple partial seizures; Attacks without alteration of consciousness ; Sim Localization-related focal symptomatic epilepsy and epileptic syndromes with complex partial seizures; Localization-related partial symptomatic epilepsy and epileptic syndromes with complex partial seizures; Attacks with alteration of consciousness, ofte Generalized idiopathic epilepsy and epileptic syndromes; Benign myoclonic epilepsy in infancy; Benign familial neonatal convulsions; Childhood absence epilepsy [pyknolepsy]; Epilepsy with grand mal seizures on awakening; Juvenile absence epilepsy; Juveni EMPHYSEMA EMPHYSEMA EMPHYSEMA EMPHYSEMA
GROUP
Case Rate 11,400 11,400 11,400 11,400
J43.9
EMPHYSEMA
11,400
3,420
7,980
J98.2 J98.3 B22.0 G92 G93.1 I67.4 N80.0 N80.1 N80.2 N80.3 N80.4 N80.5 N80.8 N80.9 J05.1
EMPHYSEMA EMPHYSEMA ENCEPHALOPATHY ENCEPHALOPATHY ENCEPHALOPATHY ENCEPHALOPATHY ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS EPIGLOTTITIS
11,400 11,400 22,200 22,200 22,200 22,200 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 9,700
3,420 3,420 6,660 6,660 6,660 6,660 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,910
7,980 7,980 15,540 15,540 15,540 15,540 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 6,790
G40.0
EPILEPSY
7,800
2,340
5,460
G40.1
EPILEPSY
7,800
2,340
5,460
G40.2
EPILEPSY
7,800
2,340
5,460
G40.3
EPILEPSY
7,800
2,340
5,460
G40.4
G40.5
Other generalized epilepsy and epileptic syndromes; Epilepsy with myoclonic absences; Epilepsy with myoclonicEPILEPSY astatic seizures; Infantile spasms; Lennox-Gastaut syndrome; Salaam attacks; Symptomatic early myoclonic; Encephalopathy; West's syndrome Special epileptic syndromes; Epilepsia partialis continua [Kozhevnikof]; Epileptic seizures related to alcohol; Epileptic seizures related to drugs; Epileptic seizures related EPILEPSY to hormonal changes; Epileptic seizures related to sleep deprivation; Epileptic Grand mal seizures, unspecified (with or without petit mal) EPILEPSY Petit mal, unspecified, without grand mal seizures Other epilepsy; Epilepsies and epileptic syndromes undetermined as to whether they are focal or generalized Epilepsy, unspecified; Epileptic convulsions NOS; Epileptic fits NOS; Epileptic seizures NOS Malignant neuroleptic syndrome Other drug-induced secondary parkinsonism Other secondary parkinsonism Secondary parkinsonism, unspecified Hallervorden-Spatz disease; Pigmentary pallidal degeneration Progressive supranuclear ophthalmoplegia [SteeleRichardson-Olszewski] Other specified degenerative diseases of basal ganglia; Calcification of basal ganglia Degenerative disease of basal ganglia, unspecified Carcinomatous neuromyopathy in Drug-induced dystonia Idiopathic familial dystonia; Idiopathic dystonia NOS Spasmodic torticollis Idiopathic orofacial dystonia; Orofacial dyskinesia Other dystonia EPILEPSY EPILEPSY EPILEPSY EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS
7,800
2,340
5,460
7,800
2,340
5,460
G40.6 G40.7 G40.8 G40.9 G21.0 G21.1 G21.8 G21.9 G23.0 G23.1 G23.8 G23.9 G24.0 G24.1 G24.3 G24.4 G24.8
7,800 7,800 7,800 7,800 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300
2,340 2,340 2,340 2,340 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490
5,460 5,460 5,460 5,460 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810
Page 32 of 111
G24.9 G25.3 G25.5 G25.8 G25.9 R56.0 R56.8 P92.1 P92.2 P92.4 P92.8 P92.9 R50.9 E87.1 E87.2 E87.3 E87.4 E87.5 E87.6 E87.7 E87.8
DESCRIPTION
Dystonia, unspecified; Dyskinesia NOS Myoclonus; Drug-induced myoclonus Other chorea; Chorea NOS Other specified extrapyramidal and movement disorders; Restless legs syndrome; Stiff-man syndrome Extrapyramidal and movement disorder, unspecified Febrile convulsions Other and unspecified convulsions; Fit NOS; Seizure (convulsive) NOS Regurgitation and rumination in newborn Slow feeding of newborn Overfeeding of newborn Other feeding problems of newborn Feeding problem of newborn, unspecified Fever, unspecified; Hyperpyrexia NOS; Pyrexia NOS Hypo-osmolality and hyponatraemia Acidosis; Acidosis NOS; Lactic Acidosis; Metabolic Acidosis; Respiratory Acidosis Alkalosis; Alkalosis NOS; Metabolic Alkalosis; Respiratory Alkalosis Mixed disorder of acid-base balance Hyperkalaemia; Potassium [K] excess; Potassium [K] overload Hypokalaemia; Potassium [K] deficiency Fluid overload Other disorders of electrolyte and fluid balance, not elsewhere classified; Electrolyte imbalance NOS; Hyperchloraemia; Hypochloraemia; Other metabolic disorders Fracture of thoracic vertebra; Fracture of thoracic spine NOS (closed) Multiple fractures of thoracic spine (closed) Fracture of sternum Fracture of sternum (closed) Fracture of rib Fracture of rib (closed) Fracture of rib (open) Multiple fractures of ribs Multiple fractures of ribs (closed) Multiple fractures of ribs (open) Fracture of other parts of bony thorax (closed) Fracture of bony thorax, part unspecified (closed) Gangrene and necrosis of lung Pyoderma gangrenosum; Dermatitis gangrenosa; Phagedenic pyoderma Gangrene, not elsewhere classified Gastro-oesophageal reflux disease with oesophagitis; Reflux oesophagitis Gastro-oesophageal reflux disease without oesophagitis; Oesophageal reflux NOS Meconium plug syndrome Transitory ileus of newborn Other specified intestinal obstruction of newborn Intestinal obstruction of newborn, unspecified Necrotizing enterocolitis of fetus and newborn Perinatal intestinal perforation; Meconium peritonitis Neonatal haematemesis and melaena due to swallowed maternal blood Noninfective neonatal diarrhoea; Neonatal diarrhoea NOS Other specified perinatal digestive system disorders; Congenital cirrhosis of liver; Peptic ulcer of newborn Perinatal digestive system disorder, unspecified Glaucoma suspect; Ocular hypertension Primary open-angle glaucoma; primary capsular with pseudoexfoliation of lens glaucoma; Residual stage capsular with pseudoexfoliation of lens; Primary chronic simple glaucoma; Residual stage chronic simple glaucoma; Primary low-tension glaucoma; Residual Primary angle-closure glaucoma; Primary acute angleclosure glaucoma ; Acute residual stage angle-closure glaucoma ; Primary chronic angle-closure glaucoma ; Residual stage chronic angle-closure glaucoma; Primary intermittent angle-cloure glaucoma; Residu Glaucoma secondary to eye trauma
GROUP
EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS FEBRILE SEIZURES FEBRILE SEIZURES FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEVER OF UNKNOWN ORIGIN FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES
Case Rate 8,300 8,300 8,300 8,300 8,300 7,000 7,000 8,700 8,700 8,700 8,700 8,700 7,000 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500
Professional Fee 2,490 2,490 2,490 2,490 2,490 2,100 2,100 2,610 2,610 2,610 2,610 2,610 2,100 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550
Health Care Institution Fee 5,810 5,810 5,810 5,810 5,810 4,900 4,900 6,090 6,090 6,090 6,090 6,090 4,900 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950
S22.00 S22.10 S22.2 S22.20 S22.3 S22.30 S22.31 S22.4 S22.40 S22.41 S22.80 S22.90 J85.0 L88 R02 K21.0 K21.9 P76.0 P76.1 P76.8 P76.9 P77 P78.0 P78.2 P78.3 P78.8 P78.9 H40.0
FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX GANGRENE GANGRENE GANGRENE GASTROESOPHAGEAL REFLUX DISEASE GASTROESOPHAGEAL REFLUX DISEASE GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GLAUCOMA
8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 8,700 13,200 13,200 13,200 6,100 6,100 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 6,500
2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 2,610 3,960 3,960 3,960 1,830 1,830 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 1,950
6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 6,090 9,240 9,240 9,240 4,270 4,270 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 4,550
H40.1
GLAUCOMA
6,500
1,950
4,550
H40.2
GLAUCOMA
6,500
1,950
4,550
H40.3
GLAUCOMA
6,500
1,950
4,550
Page 33 of 111
H40.4 H40.5 H40.8 H40.9 N00.0
DESCRIPTION
Glaucoma secondary to eye inflammation Glaucoma secondary to other eye disorders Other glaucoma Glaucoma, unspecified Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS, with Minor glomerular abnormality Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS, with Focal and segmental glomerular lesions (with focal and segmental hyalinosis; focal and segmental sclerosis) & Focal glom Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse membranous glomerulonephritis Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse mesangial proliferative glomerulonephritis Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse endocapillary proliferative glomerulonephritis Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse mesangiocapillary glomerulonephritis (Membranoproliferative glomerulonephritis, types 1 and 3, or NOS) Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute renal disease NOS with Diffuse crescentic glomerulonephritis (Extracpillary glomerulonephritis) GLAUCOMA GLAUCOMA GLAUCOMA GLAUCOMA
GROUP
Case Rate 6,500 6,500 6,500 6,500 10,000
Professional Fee 1,950 1,950 1,950 1,950 3,000
Health Care Institution Fee 4,550 4,550 4,550 4,550 7,000
GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES
N00.1
10,000
3,000
7,000
N00.2
10,000
3,000
7,000
N00.3
10,000
3,000
7,000
N00.4
10,000
3,000
7,000
N00.5
10,000
3,000
7,000
N00.7
10,000
3,000
7,000
N00.8
N00.9
Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES renal disease NOS with Other (Proliferative glomerulonephritis NOS) Acute nephritic syndrome including Acute glomerular disease, Acute glomerulonephritis, Acute nephritis, Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES renal disease NOS, Unspecified renal biopsy Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, Minor glomerular abnormality Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, Focal and segmental glomerular lesions Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, Diffuse mesangial proliferative glomerulonephritis Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, Diffuse mesangiocapillary glomerulonephritis Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, other Rapidly progressive nephritic syndrome; rapidly progressive glomerular disease; rapidly progressive glomerulonephritis; GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis, Unspecified Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with Minor glomerular abnormality Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with Focal and segmental glomerular lesions Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with Diffuse membranous glomerulonephritis
10,000
3,000
7,000
10,000
3,000
7,000
N01.0
10,000
3,000
7,000
N01.1
10,000
3,000
7,000
N01.3
10,000
3,000
7,000
N01.5
10,000
3,000
7,000
N01.8
10,000
3,000
7,000
N01.9
10,000
3,000
7,000
N02.0
10,000
3,000
7,000
N02.1
10,000
3,000
7,000
N02.2
10,000
3,000
7,000
Page 34 of 111
Case Rate Professional Fee Health Care Institution Fee
N02.5
Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with Diffuse mesangiocapillary glomerulonephritis Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with other (Proliferative glomerulonephritis NOS) Recurrent and persistent haematuria including Benign familial Haematuria; Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood; Haematuria with morphological lesion specified with Unspecified renal biopsy Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Minor glomerular abnormality Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Focal and segmental glomerular lesions Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, withDiffuse membranous glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Diffuse mesangial proliferative glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Diffuse endocapillary proliferative glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Diffuse mesangiocapillary glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Diffuse crescentic glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Other (Proliferative glomerulonephritis NOS) Chronic nephritic syndrome including Chronic glomerular disease, Chronic glomerulonephritis, Chronic nephritis, chronic renal disease NOS, with Unspecified renal biopsy Nephrotic syndrome: Minor glomerular abnormality; Minimal change lesion Nephrotic syndrome: Focal and segmental glomerular lesions; Focal and segmental hyalinosis; Focal and segmental sclerosis; Focal glomerulonephritis Nephrotic syndrome: Diffuse membranous glomerulonephritis Nephrotic syndrome: Diffuse mesangial proliferative glomerulonephritis Nephrotic syndrome: Diffuse endocapillary proliferative glomerulonephritis Nephrotic syndrome: Diffuse mesangiocapillary glomerulonephritis; Membranoproliferative glomerulonephritis, types 1 and 3, or NOS Nephrotic syndrome: Diffuse crescentic glomerulonephritis; Extracapillary glomerulonephritis Nephrotic syndrome: Other Nephrotic syndrome:Unspecified Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Minor glomerular abnormality, minimal change lesion
10,000
3,000
7,000
N02.8
10,000
3,000
7,000
N02.9
10,000
3,000
7,000
N03.0
10,000
3,000
7,000
N03.1
10,000
3,000
7,000
N03.2
10,000
3,000
7,000
N03.3
10,000
3,000
7,000
N03.4
10,000
3,000
7,000
N03.5
10,000
3,000
7,000
N03.7
10,000
3,000
7,000
N03.8
10,000
3,000
7,000
N03.9
10,000
3,000
7,000
N04.0 N04.1 N04.2 N04.3 N04.4 N04.5
GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES
10,000 10,000 10,000 10,000 10,000 10,000
3,000 3,000 3,000 3,000 3,000 3,000
7,000 7,000 7,000 7,000 7,000 7,000
N04.7 N04.8 N04.9
GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES
10,000 10,000 10,000
3,000 3,000 3,000
7,000 7,000 7,000
N05.0
10,000
3,000
7,000
N05.1
Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Focal and GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES segmental glomerular lesions (with focal and segmental hyalinosis; focal and segmental sclerosis) & Focal glomerulonephritis
10,000
3,000
7,000
Page 35 of 111
Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Diffuse membranous glomerulonephritis Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Diffuse mesangial proliferative glomerulonephritis Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Diffuse endocapillary proliferative glomerulonephritis Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Diffuse mesangiocapillary glomerulonephritis, Membranoproliferative glomerulonephritis, types 1 and 3, or NOS Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Dense deposit disease Membranoproliferative glomerulonephritis, type 2 Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Diffuse crescentic glomerulonephritis, Extracapillary glomerulonephritis Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Other (Proliferative glomerulonephritis NOS) Unspecified nephritic syndrome including Glomerular disease, Glomerulonephritis, Nephritis NOS with Unspecified renal biopsy Isolated proteinuria with specified morphological lesion with morphological lesion specified with Minor glomerular abnormality Isolated proteinuria with specified morphological lesion with Other (Proliferative glomerulonephritis NOS) Isolated proteinuria with specified morphological lesion with Unspecified renal biopsy Hereditary nephropathy, not elsewhere classified with Minor glomerular abnormality Hereditary nephropathy, not elsewhere classified with Focal and segmental glomerular lesions (with focal and segmental hyalinosis; focal and segmental sclerosis) & Focal glomerulonephritis Hereditary nephropathy, not elsewhere classified with Diffuse membranous glomerulonephritis Hereditary nephropathy, not elsewhere classified with Diffuse mesangial proliferative glomerulonephritis Hereditary nephropathy, not elsewhere classified with Diffuse mesangiocapillary glomerulonephritis, Membranoproliferative glomerulonephritis, types 1 and 3, or NOS Hereditary nephropathy, not elsewhere classified with Unspecified renal biopsy Acute tubulo-interstitial nephritis; pyelonephritis; Acute infectious interstitial nephritis; Acute pyelitis; Acute pyelonephritis Chronic tubulo-interstitial nephritis, unspecified; Chronic interstitial nephritis NOS; Chronic pyelitis NOS; Chronic pyelonephritis NOS Tubulo-interstitial nephritis, not specified as acute or chronic; Interstitial nephritis NOS; Pyelitis NOS; Pyelonephritis NOS Analgesic nephropathy
GROUP
Case Rate 10,000
N05.2
N05.3
10,000
3,000
7,000
N05.4
10,000
3,000
7,000
N05.5
10,000
3,000
7,000
N05.6
10,000
3,000
7,000
N05.7
10,000
3,000
7,000
N05.8
10,000
3,000
7,000
N05.9
10,000
3,000
7,000
N06.0
10,000
3,000
7,000
N06.8 N06.9 N07.0
GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES
10,000 10,000 10,000
3,000 3,000 3,000
7,000 7,000 7,000
N07.1
10,000
3,000
7,000
N07.2 N07.3
GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES
10,000 10,000
3,000 3,000
7,000 7,000
N07.5
10,000
3,000
7,000
N07.9 N10
10,000 10,000
3,000 3,000
7,000 7,000
N11.9
10,000
3,000
7,000
N12 N14.0 N14.1 N14.2 N14.4 N15.0 N15.8 N15.9 N39.1 N39.2 M23.20
10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 9,200
3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 2,760
7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 6,440
Nephropathy induced by other drugs, medicaments and GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES biological substances Nephropathy induced by unspecified drug, medicament or GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES biological substance Toxic nephropathy, not elsewhere classified Balkan nephropathy; Balkan endemic nephropathy Other specified renal tubulo-interstitial diseases Renal tubulo-interstitial disease, unspecified; Infection of kidney NOS Persistent proteinuria, unspecified Orthostatic proteinuria, unspecified Derangement of meniscus due to old tear or injury; Old bucket-handle tear multiple sites GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES HAND, FEET AND JOINT DEFORMITIES
Page 36 of 111
Case Rate 9,200 Professional Fee 2,760 Health Care Institution Fee 6,440
M23.21
M23.22
Derangement of meniscus due to old tear or injury; Old bucket-handle tear Anterior cruciate ligament or Anterior HAND, FEET AND JOINT DEFORMITIES horn of medial meniscus Derangement of meniscus due to old tear or injury; Old bucket-handle tear Posterior cruciate ligament or Posterior HAND, FEET AND JOINT DEFORMITIES horn of medial meniscus Derangement of meniscus due to old tear or injury; Old bucket-handle tear Posterior horn of lateral meniscus Loose body in kneeOther and unspecified lateral meniscus HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES
9,200
2,760
6,440
M23.25 M23.46 M23.5 M23.80 M23.9 M23.91 M24.08 M24.1 M24.2 M24.4 M24.41 M24.50 M24.54 M24.56 M24.6 M24.65 M24.66 M24.69 M24.7 M24.88 G43.0
9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 5,500
2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 1,650
6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 3,850
Chronic instability of knee HAND, FEET AND JOINT DEFORMITIES Other internal derangements of knee; Laxity of ligament of HAND, FEET AND JOINT DEFORMITIES knee; Snapping knee multiple sites Internal derangement of knee HAND, FEET AND JOINT DEFORMITIES Internal derangement of knee, unspecified Anterior cruciate ligament or Anterior horn of medial meniscus Loose body in joint other sites Other articular cartilage disorders Disorder of ligament; Instability secondary to old ligament injury; Ligamentous laxity NOS Recurrent dislocation and subluxation of joint Recurrent dislocation and subluxation of joint shoulder region Contracture of joint multiple sites Contracture of joint hand Contracture of joint lower leg Ankylosis of joint Ankylosis of joint pelvic region and thigh Ankylosis of joint lower leg Ankylosis of joint site unspecified Protrusio acetabuli Other specific joint derangements, not elsewhere classified; Irritable hip other sites Migraine without aura [common migraine] Migraine with aura [classical migraine]; Migraine aura without headache; Migraine, basilar; Migraine equivalents; Familial hemiplegic Migraine; Migraine with acute-onset aura; Migraine with prolonged aura; Migraine with typical aura Status migrainosus Complicated migraine Other migraine; Ophthalmoplegic migraine; Retinal migraine Migraine, unspecified Cluster headache syndrome; Chronic paroxysmal hemicrania; Chronic cluster headache; Episodic Cluster headache Vascular headache, not elsewhere classified; Vascular headache NOS Tension-type headache; Chronic tension-type headache; Episodic tension headache; Tension headache NOS Chronic post-traumatic headache Drug-induced headache, not elsewhere classified Other specified headache syndromes Headache; Facial pain NOS Atrioventricular block, complete; Complete heart block NOS; Third-degree block Other and unspecified atrioventricular block; Atrioventricular block NOS Left anterior fascicular block Other specified heart blockl; Sinoatrial NOS; Sinoauricular block Pre-excitation syndrome; Anomalous atrioventicular excitation; Atrioventricular conduction, accelerated; Atrioventicular conduction, accesory; Atrioventicular conduction pre-excitation; Lown-Ganong-Levine syndrome; Wolff-Parkinson-White syndrome Other specified HEART CONDUCTION DISORDERSs; Atrioventicular [AV] dissociation; Interference dissociation HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HAND, FEET AND JOINT DEFORMITIES HEADACHE SYNDROMES
G43.1
HEADACHE SYNDROMES
5,500
1,650
3,850
G43.2 G43.3 G43.8 G43.9 G44.0 G44.1 G44.2 G44.3 G44.4 G44.8 R51 I44.2 I44.3 I44.4 I45.5
HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS
5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500 5,500 12,300 12,300 12,300 12,300
1,650 1,650 1,650 1,650 1,650 1,650 1,650 1,650 1,650 1,650 1,650 3,690 3,690 3,690 3,690
3,850 3,850 3,850 3,850 3,850 3,850 3,850 3,850 3,850 3,850 3,850 8,610 8,610 8,610 8,610
I45.6
HEART CONDUCTION DISORDERSS
12,300
3,690
8,610
I45.8 I45.9 I09.9 I50.0 I50.00
HEART CONDUCTION DISORDERSS
12,300 12,300 15,700 15,700 15,700
3,690 3,690 4,710 4,710 4,710
8,610 8,610 10,990 10,990 10,990
HEART CONDUCTION DISORDERS, unspecified; Heart block HEART CONDUCTION DISORDERSS NOS; Stokes-Adams syndrome Rheumatic heart disease, unspecified; Rheumatic carditis; HEART FAILURE Rheumatic heart failure Congestive heart failure; Congestive heart disease; Right venticular failure (secondary to left heart failure) Advanced congestive heart failure; Grave congestive heart failure; Severe congestive heart failure HEART FAILURE HEART FAILURE
Page 37 of 111
Left ventricular failure; Acute oedema of lung with mention of heart disease NOS or heart failure; Acute pulmonary oedema with mention of heart disease NOS or heart failure; HEART FAILURE Cardiac asthma with mention of heart disease NOS or heart failure; Left heart fai Heart failure, unspecified; Cardiac, heart or myocardial HEART FAILURE failure NOS Mitral (valve) insufficiency; Incompetence mitral valve NOS or of specified cause, except rheumatic; Regurgitation HEART VALVE DISORDERS mitral valve NOS or of specified cause, except rheumatic Mitral (valve) prolapse; Floppy mitral valve syndrome Nonrheumatic mitral (valve) stenosis Other nonrheumatic mitral HEART VALVE DISORDERS Nonrheumatic mitral valve disorder, unspecified Aortic (valve) stenosis HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS
GROUP
Case Rate
Professional Fee
I50.1
15,700
4,710
10,990
I50.9
15,700
4,710
10,990
I34.0 I34.1 I34.2 I34.8 I34.9 I35.0 I35.1 I35.2 I35.8 I35.9 I36.0 I36.1 I36.8 I36.9 I37.0 I37.1 I37.8 I37.9 T67.0 T67.1 T67.2 T67.3 T67.4 T67.5 T67.9 M25.00 M25.01 M25.05 M25.06 M25.07 M25.08 M25.09 M25.38 M25.40 M25.41 M25.46 M25.47 D59.3 O08.1
8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 6,500 6,500 6,500 6,500 6,500 6,500 6,500 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 20,200 7,000
2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 2,520 1,950 1,950 1,950 1,950 1,950 1,950 1,950 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 6,060 2,100
5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 5,880 4,550 4,550 4,550 4,550 4,550 4,550 4,550 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 14,140 4,900
Aortic (valve) insufficiency; Incompetence Aortic valve NOS or of specified cause, except rheumatic; Aortic valve HEART VALVE DISORDERS regurgitation NOS or of specified cause, except rheumatic Aortic (valve) stenosis with insufficiency Other aortic HEART VALVE DISORDERS Aortic valve disorder, unspecified Nonrheumatic tricuspid (valve) stenosis Nonrheumatic tricuspid (valve) insufficiency; Incompetence tricuspid valve of specified cause, except rheumatic; Tricuspid valve regurgitation of specified cause, except rheumatic Other nonrheumatic tricuspid valve disorders Nonrheumatic tricuspid valve disorder, unspecified Pulmonary valve stenosis Pulmonary valve insufficiency; Incompetence pulmonary valve NOS or specified cause, except rheumatic; Pulmonary valve regurgitation NOS or of specified cause, except rheumatic Other pulmonary HEART VALVE DISORDERS Pulmonary valve disorder, unspecified Heat stroke and sunstroke; Heat apoplexy; Heat pyrexia; Siriasis; Thermoplegia Heat syncope; Heat collapse Heat cramp Heat exhaustion, anhydrotic; Heat prostration due to water depletion Heat exhaustion due to salt depletion; Heat prostation due to salt (and water) depletion Heat exhaustion, unspecified; Heat prostration NOS Effect of heat and light, unspecified Haemarthrosis multiple sites Haemarthrosis shoulder region Haemarthrosis pelvic region and thigh Haemarthrosis lower leg Haemarthrosis ankle and foot Haemarthrosis other sites Haemarthrosis site unspecified Other instability of joint other sites Effusion of joint multiple sites Effusion of joint shoulder region Effusion of joint lower leg Effusion of joint ankle and foot Haemolytic-uraemic syndrome Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation Third-stage haemorrhage; Haemorrhage associated with retained, trapped or adherent placenta; Retained placenta NOS Other immediate postpartum haemorrhage; Haemorrhage following delivery of placenta; Postpartum atomic haemorrhage NOS Delayed and secondary postpartum haemorrhage; Haemorrhage associated with retained portions of placenta or membranes; Retained products of concepcion NOS, following delivery Postpartum coagulation defects; Afibrinogenaemia postpartum; Fibrinolysis postpartum Retained placenta without haemorrhage; Placenta accreta without haemorrhage Retained portions of placenta and membranes without haemorrhage; Retained products of conception following delivery, without haemorrhage Fetal blood loss from vasa praevia Fetal blood loss from ruptured cord HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMOLYTIC UREMIC SYNDROME HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN
O72.0
7,000
2,100
4,900
O72.1
7,000
2,100
4,900
O72.2
7,000
2,100
4,900
O72.3 O73.0 O73.1 P50.0 P50.1
7,000 7,000 7,000 7,800 7,800
2,100 2,100 2,100 2,340 2,340
4,900 4,900 4,900 5,460 5,460
Page 38 of 111
P50.2 P50.9 P51.9 P53 P54.0 P54.2 P54.3 P54.4
DESCRIPTION
Fetal blood loss from placenta Fetal blood loss, unspecified; Fetal haemorrhage NOS Umbilical haemorrhage of newborn, unspecified Haemorrhagic disease of fetus and newborn; Vitamin K deficiency of newborn Neonatal haematemesis Neonatal rectal haemorrhage Other neonatal gastrointestinal haemorrhage Neonatal adrenal haemorrhage Neonatal cutaneous haemorrhage; Bruising in fetus or newborn; Ecchymoses in fetus or newborn; Petechiae in fetus or newborn; Superficial haematomata in fetus or newborn Neonatal vaginal haemorrhage; Pseudomenses Other specified neonatal haemorrhages Neonatal haemorrhage, unspecified Rh isoimmunization of fetus and newborn ABO isoimmunization of fetus and newborn Other haemolytic diseases of fetus and newborn Haemolytic disease of fetus and newborn, unspecified Transient neonatal thrombocytopenia; neonatal thrombocytopenia due to exchange transfusion; Neonatal thrombocytopenia due to idiophatic maternal thrombocytopenia; Neonatal thrombocytopenia due to isoimmunization Polycythaemia neonatorum Transient neonatal neutropenia Other transient neonatal disorders of coagulation Other specified perinatal haematological disorders Perinatal haematological disorder, unspecified
GROUP
HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN
Case Rate 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
P54.5
7,800
2,340
5,460
P54.6 P54.8 P54.9 P55.0 P55.1 P55.8 P55.9
7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460
P61.0
7,800
2,340
5,460
P61.1 P61.5 P61.6 P61.8 P61.9 D66
7,800 7,800 7,800 7,800 7,800 12,800
2,340 2,340 2,340 2,340 2,340 3,840
5,460 5,460 5,460 5,460 5,460 8,960
Hereditary factor VIII deficiency; Deficiency factor VIII (with HEMORRHAGIC CONDITIONS functional defect); Haemophilia NOS; Haemophilia A; Classical Haemophilia Hereditary factor IX deficiency; Christmas disease; Factor IX Deficiency (with functional defect); Plasma thromboplastin HEMORRHAGIC CONDITIONS component [PTC] Deficiency; Haemophilia B Von Willebrand's disease; Angiohaemophilia; Factor VIII deficiency with vascular defect; Vascular haemophilia Hereditary factor XI deficiency; Haemophilia C Plasma thromoplastin antecedent [PTA] deficiency Hereditary deficiency of other clotting factors; Congenital afibrinogenaemia; AC globulin Deficiency; Proaccelerin Deficiency; Deficiency of factor I [fibrinogen]; Deficiency of factor II [prothrombin]; Deficiency of factor V [labile]; Deficiency of fac Haemorrhagic disorder due to circulating anticoagulants; Haemorrhage during long term use of anticoagulants; Hyperheparinaemia; Increase in antithrombin; Increase in anti-VIIIa; Increase in anti-Ixa; Increase in anti-Xa; Increase in anti-XIa Acquired coagulation factor deficiency; Deficiency of coagulation factor due to liver disease; Deficiency of coagulation factor due to vitamin K deficiency Other specified coagulation defects; Presence of systemic lupus erythematosus [SLE] inhibitor Coagulation defect, unspecified Allergic purpura; Anaphylactoid Purpura; Henoch(Schnlein) Purpura; Nonthrombocytopenic Purpura; Haemorrhagic Purpura; Idiopathic Purpura; Vascular Purpura; AllergicVasculitis HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS
D67
12,800
3,840
8,960
D68.0 D68.1
12,800 12,800
3,840 3,840
8,960 8,960
D68.2
HEMORRHAGIC CONDITIONS
12,800
3,840
8,960
D68.3
HEMORRHAGIC CONDITIONS
12,800
3,840
8,960
D68.4 D68.8 D68.9 D69.0
HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS
12,800 12,800 12,800 12,800
3,840 3,840 3,840 3,840
8,960 8,960 8,960 8,960
Page 39 of 111
D69.1
D69.2 D69.3 D69.8
Qualitative platelet defects; Bernard-Soulier [giant platelet] syndrome; Glanzmann's disease; Grey platelet syndrome; HEMORRHAGIC CONDITIONS Haemorrhagic Thromboasthenia; Hereditary Thromboasthenia; Thrombocytopathy ; Other nonthrombocytopenic purpura; Purpura NOS; Senile HEMORRHAGIC CONDITIONS Purpura; Simplex Purpura Idiopathic thrombocytopenic purpura; Evans' syndrome Other specified haemorrhagic conditions; Hereditary Capillary fragility; Vascular pseudohaemophilia HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS
12,800
12,800 12,800 12,800
3,840 3,840 3,840
8,960 8,960 8,960
K70.4
Alcoholic hepatic failure; Alcoholic hepatic failure NOS; Acute alcoholic hepatic failure; Chronic alcoholic hepatic HEPATIC FAILURE failure; Subacute alcoholic hepatic failure; Alcoholic hepatic failure with or without hepatic coma Acute and subacute hepatic failure Chronic hepatic failure Hepatic failure Classical hydatidiform mole; Complete hydatidiform mole Incomplete and partial hydatidiform mole Hydatidiform mole, unspecified; Trophoblastic disease NOS; Vesicular mole NOS Communicating hydrocephalus Obstructive hydrocephalus Normal-pressure hydrocephalus Post-traumatic hydrocephalus, unspecified Other hydrocephalus Hydrocephalus, unspecified Other congenital hydrocephalus Congenital hydrocephalus, unspecified Hydrops fetalis due to isoimmunization Hydrops fetalis due to other and unspecified haemolytic disease Hydrops fetalis not due to haemolytic disease; Hydrops fetalis NOS Hypertension, stage II Essential Hypertension; malignant hypertension Hypertensive heart disease with (congestive) heart failure; Hypertensive heart failure Hypertensive heart disease without (congestive) heart failure; Hypertensive heart disease NOS Hypertensive renal disease with renal failure; Hypertensive renal failure Hypertensive renal disease without renal failure; Hypertensive renal disease NOS Hypertensive heart and renal disease with (congestive) heart failure Hypertensive heart and renal disease with renal failure Hypertensive heart and renal disease with both (congestive) heart failure and renal failure Hypertensive heart and renal disease, unspecified Renovascular hypertension Hypertension secondary to other renal disorders Hypertension secondary to endocrine disorders Other secondary hypertension Secondary hypertension, unspecified Thyrotoxicosis with diffuse goitre; Exophthalmic or toxic goitre NOS; Graves' disease; Toxic diffuse goitre Thyrotoxicosis with toxic single thyroid nodule; Thyrotoxicosis with toxic uninodular goitre Thyrotoxicosis with toxic multinodular goitre; Toxic nodular goitre NOS Thyrotoxicosis from ectopic thyroid tissue Thyrotoxicosis factitia Thyroid crisis or storm Other thyrotoxicosis; Overproduction of thyroid-stimulating hormone Thyrotoxicosis, unspecified; Hyperthyroidism NOS; Thyroiditis Iodine-deficiency-related diffuse (endemic) goitre Iodine-deficiency-related multinodular (endemic) goitre; Iodine-deficiency-related nodular goitre Iodine-deficiency-related (endemic) goitre, unspecified Other iodine-deficiency-related thyroid disorders and allied conditions Subclinical iodine-deficiency hypothyroidism Hypothyroidism due to medicaments and other exogenous substances Myxoedema coma Other specified hypothyroidism Hypothyroidism, unspecified; HEPATIC FAILURE HEPATIC FAILURE HEPATIC FAILURE HYDATIDIFORM MOLE HYDATIDIFORM MOLE HYDATIDIFORM MOLE HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROPS FETALIS HYDROPS FETALIS HYDROPS FETALIS HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM
20,600
6,180
14,420
K72.0 K72.1 K72.9 O01.0 O01.1 O01.9 G91.0 G91.1 G91.2 G91.3 G91.8 G91.9 Q03.8 Q03.9 P56.0 P56.9 P83.2 I10.1 I10.9 I11.0 I11.9 I12.0 I12.9 I13.0 I13.1 I13.2 I13.9 I15.0 I15.1 I15.2 I15.8 I15.9 E05.0 E05.1 E05.2 E05.3 E05.4 E05.5 E05.8 E05.9 E01.0 E01.1 E01.2 E01.8 E02 E03.2 E03.5 E03.8 E03.9
20,600 20,600 20,600 6,600 6,600 6,600 17,300 17,300 17,300 17,300 17,300 17,300 13,000 13,000 7,400 7,400 9,300 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,100 8,100 8,100 8,100 8,100 8,100 8,100 8,100 8,100
6,180 6,180 6,180 1,980 1,980 1,980 5,190 5,190 5,190 5,190 5,190 5,190 3,900 3,900 2,220 2,220 2,790 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,430 2,430 2,430 2,430 2,430 2,430 2,430 2,430 2,430
14,420 14,420 14,420 4,620 4,620 4,620 12,110 12,110 12,110 12,110 12,110 12,110 9,100 9,100 5,180 5,180 6,510 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,670 5,670 5,670 5,670 5,670 5,670 5,670 5,670 5,670
Page 40 of 111
Hereditary hypogammaglobulinaemia; Autosomal recessive agammaglobulinaemia (Swiss type); X-linked agammaglobulinaemia [Bruton] (with growth hormone deficiency) Selective deficiency of immunoglobulin A [IgA] Transient hypogammaglobulinaemia of infancy Other immunodeficiencies with predominantly antibody defects; Kappa light chain deficiency Immunodeficiency with predominantly antibody defects, unspecified Severe combined immunodeficiency [SCID] with low T- and B-cell numbers Major histocompatibility complex class I deficiency; Bare lymphocyte syndrome Combined immunodeficiency, unspecified; Severe combined immunodeficiency disorder [SCID] NOS Wiskott-Aldrich syndrome; Immunodeficiency with thrombocytopenia and eczema Di George's syndrome; Pharyngeal pouch syndrome; Thymic alymphoplasia; Thymic aplasia or hypoplasia with immunodeficiency
GROUP
Case Rate
Professional Fee 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480
Health Care Institution Fee 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120
D80.0 D80.2 D80.7 D80.8 D80.9 D81.1 D81.6 D81.9 D82.0 D82.1
IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY
11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600
D82.3 D82.4 D82.9 D83.0 D83.1 D83.9 D84.8 D84.9 D86.1 D86.8 D86.9 D89.0
Immunodeficiency following hereditary defective response IMMUNODEFICIENCY to Epstein-Barr virus; X-linked lymphoproliferative disease Hyperimmunoglobulin E [IgE] syndrome Immunodeficiency associated with major defect, unspecified Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function Common variable immunodeficiency with predominant immunoregulatory T-cell disorders Common variable immunodeficiency, unspecified Other specified immunodeficiencies Immunodeficiency, unspecified Sarcoidosis of lymph nodes Sarcoidosis of other and combined sites; Uveoparotid fever [Heerfordt] Sarcoidosis, unspecified Polyclonal hypergammaglobulinaemia; Benign hypergammaglobulinaemic purpura; Polyclonal gammopathy NOS IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY
11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120 8,120
D89.1
Cryoglobulinaemia; Essential Cryoglobulinaemia; Idiopathic Cryoglobulinaemia; Mixed Cryoglobulinaemia; Primary IMMUNODEFICIENCY Cryoglobulinaemia; Secondary Cryoglobulinaemia; Cryoglobulinaemic purpura; Cryoglobulinaemic vasculitis Hypergammaglobulinaemia, unspecified Other specified disorders involving the immune mechanism, not elsewhere classified Disorder involving the immune mechanism, unspecified; Immune disease NOS Leukoplakia of penis; Balanitis xerotica obliterans; Kraurosis of penis Balanoposthitis; Balanitis IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT
11,600
3,480
8,120
D89.2 D89.8 D89.9 N48.0 N48.1
11,600 11,600 11,600 9,000 9,000
3,480 3,480 3,480 2,700 2,700
8,120 8,120 8,120 6,300 6,300
N48.2
Other inflammatory disorders of penis; Abscess of corpus cavernosum and penis; Boil of corpus cavernosum and INFLAMMATION/INFECTION OF THE MALE penis; Carbuncle of corpus cavernosum and penis; Cellulitis GENITAL TRACT of corpus cavernosum and penis; Cavernitis (penis) of corpus cavernosum and penis Ulcer of penis Induratio penis plastica; Peyronie's disease; Plastic induration of penis Inflammatory disorders of seminal vesicle; Vesiculitis NOS Inflammatory disorders of spermatic cord, tunica vaginalis and vas deferens; Vasitis Inflammatory disorders of scrotum Inflammatory disorders of other specified male genital organs; Inflammation of multiple sites in male genital organs Inflammatory disorder of unspecified male genital organ; Abscess of unspecified male genital organ; Boil of unspecified male genital organ; Carbuncle of unspecified male genital organ; Cellulitis of unspecified male genital organ INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT
9,000
2,700
6,300
N48.5 N48.6 N49.0 N49.1 N49.2 N49.8
9,000 9,000 9,000 9,000 9,000 9,000
2,700 2,700 2,700 2,700 2,700 2,700
6,300 6,300 6,300 6,300 6,300 6,300
N49.9
INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT
9,000
2,700
6,300
Page 41 of 111
K50.0
Crohn's disease of small intestine; Crohn's disease [regional enteritis] of duodenum; Crohn's disease [regional enteritis] INFLAMMATORY BOWEL DISEASE of ileum; Crohn's disease [regional enteritis] of jejunum; Regional ileitis; Terminal ileitis Crohn's disease of large intestine; Granulomatous colitis; Regional colitis; Crohn's disease [regional enteritis] of colon; Crohn's disease [regional enteritis] of large bowel; Crohn's disease [regional enteritis] of rectum Other Crohn's disease; Crohn's disease of both small and large intestine Crohn's disease [regional enteritis], unspecified; Crohn's disease NOS; Regional enteritis NOS; Granulomatous enteritis NOS Ulcerative (chronic) enterocolitis Ulcerative (chronic) ileocolitis Ulcerative (chronic) proctitis Ulcerative (chronic) rectosigmoiditis Mucosal proctocolitis Other ulcerative colitis Ulcerative colitis, unspecified; Ulcerative enteritis NOS Acute disseminated encephalitis; Postimmunization [Encephalitis; Postimmunization Encephalomyelitis Tropical spastic paraplegia Bacterial meningoencephalitis and meningomyelitis, not elsewhere classified Other encephalitis, myelitis and encephalomyelitis; Postinfectious encephalitis and encephalomyelitis NOS Encephalitis, myelitis and encephalomyelitis, unspecified; Ventriculitis (cerebral) NOS Encephalitis, myelitis and encephalomyelitis in other diseases classified elsewhere INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA IN DISEASES CLASSIFIED ELSEWHERE Intracranial and intraspinal phlebitis and thrombophlebitis; Septic [embolism, endophlebitis, phlebitis, thrombophlebitis, thrombosis] of intracranial or intraspinal venous sinuses and veins Acute nonspecific idiopathic pericarditis Infective pericarditis; Pneumococcal pericarditis; Purulent pericarditis; Staphylococcal pericarditis; Streptococcal pericarditis; Viral pericarditis; Pyopericarditis Other forms of acute pericarditis Acute pericarditis, unspecified Chronic adhesive pericarditis; Accretio cordis; Adherent pericardium; Adhesive mediastinopericarditis Chronic constrictive pericarditis; Concretio cordis; Pericardial calcification
9,100
2,730
6,370
K50.1
INFLAMMATORY BOWEL DISEASE
9,100
2,730
6,370
K50.8 K50.9 K51.0 K51.1 K51.2 K51.3 K51.5 K51.8 K51.9 G04.0 G04.1 G04.2 G04.8 G04.9 G05.8* G07*
INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART
9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 21,600 21,600 21,600 21,600 21,600 21,600 21,600
2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 2,730 6,480 6,480 6,480 6,480 6,480 6,480 6,480
6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 6,370 15,120 15,120 15,120 15,120 15,120 15,120 15,120
G08 I30.0 I30.1 I30.8 I30.9 I31.0 I31.1
21,600 14,400 14,400 14,400 14,400 14,400 14,400
6,480 4,320 4,320 4,320 4,320 4,320 4,320
15,120 10,080 10,080 10,080 10,080 10,080 10,080
I33.0
Acute and subacute infective endocarditis; Acute bacterial endocarditis; Subacute bacterial endocarditis; Acute infective endocarditis NOS; Subacute infective endocarditis INFLAMMATORY DISEASES OF THE HEART NOS; Acute lenta endocarditis; Subacute lenta endocarditis; Acute malignant endocar Acute endocarditis, unspecified; Endocarditis, acute or subacute; Myoendocarditis, acute or subacute; Periendocarditis, acute or subacute Endocarditis, valve unspecified; Chronic Endocarditis NOS; Valvular incompetence of unspecified valve NOS or of specified cause, except rheumatic or congenital; Valvular insufficiency of unspecified valve NOS or of specified cause, except rheumatic or con Infective myocarditis; Septic myocarditis Isolated myocarditis Other acute myocarditis Acute myocarditis, unspecified Influenza A H5N1 (Avian influenza) INFLAMMATORY DISEASES OF THE HEART
14,400
4,320
10,080
I33.9
14,400
4,320
10,080
I38
INFLAMMATORY DISEASES OF THE HEART
14,400
4,320
10,080
I40.0 I40.1 I40.8 I40.9 J09 J10.0
INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLUENZA
14,400 14,400 14,400 14,400 6,600 6,600
4,320 4,320 4,320 4,320 1,980 1,980
10,080 10,080 10,080 10,080 4,620 4,620
Influenza with pneumonia, influenza virus identified; INFLUENZA Influenzal (broncho) pneumonia, influenza virus indentified Influenza with other respiratory manifestations, influenza virus identified; Influenza, influenza virus identified; Acute upper respiratory influenzal infection, influenza virus identified; Influenzal laryngitis, influenza virus identified; Influenzal pha
J10.1
INFLUENZA
6,600
1,980
4,620
Page 42 of 111
Influenza with other manifestations, influenza virus identified; Encephalopathy due to influenza, influenza virus identified; Influenzal gastroenteritis, influenza virus identified; Acute influenzal myocarditis, influenza virus identified Influenza with pneumonia, virus not identified; Influenzal (broncho) pneumonia, unspecified or specific virus not identified Influenza with other respiratory manifestations, virus not identified; Influenza NOS; Influenzal Acute upper respiratory infection, unspecified or specific virus not identified; Influenzal laryngitis, unspecified or specific virus not identified; Influen Influenza with other manifestations, virus not identified; Encephalopathy due to influenza, unspecified or specific virus not identified; Influenzal gastroentiritis, unspecified or specific virus not identified; Acute influenzal myocarditis, unspecified o Acute influenzal myocarditis, virus not identified Unspecified effects of radiation Heat fatigue, transient Other effects of heat and light Hypothermia Immersion hand and foot; Trench foot Effect of reduced temperature, unspecified Otitic barotrauma; Aero-otitis media; Effects of change in ambient atmospheric pressure on sinuses Other and unspecified effects of high altitude; Alpine sickness; Anoxia due to high altitude; Barotrauma NOS; Hypobaropathy; Mountain sickness Caisson disease [decompression sickness]; Compressed-air disease; Diver's palsy or paralysis Effects of high-pressure fluids; Traumatic jet injection (industrial) Other effects of air pressure and water pressure; Blast injury syndrome Effect of air pressure and water pressure, unspecified Effects of vibration; Pneumatic hammer syndrome; Traumatic vasospastic syndrome; Vartigo from infrasound Other specified INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS causes; Effects of abnormal gravitation [G] forces; Effects of weightlessness Concussion and oedema of cervical spinal cord Concussion and oedema of lumbar spinal cord Injury of muscle and tendon at neck level Injury of muscle and tendon of abdomen, lower back and pelvis Dislocation of shoulder joint; Dislocation of Glenohumeral joint Sprain and strain of shoulder joint; sprain and strain of Coracohumeral (ligament); Sprain and strain of Rotator cuff capsule Sprain and strain of acromioclavicular joint; sprain and strain of Acromioclavicular ligament
GROUP
Case Rate
Professional Fee
J10.8
INFLUENZA
6,600
1,980
4,620
J11.0
INFLUENZA
6,600
1,980
4,620
J11.1
INFLUENZA
6,600
1,980
4,620
J11.8
INFLUENZA
6,600
1,980
4,620
J11.8+ I41.1* T66 T67.6 T67.8 T68 T69.0 T69.9 T70.0 T70.2 T70.3 T70.4 T70.8 T70.9 T75.2
INFLUENZA INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES TO NEURAL STRUCTURES AND NERVES INJURIES TO NEURAL STRUCTURES AND NERVES INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS
6,600 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300
1,980 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790
4,620 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510
T75.8 S14.0 S34.0 S16 S39.0 S43.0 S43.4 S43.5 S43.7 S46.0 S46.1 S46.2 S46.7 S46.8 S46.9 S53.4 S56.0
9,300 18,400 18,400 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200
2,790 5,520 5,520 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160
6,510 12,880 12,880 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040
Sprain and strain of other and unspecified parts of shoulder INJURIES TO THE MUSCLES AND TENDONS AND girdle; Sprain and strain of shoulder girdle NOS JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of tendon of the rotator cuff of shoulder JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of muscle and tendon of long head of biceps JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of muscle and tendon of other parts of biceps JOINTS Injury of multiple muscles and tendons at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND upper arm level JOINTS Injury of other muscles and tendons at shoulder and upper INJURIES TO THE MUSCLES AND TENDONS AND arm level JOINTS Injury of unspecified muscle and tendon at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND upper arm level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of elbow JOINTS Injury of flexor muscle and tendon of thumb at forearm INJURIES TO THE MUSCLES AND TENDONS AND level JOINTS
Page 43 of 111
S56.1 S56.2 S56.3 S63.5
DESCRIPTION
GROUP
Case Rate 7,200 7,200 7,200 7,200
S63.6
S63.7 S66.1 S66.3 S66.5 S66.6 S66.8 S66.9 S73.1 S76.1 S76.2 S76.3 S76.4 S83.4
S83.5 S83.6 S86.8 S86.9
Injury of long flexor muscle and tendon of other finger(s) at INJURIES TO THE MUSCLES AND TENDONS AND forearm level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other flexor muscle and tendon at forearm level JOINTS Injury of extensor or abductor muscles and tendons of INJURIES TO THE MUSCLES AND TENDONS AND thumb at forearm level JOINTS Sprain and strain of wrist; Sprain and strain of Carpal joint; INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of Radiocarpal joint; Sprain and strain of JOINTS Radiocarpal ligament Sprain and strain of finger(s); Sprain and strain of INJURIES TO THE MUSCLES AND TENDONS AND Interphalangeal joint, hand; Sprain and strain JOINTS Metacarpophalangeal joint; Sprain and strain of Phalanx, hand; Sprain and strain of Thumb INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of other and unspecified parts of hand JOINTS Injury of flexor muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND and hand level JOINTS Injury of extensor muscle and tendon of other finger at INJURIES TO THE MUSCLES AND TENDONS AND wrist and hand level JOINTS Injury of intrinsic muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND and hand level JOINTS Injury of multiple flexor muscles and tendons at wrist and INJURIES TO THE MUSCLES AND TENDONS AND hand level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other muscles and tendons at wrist and hand level JOINTS Injury of unspecified muscle and tendon at wrist and hand INJURIES TO THE MUSCLES AND TENDONS AND level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of hip JOINTS Injury of quadriceps muscle and tendon; injury of Patellar INJURIES TO THE MUSCLES AND TENDONS AND ligament (tendon) JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of adductor muscle and tendon of thigh JOINTS Injury of muscle and tendon of the posterior muscle group INJURIES TO THE MUSCLES AND TENDONS AND at thigh level JOINTS Injury of other and unspecified muscles and tendons at INJURIES TO THE MUSCLES AND TENDONS AND thigh level JOINTS Sprain and strain involving fibular collateral ligament of INJURIES TO THE MUSCLES AND TENDONS AND knee; Sprain and strain involving tibial collateral ligament of JOINTS knee Sprain and strain involving anterior cruciate ligament of INJURIES TO THE MUSCLES AND TENDONS AND knee; Sprain and strain involving posterior cruciate JOINTS ligament of knee INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of other and unspecified parts of knee JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other muscles and tendons at lower leg level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of unspecified muscle and tendon at lower leg level JOINTS Sprain and strain of ankle including Calcaneofibular INJURIES TO THE MUSCLES AND TENDONS AND (ligament), Deltoid (ligament), Internal collateral (ligament), JOINTS Talofibular (ligament), Tibiofibular , distal (ligament) Sprain and strain of toe(s) including Interphalangeal (joint(s), metatarsophalangeal (joint(s) Sprain and strain of other and unspecified parts of foot including Tarsal (ligament), Tarsometatarsal (ligament) Injury of muscle and tendon of long flexor muscle of toe at ankle and foot level Injury of unspecified muscle and tendon at ankle and foot level Multiple dislocations, sprains and strains, unspecified Pulmonary oedema; Acute oedema of lung; Passive pulmonary congestion; Lung dropsy Pulmonary eosinophilia, not elsewhere classified; Eosinophilic asthma; Loffler's pneumonia; Tropical pulmonary eosinophilia NOS Alveolar and parietoalveolar conditions; Alveolar proteinosis; Pulmonary alveolar microlithiasis Other interstitial pulmonary diseases with fibrosis; Diffuse pulmonary fibrosis; Cryptogenic fibrosing alveolitis; Hamman-Rich syndrome; Idiopathic pulmonary fibrosis INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INTERSTITIAL PULMONARY DISEASE INTERSTITIAL PULMONARY DISEASE INTERSTITIAL PULMONARY DISEASE
7,200
2,160
5,040
7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200 7,200
2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160 2,160
5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040 5,040
7,200 7,200 7,200 7,200
2,160 2,160 2,160 2,160
5,040 5,040 5,040 5,040
S93.4
7,200
2,160
5,040
S93.5 S93.6 S96.0 S96.9 T03.9 J81 J82 J84.0
7,200 7,200 7,200 7,200 7,200 14,000 14,000 14,000
2,160 2,160 2,160 2,160 2,160 4,200 4,200 4,200
5,040 5,040 5,040 5,040 5,040 9,800 9,800 9,800
J84.1 J84.8 J84.9
INTERSTITIAL PULMONARY DISEASE
14,000 14,000 14,000
4,200 4,200 4,200
9,800 9,800 9,800
K55.0
Other specified interstitial pulmonary diseases INTERSTITIAL PULMONARY DISEASE Interstitial pulmonary disease, unspecified; Interstitial INTERSTITIAL PULMONARY DISEASE pneumonia NOS Acute vascular disorders of intestine; Acute fulminant ischaemic colitis; Acute intestinal infarction; Acute small intestine ischaemia; Mesentric artery embolism; Mesentric INTESTINAL DISORDERS vein embolism; Mesentric artery infarction; Mesentric vein infarction; Mesentric a
9,500
2,850
6,650
Page 44 of 111
Chronic vascular disorders of intestine; Chronic ischaemic colitis; Chronic ischaemic enteritis; Chronic ischaemic enterocolitis; Ischaemic stricture of intestine; Mesentric atherosclerosis; Mesentric vascular insufficiency Angiodysplasia of colon
GROUP
Case Rate
Professional Fee
K55.1
INTESTINAL DISORDERS
9,500
2,850
6,650
K55.2 K55.9
9,500 9,500
2,850 2,850
6,650 6,650
Vascular disorder of intestine, unspecified; Ischaemic colitis INTESTINAL DISORDERS NOS; Ischaemic enteritis NOS; Ischaemic enterocolitis NOS Diverticular disease of small intestine with perforation and INTESTINAL DISORDERS abscess; Diverticular disease of small intestine with peritonitis Diverticular disease of small intestine without perforation or abscess; Diverticular disease of small intestine NOS Diverticular disease of large intestine with perforation and abscess; Diverticular disease/ Diverticulitis/ Diverticulosis/ Diverticulum of colon with peritonitis Diverticular disease of large intestine without perforation or abscess; Diverticular disease of colon NOS Diverticular disease of both small and large intestine with perforation and abscess; Diverticular disease of both small and large intestine with peritonitis Diverticular disease of both small and large intestine without perforation or abscess; Diverticular disease of both small and large intestine NOS Diverticular disease of intestine, part unspecified, with perforation and abscess; Diverticular disease of intestine NOS with peritonitis Diverticular disease of intestine, part unspecified, without perforation or abscess; Diverticular disease of intestine NOS Megacolon, not elsewhere classified; Dilatation of colon; Toxic megacolon Other specified functional intestinal disorders; Atony of colon Functional intestinal disorder, unspecified Abscess of intestine Nontraumatic perforation of intestine Fistula of intestine Ulcer of intestine; Primary ulcer of small intestine Enteroptosis Polyp of colon Other specified diseases of intestine Disease of intestine, unspecified Coeliac disease; Gluten-sensitive enteropathy; Idiopathic steatorrhoea; Nontropical sprue Tropical sprue; Sprue NOS; Tropical steatorrhoea Blind loop syndrome, not elsewhere classified; Blind loop syndrome NOS Pancreatic steatorrhoea Malabsorption due to intolerance, not elsewhere classified; Malabsorption due to intolerance to carbohydrate; Malabsorption due to intolerance to fat; Malabsorption due to intolerance to protein; Malabsorption due to intolerance to starch Other intestinal malabsorption Intestinal malabsorption, unspecified Paralytic ileus; Paralysis of bowel; Paralysis of colon; Paralysis of intestine Intussusception; Intussusception or invagination of bowel; Intussusception or invagination of colon; Intussusception or invagination of intestine; Intussusception or invagination of rectum Volvulus; Strangulation of colon or intestine; Torsion of colon or intestine; Twist of colon or intestine Gallstone ileus; Obstruction of intestine by gallstone Other impaction of intestine; Enterolith; Impaction of colon; Imfaction of faecal Intestinal adhesions [bands] with obstruction; Peritoneal adhesions [bands] with intestinal obstruction INTESTINAL DISORDERS
K57.0
9,500
2,850
6,650
K57.1
9,500
2,850
6,650
K57.2
9,500
2,850
6,650
K57.3
9,500
2,850
6,650
K57.4
9,500
2,850
6,650
K57.5
9,500
2,850
6,650
K57.8
9,500
2,850
6,650
K57.9 K59.3 K59.8 K59.9 K63.0 K63.1 K63.2 K63.3 K63.4 K63.5 K63.8 K63.9 K90.0 K90.1 K90.2 K90.3
INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION
9,500 9,500 9,500 9,500 9,500 9,500 9,500 9,500 9,500 9,500 9,500 9,500 4,100 4,100 4,100 4,100
2,850 2,850 2,850 2,850 2,850 2,850 2,850 2,850 2,850 2,850 2,850 2,850 1,230 1,230 1,230 1,230
6,650 6,650 6,650 6,650 6,650 6,650 6,650 6,650 6,650 6,650 6,650 6,650 2,870 2,870 2,870 2,870
K90.4
INTESTINAL MALABSORPTION
4,100
1,230
2,870
K90.8 K90.9 K56.0
INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL OBSTRUCTION
4,100 4,100 10,100
1,230 1,230 3,030
2,870 2,870 7,070
K56.1
INTESTINAL OBSTRUCTION
10,100
3,030
7,070
K56.2 K56.3 K56.4 K56.5
INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION
10,100 10,100 10,100 10,100
3,030 3,030 3,030 3,030
7,070 7,070 7,070 7,070
K56.6 K56.7
Other and unspecified intestinal obstruction; Enterotenosis; Obstructive ileus NOS; Occlusion of colon or INTESTINAL OBSTRUCTION intestine; Stenosis of colon or intestine; Stricture of colon or intestine Ileus, unspecified INTESTINAL OBSTRUCTION
10,100 10,100
3,030 3,030
7,070 7,070
Page 45 of 111
G06.0
Intracranial abscess and granuloma; Abscess (embolic)(of) brain [any part]; Abscess (embolic)(of) cerebellar; Abscess INTRACRANIAL AND INTRASPINAL ABSCESS AND (embolic)(of) cerebral; Abscess (embolic)(of) otogenic; GRANULOMA IIntracranial abscess or granuloma, epidural; Intracranial abscess or granulom Intraspinal abscess and granuloma; Abscess (embolic) of spinal cord [any part]; Intraspinal abscess or granuloma epidural; Intraspinal abscess or granuloma extradural; Intraspinal abscess or granuloma subdural Encephalitis, myelitis and encephalomyelitis in Extradural and subdural abscess, unspecified
27,900
8,370
19,530
G06.1
INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA
27,900
8,370
19,530
G06.2 S04.0 S04.1 S04.4 S04.5 S04.6
27,900 8,800 8,800 8,800 8,800 8,800
8,370 2,640 2,640 2,640 2,640 2,640
19,530 6,160 6,160 6,160 6,160 6,160
Injury of optic nerve and pathways; Injury of Optic chiasm; INTRACRANIAL INJURIES Injury of 2nd cranial nerve; Injury of Visual cortex Injury of oculomotor nerve; injury of 3rd cranial nerve Injury of abducent nerve; injury of 6th cranial nerve Injury of facial nerve; injury of 7th cranial nerve Injury of acoustic nerve; injury of Auditory nerve; injury of 8th cranial nerve INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES
S04.8 S04.9 S05.0 S06.00 S06.01 S06.10 S06.20
Injury of other cranial nerves; injury of Glossopharyngeal [9th] nerve; injury of Hypoglossal [12th] nerve; injury of; INTRACRANIAL INJURIES injury of Olfactory [1st] nerve; injury of Vagus [10th] nerve Injury of unspecified cranial nerve Injury of conjunctiva and corneal abrasion without mention of foreign body Concussion; Commotio cerebri (without open intracranial wound) Concussion; Commotio cerebri (with open intracranial wound) Traumatic cerebral oedema (without open intracranial wound) Diffuse brain injury; Cerebral contusion NOS; Cerebral laceration NOS; Traumatic compression of brain NOS (without open intracranial wound) Diffuse brain injury; Cerebral contusion NOS; Cerebral laceration NOS; Traumatic compression of brain NOS (without open intracranial wound) INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES
8,800 8,800 8,800 8,800 8,800 8,800 8,800
2,640 2,640 2,640 2,640 2,640 2,640 2,640
6,160 6,160 6,160 6,160 6,160 6,160 6,160
S06.21
INTRACRANIAL INJURIES
8,800
2,640
6,160
S06.30
Focal brain injury; Focal cerebral; Focal cerebral contusion; Focal cerebral laceration; Focal traumatic intracerebral INTRACRANIAL INJURIES haemorrhage (without open intracranial wound) Focal brain injury; Focal cerebral; Focal cerebral contusion; Focal cerebral laceration; Focal traumatic intracerebral INTRACRANIAL INJURIES haemorrhage (with open intracranial wound) Epidural haemorrhage; Extradural haemorrhage, traumatic (without open intracranial wound) Epidural haemorrhage; Extradural haemorrhage, traumatic (with open intracranial wound) Traumatic subdural haemorrhage (without open intracranial wound) Traumatic subdural haemorrhage (with open intracranial wound) Traumatic subarachnoid haemorrhage (without open intracranial wound) Traumatic subarachnoid haemorrhage (with open intracranial wound) Intracranial injury with prolonged coma (without open intracranial wound) Other intracranial injuries; traumatic haemorrhage cerebellar; traumatic haemorrhage intracranial NOS (without open intracranial wound) Other intracranial injuries; traumatic haemorrhage cerebellar; traumatic haemorrhage intracranial NOS (with open intracranial wound) Intracranial injury, unspecified; brain injury NOS (without open intracranial wound) Intracranial injury, unspecified; brain injury NOS (with open intracranial wound) Injury of blood vessels of head, not elsewhere classified Injury of muscle and tendon of head Traumatic rupture of ear drum Multiple injuries of head Other specified injuries of head Unspecified injury of head; Injury of face NOS; Injury of ear NOS; Injury of nose NOS Intraventricular (nontraumatic) haemorrhage, grade 1, of fetus and newborn; Subependymal haemorrhage (without intraventricular extension) INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES
8,800
2,640
6,160
S06.31
8,800
2,640
6,160
S06.40 S06.41 S06.50 S06.51 S06.60 S06.61 S06.70 S06.80
8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800
2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640
6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160
S06.81 S06.90 S06.91 S09.0 S09.1 S09.2 S09.7 S09.8 S09.9 P52.0
INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE NEWBORN
8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 25,600
2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 7,680
6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 17,920
Page 46 of 111
Intraventricular (nontraumatic) haemorrhage, grade 2, of fetus and newborn; Subependymal haemorrhage with intraventricular extension
GROUP
Case Rate 25,600
P52.1
P52.3
P52.4
P52.5
P52.6
P52.8
P52.9
INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE NEWBORN INTRAVENTRICULAR Unspecified intraventricular (nontraumatic) haemorrhage HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN of fetus and newborn THE NEWBORN INTRAVENTRICULAR Intracerebral (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn THE NEWBORN INTRAVENTRICULAR Subarachnoid (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn THE NEWBORN INTRAVENTRICULAR Cerebellar (nontraumatic) and posterior fossa haemorrhage HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN of fetus and newborn THE NEWBORN INTRAVENTRICULAR Other intracranial (nontraumatic) haemorrhages of fetus HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN and newborn THE NEWBORN INTRAVENTRICULAR Intracranial (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn, unspecified THE NEWBORN Acute transmural myocardial infarction of anterior wall [or duration of <4 weeks] KILLIPS stage unspecified; Acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL transmural infarction of anterior wall NOS [or duration of INFARCTION <4 weeks] KILLIPS stage unspecified; Acute anteroapical transmural infarction [or Acute transmural myocardial infarction of inferior wall [or duration of <4 weeks] KILLIPS I; Acute transmural infarction ISCHEMIC HEART DISEASE WITH MYOCARDIAL of diaphragmatic wall [or duration of <4 weeks] KILLIPS I; INFARCTION Acute transmural infarction of inferior wall NOS [or duration of <4 weeks] Acute transmural myocardial infarction of other sites [or duration of <4 weeks] KILLIPS II; Acute apical-lateral ISCHEMIC HEART DISEASE WITH MYOCARDIAL transmural infarction [or duration of <4 weeks] KILLIPS II; INFARCTION Acute basal-lateral transmural infarction [or duration of <4 weeks] KILLIPS I Acute transmural myocardial infarction of unspecified site; ISCHEMIC HEART DISEASE WITH MYOCARDIAL Transmural myocardial infarction NOS INFARCTION Acute subendocardial myocardial infarction; Nontransmural myocardial infarction NOS Acute myocardial infarction, unspecified [or duration of <4 weeks] KILLIPS I; Acute myocardial infarction NOS [or duration of <4 weeks] KILLIPS I Subsequent myocardial infarction of anterior wall; Acute Subsequent infarction of anterior wall NOS; Acute subsequent infarction of anteroapical wall; Acute subsequent infarction of anterolateral wall; Acute subsequent infarction of anteroseptal wall Subsequent myocardial infarction of inferior wall; Acute subsequent infarction of diaphragmatic wall; Acute subsequent infarction of inferior wall NOS; Acute subsequent infarction of inferolateral wall; Acute subsequent infarction of inferoposterior wall Subsequent myocardial infarction of other sites; Acute myocardial infarction of apical-lateral wall; Acute myocardial infarction of basal-lateral wall; Acute myocardial infarction of high lateral wall; Acute myocardial infarction of lateral wall NOS; Acut Subsequent myocardial infarction of unspecified site ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
25,600
7,680
17,920
25,600
7,680
17,920
25,600
7,680
17,920
25,600
7,680
17,920
25,600
7,680
17,920
25,600
7,680
17,920
I21.0
18,900
5,670
13,230
I21.1
18,900
5,670
13,230
I21.2
18,900
5,670
13,230
I21.3 I21.4 I21.9
18,900 18,900 18,900
5,670 5,670 5,670
13,230 13,230 13,230
I22.0
ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
18,900
5,670
13,230
I22.1
18,900
5,670
13,230
I22.8
18,900
5,670
13,230
I22.9 I23.0 I23.1 I23.2 I23.3 I23.4 I23.5 I23.8 I24.1 I20.0
ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION Haemopericardium as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL myocardial infarction INFARCTION Atrial septal defect as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL myocardial infarction INFARCTION Ventricular septal defect as current complication following ISCHEMIC HEART DISEASE WITH MYOCARDIAL acute myocardial infarction INFARCTION Rupture of cardiac wall without haemopericardium as ISCHEMIC HEART DISEASE WITH MYOCARDIAL current complication following acute myocardial infarction INFARCTION Rupture of chordae tendineae as current complication following acute myocardial infarction Rupture of papillary muscle as current complication following acute myocardial infarction Other current complications following acute myocardial infarction Dressler's syndrome; Postmyocardial infarction syndrome ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION
18,900 18,900 18,900 18,900 18,900 18,900 18,900 18,900 18,900 12,000
5,670 5,670 5,670 5,670 5,670 5,670 5,670 5,670 5,670 3,600
13,230 13,230 13,230 13,230 13,230 13,230 13,230 13,230 13,230 8,400
Unstable angina; Angina crescendo; Angina de novo effort; ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL Angina worsening effort; Intermediate coronary syndrome; INFARCTION Preinfarction syndrome
Page 47 of 111
Angina pectoris with documented spasm; Angiospastic Angina ; Prinzmetal Angina ; spasm-induced Angina ; Variant Angina Other forms of angina pectoris; Angina of effort; Stenocardia Angina pectoris, unspecified; Angina NOS; Cardiac Angina ; Anginal syndrome; Ischaemic chest pain Coronary thrombosis not resulting in myocardial infarction; Coronary artery embolism not resulting in myocardial infaction; Coronary vein embolism not resulting in myocardial infarction; Coronary artery occlusion not resulting in myocardial infarction; Co Other forms of acute ischaemic heart disease; Coronary failure; Coronary insufficiency Ischaemic cardiomyopathy Silent myocardial ischaemia Other forms of chronic ischaemic heart disease
GROUP
ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN
Case Rate 12,000 12,000 12,000
I20.1 I20.8 I20.9
I24.0
12,000
3,600
8,400
I24.8 I25.5 I25.6 I25.8 I25.9 P57.0 P57.8 P57.9 P58.1 P58.2 P58.3 P58.4 P58.8 P58.9 P59.0 P59.1 P59.2 P59.3 P59.8 P59.9 A30.0 A30.1 A30.2 A30.4 A30.5 A30.8 A30.9 A27.0 A27.8 A27.9 K70.0 K70.1 K70.2 K70.3 K70.9 K71.0 K71.1 K71.2 K71.3 K71.5 K71.6
12,000 12,000 12,000 12,000 12,000 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 7,400 8,800 8,800 8,800 8,800 8,800 8,800 8,800 11,000 11,000 11,000 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800
3,600 3,600 3,600 3,600 3,600 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,220 2,640 2,640 2,640 2,640 2,640 2,640 2,640 3,300 3,300 3,300 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540
8,400 8,400 8,400 8,400 8,400 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 5,180 6,160 6,160 6,160 6,160 6,160 6,160 6,160 7,700 7,700 7,700 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260
Chronic ischaemic heart disease, unspecified; Chronic Ischaemic heart disease NOS Kernicterus due to isoimmunization Other specified kernicterus Kernicterus, unspecified Neonatal jaundice due to bleeding Neonatal jaundice due to infection Neonatal jaundice due to polycythaemia Neonatal jaundice due to drugs or toxins transmitted from JAUNDICE IN THE NEWBORN mother or given to newborn Neonatal jaundice due to other specified excessive JAUNDICE IN THE NEWBORN haemolysis Neonatal jaundice due to excessive haemolysis, unspecified JAUNDICE IN THE NEWBORN Neonatal jaundice associated with preterm delivery; Hyperbilirubinaemia of prematurity; Jaundice due to delayed conjucation associated with preterm delivery Inspissated bile syndrome Neonatal jaundice from other and unspecified hepatocellular damage Neonatal jaundice from breast milk inhibitor Neonatal jaundice from other specified causes Neonatal jaundice, unspecified; Intense physiological jaundice, NOS; Prolonged physiological jaundice, NOS Hansen's disease: Indeterminate leprosy; I leprosy Hansen's disease : Tuberculoid leprosy; TT leprosy Hansen's disease: Borderline tuberculoid leprosy; BT leprosy Hansen's disease: Borderline lepromatous leprosy; BL leprosy Hansen's disease: Lepromatous leprosy; LL leprosy Other forms of leprosy Leprosy, unspecified Leptospirosis icterohaemorrhagica; Leptospirosis due to Leptospira interrogans serovar icterohaemorrhagiae Other forms of leptospirosis Leptospirosis, unspecified Alcoholic fatty liver Alcoholic hepatitis Alcoholic fibrosis and sclerosis of liver Alcoholic cirrhosis of liver; Alcoholic cirrhosis NOS; Laennec's cirrhosis Alcoholic liver disease, unspecified Toxic liver disease with cholestasis; Cholestatis with hepatocyte injury; Pure cholestasis Toxic liver disease with hepatic necrosis; Acute hepatic failure due to drugs; Chronic hepatic failure due to drugs Toxic liver disease with acute hepatitis Toxic liver disease with chronic persistent hepatitis Toxic liver disease with chronic active hepatitis; Toxic liver disease with lupoid hepatitis Toxic liver disease with hepatitis, not elsewhere classified Toxic liver disease with other disorders of liver; Toxic liver disease with focal nodular hyperplasia; Toxic liver disease with hepatic granulomas; Toxic liver disease with peliosis hepatis; Toxic liver disease with veno-occlusive disease of liver Toxic liver disease, unspecified Chronic persistent hepatitis, not elsewhere classified JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY
LEPTOSPIROSIS MODERATE TO SEVERE LEPTOSPIROSIS MODERATE TO SEVERE LEPTOSPIROSIS MODERATE TO SEVERE LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I
K71.8
LIVER DISEASES I
11,800
3,540
8,260
K71.9 K73.0
LIVER DISEASES I LIVER DISEASES I
11,800 11,800
3,540 3,540
8,260 8,260
Page 48 of 111
K73.2 K73.8 K73.9 K74.1 K74.6+I98.2*
DESCRIPTION
Chronic active hepatitis, not elsewhere classified; Lupoid hepatitis NEC Other chronic hepatitis, not elsewhere classified Chronic hepatitis, unspecified Hepatic sclerosis Oesophageal varices in other and unspecified cirrhosis of liver Abscess of liver; Hepatic abscess NOS; Cholangitic hepatic abscess; Haematogenic hepatic abscess; Lymphogenic hepatic abscess; Pylephlebitic hepatic abscess Phlebitis of portal vein; Pylephlebitis Nonspecific reactive hepatitis Granulomatous hepatitis, not elsewhere classified Autoimmune hepatitis Other specified inflammatory liver diseases Inflammatory liver disease, unspecified; Hepatitis NOS Fatty (change of) liver, not elsewhere classified Other specified diseases of liver; Focal nodular hyperplasia of liver; Hepatoptosis Liver disease, unspecified Toxic liver disease with chronic lobular hepatitis Toxic liver disease with fibrosis and cirrhosis of liver Hepatic fibrosis Hepatic fibrosis with hepatic sclerosis Other and unspecified cirrhosis of liver; Cirrhosis of liver NOS; Cryptogenic cirrhosis of liver; Macronodular cirrhosis of liver; Micronodular cirrhosis of liver; Mixed type cirrhosis of liver; Portal cirrhosis of liver; Postnecrotic cirrhosis of liver; Chronic passive congestion of liver; Cardiac cirrhosis (socalled) of liver; Cardiac sclerosis of liver Central haemorrhagic necrosis of liver Infarction of liver Peliosis hepatis; Hepatic angiomatosis Portal hypertension Hepatorenal syndrome Nonspecific mesenteric lymphadenitis; Acute Mesenteric lymphadenitis; Chronic Mesenteric lymphadenitis Lymphangitis; Lymphangitis NOS; Chronic Lymphangitis; Subacute Lymphangitis Other specified noninfective disorders of lymphatic vessels and lymph nodes; Chylocele (nonfilarial); Lipomelanotic reticulosis Noninfective disorder of lymphatic vessels and lymph nodes, unspecified; Disease of lymphatic vessels NOS Malignant neoplasm of kidney, except renal pelvis & renal calyces LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I
GROUP
Case Rate 11,800 11,800 11,800 11,800 11,800
K75.0 K75.1 K75.2 K75.3 K75.4 K75.8 K75.9 K76.0 K76.8 K76.9 K71.4 K71.7 K74.0 K74.2
LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II
11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 15,100 15,100 15,100 15,100
3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 4,530 4,530 4,530 4,530
8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 10,570 10,570 10,570 10,570
K74.6
LIVER DISEASES II
15,100
4,530
10,570
K76.1 K76.2 K76.3 K76.4 K76.6 K76.7 I88.0 I89.1 I89.8 I89.9 C64 C65 C66 C67.0 C67.1 C67.2 C67.3 C67.5 C67.6 C67.7 C67.8 C67.9 C68.0 C68.9 C79.0 C79.1 C40.0 C40.1 C40.2 C40.3 C40.9 C41.0
LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LYMPHADENITIS LYMPHATIC VESSELS DISORDER LYMPHATIC VESSELS DISORDER LYMPHATIC VESSELS DISORDER MALIGNANT NEOPLASM OF URINARY TRACT
15,100 15,100 15,100 15,100 15,100 15,100 6,800 8,900 8,900 8,900 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 14,100 16,500 16,500 16,500 16,500 16,500 16,500
4,530 4,530 4,530 4,530 4,530 4,530 2,040 2,670 2,670 2,670 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,230 4,950 4,950 4,950 4,950 4,950 4,950
10,570 10,570 10,570 10,570 10,570 10,570 4,760 6,230 6,230 6,230 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 9,870 11,550 11,550 11,550 11,550 11,550 11,550
Malignant neoplasm of renal pelvis; Malignant neoplasm of MALIGNANT NEOPLASM OF URINARY TRACT Pelviureteric junction; Malignant neoplasm of Renal calyces Malignant neoplasm of ureter Malignant neoplasm of Trigone of bladder Malignant neoplasm of Dome of bladder Malignant neoplasm of Lateral wall of bladder Malignant neoplasm of Anterior wall of bladder Malignant neoplasm of Bladder neck; Malignant neoplasm of Internal urethral orifice Malignant neoplasm of Ureteric orifice Malignant neoplasm of Urachus Malignant neoplasm of Overlapping lesion of bladder Malignant neoplasm of Bladder, unspecified Malignant neoplasm of Urethra Malignant neoplasm of Urinary organ, unspecified; Malignant neoplasm of Urinary system NOS Secondary malignant neoplasm of kidney and renal pelvis Secondary malignant neoplasm of bladder and other and unspecified urinary organs Malignant neoplasm of Scapula and long bones of upper limb MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT
MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Short bones of upper limb ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Long bones of lower limb ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Short bones of lower limb ARTICULAR CARTILAGE Malignant neoplasm of Bone and articular cartilage of limb, MALIGNANT NEOPLASMS OF BONE AND unspecified ARTICULAR CARTILAGE Malignant neoplasm of Bones of skull and face; Malignant MALIGNANT NEOPLASMS OF BONE AND neoplasm o f Superior maxilla; Malignant neoplasm of ARTICULAR CARTILAGE Orbital bone
Page 49 of 111
C41.1 C41.2 C41.3 C41.4 C41.8 C41.9 C79.5 C70.0 C70.1 C70.9 C71.0 C71.1 C71.2 C71.3 C71.4 C71.5 C71.6 C71.7 C71.8 C71.9 C72.0 C72.1 C72.2 C72.3 C72.4 C72.5 C72.8 C72.9 C79.3 C79.4 C15.0 C15.2 C15.3 C15.4 C15.5 C15.8 C15.9 C16
DESCRIPTION
Malignant neoplasm of Mandible; Malignant neoplasm of Lower jaw bone Malignant neoplasm of Vertebral column Malignant neoplasm of Ribs, sternum and clavicle Malignant neoplasm of Pelvic bones, sacrum and coccyx Malignant neoplasm of Overlapping lesion of bone and articular cartilage Malignant neoplasm of Bone and articular cartilage, unspecified Secondary malignant neoplasm of bone and bone marrow Malignant neoplasm of Cerebral meninges Malignant neoplasm of Spinal meninges Malignant neoplasm of Meninges, unspecified Malignant neoplasm of Cerebrum, except lobes and ventricles; Malignant neoplasm of Supratentorial NOS Malignant neoplasm of Frontal lobe Malignant neoplasm of Temporal lobe Malignant neoplasm of Parietal lobe Malignant neoplasm of Occipital lobe Malignant neoplasm of Cerebral ventricle Malignant neoplasm of Cerebellum
GROUP
MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM
Case Rate 16,500 16,500 16,500 16,500 16,500 16,500 16,500 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200
Professional Fee 4,950 4,950 4,950 4,950 4,950 4,950 4,950 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 5,070 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260
Health Care Institution Fee 11,550 11,550 11,550 11,550 11,550 11,550 11,550 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 11,830 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940
Malignant neoplasm of Brain stem; Malignant neoplasm of MALIGNANT NEOPLASMS OF CENTRAL NERVOUS Fourth Ventricle; Malignant neoplasm of Infratentorial NOS SYSTEM Malignant neoplasm of Overlapping lesion of brain Malignant neoplasm of Brain, unspecified Malignant neoplasm of Spinal cord Malignant neoplasm of Cauda equina Malignant neoplasm of Olfactory nerve; Malignant neoplasm of Olfactory bulb Malignant neoplasm of Optic nerve Malignant neoplasm of Acoustic nerve Malignant neoplasm of Other and unspecified cranial nerves; Malignant neoplasm of Cranial nerve NOS Malignant neoplasm of Overlapping lesion of brain and other parts of central nervous system Malignant neoplasm of Central nervous system, unspecified; Malignant neoplasm of Nervous system NOS Secondary malignant neoplasm of brain and cerebral meninges Secondary malignant neoplasm of other and unspecified parts of nervous system Malignant neoplasm of Cervical part of oesophagus Malignant neoplasm of Abdominal part of oesophagus Malignant neoplasm of Upper third of oesophagus Malignant neoplasm of Middle third of oesophagus Malignant neoplasm of Lower third of oesophagus Malignant neoplasm of Overlapping lesion of oesophagus Malignant neoplasm of Oesophagus, unspecified Dermato(poly)myositis in Malignant neoplasm of stomach MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
C16.0
Malignant neoplasm of Cardia; Malignant neoplasm of Cardiac orifice; Malignant neoplasm of Cardio-oesophageal MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS junction; Malignant neoplasm of Gastro-oesophageal junction; Malignant neoplasm of Oesophagus and stomach
14,200
4,260
9,940
Page 50 of 111
C16.1 C16.2 C16.3 C16.4 C16.5 C16.6 C16.9 C17.0 C17.1 C17.2 C17.9 C18.0 C18.1 C18.2 C18.3 C18.4 C18.5 C18.6 C18.7 C18.8 C18.9 C19 C20 C21.0 C21.1
DESCRIPTION
Malignant neoplasm of Fundus of stomach Malignant neoplasm of Body of stomach Malignant neoplasm of Pyloric antrum; Malignant neoplasm of Gastric antrum Malignant neoplasm of Pylorus; Malignant neoplasm of Prepylorus; Malignant neoplasm of pyloric canal Malignant neoplasm of Lesser curvature of stomach, unspecified Malignant neoplasm of Greater curvature of stomach, unspecified Malignant neoplasm of Stomach, unspecified Malignant neoplasm of Duodenum Malignant neoplasm of Jejunum Malignant neoplasm of Ileum Malignant neoplasm of Small intestine, unspecified Malignant neoplasm of Caecum; Malignant neoplasm of Ileocaecal valve Malignant neoplasm of Appendix Malignant neoplasm of Ascending colon Malignant neoplasm of Hepatic flexure Malignant neoplasm of Transverse colon Malignant neoplasm of Splenic flexure Malignant neoplasm of Descending colon
GROUP
MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
Case Rate 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200
Professional Fee 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260
Health Care Institution Fee 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940
Malignant neoplasm of Sigmoid colon; Malignant neoplasm MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS of Sigmoid flexure Malignant neoplasm of Overlapping lesion of colon Malignant neoplasm of Colon, unspecified; Malignant neoplasm of Large intestine NOS Malignant neoplasm of rectosigmoid junction; Malignant neoplasm of Colon with rectum; Malignant neoplasm of Rectosigmoid colon Malignant neoplasm of rectum; Malignant neoplasm of Rectal ampulla Malignant neoplasm of Anus, unspecified Malignant neoplasm of Anal canal; Malignant neoplasm of Anal sphincter MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
C21.8
Malignant neoplasm of Overlapping lesion of rectum, anus and anal canal; Malignant neoplasm of Anorectal junction; MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Malignant neoplasm of Anorectum Liver cell carcinoma; Hepatocellular carcinoma Hepatoma Intrahepatic bile duct carcinoma; Cholangiocarcinoma Hepatoblastoma Angiosarcoma of liver; Kupffer cell sarcoma Other sarcomas of liver Other specified carcinomas of liver Liver, unspecified Malignant neoplasm of gallbladder Malignant neoplasm of Extrahepatic bile duct; Malignant neoplasm of Biliary duct or passage NOS; Malignant neoplasm of Common bile duct; Malignant neoplasm of Cystic duct; Malignant neoplasm of Hepatic duct Malignant neoplasm of Ampulla of Vater Malignant neoplasm of Overlapping lesion of biliary tract Malignant neoplasm of Biliary tract, unspecified Malignant neoplasm of Head of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
14,200
4,260
9,940
C22.0 C22.1 C22.2 C22.3 C22.4 C22.7 C22.9 C23
14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200
4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260
9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940
C24.0
MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
14,200
4,260
9,940
C24.1 C24.8 C24.9 C25.0
MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
14,200 14,200 14,200 14,200
4,260 4,260 4,260 4,260
9,940 9,940 9,940 9,940
Page 51 of 111
C25.1 C25.2 C25.3 C25.4 C25.7 C25.8 C25.9 C26.0 C26.1 C26.8
DESCRIPTION
Malignant neoplasm of Body of pancreas Malignant neoplasm of Tail of pancreas Malignant neoplasm of Pancreatic duct
GROUP
MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
Case Rate 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200
Malignant neoplasm of Endocrine pancreas; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Islets of Langerhans Malignant neoplasm of Other parts of pancreas; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Neck of pancreas Malignant neoplasm of Overlapping lesion of pancreas Malignant neoplasm of Pancreas, unspecified Malignant neoplasm of Intestinal tract, part unspecified; Malignant neoplasm of Intestine NOS Malignant neoplasm of Spleen Malignant neoplasm of Overlapping lesion of digestive system MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
C26.9
Malignant neoplasm of Ill-defined sites within the digestive system; Malignant neoplasm of Alimentary canal or tract MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS NOS; Malignant neoplasm of Gastrointestinal tract NOS Mesothelioma of peritoneum; Mesothelioma of Mesentery; Mesothelioma of Mesocolon; Mesothelioma of Omentum; MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Mesothelioma of Parietal Peritoneum; Mesothelioma of Pelvic Peritoneum Malignant neoplasm of Specified parts of peritoneum; Malignant neoplasm of Mesentery; Malignant neoplasm of Mesocolon; Malignant neoplasm of Omentum; Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Parietal Peritoneum; Malignant neoplasm of Pelvic peritoneum Malignant neoplasm of Peritoneum, unspecified Malignant neoplasm of Abdomen Secondary and unspecified malignant neoplasm of Intraabdominal lymph nodes Secondary malignant neoplasm of small intestine Secondary malignant neoplasm of large intestine and rectum Secondary malignant neoplasm of retroperitoneum and peritoneum; Malignant ascites NOS Secondary malignant neoplasm of liver Secondary malignant neoplasm of other and unspecified digestive organs Malignant neoplasm of Nasal cavity; Malignant neoplasm of Cartilage of nose; Malignant neoplasm of nasal Concha; Malignant neoplasm of Internal nose; Malignant neoplasm of Septum of nose; Malignant neoplasm of Vestibule of nose Malignant neoplasm of Middle ear; Malignant neoplasm of Eustachian tube; Malignant neoplasm of Inner ear; Malignant neoplasm of Mastoid air cells Malignant neoplasm of Cornea Malignant neoplasm of Retina Malignant neoplasm of Choroid Malignant neoplasm of Ciliary body; Malignant neoplasm of Eyeball Malignant neoplasm of Lacrimal gland and duct; Malignant neoplasm of Lacrimal sac; Malignant neoplasm of Nasolacrimal duct MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS
14,200
4,260
9,940
C45.1
14,200
4,260
9,940
C48.1
14,200
4,260
9,940
C48.2 C76.2 C77.2 C78.4 C78.5 C78.6 C78.7 C78.8
14,200 14,200 14,200 14,200 14,200 14,200 14,200 14,200
4,260 4,260 4,260 4,260 4,260 4,260 4,260 4,260
9,940 9,940 9,940 9,940 9,940 9,940 9,940 9,940
C30.0
MALIGNANT NEOPLASMS OF EARS AND NOSE
10,300
3,090
7,210
C30.1 C69.1 C69.2 C69.3 C69.4 C69.5
MALIGNANT NEOPLASMS OF EARS AND NOSE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE
10,300 16,900 16,900 16,900 16,900 16,900
3,090 5,070 5,070 5,070 5,070 5,070
7,210 11,830 11,830 11,830 11,830 11,830
C69.6
Malignant neoplasm of Orbit; Malignant neoplasm of Connective tissue of orbit; Malignant neoplasm of Extraocular muscle; Malignant neoplasm of Peripheral MALIGNANT NEOPLASMS OF EYE nerves of orbit; Malignant neoplasm of Retrobulbar tissue; Malignant neoplasm of Retro-ocular Malignant neoplasm of Eye, unspecified MALIGNANT NEOPLASMS OF EYE Malignant neoplasm of Labium majus; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Bartholin's [greater vestibular] gland TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Labium minus TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Clitoris TRACT Malignant neoplasm of Vulva, unspecified; Malignant MALIGNANT NEOPLASMS OF FEMALE GENITAL neoplasm of External female genitalia NOS; Malignant TRACT neoplasm of Pudendum
16,900
5,070
11,830
C69.9 C51.0 C51.1 C51.2 C51.9
16,900 11,400 11,400 11,400 11,400
5,070 3,420 3,420 3,420 3,420
11,830 7,980 7,980 7,980 7,980
Page 52 of 111
C52 C53.0 C53.1 C53.8 C53.9 C54.0 C54.1 C54.2 C54.3 C54.8 C54.9 C55 C56 C57.0 C57.3 C57.4 C57.7
DESCRIPTION
Malignant neoplasm of vagina
GROUP
Case Rate 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400
Professional Fee 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420
Health Care Institution Fee 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980
MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Endocervix TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Exocervix TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Overlapping lesion of cervix uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Cervix uteri, unspecified TRACT Malignant neoplasm of Isthmus uteri; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Lower uterine segment TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Endometrium TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Myometrium TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Fundus uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Overlapping lesion of corpus uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Corpus uteri, unspecified TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of uterus, part unspecified TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of ovary TRACT Malignant neoplasm of Fallopian tube; Malignant MALIGNANT NEOPLASMS OF FEMALE GENITAL neoplasm of Oviduct; Malignant neoplasm of Uterine tube TRACT Malignant neoplasm of Parametrium; Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Uterine ligament NOS TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Uterine adnexa, unspecified TRACT Malignant neoplasm of Other specified female genital organs; Malignant neoplasm of Wolffian body or duct MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
C57.8
Malignant neoplasm of Overlapping lesion of female genital MALIGNANT NEOPLASMS OF FEMALE GENITAL organs; Malignant neoplasm of Tubo-ovarian; Malignant TRACT neoplasm of Utero-ovarian Malignant neoplasm of Female genital organ, unspecified; Malignant neoplasm of Female genitourinary tract NOS Malignant neoplasm of placenta; Choriocarcinoma NOS; Chorionepithelioma NOS Secondary malignant neoplasm of ovary MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT
11,400
3,420
7,980
C57.9 C58 C79.6
11,400 11,400 11,400
3,420 3,420 3,420
7,980 7,980 7,980
C00.0
C00.9 C01
C02.0 C02.1
C02.2
Malignant neoplasm of External upper lip; Malignant neoplasm of Upper lip NOS; Malignant neoplasm of Upper MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX lip; Malignant neoplasm of lipstick area; Malignant neoplasm of Upper lip, vermilion border MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Lip, unspecified PHARYNX Malignant neoplasm of base of Dorsal surface of tongue ; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Fixed part of tongue NOS; PHARYNX Malignant neoplasm of Posterior third of tongue Malignant neoplasm of Dorsal surface of base of tongue; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Anterior two-thirds of dorsal PHARYNX surface of tongue Malignant neoplasm of Border of tongue; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, neoplasm of Tip of tongue PHARYNX Malignant neoplasm of Ventral surface of tongue; MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Anterior two-thirds of ventral PHARYNX surface of tongue; Malignant neoplasm of Frenulum linguae Malignant neoplasm of Anterior two-thirds of tongue, part MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, unspecified; Malignant neoplasm of Middle third of tongue PHARYNX NOS; Malignant neoplasm of Mobile part of tongue NOS Malignant neoplasm of Lingual tonsil Malignant neoplasm of Overlapping lesion of tongue Malignant neoplasm of Tongue, unspecified Malignant neoplasm of Upper gum Malignant neoplasm of Lower gum Malignant neoplasm of Gum, unspecified Malignant neoplasm of Floor of mouth, unspecified Malignant neoplasm of Hard palate MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
11,500
3,450
8,050
11,500 11,500
3,450 3,450
8,050 8,050
11,500 11,500
3,450 3,450
8,050 8,050
11,500
3,450
8,050
C02.3
11,500
3,450
8,050
C02.4 C02.8 C02.9 C03.0 C03.1 C03.9 C04.9 C05.0
11,500 11,500 11,500 11,500 11,500 11,500 11,500 11,500
3,450 3,450 3,450 3,450 3,450 3,450 3,450 3,450
8,050 8,050 8,050 8,050 8,050 8,050 8,050 8,050
Page 53 of 111
C05.1 C05.9 C06.0
DESCRIPTION
Malignant neoplasm of Soft palate Malignant neoplasm of Palate, unspecified
GROUP
MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
Case Rate 11,500 11,500 11,500
Malignant neoplasm of Cheek mucosa; Malignant neoplasm MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, of Buccal mucosa NOS; Malignant neoplasm of Internal PHARYNX cheek Malignant neoplasm of Vestibule of mouth; Malignant neoplasm of Upper buccal sulcus; Malignant neoplasm of Lower buccal sulcus; Malignant neoplasm of Upper Labial sulcus; Malignant neoplasm of Lower Labial sulcus Malignant neoplasm of Retromolar area Malignant neoplasm of Mouth, unspecified; Minor Malignant neoplasm of minor salivary gland, unspecified site; Malignant neoplasm of Oral cavity NOS Malignant neoplasm of parotid gland Malignant neoplasm of Submandibular gland; Malignant neoplasm of Submaxillary gland Malignant neoplasm of Sublingual gland Malignant neoplasm of Major salivary gland, unspecified; Malignant neoplasm of Major Salivary gland NOS Malignant neoplasm of Tonsillar fossa Malignant neoplasm of Tonsil, unspecified; Malignant neoplasm of Tonsil NOS; Malignant neoplasm of Faucial Tonsil; Malignant neoplasm of Palatine Tonsil Malignant neoplasm of Vallecula MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
C06.1
11,500
3,450
8,050
C06.2
11,500
3,450
8,050
C06.9
11,500
3,450
8,050
C07 C08.0 C08.1 C08.9 C09.0
11,500 11,500 11,500 11,500 11,500
3,450 3,450 3,450 3,450 3,450
8,050 8,050 8,050 8,050 8,050
C09.9
11,500
3,450
8,050
C10.0 C10.3 C10.4 C10.9 C11.0
MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Posterior wall of oropharynx PHARYNX Malignant neoplasm of Branchial cleft; Malignant neoplasm MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, of Branchial cyst PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Oropharynx, unspecified PHARYNX Malignant neoplasm of Superior wall of nasopharynx; Malignant neoplasm of Roof of nasopharynx Malignant neoplasm of Posterior wall of nasopharynx; Malignant neoplasm of Adenoid; Malignant neoplasm of Pharyngeal tonsil Malignant neoplasm of Lateral wall of nasopharynx; Malignant neoplasm of Fossa of Rosenmller; Malignant neoplasm of Opening of auditory tube; Malignant neoplasm of Pharyngeal recess Malignant neoplasm of Anterior wall of nasopharynx; Malignant neoplasm of A nterior Nasopharyngeal surface of soft palate; Malignant neoplasm of Posterior Nasopharyngeal surface of soft palate; Malignant neoplasm of Posterior margin of nasal choana; M Malignant neoplasm of Nasopharynx, unspecified Malignant neoplasm of Aryepiglottic fold, hypopharyngeal aspect hypopharynx ; Malignant neoplasm of Aryepiglottic fold, hypopharynx NOS; Malignant neoplasm of Aryepiglottic fold, marginal zone, hypopharynx Malignant neoplasm of Hypopharynx, unspecified; Malignant neoplasm of Hypopharyngeal wall NOS MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
11,500 11,500 11,500 11,500 11,500
3,450 3,450 3,450 3,450 3,450
8,050 8,050 8,050 8,050 8,050
C11.1
11,500
3,450
8,050
C11.2
11,500
3,450
8,050
C11.3
MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
11,500
3,450
8,050
C11.9
MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX
11,500
3,450
8,050
C13.1
11,500
3,450
8,050
C13.9 C14.0 C14.8 C76.0
MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, Malignant neoplasm of Pharynx, unspecified PHARYNX Malignant neoplasm of Overlapping lesion of lip, oral cavity MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, and pharynx PHARYNX Malignant neoplasm of Head, face and neck; Malignant MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, neoplasm of Cheek NOS; Malignant neoplasm of Nose NOS PHARYNX Secondary and unspecified malignant neoplasm of Lymph nodes of head, face and neck; Malignant neoplasm of Supraclavicular lymph nodes Human immunodeficiency virus [HIV] disease resulting in Burkitt's lymphoma Human immunodeficiency virus [HIV] disease resulting in other types of non-Hodgkin's lymphoma Human immunodeficiency virus [HIV] disease resulting in other malignant neoplasms of lymphoid, haematopoietic and related tissue MALIGNANT NEOPLASMS OF LIP, ORAL CAVITY, PHARYNX MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE
11,500 11,500 11,500 11,500
3,450 3,450 3,450 3,450
8,050 8,050 8,050 8,050
C77.0 B21.1 B21.2 B21.3
11,500 13,900 13,900 13,900
3,450 4,170 4,170 4,170
8,050 9,730 9,730 9,730
Page 54 of 111
Case Rate 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 Professional Fee 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 4,170 Health Care Institution Fee 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730 9,730
C81.0 C81.1 C81.9 C82.0 C82.1 C82.2 C82.7 C82.9 C83.0 C83.2 C83.3 C83.4 C83.5 C83.7 C83.8 C83.9 C84.0 C84.1 C84.3 C84.4 C84.5 C85.0 C85.1 C85.7 C85.9 C90.0 C90.1 C90.2 C91.1 C91.2 C91.3 C91.4 C91.5 C91.7 C91.9 C92.0 C92.1 C92.2 C92.3 C92.4
Hodgkin's disease (Lymphocytic predominance); Hodgkin's MALIGNANT NEOPLASMS OF LYMPHOID, disease (Lymphocytic-histiocytic predominance) HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Hodgkin's disease( Nodular sclerosis) HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Hodgkin's disease, unspecified HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Small cleaved cell, follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE Mixed small cleaved non-Hodgkin's lymphoma and large MALIGNANT NEOPLASMS OF LYMPHOID, cell, follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Large cell, follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Other types of follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE Follicular non-Hodgkin's lymphoma, unspecified; Nodular MALIGNANT NEOPLASMS OF LYMPHOID, non-Hodgkin's lymphoma NOS HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Small cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Mixed small and large cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Large cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Immunoblastic diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Lymphoblastic diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Burkitt's tumour HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Other types of diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Diffuse non-Hodgkin's lymphoma, unspecified HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Mycosis fungoides HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Szary's disease HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Lymphoepithelioid lymphoma; Lennert's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Peripheral T-cell lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Other and unspecified T-cell lymphomas HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Lymphosarcoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, B-cell lymphoma, unspecified HEMATOPOIETIC AND RELATED TISSUE Other specified types of non-Hodgkin's lymphoma; MALIGNANT NEOPLASMS OF LYMPHOID, Malignant reticuloendotheliosis; Malignant reticulosis; HEMATOPOIETIC AND RELATED TISSUE Microglioma Non-Hodgkin's lymphoma, unspecified type; Lymphoma MALIGNANT NEOPLASMS OF LYMPHOID, NOS HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Multiple myeloma; Kahler's disease; Myelomatosis HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, Plasma cell leukaemia HEMATOPOIETIC AND RELATED TISSUE Extramedullary Plasmacytoma; Malignant plasma cell tumour NOS; Plasmacytoma NOS ; Solitary myeloma Chronic lymphocytic leukaemia Subacute lymphocytic leukaemia Prolymphocytic leukaemia Hairy-cell leukaemia; Leukaemic reticuloendotheliosis Adult T-cell leukaemia Other lymphoid leukaemia Lymphoid leukaemia, unspecified Acute myeloid leukaemia Chronic myeloid leukaemia Subacute myeloid leukaemia Myeloid sarcoma; Chloroma; Granulocytic sarcoma Acute promyelocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE
Page 55 of 111
C92.5 C92.7 C92.9 C93.0 C93.1 C93.9 C94.0 C94.2 C94.4 C94.5 C95.0 C95.1 C95.2 C95.7 C95.9 C96.0 C96.1 C96.2 C96.7 C96.9 C60.9 C61 C62.0 C62.1 C62.9 C63.0 C63.1 C63.2 C63.7 C63.9 C45.2 C45.7 C45.9 C48.0 C76.3 C76.4 C76.5 C76.7 C76.8
DESCRIPTION
Acute myelomonocytic leukaemia Other myeloid leukaemia Myeloid leukaemia, unspecified Acute monocytic leukaemia Chronic monocytic leukaemia Monocytic leukaemia, unspecified Acute erythraemia and erythroleukaemia; Acute erythraemic myelosis; Di Guglielmo's disease Acute megakaryoblastic leukaemia; Acute megakaryocytic Leukaemia Acute panmyelosis Acute myelofibrosis Acute leukaemia of unspecified cell type; Blast cell leukaemia; Stem cell leukaemia Chronic leukaemia of unspecified cell type Subacute leukaemia of unspecified cell type Other leukaemia of unspecified cell type Leukaemia, unspecified Letterer-Siwe disease; Nonlipid reticuloendotheliosis; Nonlipid reticulosis Malignant histiocytosis; Histiocytic medullary reticulosis Malignant mast cell tumour; Malignant mastocytoma; Malignant mastocytosis; Mast cell sarcoma Other specified malignant neoplasms of lymphoid, haematopoietic and related tissue Malignant neoplasm of lymphoid, haematopoietic and related tissue, unspecified Malignant neoplasm of Penis, unspecified; Malignant neoplasm of Skin of penis NOS Malignant neoplasm of prostate Malignant neoplasm of Undescended testis; Ectopic testis ; Malignant neoplasm of Retained testis Malignant neoplasm of Descended testis; Malignant neoplasm of Scrotal Testis Malignant neoplasm of Testis, unspecified Malignant neoplasm of Epididymis Malignant neoplasm of Spermatic cord Malignant neoplasm of Scrotum; Malignant neoplasm of Skin of scrotum Malignant neoplasm of Seminal vesicle; Malignant neoplasm of Tunica vaginalis Malignant neoplasm of Male genital organ, unspecified; Male genitourinary tract NOS Mesothelioma of pericardium Mesothelioma of other sites Mesothelioma, unspecified Malignant neoplasm of Retroperitoneum Malignant neoplasm of Pelvis; Malignant neoplasm of Groin NOS; Malignant neoplasm of Sites overlapping systems within the pelvis, such as rectovaginal (septum) & rectovesical (septum) Malignant neoplasm of Upper limb Malignant neoplasm of Lower limb Malignant neoplasm of Other ill-defined sites Malignant neoplasm of Overlapping lesion of other and illdefined sites Secondary and unspecified malignant neoplasm of Axillary and upper limb lymph nodes; Secondary and unspecified malignant neoplasm of Pectoral lymph nodes Secondary and unspecified malignant neoplasm of Lymph node, unspecified Secondary malignant neoplasm of adrenal gland Secondary malignant neoplasm of other specified sites
GROUP
MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID, HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES
Case Rate 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,900 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 13,400 10,600 10,600 10,600 10,600 16,100 16,100 16,100 16,100 16,100
C77.3
MALIGNANT NEOPLASMS OF OTHER SITES
16,100
4,830
11,270
C77.9 C79.7 C79.8
MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES
16,100 16,100 16,100
4,830 4,830 4,830
11,270 11,270 11,270
Page 56 of 111
Malignant neoplasm without specification of site; Unspecified site whether primary or secondary [Cancer, Carcinoma, Carcinomatosis, Generalized cancer, Generalized malignancy, Malignancy, Multiple cancer]; Malignant cachexia; Malignant neoplasm of Primary
GROUP
Case Rate
Professional Fee
C80
MALIGNANT NEOPLASMS OF OTHER SITES
16,100
4,830
11,270
C47.0 C47.1 C47.2 C47.3 C47.4 C47.5 C47.6 C47.9 C32.0
Malignant neoplasm of Peripheral nerves of head, face and MALIGNANT NEOPLASMS OF PERIPHERAL NERVES neck Malignant neoplasm of Peripheral nerves of upper limb, MALIGNANT NEOPLASMS OF PERIPHERAL NERVES including shoulder Malignant neoplasm of Peripheral nerves of lower limb, MALIGNANT NEOPLASMS OF PERIPHERAL NERVES including hip Malignant neoplasm of Peripheral nerves of thorax Malignant neoplasm of Peripheral nerves of abdomen Malignant neoplasm of Peripheral nerves of pelvis Malignant neoplasm of Peripheral nerves of trunk, unspecified Malignant neoplasm of Peripheral nerves and autonomic nervous system, unspecified MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES
13,300 13,300 13,300 13,300 13,300 13,300 13,300 13,300 14,600
3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 4,380
9,310 9,310 9,310 9,310 9,310 9,310 9,310 9,310 10,220
Malignant neoplasm of Glottis; Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Intrinsic larynx; Malignant neoplasm of true Vocal cord NOS INTRATHORACIC ORGANS Malignant neoplasm of Supraglottis: Malignant neoplasm of Aryepiglottic fold, laryngeal aspect; Malignant neoplasm MALIGNANT NEOPLASMS OF RESPIRATORY AND of Epiglottis (suprahyoid portion) NOS; Malignant neoplasm INTRATHORACIC ORGANS of Extrinsic larynx; Malignant neoplasm of False vocal cord; Malignant neoplasm Malignant neoplasm of Subglottis Malignant neoplasm of Laryngeal cartilage Malignant neoplasm of Larynx, unspecified Malignant neoplasm of trachea Malignant neoplasm of Main bronchus; Malignant neoplasm of Carina; Malignant neoplasm of Hilus of lung Malignant neoplasm of Upper lobe, bronchus or lung MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS
C32.1
14,600
4,380
10,220
C32.2 C32.3 C32.9 C33 C34.0 C34.1 C34.2 C34.3 C34.8 C34.9 C37 C38.0 C38.1 C38.3 C38.4 C38.8 C39.0 C39.8 C39.9 C45.0 C76.1 C77.1 C78.0 C78.1 C78.2
14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 14,600 10,600 14,600 14,600 14,600 14,600 14,600
4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 4,380 3,180 4,380 4,380 4,380 4,380 4,380
10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 10,220 7,420 10,220 10,220 10,220 10,220 10,220
MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Middle lobe, bronchus or lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Lower lobe, bronchus or lung INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of bronchus and MALIGNANT NEOPLASMS OF RESPIRATORY AND lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Bronchus or lung, unspecified INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of thymus INTRATHORACIC ORGANS Malignant neoplasm of Heart; Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Pericardium INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Anterior mediastinum INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Mediastinum, part unspecified INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Pleura INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of heart, MALIGNANT NEOPLASMS OF RESPIRATORY AND mediastinum and pleura INTRATHORACIC ORGANS Malignant neoplasm of Upper respiratory tract, part MALIGNANT NEOPLASMS OF RESPIRATORY AND unspecified INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of respiratory MALIGNANT NEOPLASMS OF RESPIRATORY AND and intrathoracic organs INTRATHORACIC ORGANS Malignant neoplasm of Ill-defined sites within the MALIGNANT NEOPLASMS OF RESPIRATORY AND respiratory system; Respiratory tract NOS INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Mesothelioma of pleura INTRATHORACIC ORGANS Malignant neoplasm of Thorax; Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Axilla NOS; Malignant neoplasm of Intrathoracic NOS; INTRATHORACIC ORGANS Malignant neoplasm of Thoracic NOS Secondary and unspecified malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Intrathoracic lymph nodes INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Secondary malignant neoplasm of lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Secondary malignant neoplasm of mediastinum INTRATHORACIC ORGANS Secondary malignant neoplasm of pleura; Malignant pleural MALIGNANT NEOPLASMS OF RESPIRATORY AND effusion NOS INTRATHORACIC ORGANS
Page 57 of 111
C78.3 C31.0 C31.1 C31.2 C31.3 C31.8 C31.9 B21.0 C46.9 C49.0
DESCRIPTION
Secondary malignant neoplasm of other and unspecified respiratory organs Malignant neoplasm of Maxillary sinus; Malignant neoplasm of Antrum (Highmore); Malignant neoplasm of Antrum (maxillary) Malignant neoplasm of Ethmoidal sinus Malignant neoplasm of Frontal sinus Malignant neoplasm of Sphenoidal sinus Malignant neoplasm of Overlapping lesion of accessory sinuses Malignant neoplasm of Accessory sinus, unspecified HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE RESULTING IN KAPOSI'S SARCOMA Kaposi's sarcoma, unspecified
GROUP
MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES
Case Rate 14,600 11,500 11,500 11,500 11,500 11,500 11,500 12,000 12,000 12,000
Malignant neoplasm of Connective and soft tissue of head, face and neck; Malignant neoplasm of Connective tissue of MALIGNANT NEOPLASMS OF SOFT TISSUES ear; Malignant neoplasm of Connective tissue of eyelid Malignant neoplasm of Connective and soft tissue of upper limb, including shoulder Malignant neoplasm of Connective and soft tissue of lower limb, including hip Malignant neoplasm of Connective and soft tissue of thorax; Malignant neoplasm of Connective and soft tissue of Axilla; Malignant neoplasm of Connective and soft tissue of Diaphragm; Malignant neoplasm of Connective and soft tissue of Great vessels Malignant neoplasm of Connective and soft tissue of abdomen; Malignant neoplasm of Connective and soft tissue of Abdominal wall; Malignant neoplasm of Connective and soft tissue of Hypochondrium Malignant neoplasm of Connective and soft tissue of pelvis; Malignant neoplasm of Connective and soft tissue of Buttock; Malignant neoplasm of Connective and soft tissue of Groin; Malignant neoplasm of Connective and soft tissue of Perineum Malignant neoplasm of Connective and soft tissue of trunk, unspecified; Malignant neoplasm of Connective and soft tissue of Back NOS Malignant neoplasm of Overlapping lesion of connective and soft tissue Malignant neoplasm of Connective and soft tissue, unspecified Malignant neoplasm of thyroid gland Malignant neoplasm of Cortex of adrenal gland Malignant neoplasm of Medulla of adrenal gland Malignant neoplasm of Adrenal gland, unspecified Malignant neoplasm of Parathyroid gland Malignant neoplasm of Pituitary gland Malignant neoplasm of Pineal gland Malignant neoplasm of Aortic body and other paraganglia Malignant neoplasm of Endocrine gland, unspecified Kwashiorkor MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES
C49.1 C49.2
12,000 12,000
3,600 3,600
8,400 8,400
C49.3
MALIGNANT NEOPLASMS OF SOFT TISSUES
12,000
3,600
8,400
C49.4
12,000
3,600
8,400
C49.5
12,000
3,600
8,400
C49.6 C49.8 C49.9 C73 C74.0 C74.1 C74.9 C75.0 C75.1 C75.3 C75.5 C75.9 E40 E41
MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALNUTRITION
12,000 12,000 12,000 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,700 11,700
3,600 3,600 3,600 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,420 3,510 3,510
8,400 8,400 8,400 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 7,980 8,190 8,190
Nutritional marasmus; Severe malnutrition with marasmus MALNUTRITION Marasmic kwashiorkor; Severe protein-energy malnutrition, intermediate form; Severe protein-energy MALNUTRITION malnutrition with signs of both kwashiorkor and marasmus Unspecified severe protein-energy malnutrition Moderate protein-energy malnutrition Mild protein-energy malnutrition Retarded development following protein-energy malnutrition; Nutritional short stature; Nutritional stunting; Physical retardation due to malnutrition Unspecified protein-energy malnutrition; Malnutrition NOS; Protein-energy imbalance NOS Pre-existing essential hypertension complicating pregnancy child birth and the puerperium Pre-existing hypertensive heart disease complicating pregnancy, childbirth and the puerperium Pre-existing hypertensive renal disease complicating pregnancy childbirth and the puerperium MALNUTRITION MALNUTRITION MALNUTRITION MALNUTRITION MALNUTRITION MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
E42 E43 E44.0 E44.1 E45 E46 O10.0 O10.1 O10.2
11,700 11,700 11,700 11,700 11,700 11,700 6,800 6,800 6,800
3,510 3,510 3,510 3,510 3,510 3,510 2,040 2,040 2,040
8,190 8,190 8,190 8,190 8,190 8,190 4,760 4,760 4,760
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Pre-existing hypertensive heart and renal disease complicating pregnancy, childbirth and the puerperium Pre-existing secondary hypertension complicating pregnancy, childbirth and the puerperium Unspecified pre-existing hypertension complicating pregnancy, childbirth and the puerperium Pre-existing hypertensive disorder with superimposed proteinuria Gestational proteinuria Gestational oedema with proteinuria Gestational [pregnancy-induced] hypertension wihtout significant proteinuria; Gestational hypertension NOS; Mild pre-eclampsia Moderate pre-eclampsia Severe pre-eclampsia Pre-eclampsia, unspecified Eclampsia in pregnancy Eclampsia in labour Eclampsia, unspecified as to time period; Eclampsia NOS Unspecified maternal hypertension Threatened abortion; Haemorrhage specified as due to threatened abortion Other haemorrhage in early pregnancy Haemorrhage in early pregnancy, unspecified Mild hyperemesis gravidarum; Hyperemesis gravidarum, mild or unspecified, starting before the end of the 22nd week of gestation
GROUP
Case Rate 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
Professional Fee 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
Health Care Institution Fee 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
O10.3 O10.4 O10.9 O11 O12.1 O12.2 O13 O14.0 O14.1 O14.9 O15.0 O15.1 O15.9 O16 O20.0 O20.8 O20.9 O21.0
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
O21.1
Hyperemesis gravidarum with metabolic disturbance; Hyperemesis gravidarum, starting before the end of the MATERNAL COMORBIDITIES CONDITIONS 22nd week of gestation, with metabolic disturbance such as carbohydrate depletion, dehydration, elctrolyte imbalance Late vomiting of pregnancy; Excessive vomiting starting after 22 completed weeks of gestation Other vomiting complicating pregnancy; Vomiting due to disease classified elsewhere, complicating pregnancy Vomiting of pregnancy, unspecified Deep phlebothrombosis in pregnancy; Deep-vein thrombosis, antepartum Cerebral venous thrombosis in pregnancy; Cerebrovenous sinus thrombosis in pregnancy Venous complication in pregnancy, unspecified; Gestational phlebitis NOS; Gestational phlebopathy NOS; Gestational thrombosis NOS Infections of kidney in pregnancy Infections of other parts of urinary tract in pregnancy Pre-existing diabetes mellitus, insulin-dependent Pre-existing diabetes mellitus, non-insulin-dependent Pre-existing malnutrition-related diabetes mellitus Pre-existing diabetes mellitus, unspecified Diabetes mellitus arising in pregnancy; Gestational diabetes mellitus NOS Diabetes mellitus in pregnancy, unspecified Pregnancy care of habitual aborter Retained in trauterine contraceptive device in pregnancy Herpes gestationis Maternal hypotension syndrome; Supine hypotensive syndrome MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O21.2 O21.8 O21.9 O22.3 O22.5 O22.9 O23.0 O23.3 O24.0 O24.1 O24.2 O24.3 O24.4 O24.9 O26.2 O26.3 O26.4 O26.5 O26.6 O26.7
6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
Liver disorders in pregnancy, childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS Subluxation of symphysis (pubis) in pregnancy childbirth and the puerperium Other specified pregnancy-related conditions; Exhaustion and fatigue pregnancy-related; Peripheral neuritis pregnancy-related; Renal disease pregnancy-related Pregnancy-relatedcondition, unspecified Abnormal haematological finding on antenatal screening of mother Abnormal ultrasonic finding on antenatal screening of mother Abnormal chromosomal and genetic finding on antenatal screening of mother MATERNAL COMORBIDITIES CONDITIONS
O26.8 O26.9 O28.0 O28.3 O28.5 O28.8 O28.9 O29.8 O30.0 O30.1
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
Other abnormal findings on antenatal screening of mother MATERNAL COMORBIDITIES CONDITIONS Abnormal finding on antenatal screening of mother, unspecified Other complications of anaesthesia during pregnancy Twin pregnancy Triplet pregnancy MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
Page 59 of 111
O30.8 O30.9 O31.0 O31.1 O31.2 O31.8 O32.0 O32.1 O32.2 O32.3 O32.4 O32.5 O32.6 O32.8 O32.9 O33.0
DESCRIPTION
Other multiple gestation Multiple gestation, unspecified; Multiple pregnancy NOS Papyraceous fetus; Fetus compressus Continuing pregnancy after abortion of one fetus or more Continuing pregnancy after intrauterine death of one fetus or more Other complications specific to multiple gestation Maternal care for unstable lie Maternal care for breech presentation Maternal care for transverse and oblique lie; Oblique presentation; Transverse presentation Maternal care for face, brow and chin presentation Maternal care for high head at term; Failure of head to enter pelvic brim Maternal care for multiple gestation with malpresentation of one fetus or more Maternal care for compound presentation Maternal care for other malpresentation of fetus Maternal care for malpresentation of fetus, unspecified Maternal care for disproportion due to deformity of maternal pelvic bones; Pelvic deformity causing disproportion NOS Maternal care for disproportion due to generally contracted pelvis; Contracted pelvis NOS causing disproportion
GROUP
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
Case Rate 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
Professional Fee 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
Health Care Institution Fee 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
O33.1
MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O33.2
Maternal care for disproportion due to inlet contraction of MATERNAL COMORBIDITIES CONDITIONS pelvis; Inlet contraction (pelvis) causing disproportion Maternal care for disproportion due to outlet contraction of pelvis; Mid-cavity contraction pelvis causing disproportion; Outlet contraction pelvis causing disproportion Maternal care for disproportion of mixed maternal and fetal origin Maternal care for disproportion due to unusually large fetus; Disproportion of fetal origin with normally formed fetus; Fetal disproportion NOS
6,800
2,040
4,760
O33.3
6,800
2,040
4,760
O33.4 O33.5 O33.6
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800 6,800
2,040 2,040 2,040
4,760 4,760 4,760
Maternal care for disproportion due to hydrocephalic fetus MATERNAL COMORBIDITIES CONDITIONS Maternal care for disproportion due to other fetal deformities; Conjoined twins; Fetal ascites causing disproportion; Fetal hydrops causing disproportion; Fetal meaningomyelocele causing disproportion; Fetal tumour causing disproportion
O33.7
6,800
2,040
4,760
O33.9
Maternal care for disproportion, unspecified; Cephalopelvic MATERNAL COMORBIDITIES CONDITIONS disproportion NOS; Fetopelvic disproportion NOS Maternal care for congenital malformation of uterus; Maternal care for double uterus; Maternal care for Uterus bicornis Maternal care for tumour of corpus uteri; Maternal for polyp of corpus uteri; Maternal care for uterine fibroid MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O34.0
6,800
2,040
4,760
O34.1 O34.2
6,800 6,800
2,040 2,040
4,760 4,760
O34.3
Maternal care due to uterine scar from previous surgery; MATERNAL COMORBIDITIES CONDITIONS Maternal care for scar from previous Maternal care for cervical incompetence; Maternal care for cerclage with or without mention of cervical incompetence; MATERNAL COMORBIDITIES CONDITIONS Maternal care for Shirodkar suture with or without mention of cervical incompetence Maternal care for other abnormalities of cervix; Maternal care for polyp of cervix; Maternal care for previous surgery MATERNAL COMORBIDITIES CONDITIONS to cervix; Maternal care for stricture or stenosis of cervix; Maternal care for tumour of cervix Maternal care for other abnormalities of gravid uterus; Maternal care for incarceratiion of gravid uterus; Maternal MATERNAL COMORBIDITIES CONDITIONS care for prolapse of gravid uterus; Maternal care for retroversion of gravid uterus Maternal care for abnormality of vagina; Maternal care for previous surgery to vagina; Maternal care for septate MATERNAL COMORBIDITIES CONDITIONS vagina; Maternal care for acquired stenosis of vagina; Maternal care for congenital stenosis of vagina; Maternal care for tumour of vagina Maternal care for abnormality of vulva and perineum; Maternal care for fibrosis of perineum; Maternal care for MATERNAL COMORBIDITIES CONDITIONS previous surgery to perineum or vulva; Maternal care for rigid perineum; Maternal care for tumour of vulva
6,800
2,040
4,760
O34.4
6,800
2,040
4,760
O34.5
6,800
2,040
4,760
O34.6
6,800
2,040
4,760
O34.7
6,800
2,040
4,760
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Maternal care for other abnormalities of pelvic organs; Maternal care for cystocele; Maternal care for previous pelvic floor repair; Maternal care for pendulous abdomen; Maternal care for rectocele; Maternal care for rigid pelvic floor Maternal care for abnormality of pelvic organ, unspecified
GROUP
Case Rate
Professional Fee
O34.8
6,800
2,040
4,760
O34.9
6,800
2,040
4,760
O35.0
Maternal care for (suspected) central nervous system malformation in fetus; Maternal care for suspected fetal MATERNAL COMORBIDITIES CONDITIONS anencephaly; Maternal care for suspected fetal spina bifida Maternal care for (suspected) hereditary disease in fetus MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O35.2
6,800
2,040
4,760
O35.3
Maternal care for (suspected) damage to fetus from viral disease in mother; Maternal care for suspected damage to MATERNAL COMORBIDITIES CONDITIONS fetus from maternal cytomegalovirus infection; Maternal care for suspected damage to fetus from maternal rubella Maternal care for (suspected) damage to fetus by drugs; Maternal care for suspected damage to fetus from drug addiction MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O35.5
6,800
2,040
4,760
O35.8
Maternal care for other (suspected) fetal abnormality and damage; Maternal care for suspected damage to fetus from MATERNAL COMORBIDITIES CONDITIONS maternal listeriosis; Maternal care for suspected damage to fetus from maternal toxoplasmosis Maternal care for (suspected) fetal abnormality and damage, unspecified Maternal care for rhesus isoimmunization; Anti-D [Rh] antibodies; Rh incompatibility (with hydrops fetalis) Maternal care for other isoimmunization; ABO isoimmunization; Isoimmunization NOS (with hydrops fetalis) Maternal care for hydrops fetalis; Hydrops fetalis NOS; Hydrops fetalis not associated with isoimmunization Maternal care for signs of fetal hypoxia Maternal care for intrauterine death Maternal care for poor fetal growth; Maternal care for known or suspected light-for-dates; Maternal care for known or suspected placental insufficiency; Maternal care for known or suspected small-for-dates Maternal care for excessive fetal growth; Maternal care for known or suspected large-for-dates Maternal care for other specified fetal problems Maternal care for fetal problem, unspecified POLYHYDRAMNIOS; HYDRAMNIOS Oligohydramnios; Oligohydramnios without mention of rupture of membrane Infection of amniotic sac and membranes; Amnionitis; Chorioamnionitis; Membranitis; Placentitis MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O35.9 O36.0
6,800 6,800
2,040 2,040
4,760 4,760
O36.1
6,800
2,040
4,760
O36.2 O36.3 O36.4
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800 6,800
2,040 2,040 2,040
4,760 4,760 4,760
O36.5
6,800
2,040
4,760
O36.6 O36.8 O36.9 O40 O41.0 O41.1 O41.8 O41.9 O42.0 O42.1 O42.2 O42.9 O43.0 O43.1 O43.8 O43.9 O44.0
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
Other specified disorders of amniotic fluid and membranes MATERNAL COMORBIDITIES CONDITIONS Disorder of amniotic fluid and membranes, unspecified; Premature rupture of membranes Premature rupture of membranes on set of labour within 24 hours Premature rupture of membranes on set of labour after 24 hours Premature rupture of membranes, labour delayed by therapy Premature rupture of membranes, unspecified MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
Placental transfusion syndromes; Fetomaternal transfusion; MATERNAL COMORBIDITIES CONDITIONS Maternofetal transfusion; Twin-to-twin transfusion Malformation of placenta; Abnormal placenta NOS; Circumvallate placenta Other placental disorders; Placental dysfunction; Placental infarction Placental disorder, unspecified Placenta praevia specified as without haemorrhage; Low implantation of placenta, NOS or with haemorrhage Placenta praevia with haemorrhage; Low implantation of placenta, NOS or with haemorrhage; Placenta praevia, marginal NOS or with haemorrhage; Placenta praevia, partial NOS or with haemorrhage; Placenta praevia, total NOS or with haemorrhage MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
O44.1
6,800
2,040
4,760
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O45.0
Premature separation of placenta with coagulation defect; Abruptio placentae with (excessive) haemorrhage associated with afibrinogenaemia; Abruptio placentae with MATERNAL COMORBIDITIES CONDITIONS (excessive) haemorrhage associated with disseminated intravascular coagulation; Abruptio Other premature separation of placenta Premature separation of placenta, unspecified; Abruptio placenta NOS Antepartum haemorrhage with coagulation defect; Antepartum haemorrhage (excessive) associated with afibrinogenaemia; Antepartum haemorrhage (excessive) associated with disseminated intravascular coagulation; Antepartum haemorrhage (excessive) associated w Other antepartum haemorrhage Antepartum haemorrhage, unspecified False labour before 37 completed weeks of gestation False labour at or after 37 completed weeks of gestation False labour, unspecified Prolonged pregnancy; Post-dates; Post-term Tuberculosis complicating pregnancy, childbirth and the puerperium Syphilis complicating pregnancy, childbirth and the puerperium Gonorrhoeacomplicatingpregnancychildbirthandthepuerpe rium Other infections with apredominantly sexual mode of transmission complicating pregnancy, childbirth and the puerperium Viral hepatitis complicating pregnancy, childbirth and the puerperium Other viral diseases complicating pregnancy, childbirth and the puerperium Protozoal diseases complicating pregnancy, childbirth and the puerperium Other maternal infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium Unspecified maternal infectious or parasitic disease complicating pregnancy, childbirth and the puerperium Anaemia complicating pregnancy, childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O45.8 O45.9
6,800 6,800
2,040 2,040
4,760 4,760
O46.0
6,800
2,040
4,760
O46.8 O46.9 O47.0 O47.1 O47.9 O48 O98.0 O98.1 O98.2 O98.3 O98.4 O98.5 O98.6 O98.8
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800
2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040
4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760
O98.9 O99.0
MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
6,800 6,800
2,040 2,040
4,760 4,760
O99.1
Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism MATERNAL COMORBIDITIES CONDITIONS complicating pregnancy, childbirth and the puerperium Endocrine, nutritional and metabolic diseases complicating MATERNAL COMORBIDITIES CONDITIONS pregnancy, childbirth and the puerperium Mental disorders and diseases of the nervous system complicating pregnancy, childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS
6,800
2,040
4,760
O99.2
6,800
2,040
4,760
O99.3 O99.4 O99.5 O99.6 O99.7 O99.8 O60.0 Z34.0 Z34.8 Z34.9 Z35.0 Z35.1 Z35.2 Z35.4 Z35.5 Z35.6 Z35.7 Z35.8 Z35.9 A87.8 A87.9
6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 6,800 25,700 25,700
2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 2,040 7,710 7,710
4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 4,760 17,990 17,990
Diseases of the circulatory system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the respiratory system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the digestive system complicating pregnancy, MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the skin and subcutaneous tissue complicating pregnancy, childbirth and the puerperium Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium Preterm labor, not resulting to delivery Supervision of normal first pregnancy Supervision of other normal pregnancy Supervision of normal pregnancy, unspecified Supervision of pregnancy with history of infertility MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS
Supervision of pregnancy with history of abortive outcome MATERNAL COMORBIDITIES CONDITIONS Supervision of pregnancy with other poor reproductive or obstetric history Supervision of pregnancy with grand multiparity Supervision of elderly primigravida Supervision of very young primigravida Supervision of high-risk pregnancy due to social problems Supervision of other high-risk pregnancies Supervision of high-risk pregnancy, unspecified Other viral meningitis Viral meningitis, unspecified MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MENINGITIS MENINGITIS
Page 62 of 111
G00.0 G00.1 G00.2 G00.3 G00.8
DESCRIPTION
Haemophilus meningitis; Meningitis due to Haemophilus influenzae Pneumococcal meningitis Streptococcal meningitis Staphylococcal meningitis Other bacterial meningitis; Meningitis due to Escherichia coli; Meningitis due to Friedlnder bacillus; Meningitis due to Klebsiella MENINGITIS MENINGITIS MENINGITIS MENINGITIS MENINGITIS
GROUP
Case Rate 25,700 25,700 25,700 25,700 25,700
G00.9 G03.0 G03.1 G03.8 G03.9 A39.2 A39.3 A39.4 A39.9 N91.0 N91.1 N91.2 N91.5 N92.0
Bacterial meningitis, unspecified; Meningitis purulent NOS; MENINGITIS Meningitis pyogenic NOS; Meningitis suppurative NOS Nonpyogenic meningitis; Nonbacterial meningitis Chronic meningitis Meningitis due to other specified causes Meningitis, unspecified; Arachnoiditis (spinal) NOS Acute meningococcaemia Chronic meningococcaemia Meningococcaemia, unspecified; Meningococcal bacteraemia NOS Meningococcal infection, unspecified; Meningococcal disease NOS Primary amenorrhoea; Failure to start menstruation at puberty. Secondary amenorrhoea; Absence of menstruation in a woman who had previously menstruated. Amenorrhoea, unspecified; Absence of menstruation NOS Oligomenorrhoea, unspecified; Hypomenorrhoea NOS Excessive and frequent menstruation with regular cycle; Heavy periods NOS; Menorrhagia NOS; Polymenorrhoea MENINGITIS MENINGITIS MENINGITIS MENINGITIS MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES
25,700 25,700 25,700 25,700 25,700 19,800 19,800 19,800 19,800 6,600 6,600 6,600 6,600 6,600
7,710 7,710 7,710 7,710 7,710 5,940 5,940 5,940 5,940 1,980 1,980 1,980 1,980 1,980
17,990 17,990 17,990 17,990 17,990 13,860 13,860 13,860 13,860 4,620 4,620 4,620 4,620 4,620
N92.1
N92.2 N92.3
Excessive and frequent menstruation with irregular cycle; Irregular intermenstrual bleeding; Irregular, shortened MENSTRUAL IRREGULARITIES intervals between menstrual bleeding; Menometrorrhagia; Metrorrhagia Excessive menstruation at puberty; Excessive bleeding MENSTRUAL IRREGULARITIES associated with onset of menstrual periods; Pubertal menorrhagia; Puberty bleeding Ovulation bleeding; Regular intermenstrual bleeding MENSTRUAL IRREGULARITIES Excessive bleeding in the premenopausal period; Climateric menorrhagia or metrorrhagia; Menopausal menorrhagia or MENSTRUAL IRREGULARITIES metrorrhagia; Preclimateric menorrhagia or metrorrhagia; Premenopausal menorrhagia or metrorrhagia Other specified irregular menstruation Irregular menstruation, unspecified; Irregular bleeding NOS; Irregular periods NOS Postcoital and contact bleeding MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES
6,600
1,980
4,620
6,600 6,600
1,980 1,980
4,620 4,620
N92.4
6,600
1,980
4,620
N92.5 N92.6 N93.0 N93.8 N93.9 N94.8 N94.9 F01.1 F01.8 F01.9 F03
6,600 6,600 6,600 6,600 6,600 6,600 6,600 7,800 7,800 7,800 7,800
1,980 1,980 1,980 1,980 1,980 1,980 1,980 2,340 2,340 2,340 2,340
4,620 4,620 4,620 4,620 4,620 4,620 4,620 5,460 5,460 5,460 5,460
Other specified abnormal uterine and vaginal bleeding; MENSTRUAL IRREGULARITIES Dysfunctional or functional uterine or vaginal bleeding NOS Abnormal uterine and vaginal bleeding, unspecified Other specified conditions associated with female genital organs and menstrual cycle Unspecified condition associated with female genital organs and menstrual cycle Multi-infarct dementia; Predominantly cortical dementia Other vascular dementia Vascular dementia, unspecified Unspecified dementia; Presenile dementia NOS; Presenile psychosis NOS; Senile dementia NOS; Senile dementia depressed or paranoid type; Senile psychosis NOS Organic amnesic syndrome, not induced by alcohol and other psychoactive substances; Korsakov's psychosis or syndrome, nonalcoholic Delirium not superimposed on dementia, so described Other delirium Other delirium Organic hallucinosis; Organic hallucinatory state (nonalcoholic) Organic delusional [schizophrenia-like] disorder; Paranoid and paranoid-hallucinatory organic states; Schizophrenialike psychosis in epilepsy Organic mood [affective] disorders Organic anxiety disorder Mild cognitive disorder Other specified mental disorders due to brain damage and dysfunction and to physical disease; Epileptic psychosis NOS MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
F04 F05.0 F05.8 F05.9 F06.0 F06.2 F06.3 F06.4 F06.7 F06.8
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
Page 63 of 111
Unspecified mental disorder due to brain damage and dysfunction and to physical disease; Organic brain syndrome NOS; Organic mental disorder NOS Organic personality disorder; Organic pseudopsychopathic personality; Organic pseudoretarded personality; Frontal lobe Syndrome; Limbic epilepsy personalitySyndrome ; Lobotomy Syndrome; Postleucotomy Syndrome Postencephalitic syndrome Postconcussional syndrome; Postcontusional syndrome (encephalopathy); Post-traumatic brain syndrome, nonpsychotic Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction; Organic psychosyndrome Unspecified organic or symptomatic mental disorder; Organic Psychosis NOS; Symptomatic Psychosis NOS Mental and behavioural disorders due to use of alcohol in acute intoxication Mental and behavioural disorders due to use of alcohol:harmful use Mental and behavioural disorders due to use of alcohol: dependency syndrome Mental and behavioural disorders due to use of alcohol:withdrawal state Mental and behavioural disorders due to use of alcohol: withdrawal state with delirium Mental and behavioural disorders due to use of alcohol: psychotic disorder Mental and behavioural disorders due to use of alcohol: amnesic syndrome Mental and behavioural disorders due to use of alcohol: residual and late-onset psychotic disorder Mental and behavioural disorders due to use of alcohol: other mental and behavioural disorders Mental and behavioural disorders due to use of alcohol: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of opioids: harmful use Mental and behavioural disorders due to use of opioids: dependence syndrome Mental and behavioural disorders due to use of opioids: psychotic disorder Mental and behavioural disorders due to use of opioids: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of cannabinoids: acute intoxication Mental and behavioural disorders due to use of cannabinoids: psychotic disorder Mental and behavioural disorders due to use of sedatives or hypnotics: harmful use Mental and behavioural disorders due to use of sedatives or hypnotics: dependence syndrome Mental and behavioural disorders due to use of sedatives or hypnotics: withdrawal state Mental and behavioural disorders due to use of sedatives or hypnotics: withdrawal state with delirium Mental and behavioural disorders due to use of sedatives or hypnotics: psychotic disorder Mental and behavioural disorders due to use of sedatives or hypnotics: residual and late-onset psychotic disorder Mental and behavioural disorders due to use of cocaine: acute intoxication Mental and behavioural disorders due to use of cocaine: dependence syndrome Mental and behavioural disorders due to use of cocaine: psychotic disorder Mental and behavioural disorders due to use of cocaine: amnesic syndrome Mental and behavioural disorders due to use of cocaine: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of other stimulants, including caffeine: acute intoxication Mental and behavioural disorders due to use of other stimulants, including caffeine: harmful use Mental and behavioural disorders due to use of other stimulants, including caffeine: dependence syndrome Mental and behavioural disorders due to use of other stimulants, including caffeine: withdrawal state
GROUP
Case Rate 7,800
F06.9
MENTAL AND BEHAVIORAL DISORDERS
F07.0
7,800
2,340
5,460
F07.1 F07.2
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800
2,340 2,340
5,460 5,460
F07.9 F09 F10.0 F10.1 F10.2 F10.3 F10.4 F10.5 F10.6 F10.7 F10.8 F10.9 F11.1 F11.2 F11.5 F11.9 F12.0 F12.5 F13.1 F13.2 F13.3 F13.4 F13.5 F13.7 F14.0 F14.2 F14.5 F14.6 F14.9 F15.0 F15.1 F15.2 F15.3
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
Page 64 of 111
F15.5 F15.8
DESCRIPTION
Mental and behavioural disorders due to use of other stimulants, including caffeine: psychotic disorder Mental and behavioural disorders due to use of other stimulants, including caffeine: other mental and behavioural disorders Mental and behavioural disorders due to use of other stimulants, including caffeine: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of hallucinogens: acute intoxication Mental and behavioural disorders due to use of hallucinogens: harmful use Mental and behavioural disorders due to use of hallucinogens: dependence syndrome Mental and behavioural disorders due to use of hallucinogens: psychotic disorder Mental and behavioural disorders due to use of tobacco: dependence syndrome Mental and behavioural disorders due to use of tobacco: withdrawal state Mental and behavioural disorders due to use of volatile solvents: acute intoxication Mental and behavioural disorders due to use of volatile solvents: withdrawal state with delirium Mental and behavioural disorders due to use of volatile solvents: amnesic syndrome Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs NOS: harmful use Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs NOS: dependence syndrome Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs NOS: withdrawal state Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs NOS: psychotic disorder
GROUP
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
Case Rate 7,800 7,800
F15.9 F16.0 F16.1 F16.2 F16.5 F17.2 F17.3 F18.0 F18.4 F18.6 F19.1
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
F19.2
7,800
2,340
5,460
F19.3
7,800
2,340
5,460
F19.5
7,800
2,340
5,460
F19.7
Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: residual and late-onset psychotic disorder Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: other mental and behavioural disorders Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances; misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: unspecified mental and behavioural disorder Paranoid schizophrenia; Paraphrenic schizophrenia Hebephrenic schizophrenia; Disorganized schizophrenia; Hebephrenia Catatonic schizophrenia; Catatonic stupor; Schizophrenic catalepsy; Schizophrenic catatonia; Schizophrenic flexibilitas cerea Undifferentiated schizophrenia; Atypical schizophrenia Residual schizophrenia; Chronic undifferentiated schizophrenia; Restzustand (schizophrenic); Schizophrenic residual state Simple schizophrenia Other schizophrenia; Cenesthopathic schizophrenia; Schizophreniform disorder NOS; Schizophreniform psychosis NOS Schizophrenia, unspecified Schizotypal disorder; Latent schizophrenic reaction; Schizophrenia borderline; Schizophrenia latent; Schizophrenia prepsychotic; Schizophrenia prodromal; Schizophrenia pseudoneurotic; Schizophrenia pseudopsychopathic; Schizotypal personality disorder Delusional disorder; Paranoia; Paranoid psychosis; Paranoid state; Paraphrenia (late); Sensitiver Beziehungswahn Other persistent delusional disorders; Delusional dysmorphophobia; Involutional paranoid state; Paranoia querulans Acute polymorphic psychotic disorder without symptoms of schizophrenia; Bouffe dlirante without symptoms of schizophrenia or unspecified; Cycloid psychosis without symptoms of schizophrenia or unspecified MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800
2,340
5,460
F19.8
7,800
2,340
5,460
F19.9 F20.0 F20.1 F20.2 F20.3 F20.5 F20.6 F20.8 F20.9
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
F21
7,800
2,340
5,460
F22.0
7,800
2,340
5,460
F22.8
7,800
2,340
5,460
F23.0
7,800
2,340
5,460
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F23.1
F23.2
Acute polymorphic psychotic disorder with symptoms of schizophrenia; Bouffe dlirante with symptoms of MENTAL AND BEHAVIORAL DISORDERS schizophrenia; Cycloid psychosis with symptoms of schizophrenia Acute schizophrenia-like psychotic disorder;Acute (undifferentiated) schizophrenia;Brief schizophreniform MENTAL AND BEHAVIORAL DISORDERS disorder; Brief schizophreniform psychosis; Oneirophrenia; Schizophrenic reaction Other acute predominantly delusional psychotic disorders; MENTAL AND BEHAVIORAL DISORDERS Paranoid reaction; Psychogenic paranoid psychosis Other acute and transient psychotic disorders Acute and transient psychotic disorder, unspecified; Brief reactive psychosis NOS; Reactive psychosis Induced delusional disorder; Folie deux; Induced paranoid disorder; Induced psychotic disorder Schizoaffective disorder, manic type; Schizoaffective psychosis, manic type; Schizophreniform psychosis, manic type Schizoaffective disorder, depressive type; Schizoaffective psychosis, depressive type; Schizophreniform psychosis, depressive type Schizoaffective disorder, mixed type; Cyclic schizophrenia; Mixed schizophrenic and affective psychosis Other schizoaffective disorders Schizoaffective disorder, unspecified; Schizoaffective psychosis NOS Other nonorganic psychotic disorders; Chronic hallucinatory psychosis Unspecified nonorganic psychosis; Psychosis NOS Hypomania Mania without psychotic symptoms Mania with psychotic symptoms; Mania with moodcongruent psychotic symptoms; Mania with moodincongruent psychotic symptoms; Manic stupor Manic episode, unspecified; Mania NOS Bipolar affective disorder, current episode hypomanic Bipolar affective disorder, current episode manic without psychotic symptoms Bipolar affective disorder, current episode manic with psychotic symptoms Bipolar affective disorder, current episode mild or moderate depression Bipolar affective disorder, current episode severe depression with psychotic symptoms Bipolar affective disorder, current episode mixed Bipolar affective disorder, currently in remission Other bipolar affective disorders; Bipolar II disorder; Recurrent manic episodes NOS Bipolar affective disorder, unspecified Mild depressive episode Moderate depressive episode Severe depressive episode without psychotic symptoms; [Agitated depression, Major depression, Vital depression] single episode without psychotic symptoms MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800
7,800
2,340
5,460
F23.3 F23.8 F23.9 F24 F25.0
7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460
F25.1
7,800
2,340
5,460
F25.2 F25.8 F25.9 F28 F29 F30.0 F30.1 F30.2 F30.9 F31.0 F31.1 F31.2 F31.3 F31.5 F31.6 F31.7 F31.8 F31.9 F32.0 F32.1 F32.2
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
F32.3
F32.8 F32.9
Severe depressive episode with psychotic symptoms; Single episodes of major depression with psychotic symptoms; Single episodes of psychogenic depressive psychosis; Single MENTAL AND BEHAVIORAL DISORDERS episodes of psychotic depression; Single episodes of reactive depressive psychosis Other depressive episodes; Atypical depression; Single MENTAL AND BEHAVIORAL DISORDERS episodes of "masked" depression NOS Depressive episode, unspecified; Depression NOS; MENTAL AND BEHAVIORAL DISORDERS Depressive disorder NOS Recurrent depressive disorder, current episode severe without psychotic symptoms; Endogenous depression without psychotic symptoms; Major depression, recurrent MENTAL AND BEHAVIORAL DISORDERS without psychotic symptoms; Manic-depressive psychosis, depressed type without psychotic sympto Recurrent depressive disorder, current episode severe with psychotic symptoms including Endogenous depression with psychotic symptoms; Manic-depressive psychosis, MENTAL AND BEHAVIORAL DISORDERS depressed type with psychotic symptoms; Recurrent severe episodes of major depression with Other recurrent depressive disorders Recurrent depressive disorder, unspecified; Monopolar depression NOS Cyclothymia; Affective personality disorder; Cycloid personality; Cyclothymic personality MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800
2,340
5,460
7,800 7,800
2,340 2,340
5,460 5,460
F33.2
7,800
2,340
5,460
F33.3
7,800
2,340
5,460
F33.8 F33.9 F34.0
7,800 7,800 7,800
2,340 2,340 2,340
5,460 5,460 5,460
Page 66 of 111
Dysthymia; Depressive neurosis; Depressive personality disorder; Neurotic depression; Persistent anxiety depression Predominantly compulsive acts [obsessional rituals] Mixed obsessional thoughts and acts Other obsessive-compulsive disorders Obsessive-compulsive disorder, unspecified Acute stress reaction including Acute crisis reaction; Acute reaction to stress; Combat fatigue; Crisis state; Psychic shock Post-traumatic stress disorder; Traumatic neurosis Adjustment disorders; Culture shock; Grief reaction; Hospitalism in children Other reactions to severe stress Dissociative amnesia Dissociative motor disorders; Psychogenic aphonia; Psychogenic dysphonia Other dissociative [conversion] disorders; Ganser's syndrome; Multiple personality; Psychogenic confusion; Psychogenic twilight state Dissociative [conversion] disorder, unspecified Somatization disorder; Briquets disorder; Multiple psychosomatic disorder Undifferentiated somatoform disorder; Undifferentiated psychosomatic disorder Hypochondriacal disorder; Body dysmorphic disorder; Dysmorphophobia (nondelusional); Hypochondriacal neurosis; Hypochondriasis; Nosophobia Somatoform autonomic dysfunction; Cardiac neurosis; Da Costa's syndrome; Gastric neurosis ; Neurocirculatory asthenia Psychogenic forms of aerophagy; Psychogenic forms of cough, Psychogenic forms of diarrhea; Psychogenic forms of dyspepsia; Psychogenic Persistent somatoform pain disorder; Psychalgia; Psychogenic backache; Psychogenic headache; Somatoform pain disorder Other somatoform disorders; Psychogenic dysmenorrhoea; Psychogenic dysphagia, including "globus hystericus"; Psychogenic pruritus; Psychogenic torticollis; Teethgrinding Somatoform disorder, unspecified; Psychosomatic disorder NOS Other specified neurotic disorders; Dhat syndrome; Occupational neurosis, including writer's cramp; Psychasthenia; Psychasthenic neurosis; Psychogenic syncope Neurotic disorder, unspecified; Neurosis NOS Bulimia nervosa; Bulimia NOS; Hyperorexia nervosa
GROUP
Case Rate 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
Professional Fee 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
Health Care Institution Fee 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
F34.1 F42.1 F42.2 F42.8 F42.9 F43.0 F43.1 F43.2 F43.8 F44.0 F44.4 F44.8 F44.9 F45.0 F45.1
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
F45.2
7,800
2,340
5,460
F45.3
7,800
2,340
5,460
F45.4
7,800
2,340
5,460
F45.8
7,800
2,340
5,460
F45.9
7,800
2,340
5,460
F48.8 F48.9 F50.2 F53.0
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460
Mild mental and behavioural disorders associated with the puerperium, not elsewhere classified; Depression postnatal MENTAL AND BEHAVIORAL DISORDERS NOS; Depression postpartum NOS Severe mental and behavioural disorders associated with the puerperium, not elsewhere classified; Puerperal psychosis NOS Puerperal mental disorder, unspecified MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
F53.1 F53.9 F55
7,800 7,800 7,800
2,340 2,340 2,340
5,460 5,460 5,460
Abuse of non-dependence-producing substances; Abuse of antacids; Abuse of herbal or folk remedies; Abuse of MENTAL AND BEHAVIORAL DISORDERS steroids or hormones; Abuse of vitamins; Laxative habit Unspecified behavioural syndromes associated with physiological disturbances and physical factors; Psychogenic physiological dysfunction NOS Mild mental retardation; feeble-mindedness; mild mental subnormality with the statement of no, or minimal, impairment of behaviour Severe mental retardation; severe mental subnormality without mention of impairment of behaviour Other mental retardation with significant impairment of behaviour requiring attention or treatment Other mental retardation with other impairments of behaviour Other mental retardation without mention of impairment of behaviour Unspecified mental retardation; mental deficiency NOS; mental subnormality NOS with other impairments of behaviour Acquired aphasia with epilepsy [Landau-Kleffner] Specific developmental disorder of motor function; Clumsy child syndrome; Developmental coordination disorder; Developmental dyspraxia MENTAL AND BEHAVIORAL DISORDERS
F59
7,800
2,340
5,460
F70.0
7,800
2,340
5,460
F72.9 F78.1 F78.8 F78.9 F79.8 F80.3 F82
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS
7,800 7,800 7,800 7,800 7,800 7,800 7,800
2,340 2,340 2,340 2,340 2,340 2,340 2,340
5,460 5,460 5,460 5,460 5,460 5,460 5,460
Page 67 of 111
F84.0 F84.2 F84.3 F84.5 F84.9 F89 F90.8 F92.0 F98.1 F99 E88.0 E88.1 E88.8 E88.9 P70.0 P70.1 P70.2 P70.3 P70.4 P70.9 P71.0 P71.1 P71.3 P71.4 P71.9 P72.0 P72.1 P72.2 P72.8 P72.9 P74.0 P74.1 P74.2 P74.4 P74.8 P74.9 P80.9 P81.0 P81.8 P81.9 P83.1 P83.4 P83.8
DESCRIPTION
Childhood autism; Autistic disorder; Infantile autism; Infantile psychosis; Kanner's syndrome Rett's syndrome Other childhood disintegrative disorder; Dementia infantilis; Disintegrative psychosis; Heller's syndrome; Symbiotic psychosis Asperger's syndrome; Autistic psychopathy; Schizoid disorder of childhood Pervasive developmental disorder, unspecified Unspecified disorder of psychological development; Developmental disorder NOS Other hyperkinetic disorders Depressive conduct disorder Nonorganic encopresis; Functional encopresis; Incontinence of faeces of nonorganic origin; Psychogenic encopresis Mental disorder, not otherwise specified; Mental illness NOS Disorders of plasma-protein metabolism, not elsewhere classified; a-1-Antitrypsin deficiency; Bisalbuminaemia Lipodystrophy, not elsewhere classified; Lipodystrophy NOS Other specified metabolic disorders; Launois-Bensaude adenolipomatosis; Trimethylaminuria Metabolic disorder, unspecified Syndrome of infant of mother with gestational diabetes Syndrome of infant of a diabetic mother; Maternal diabetes mellitus (pre-existing) affecting fetus or newborn with hypoglycaemia Neonatal diabetes mellitus Iatrogenic neonatal hypoglycaemia Other neonatal hypoglycaemia; Transitory neonatal hypoglycaemia Transitory disorder of carbohydrate metabolism of fetus and newborn, unspecified Cow's milk hypocalcaemia in newborn Other neonatal hypocalcaemia Neonatal tetany without calcium or magnesium deficiency; Neonatal tetany NOS Transitory neonatal hypoparathyroidism Transitory neonatal disorder of calcium and magnesium metabolism, unspecified Neonatal goitre, not elsewhere classified; Transitory congenital goitre with normal function Transitory neonatal hyperthyroidism; neonatal thyrotoxicosis
GROUP
MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN
Case Rate 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 10,700 10,700 10,700 10,700 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300
Professional Fee 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 3,210 3,210 3,210 3,210 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790
Health Care Institution Fee 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 7,490 7,490 7,490 7,490 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510
Other transitory neonatal disorders of thyroid function, not METABOLIC DISORDERS OF THE NEWBORN elsewhere classified; Transitory neonatal hypothyroidism Other specified transitory neonatal endocrine disorders Transitory neonatal endocrine disorder, unspecified Late metabolic acidosis of newborn Dehydration of newborn Disturbances of sodium balance of newborn Other transitory electrolyte disturbances of newborn Other transitory metabolic disturbances of newborn Transitory metabolic disturbance of newborn, unspecified Hypothermia of newborn, unspecified Environmental hyperthermia of newborn Other specified disturbances of temperature regulation of newborn Disturbance of temperature regulation of newborn, unspecified; Fever of newborn NOS Neonatal erythema toxicum Breast engorgement of newborn; Noninfective mastitis of newborn Other specified conditions of integument specific to fetus and newborn; Bronze baby syndrome; Neonatal scleroderma; Urticaria neonatorum METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN
O02.0 O02.1 O02.8 O02.9 O03.4 O03.9
Blighted ovum and nonhydatidiform mole; Carneous mole; MISCARRIAGE Fleshy mole; Intrauterine mole NOS; Pathological ovum Missed abortion; Early fetal death with retention of dead fetus Other specified abnormal products of conception Abnormal product of conception, unspecified Spontaneous abortion, incomplete, without complication Spontaneous abortion, complete or unspecified, without complication MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE
5,000 5,000 5,000 5,000 5,000 5,000
1,500 1,500 1,500 1,500 1,500 1,500
3,500 3,500 3,500 3,500 3,500 3,500
Page 68 of 111
O05.4 O05.9 O06.4 O06.9
DESCRIPTION
Other abortion, incomplete, without complication Other abortion, complete or unspecified, without complication Unspecified abortion or induced abortion NOS, incomplete, without complication Unspecified abortion or induced abortion NOS, complete or unspecified, without complication MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE
GROUP
Case Rate 5,000 5,000 5,000 5,000
O07.0
Failed medical abortion, complicated by genital tract and pelvic infection with Endometritis; Oophoritis; Parametritis; MISCARRIAGE Parametritis; Pelvic peritonitis; Salpingitis; Salpingooophoritis; Sepsis; Septic shock; Septicaemia Failed medical abortion with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and molar pregnancy; Oliguria Acute re Failed medical abortion without complication; Failed medical abortion NOS Other and unspecified failed attempted abortion with other and unspecified complications with with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and mola Other and unspecified failed attempted abortion without complication; Failed attempted abortion NOS Spontaneous abortion, incomplete, complicated by Genital tract and pelvic infection with Genital tract and pelvic infection following abortion and ectopic and molar pregnancy; Endometritis; Oophoritis; Parametritis; Pelvic peritonitis; Salpingitis; Salpin Spontaneous abortion, incomplete, complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation Spontaneous abortion, incomplete, complicated by Embolism with Embolism NOS or Air embolism or Amniotic fluid embolism or Blood-clot embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap embolism Spontaneous abortion, incomplete, with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and molar pregnancy; Oliguri
5,000
1,500
3,500
O07.3
MISCARRIAGE
5,000
1,500
3,500
O07.4
MISCARRIAGE
5,000
1,500
3,500
O07.8
MISCARRIAGE
5,000
1,500
3,500
O07.9
MISCARRIAGE
5,000
1,500
3,500
O03.0
MISCARRIAGE WITH COMPLICATIONS
6,900
2,070
4,830
O03.1
6,900
2,070
4,830
O03.2
6,900
2,070
4,830
O03.3
6,900
2,070
4,830
O03.5
O03.6
O03.7
Spontaneous abortion, complete, complicated by Genital tract and pelvic infection with Genital tract and pelvic MISCARRIAGE WITH COMPLICATIONS infection following abortion and ectopic and molar pregnancy; Endometritis; Oophoritis; Parametritis; Pelvic peritonitis; Salpingitis; Salpingo Spontaneous abortion, complete or unspecified, complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and MISCARRIAGE WITH COMPLICATIONS ectopic and molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation Spontaneous abortion, complete or unspecified, with other complicated by Embolism with Embolism following abortion and ectopic and molar pregnancy; Embolism NOS; MISCARRIAGE WITH COMPLICATIONS Air embolism; Amniotic fluid embolism; Blood-clot embolism; Pulmonary embolism; Pyaemic embo Spontaneous abortion, complete or unspecified, with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and molar preg
6,900
2,070
4,830
6,900
2,070
4,830
6,900
2,070
4,830
O03.8
6,900
2,070
4,830
O05.0
Other abortion, incomplete, complicated by Genital tract and pelvic infection with Endometritis and/or Oophoritis and/or Parametritis and/or Pelvic peritonitis and/or MISCARRIAGE WITH COMPLICATIONS Salpingitis and/or Salpingo-oophoritis and/or Sepsis and/or Septic shock and/or Septicae Other abortion, incomplete, complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation
6,900
2,070
4,830
O05.1
6,900
2,070
4,830
Page 69 of 111
O05.8
O06.0
Other abortion, complete, with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative MISCARRIAGE WITH COMPLICATIONS Shock; Renal failure following abortion and ectopic and molar pregnancy; Oliguria Acute Unspecified abortion or induced abortion NOS, incomplete, complicated by Genital tract and pelvic infection with Endometritis and/or Oophoritis and/or Parametritis and/or MISCARRIAGE WITH COMPLICATIONS Pelvic peritonitis and/or Salpingitis and/or Salpingooophoritis and/or Sepsis and/ Unspecified abortion or induced abortion NOS, incomplete, complicated Delayed or excessive haemorrhage with MISCARRIAGE WITH COMPLICATIONS Afibrinogenaemia or Defibrination syndrome or Intravascular coagulation Unspecified abortion or induced abortion NOS, incomplete, complicated by Embolism or Embolism NOS with Air embolism or Amniotic fluid embolism or Blood-clot MISCARRIAGE WITH COMPLICATIONS embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap e Unspecified abortion or induced abortion NOS, incomplete, with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; MISCARRIAGE WITH COMPLICATIONS Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and Unspecified abortion or induced abortion NOS, complete, or unspecified, complicated by Genital tract and pelvic infection or Endometritis and/or Oophoritis and/or Parametritis and/or Pelvic peritonitis and/or Salpingitis and/or Salpingo-oophoritis and/or
6,900
2,070
4,830
6,900
2,070
4,830
O06.1
6,900
2,070
4,830
O06.2
6,900
2,070
4,830
O06.3
6,900
2,070
4,830
O06.5
6,900
2,070
4,830
O06.6
O06.7
Unspecified abortion or induced abortion NOS, complete, complicated by Delayed or excessive haemorrhage or MISCARRIAGE WITH COMPLICATIONS Afibrinogenaemia or Defibrination syndrome or Intravascular coagulation Unspecified abortion or induced abortion NOS, complete, complicated by Embolism or Embolism NOS or Air embolism or Amniotic fluid embolism or Blood-clot MISCARRIAGE WITH COMPLICATIONS embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap emboli Unspecified abortion or induced abortion NOS, complete, with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy; Circulatory collapase; Postoperative Shock; Renal failure following abortion and ectopic and m
6,900
2,070
4,830
6,900
2,070
4,830
O06.8
6,900
2,070
4,830
O07.1
O07.5
O07.6
Failed medical abortion complicated by delayed or excessive haemorrhage; Afibrinogenaemia with Delayed or excessive haemorrhage following abortion and ectopic and MISCARRIAGE WITH COMPLICATIONS molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation Other and unspecified failed attempted abortion complicated by genital tract and pelvic infection with MISCARRIAGE WITH COMPLICATIONS Endometritis; Oophoritis; Parametritis; Pelvic peritonitis; Salpingitis; Salpingo-oophoritis; Sepsi; Septic shock; Septicaemia Other and unspecified failed attempted abortion complicated by delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and MISCARRIAGE WITH COMPLICATIONS ectopic and molar pregnancy; Afibrinogenaemia; Defibrination syndrome; Intravascular coagulation Shock following abortion and ectopic and molar pregnancy; MISCARRIAGE WITH COMPLICATIONS Circulatory collapase; Postoperative Shock Other complications following abortion and ectopic and molar pregnancy; Cardiac arrest; Urinary tract infection Infective myositis; Tropical pyomyositis Infective myositis; Tropical pyomyositis Multiple site Infective myositis; Tropical pyomyositis Shoulder region Infective myositis; Tropical pyomyositis Upper arm Infective myositis; Tropical pyomyositis Pelvic region and thigh Infective myositis; Tropical pyomyositis Lower leg Infective myositis; Tropical pyomyositis Ankle and foot Infective myositis; Tropical pyomyositis Other Infective myositis; Tropical pyomyositis Site unspecified MISCARRIAGE WITH COMPLICATIONS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS
6,900
2,070
4,830
6,900
2,070
4,830
6,900
2,070
4,830
O08.3
6,900
2,070
4,830
O08.8 M60.0 M60.00 M60.01 M60.02 M60.05 M60.06 M60.07 M60.08 M60.09
6,900 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500
2,070 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950
4,830 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550
Page 70 of 111
M60.1 M60.11 M60.2 M60.21 M60.23 M60.27 M60.8 M60.80 M60.81 M60.88 M60.89 M60.9 M60.90 M60.91 M60.92 M60.95 M60.96 M60.98 M60.99 M61.3 M61.55 M61.59 M61.9 M62.0 M62.05 M62.08 M62.1 M62.48 M62.49 M62.56 M62.59 M62.60 M62.61 M62.62 M62.63 M62.65 M62.66 M62.67 M62.68 M62.69 M62.8 M62.80 M62.85 M62.86 M62.88 M62.89 M62.9 M62.90 M62.91 M62.95 M62.96 M62.97 M62.98 M62.99 M65.0 M65.1 M65.13 M65.2 M65.20 M65.22 M65.25 M65.29 M65.3 M65.4 M65.8 M65.80 M65.84 M65.86 M65.87 M65.89 M65.9 M65.90 M65.91 M65.92
DESCRIPTION
Interstitial myositis Interstitial myositis Shoulder region Foreign body granuloma of soft tissue, not elsewhere classified Foreign body granuloma of soft tissue, not elsewhere classified Shoulder region Foreign body granuloma of soft tissue, not elsewhere classified Forearm Foreign body granuloma of soft tissue, not elsewhere classified Ankle and foot Other myositis Other myositis Multiple site Other myositis Shoulder region Other myositis Other Other myositis Site unspecified Myositis, unspecified Myositis, unspecified Multiple site Myositis, unspecified Shoulder region Myositis, unspecified Upper arm Myositis, unspecified Pelvic region and thigh Myositis, unspecified Lower leg Myositis, unspecified Other Myositis, unspecified Site unspecified Calcification and ossification of muscles associated with burns; Myositis ossificans associated with burns Other ossification of muscle Pelvic region and thigh Other ossification of muscle Site unspecified Calcification and ossification of muscle, unspecified Diastasis of muscle Diastasis of muscle Pelvic region and thigh Diastasis of muscle Other Other rupture of muscle (nontraumatic) Contracture of muscle Other Contracture of muscle Site unspecified Muscle wasting and atrophy, not elsewhere classified; Disuse atrophy NEC Lower leg Muscle wasting and atrophy, not elsewhere classified; Disuse atrophy NEC Site unspecified Muscle strain Multiple site Muscle strain Shoulder region Muscle strain Upper arm Muscle strain Forearm Muscle strain Pelvic region and thigh Muscle strain Lower leg Muscle strain Ankle and foot Muscle strain Other Muscle strain Site unspecified Muscle (sheath) hernia Muscle (sheath) hernia Multiple site Muscle (sheath) hernia Pelvic region and thigh Muscle (sheath) hernia Lower leg Muscle (sheath) hernia Other Muscle (sheath) hernia Site unspecified Disorder of muscle, unspecified Disorder of muscle, unspecified Multiple site Disorder of muscle, unspecified Shoulder region Disorder of muscle, unspecified Pelvic region and thigh Disorder of muscle, unspecified Lower leg Disorder of muscle, unspecified Ankle and foot Disorder of muscle, unspecified Other Disorder of muscle, unspecified Site unspecified Abscess of tendon sheath Other infective tenosynovitis Other infective (teno)synovitis Forearm Calcific tendinitis Calcific tendinitis Multiple site Calcific tendinitis Upper arm Calcific tendinitis Pelvic region and thigh Calcific tendinitis Site unspecified Trigger finger;Nodular tendinous disease Radial styloid tenosynovitis [de Quervain] Other synovitis and tenosynovitis Other synovitis and tenosynovitis Multiple site Other synovitis and tenosynovitis Hand Other synovitis and tenosynovitis Lower leg Other synovitis and tenosynovitis Ankle and foot Other synovitis and tenosynovitis Site unspecified Synovitis and tenosynovitis, unspecified Synovitis and tenosynovitis, unspecified Multiple site Synovitis and tenosynovitis, unspecified Shoulder region Synovitis and tenosynovitis, unspecified Upper arm
GROUP
MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS
Case Rate 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500
Professional Fee 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950
Health Care Institution Fee 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550
Page 71 of 111
M65.93 M65.94 M65.95 M65.96 M65.97 M65.99 M66.0 M66.4 M66.5 M67.0 M67.1 M67.2 M67.3 M67.4 M67.8 M67.9 M70.0 M70.1 M70.2 M70.3 M70.4 M70.5 M70.6 M70.7 M70.8 M70.9 M71.1 M71.2 M71.3 M71.31 M71.5 M71.51 M71.8 M71.9 M71.91 M71.99 M72.0 M72.2 M72.5 M72.88 M72.9 M72.98 M72.99 M75.0 M75.1 M75.2 M75.3 M75.4 M75.5 M75.8 M75.9 M76 M76.0 M76.1 M76.3 M76.4 M76.5 M76.6 M76.7 M76.8 M76.9 M77.0 M77.1 M77.3 M77.5 M77.8 M77.9 M79.80
DESCRIPTION
Synovitis and tenosynovitis, unspecified Forearm Synovitis and tenosynovitis, unspecified Hand Synovitis and tenosynovitis, unspecified Pelvic region and thigh Synovitis and tenosynovitis, unspecified Lower leg Synovitis and tenosynovitis, unspecified Ankle and foot Synovitis and tenosynovitis, unspecified Site unspecified Rupture of popliteal cyst Spontaneous rupture of other tendons Spontaneous rupture of unspecified tendon; Rupture at musculotendinous junction, nontraumatic Short Achilles tendon (acquired) Other contracture of tendon (sheath) Synovial hypertrophy, not elsewhere classified Transient synovitis; Toxic synovitis Ganglion; Ganglion of joint or tendon (sheath) Other specified disorders of synovium and tendon Disorder of synovium and tendon, unspecified Chronic crepitant synovitis of hand and wrist Bursitis of hand Olecranon bursitis Other bursitis of elbow Prepatellar bursitis Other bursitis of knee Trochanteric bursitis; Trochanteric tendinitis Other bursitis of hip; Ischial bursitis Other soft tissue disorders related to use, overuse and pressure Unspecified soft tissue disorder related to use, overuse and pressure Other infective bursitis Synovial cyst of popliteal space [Baker] Other bursal cyst; Synovial cyst NOS Other bursal cyst; Synovial cyst NOS Shoulder region Other bursitis, not elsewhere classified Other bursitis, not elsewhere classified Shoulder region Other specified bursopathies Bursopathy, unspecified Bursopathy, unspecified Shoulder region Bursopathy, unspecified Site unspecified Palmar fascial fibromatosis [Dupuytren] Plantar fascial fibromatosis; Plantar fasciitis FASCIITIS, NOT ELSEWHERE CLASSIFIED, Other fibroblastic disorders; Abscess of fascia Other Fibroblastic disorder, unspecified; Fasciitis NOS; Fibromatosis NOS Fibroblastic disorder, unspecified; Fasciitis NOS; Fibromatosis NOS Other Fibroblastic disorder, unspecified; Fasciitis NOS; Fibromatosis NOS Site unspecified Adhesive capsulitis of shoulder; Frozen shoulder; Periarthritis of shoulder Rotator cuff syndrome; Rotator cuff or supraspinatus tear or rupture complete)(incomplete), not specified as traumatic; Supraspinatus syndrome Bicipital tendinitis Calcific tendinitis of shoulder; Calcified bursa of shoulder Impingement syndrome of shoulder Bursitis of shoulder Other shoulder lesions Shoulder lesion, unspecified Enthesopathies of lower limb, excluding foot Gluteal tendinitis Psoas tendinitis Iliotibial band syndrome Tibial collateral bursitis [Pellegrini-Stieda] Patellar tendinitis Achilles tendinitis; Achilles bursitis Peroneal tendinitis Other enthesopathies of lower limb, excluding foot; Anterior tibial syndrome; Posterior tibial tendinitis Enthesopathy of lower limb, unspecified Medial epicondylitis Lateral epicondylitis; Tennis elbow Calcaneal spur Other enthesopathy of foot Other enthesopathies, not elsewhere classified Enthesopathy, unspecified; Bone spur NOS; Capsulitis NOS; Periarthritis NOS; Tendinitis NOS Other specified soft tissue disorders Multiple site
GROUP
MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS
Case Rate 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500
Professional Fee 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950 1,950
Health Care Institution Fee 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550 4,550
Page 72 of 111
M79.81 M79.82 M79.84 M79.85 M79.86 M79.87 M79.88 M79.89 M79.91 M79.95 M79.98 M79.99 M79.00 M79.01 M79.02 M79.05 M79.07 M79.08 M79.09 M79.10 M79.11 M79.12 M79.15 M79.16 M79.18 M79.19 M79.20 M79.21 M79.22 M79.25 M79.28 M79.29 M79.39 M96.8 P94.0 G70.0 G70.2 G70.8 G70.9
DESCRIPTION
Other specified soft tissue disorders Shoulder region Other specified soft tissue disorders Upper arm Other specified soft tissue disorders Hand
GROUP
MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS
Case Rate 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 6,500 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 5,900 11,600 7,900 7,900 7,900 7,900
Other specified soft tissue disorders Pelvic region and thigh MUSCLE, TENDON, SOFT TISSUE DISORDERS Other specified soft tissue disorders Lower leg Other specified soft tissue disorders Ankle and foot Other specified soft tissue disorders Other Other specified soft tissue disorders Site unspecified Soft tissue disorder, unspecified Shoulder region Soft tissue disorder, unspecified Pelvic region and thigh Soft tissue disorder, unspecified Other Soft tissue disorder, unspecified Site unspecified Rheumatism, unspecified Multiple site Rheumatism, unspecified Shoulder region Rheumatism, unspecified Upper arm Rheumatism, unspecified Pelvic region and thigh Rheumatism, unspecified Ankle and foot Rheumatism, unspecified Other Rheumatism, unspecified Site unspecified Myalgia Multiple site Myalgia Shoulder region Myalgia Upper arm Myalgia Pelvic region and thigh Myalgia Lower leg Myalgia Other Myalgia Site unspecified Neuralgia and neuritis, unspecified Multiple site Neuralgia and neuritis, unspecified Shoulder region Neuralgia and neuritis, unspecified Upper arm Neuralgia and neuritis, unspecified Pelvic region and thigh Neuralgia and neuritis, unspecified Other Neuralgia and neuritis, unspecified Site unspecified Panniculitis, unspecified Site unspecified Other postprocedural musculoskeletal disorders Transient neonatal myasthenia gravis Myasthenia gravis Congenital and developmental myasthenia Other specified myoneural disorders Myoneural disorder, unspecified MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MUSCLE, TENDON, SOFT TISSUE DISORDERS MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYALGIA, NEURALGIA, RHEUMATISM MYASTHENIA GRAVIS NEWBORN MYOPATHIES MYOPATHIES MYOPATHIES MYOPATHIES
G71.0
Muscular dystrophy; Muscular dystrophy autosomal recessive, childhood type, resembling Duchenne or Becker; Muscular dystrophy benign [Becker]; Muscular dystrophy MYOPATHIES benign; capuloperoneal with early contractures [EmeryDreifuss]; Muscular dystrophy distal; Myotonic disorders; Dystrophia myotonica [Steinert]; Myotonia, chondrodystrophic; Myotonia, drug-induced; Myotonia, symptomatic; Myotonia, congenita NOS; Myotonia, congenita dominant [Thomsen]; Myotonia, congenital recessive [Becker]; Neuromyotonia [Isaac Congenital myopathies; Congenital muscular dystrophy NOS; Congenital muscular dystrophy with specific morphological abnormalities of the muscle fibre; Central coreDisease ; Minicore Disease ; MulticoreDisease ; Fibretype disproportion; Myopathy myotubula Primary disorder of muscle, unspecified; Hereditary myopathy NOS Drug-induced myopathy Alcoholic myopathy Myopathy due to other toxic agents Periodic paralysis; Periodic paralysis (familial) hyperkalaemic; Periodic paralysis (familial) hypokalaemic; Periodic paralysis (familial) myotonic; Periodic paralysis (familial) normokalaemic Inflammatory myopathy, not elsewhere classified Other specified myopathies Myopathy, unspecified Neonatal cerebral ischaemia Fetus and newborn affected by maternal hypertensive disorders Fetus and newborn affected by maternal renal and urinary tract diseases Fetus and newborn affected by maternal infectious and parasitic diseases Fetus and newborn affected by other maternal circulatory and respiratory diseases Fetus and newborn affected by maternal nutritional disorders
7,900
2,370
5,530
G71.1
MYOPATHIES
7,900
2,370
5,530
G71.2
MYOPATHIES
7,900
2,370
5,530
G71.9 G72.0 G72.1 G72.2
MYOPATHIES MYOPATHIES MYOPATHIES MYOPATHIES
7,900 7,900 7,900 7,900
2,370 2,370 2,370 2,370
5,530 5,530 5,530 5,530
G72.3
MYOPATHIES
7,900
2,370
5,530
G72.4 G72.8 G72.9 P91.0 P00.0 P00.1 P00.2 P00.3 P00.4
MYOPATHIES MYOPATHIES MYOPATHIES NEONATAL CEREBRAL ISCHEMIA NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS
7,900 7,900 7,900 25,800 7,700 7,700 7,700 7,700 7,700
2,370 2,370 2,370 7,740 2,310 2,310 2,310 2,310 2,310
5,530 5,530 5,530 18,060 5,390 5,390 5,390 5,390 5,390
Page 73 of 111
P00.5 P00.6 P00.7 P00.8 P00.9 P01.0 P01.1 P01.2 P01.3 P01.4 P01.5 P01.6
DESCRIPTION
Fetus and newborn affected by maternal injury Fetus and newborn affected by surgical procedure on mother Fetus and newborn affected by other medical procedures on mother, not elsewhere classified Fetus and newborn affected by other maternal conditions Fetus and newborn affected by unspecified maternal condition Fetus and newborn affected by incompetent cervix Fetus and newborn affected by premature rupture of membranes Fetus and newborn affected by oligohydramnios Fetus and newborn affected by polyhydramnios; Hydramnios Fetus and newborn affected by ectopic pregnancy; Abdominal pregnancy Fetus and newborn affected by multiple pregnancy; Triplet pregnance; Twin pregnancy Fetus and newborn affected by maternal death
GROUP
NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS
Case Rate 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700
Professional Fee 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310
Health Care Institution Fee 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390
P01.7
Fetus and newborn affected by malpresentation before labour; Breech presentation before labor; External version NEONATE AFFECTED BY MATERNAL FACTORS before labour; Face presentation before labour; Transverse lie before labour; Unstable lie before labour Fetus and newborn affected by other maternal complications of pregnancy; Spontaneous abortion, fetus Fetus and newborn affected by maternal complication of pregnancy, unspecified Fetus and newborn affected by placenta praevia NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS
7,700
2,310
5,390
P01.8 P01.9 P02.0
7,700 7,700 7,700
2,310 2,310 2,310
5,390 5,390 5,390
P02.1
Fetus and newborn affected by other forms of placental separation and haemorrhage; Abruptio placentae; Accidental haemorrhage; Antepartum haemorrhage; NEONATE AFFECTED BY MATERNAL FACTORS Damage to placenta from amniocentesis, caesarian section or surgical induction; Maternal blood loss; Pre Fetus and newborn affected by other and unspecified morphological and functional abnormalities of placenta; Placental dysfunction; Placental infarction; Placental insufficiency Fetus and newborn affected by placental transfusion syndromes; Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion
7,700
2,310
5,390
P02.2
NEONATE AFFECTED BY MATERNAL FACTORS
7,700
2,310
5,390
P02.3 P02.4 P02.5
NEONATE AFFECTED BY MATERNAL FACTORS
7,700 7,700 7,700
2,310 2,310 2,310
5,390 5,390 5,390
Fetus and newborn affected by prolapsed cord NEONATE AFFECTED BY MATERNAL FACTORS Fetus and newborn affected by other compression of umbilical cord; Cord (tightly) around neck; Entanglement of NEONATE AFFECTED BY MATERNAL FACTORS cord; Knot in cord Fetus and newborn affected by other and unspecified conditions of umbilical cord; Short cord; Vasa praevia Fetus and newborn affected by chorioamnionitis; Amnionitis; Membranitis; Placentitis Fetus and newborn affected by other abnormalities of membranes Fetus and newborn affected by abnormality of membranes, unspecified Fetus and newborn affected by breech delivery and extraction Fetus and newborn affected by other malpresentation, malposition and disproportion during labour and delivery; Contracted pelvis; Persistent occipitoposterior; Transverse lie Fetus and newborn affected by forceps delivery Fetus and newborn affected by delivery by vacuum extractor [ventouse] Fetus and newborn affected by caesarean delivery Fetus and newborn affected by precipitate delivery Fetus and newborn affected by abnormal uterine contractions Fetus and newborn affected by other specified complications of labour and delivery Fetus and newborn affected by complication of labour and delivery, unspecified Fetus and newborn affected by maternal anaesthesia and analgesia in pregnancy, labour and delivery Fetus and newborn affected by other maternal medication; Cancer chemotherapy; Cytotoxic drugs Fetus and newborn affected by maternal use of tobacco Fetus and newborn affected by maternal use of alcohol NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS
P02.6 P02.7 P02.8 P02.9 P03.0
7,700 7,700 7,700 7,700 7,700
2,310 2,310 2,310 2,310 2,310
5,390 5,390 5,390 5,390 5,390
P03.1 P03.2 P03.3 P03.4 P03.5 P03.6 P03.8 P03.9 P04.0 P04.1 P04.2 P04.3
NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS
7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700 7,700
2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310 2,310
5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390 5,390
Page 74 of 111
P04.5 P04.8
DESCRIPTION
GROUP
Case Rate 7,700 7,700
Fetus and newborn affected by maternal use of nutritional NEONATE AFFECTED BY MATERNAL FACTORS chemical substances Fetus and newborn affected by other maternal noxious NEONATE AFFECTED BY MATERNAL FACTORS influences Neoplasm of uncertain or unknown behaviour of Lip, oral cavity and pharynx; Neoplasm of uncertain or unknown behaviour of Aryepiglottic fold NOS; Neoplasm of NEOPLASMS OF UNKNOWN BEHAVIOR uncertain or unknown behaviour of hypopharyngeal aspect of Aryepiglottic fold ; Neoplasm of un Neoplasm of uncertain or unknown behaviour of Stomach Neoplasm of uncertain or unknown behaviour of Small intestine NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
D37.0
12,200
3,660
8,540
D37.1 D37.2 D37.3 D37.4 D37.5
12,200 12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540 8,540
Neoplasm of uncertain or unknown behaviour of Appendix NEOPLASMS OF UNKNOWN BEHAVIOR Neoplasm of uncertain or unknown behaviour of Colon Neoplasm of uncertain or unknown behaviour of Rectum; Neoplasm of uncertain or unknown behaviour of Rectosigmoid junction Neoplasm of uncertain or unknown behaviour of Liver, gallbladder and bile ducts; Neoplasm of uncertain or unknown behaviour of Ampulla of Vater Neoplasm of uncertain or unknown behaviour of Other digestive organs; Neoplasm of uncertain or unknown behaviour of Anal canal; Neoplasm of uncertain or unknown behaviour of Anal sphincter; Neoplasm of uncertain or unknown behaviour of Anus NOS; Neoplasm NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
D37.6
NEOPLASMS OF UNKNOWN BEHAVIOR
12,200
3,660
8,540
D37.7
12,200
3,660
8,540
D37.9
Neoplasm of uncertain or unknown behaviour of Digestive NEOPLASMS OF UNKNOWN BEHAVIOR organ, unspecified Neoplasm of uncertain or unknown behaviour of Larynx; Neoplasm of uncertain or unknown behaviour of laryngeal NEOPLASMS OF UNKNOWN BEHAVIOR aspect of Aryepiglottic fold; Neoplasm of uncertain or unknown behaviour of Suprahyoid portion of Epiglottis Neoplasm of uncertain or unknown behaviour of Trachea, bronchus and lung Neoplasm of uncertain or unknown behaviour of Pleura Neoplasm of uncertain or unknown behaviour of Mediastinum Neoplasm of uncertain or unknown behaviour of Thymus NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200
3,660
8,540
D38.0
12,200
3,660
8,540
D38.1 D38.2 D38.3 D38.4
12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540
D38.5
Neoplasm of uncertain or unknown behaviour of Other respiratory organs; Neoplasm of uncertain or unknown behaviour of Accessory sinuses; Neoplasm of uncertain or NEOPLASMS OF UNKNOWN BEHAVIOR unknown behaviour of Cartilage of nose; Neoplasm of uncertain or unknown behaviour of Middle Neoplasm of uncertain or unknown behaviour of Respiratory organ, unspecified Neoplasm of uncertain or unknown behaviour of Uterus Neoplasm of uncertain or unknown behaviour of Ovary NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200
3,660
8,540
D38.6 D39.0 D39.1 D39.2
12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540
Neoplasm of uncertain or unknown behaviour of Placenta; NEOPLASMS OF UNKNOWN BEHAVIOR Chorioadenoma destruens; Invasive Hydatidiform mole; Malignant Hydatidiform mole Neoplasm of uncertain or unknown behaviour of Other female genital organs; Neoplasm of uncertain or unknown behaviour of Skin of female genital organs Neoplasm of uncertain or unknown behaviour of Female genital organ, unspecified Neoplasm of uncertain or unknown behaviour of Prostate Neoplasm of uncertain or unknown behaviour of Testis Neoplasm of uncertain or unknown behaviour of Other male genital organs; Neoplasm of uncertain or unknown behaviour of Skin of male genital organs Neoplasm of uncertain or unknown behaviour of Male genital organ, unspecified Neoplasm of uncertain or unknown behaviour of Kidney Neoplasm of uncertain or unknown behaviour of Renal pelvis Neoplasm of uncertain or unknown behaviour of Ureter Neoplasm of uncertain or unknown behaviour of Urethra NEOPLASMS OF UNKNOWN BEHAVIOR
D39.7
12,200
3,660
8,540
D39.9 D40.0 D40.1 D40.7 D40.9 D41.0 D41.1 D41.2 D41.3
NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540
Page 75 of 111
D41.4 D41.9 D42.0 D42.1 D42.9
DESCRIPTION
Neoplasm of uncertain or unknown behaviour of Bladder Neoplasm of uncertain or unknown behaviour of Urinary organ, unspecified Neoplasm of uncertain or unknown behaviour of Cerebral meninges Neoplasm of uncertain or unknown behaviour of Spinal meninges Neoplasm of uncertain or unknown behaviour of Meninges, unspecified Neoplasm of uncertain or unknown behaviour of Brain, supratentorial; Neoplasm of uncertain or unknown behaviour of Cerebral ventricle; Neoplasm of uncertain or unknown behaviour of Cerebrum; Neoplasm of uncertain or unknown behaviour of Frontal lobe; Neop Neoplasm of uncertain or unknown behaviour of Brain, infratentorial; Neoplasm of uncertain or unknown behaviour of Brain stem; Neoplasm of uncertain or unknown behaviour of Cerebellum; Neoplasm of uncertain or unknown behaviour of Fourth ventricle Neoplasm of uncertain or unknown behaviour of Brain, unspecified Neoplasm of uncertain or unknown behaviour of Cranial nerves Neoplasm of uncertain or unknown behaviour of Spinal cord Neoplasm of uncertain or unknown behaviour of Other parts of central nervous system Neoplasm of uncertain or unknown behaviour of Central nervous system, unspecified; Neoplasm of uncertain or unknown behaviour of Central Nervous system NOS Neoplasm of uncertain or unknown behaviour of Thyroid gland Neoplasm of uncertain or unknown behaviour of Adrenal gland Neoplasm of uncertain or unknown behaviour of Parathyroid gland Neoplasm of uncertain or unknown behaviour of Pituitary gland Neoplasm of uncertain or unknown behaviour of Craniopharyngeal duct Neoplasm of uncertain or unknown behaviour of Pineal gland Neoplasm of uncertain or unknown behaviour of Carotid body Neoplasm of uncertain or unknown behaviour of Aortic body and other paraganglia Neoplasm of uncertain or unknown behaviour of Pluriglandular involvement; Multiple endocrine adenomatosis Neoplasm of uncertain or unknown behaviour of Endocrine gland, unspecified Polycythaemia vera Myelodysplastic syndromes Other myelodysplastic syndromes Myelodysplastic syndrome, unspecified; Myelodysplastic syndrome NOS; Myelodysplasia NOS; Preleukaemia syndrome NOS Histiocytic and mast cell tumours of uncertain and unknown behaviour; Mast cell tumour NOS; Mastocytoma NOS Chronic myeloproliferative disease; Myelofibrosis with myeloid metaplasia; Myeloproliferative disease, unspecified; Megakaryocytic Myelosclerosis with myeloid metaplasia Monoclonal gammopathy Essential thrombocythaemia; Haemorrhagic thrombocythaemia; Idiopathic haemorrhagic thrombocythaemia Other specified neoplasms of uncertain or unknown behaviour of lymphoid, haematopoietic and related tissue
GROUP
NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
Case Rate 12,200 12,200 12,200 12,200 12,200
D43.0
12,200
3,660
8,540
D43.1
12,200
3,660
8,540
D43.2 D43.3 D43.4 D43.7
NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540
D43.9
12,200
3,660
8,540
D44.0 D44.1 D44.2 D44.3 D44.4 D44.5 D44.6 D44.7 D44.8 D44.9 D45 D46 D46.7 D46.9
NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200
3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660 3,660
8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540 8,540
D47.0
12,200
3,660
8,540
D47.1 D47.2 D47.3
NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR
12,200 12,200 12,200
3,660 3,660 3,660
8,540 8,540 8,540
D47.7
12,200
3,660
8,540
D47.9 D48.0
Neoplasm of uncertain or unknown behaviour of lymphoid, NEOPLASMS OF UNKNOWN BEHAVIOR haematopoietic and related tissue, unspecified; Lymphoproliferative disease NOS Neoplasm of uncertain or unknown behaviour of Bone and NEOPLASMS OF UNKNOWN BEHAVIOR articular cartilage
12,200 12,200
3,660 3,660
8,540 8,540
Page 76 of 111
D48.1
Neoplasm of uncertain or unknown behaviour of Connective and other soft tissue; Neoplasm of uncertain or NEOPLASMS OF UNKNOWN BEHAVIOR unknown behaviour of Connective tissue of ear; Neoplasm of uncertain or unknown behaviour of eyelid Neoplasm of uncertain or unknown behaviour of Peripheral NEOPLASMS OF UNKNOWN BEHAVIOR nerves and autonomic nervous system Neoplasm of uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR Retroperitoneum Neoplasm of uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR Peritoneum Neoplasm of uncertain or unknown behaviour of Breast; Neoplasm of uncertain or unknown behaviour of Connective tissue of breast; Cystosarcoma phyllodes Neoplasm of uncertain or unknown behaviour of Other specified sites; Neoplasm of uncertain or unknown behaviour of Eye; Neoplasm of uncertain or unknown behaviour of Heart; Neoplasm of uncertain or unknown behaviour of Peripheral nerves of orbit Neoplasm of uncertain or unknown behaviour, unspecified; "Growth" NOS ; Neoplasm NOS; New growth NOS; Tumour NOS Brachial plexus disorders; Thoracic outlet syndrome Lumbosacral plexus disorders Cervical root disorders, not elsewhere classified Thoracic root disorders, not elsewhere classified Lumbosacral root disorders, not elsewhere classified Neuralgic amyotrophy; Parsonage-Aldren-Turner syndrome; Shoulder-girdle neuritis Other nerve root and plexus disorders Nerve root and plexus disorder, unspecified Nerve root and plexus compressions in other diseases classified elsewhere Light for gestational age Small for gestational age Fetal malnutrition without mention of light or small for gestational age Slow fetal growth, unspecified Extremely low birth weight; Birth weight 999 g or less. Other low birth weight; Birth weight 1000-2499 g. Extreme immaturity; Less than 28 completed weeks (less than 196 completed days) of gestation. NEOPLASMS OF UNKNOWN BEHAVIOR
12,200
3,660
8,540
D48.2 D48.3 D48.4
12,200 12,200 12,200
3,660 3,660 3,660
8,540 8,540 8,540
D48.6
12,200
3,660
8,540
D48.7
12,200
3,660
8,540
D48.9 G54.0 G54.1 G54.2 G54.3 G54.4 G54.5 G54.8 G54.9 G55.8* P05.0 P05.1 P05.2 P05.9 P07.0 P07.1 P07.2
NEOPLASMS OF UNKNOWN BEHAVIOR NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED- LOW BIRTH WEIGHT/PRETERM
12,200 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 7,900 16,900 16,900 16,900 16,900 16,900 16,900 16,900
3,660 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 2,370 5,070 5,070 5,070 5,070 5,070 5,070 5,070
8,540 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 5,530 11,830 11,830 11,830 11,830 11,830 11,830 11,830
P07.3
Other preterm infants; 28 completed weeks or more but NEWBORN COMPLICATED- LOW BIRTH less than 37 completed weeks (196 completed days but less WEIGHT/PRETERM than 259 completed days) of gestation; Prematurity NOS Exceptionally large baby; Usually implies a birth weight of 4500 g or more. Other heavy for gestational age infants; Other fetus or infant heavy- or large-for-dates regardless of period of gestation. Post-term infant, not heavy for gestational age; Fetus or infant with gestation period of 42 completed weeks or more (294 days or more), not heavy- or large-for-dates; Postmaturity NOS Sepsis of newborn due to streptococcus, group B Sepsis of newborn due to other and unspecified streptococci Sepsis of newborn due to Staphylococcus aureus Sepsis of newborn due to other and unspecified staphylococci Sepsis of newborn due to Escherichia coli Sepsis of newborn due to anaerobes Other bacterial sepsis of newborn Bacterial sepsis of newborn, unspecified Other noninflammatory disorders of ovary, fallopian tube and broad ligament; Broad ligament laceration syndrome [Allen-Masters] Noninflammatory disorder of ovary, fallopian tube and broad ligament, unspecified Other specified noninflammatory disorders of uterus; Atrophy of uterus, acquired; Fibrosis of uterus NOS Noninflammatory disorder of uterus, unspecified; Disorder of uterus NOS Vitamin A deficiency with conjunctival xerosis Vitamin A deficiency with Bitot's spot and conjunctival xerosis; Bitot's spot in the young child NEWBORN COMPLICATED-LARGE BABY NEWBORN COMPLICATED-LARGE BABY
16,900
5,070
11,830
P08.0 P08.1
7,000 7,000
2,100 2,100
4,900 4,900
P08.2
NEWBORN COMPLICATED-POSTTERM
7,500
2,250
5,250
P36.0 P36.1 P36.2 P36.3 P36.4 P36.5 P36.8 P36.9 N83.8 N83.9 N85.8 N85.9 E50.0 E50.1
NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NUTRITIONAL DISORDER NUTRITIONAL DISORDER
11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 8,500 8,500 8,500 8,500 9,200 9,200
3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 2,550 2,550 2,550 2,550 2,760 2,760
8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 5,950 5,950 5,950 5,950 6,440 6,440
Page 77 of 111
E50.8 E50.9 E51.1 E51.2 E51.8 E51.9 E53.1 E53.8 E53.9 E54 E55.0 E55.9 E56.0 E56.1 E56.8 E56.9 E58 E60 E61.1 E61.2 E61.6 E61.9 E63.1 E63.8 E63.9 E64.9 E67.0 E67.1 E67.3 E66.2 N13.0 N13.1 N13.2 N13.3 N13.4 N13.5 N13.6 N13.7 N13.8 N13.9 N45.0 N45.9 M86.0 M86.1 M86.15 M86.17 M86.19 M86.2 M86.29 M86.4 M86.5 M86.50 M86.6 M86.60 M86.61 M86.62 M86.63 M86.65 M86.66 M86.67 M86.68 M86.69 M86.8 M86.80 M86.81
DESCRIPTION
OTHER MANIFESTATIONS OF VITAMIN A DEFICIENCY Vitamin A deficiency, unspecified; Hypovitaminosis A NOS Dry Beriberi Wernicke's encephalopathy Other manifestations of thiamine deficiency Thiamine deficiency, unspecified Pyridoxine deficiency; Vitamin B6 deficiency Deficiency of other specified B group vitamins; Biotin Deficiency; Cyanocobalamin Deficiency; Folate Deficiency; Folic acid Deficiency; Pantothenic acid Deficiency; Vitamin B12 Deficiency Vitamin B deficiency, unspecified Ascorbic acid deficiency; Deficiency of vitamin C; Scurvy Rickets, active; Infantile Osteomalacia; Juvenile Osteomalacia Vitamin D deficiency, unspecified; Avitaminosis D Deficiency of vitamin E Deficiency of vitamin K Deficiency of other vitamins Vitamin deficiency, unspecified Dietary calcium deficiency Dietary zinc deficiency Iron deficiency Magnesium deficiency Vanadium deficiency Deficiency of nutrient element, unspecified Imbalance of constituents of food intake Other specified nutritional deficiencies Nutritional deficiency, unspecified Sequelae of unspecified nutritional deficiency Hypervitaminosis A Hypercarotenaemia Hypervitaminosis D Extreme obesity with alveolar hypoventilation; Pickwickian syndrome Hydronephrosis with ureteropelvic junction obstruction Hydronephrosis with ureteral stricture, not elsewhere classified Hydronephrosis with renal and ureteral calculous obstruction Other and unspecified hydronephrosis Hydroureter Kinking and stricture of ureter without hydronephrosis Pyonephrosis; Conditions in N13.0-N13.5 with infection; Obstructive uropathy with infection Vesicoureteral-reflux-associated uropathy; Vesicoureteral reflux NOS; Vesicoureteral reflux with scarring Other obstructive and reflux uropathy Obstructive and reflux uropathy, unspecified; Urinary tract obstruction NOS Orchitis, epididymitis and epididymo-orchitis with abscess; Abscess of epididymis or testis Orchitis, epididymitis and epididymo-orchitis without abscess; Epididymitis NOS; Orchitis NOS Acute haematogenous osteomyelitis Other acute osteomyelitis Other acute osteomyelitis Pelvic region and thigh Other acute osteomyelitis Ankle and foot Other acute osteomyelitis Site unspecified Subacute osteomyelitis Subacute osteomyelitis Site unspecified Chronic osteomyelitis with draining sinus Other chronic haematogenous osteomyelitis Other chronic haematogenous osteomyelitis Multiple site Other chronic osteomyelitis Other chronic osteomyelitis Multiple site Other chronic osteomyelitis Shoulder region Other chronic osteomyelitis Upper arm Other chronic osteomyelitis Forearm Other chronic osteomyelitis Pelvic region and thigh Other chronic osteomyelitis Lower leg Other chronic osteomyelitis Ankle and foot Other chronic osteomyelitis Other Other chronic osteomyelitis Site unspecified Other osteomyelitis; Brodie's abscess Other osteomyelitis; Brodie's abscess Multiple site Other osteomyelitis; Brodie's abscess Shoulder region
GROUP
NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER OBESITY HYPOVENTILATION OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES ORCHITIS ORCHITIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS
Case Rate 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 13,600 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 9,700 7,900 7,900 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000
Professional Fee 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 4,080 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,910 2,370 2,370 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900
Health Care Institution Fee 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 9,520 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 6,790 5,530 5,530 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100
Page 78 of 111
M86.88 M86.9 M86.90
DESCRIPTION
Other osteomyelitis; Brodie's abscess Other Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Multiple site Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Shoulder region Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Upper arm Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Hand Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Pelvic region and thigh Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Lower leg
GROUP
OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS
Case Rate 13,000 13,000 13,000
M86.91
OSTEOMYELITIS AND OSTEONECROSIS
13,000
3,900
9,100
M86.92 M86.94 M86.95
OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS
13,000 13,000 13,000
3,900 3,900 3,900
9,100 9,100 9,100
M86.96
OSTEOMYELITIS AND OSTEONECROSIS
13,000
3,900
9,100
M86.97 M86.98 M86.99 M87.05 M87.2 M87.8 M87.85 M87.86 M87.9 M87.90 M87.91 M87.95 M87.99 M88.0 M88.9 A31.8 A31.9 A42.0 A42.1 A42.2 A42.7 A42.8 A42.9 A43.1 A43.9 A44.1 A44.9 A48.8 A49.0 A49.2 A49.3 A49.8 A49.9 B20.1 M89.0 M89.01 M89.2 M89.4 M89.48 M89.5 M89.54 M89.6 M89.8
Osteomyelitis, unspecified; Infection of bone NOS; OSTEOMYELITIS AND OSTEONECROSIS Periostitis without mention of osteomyelitis Ankle and foot Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Other Osteomyelitis, unspecified; Infection of bone NOS; Periostitis without mention of osteomyelitis Site unspecified Idiopathic aseptic necrosis of bone Pelvic region and thigh Osteonecrosis due to previous trauma Other osteonecrosis Other osteonecrosis Pelvic region and thigh Other osteonecrosis Lower leg Osteonecrosis, unspecified Osteonecrosis, unspecified Multiple site Osteonecrosis, unspecified Shoulder region Osteonecrosis, unspecified Pelvic region and thigh Osteonecrosis, unspecified Site unspecified Paget's disease of skull Paget's disease of bone, unspecified Other mycobacterial infections Mycobacterial infection, unspecified ; Atypical mycobacterium infection Not Otherwise Specified; Mycobacteriosis NOS; Listeriosis (listerial foodborne infection) Pulmonary actinomycosis Abdominal actinomycosis Cervicofacial actinomycosis Actinomycotic septicaemia Other forms of actinomycosis Actinomycosis, unspecified Cutaneous nocardiosis Nocardiosis, unspecified Cutaneous and mucocutaneous bartonellosis; Verruga peruana Bartonellosis, unspecified Other specified bacterial diseases Staphylococcal infection, unspecified Haemophilus influenzae infection, unspecified Mycoplasma infection, unspecified Other bacterial infections of unspecified site Bacterial infection, unspecified; Bacteraemia NOS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES
13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 13,000 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,900 8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800
3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 3,900 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,670 2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640
9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 9,100 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,230 6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160
HIV DISEASE RESULTING IN OTHER BACTERIAL INFECTIONS OTHER BACTERIAL DISEASES Algoneurodystrophy; Shoulder-hand syndrome; Sudeck's atrophy; Sympathetic reflex dystrophy Algoneurodystrophy; Shoulder-hand syndrome; Sudeck's atrophy; Sympathetic reflex dystrophy Shoulder region Other disorders of bone development and growth Other hypertrophic osteoarthropathy; Marie-Bamberger disease; Pachydermoperiostosis Other hypertrophic osteoarthropathy; Marie-Bamberger disease; Pachydermoperiostosis Other Osteolysis Osteolysis Hand Osteopathy after poliomyelitis Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Pelvic region and thigh OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS
M89.85
OTHER BONE DISORDERS
8,800
2,640
6,160
Page 79 of 111
Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Lower leg Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Ankle and foot Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Other Other specified disorders of bone; Infantile cortical hyperostoses; Post-traumatic subperiosteal ossification Site unspecified Disorder of bone, unspecified Pelvic region and thigh Disorder of bone, unspecified Other Disorder of bone, unspecified Site unspecified JUVENILE OSTEOCHONDROSIS OF HEAD OF FEMUR [LEGGCALV-PERTHES] OTHER JUVENILE OSTEOCHONDROSIS OF HIP AND PELVIS; JUVENILE OSTEOCHONDROSIS AFTER REDUCTION OF CONGENITAL DISLOCATION OF HIP Chondrocostal junction syndrome [Tietze] Other specified disorders of cartilage Other biomechanical lesions Biomechanical lesion, unspecified Occlusion and stenosis of carotid artery Dissection of cerebral arteries, nonruptured Cerebral aneurysm, nonruptured; Cerebral aneurysm NOS; Cerebral arteriovenous fistula, acquired Cerebral atherosclerosis; Atheroma of cerebral arteries Progressive vascular leukoencephalopathy; Binswanger's disease Moyamoya disease Nonpyogenic thrombosis of intracranial venous system; Nonpyogenic thrombosis of cerebral vein; Nonpyogenic thrombosis of intracrannial venous sinus Cerebral arteritis, not elsewhere classified Other specified cerebrovascular diseases; Acute cerebrovascular insufficiency NOS; Chronic Cerebral ischaemia Other lacunar syndrome in unspecified cerebrovascular disease Other vascular syndrome in unspecified cerebrovascular disease Chlamydial infection of pharynx Active stage of trachoma; Active stage of trachoma; Trachomatous Granular conjunctivitis; Trachomatous follicular conjunctivitis; Trachomatous pannus Trachoma, unspecified Chlamydial infection, unspecified; Chlamydiosis NOS Tuberous sclerosis; Bourneville's disease; Epiloia Congenital malformation syndromes predominantly affecting facial appearance; Acrocephalopolysyndactyly; Acrocephalosyndactyly [Apert]; Cryptophthalmos syndrome; Cyclopia; Syndrome Goldenhar; Moebius Syndrome; oro-facial-digital Syndrome; Robin Syndrom Congenital malformation syndromes predominantly associated with short stature; Aarskog Syndrome; Cockayne Syndrome; De Lange Syndrome ; Dubowitz Syndrome; Noonan; Syndrome Prader-Willi Syndrome; Robinow-Silverman-Smith Syndrome ; Russell-Silver; Syn Congenital malformation syndromes predominantly involving limbs; Holt-Oram Syndrome; Klippel-TrnaunayWeber Syndrome; nail patella Syndrome; Rubinstein-Taybi Syndrome; sirenomelia Syndrome; thrombocytopenia Syndrome with absent radius [TAR]; VAT Congenital malformation syndromes involving early overgrowth; Beckwith-Wiedemann Syndrome; Sotos; Syndrome Weaver Syndrome Marfan's syndrome Other specified congenital malformation syndromes, not elsewhere classified; Alpor Syndrome; Laurence-Moon(Bardet)-Biedl Syndrome; Zellweger Syndrome Congenital malformations of spleen; Asplenia (congenital); Congenital splenomegaly Congenital malformations of adrenal gland Congenital malformations of other endocrine glands; Congenital malformation of parathyroid or thyroid gland; Persistent thyroglossal duct; Thyroglossal cyst
GROUP
Case Rate 8,800
M89.86
M89.87
8,800
2,640
6,160
M89.88
8,800
2,640
6,160
M89.89 M89.95 M89.98 M89.99 M91.1 M91.8 M94.0 M94.8 M99.8 M99.9 I65.2 I67.0 I67.1 I67.2 I67.3 I67.5 I67.6 I67.7 I67.8 I67.9+G46.7* I67.9+G46.8* A56.4 A71.1 A71.9 A74.9 Q85.1
OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CONGENITAL MALFORMATIONS
8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 8,800 15,200 15,200 15,200 15,200 15,200 15,200 15,200 15,200 15,200 15,200 15,200 8,500 8,500 8,500 8,500 11,600
2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 2,640 4,560 4,560 4,560 4,560 4,560 4,560 4,560 4,560 4,560 4,560 4,560 2,550 2,550 2,550 2,550 3,480
6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 6,160 10,640 10,640 10,640 10,640 10,640 10,640 10,640 10,640 10,640 10,640 10,640 5,950 5,950 5,950 5,950 8,120
Q87.0
OTHER CONGENITAL MALFORMATIONS
11,600
3,480
8,120
Q87.1
11,600
3,480
8,120
Q87.2
11,600
3,480
8,120
Q87.3 Q87.4 Q87.8 Q89.0 Q89.1 Q89.2
OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS
11,600 11,600 11,600 11,600 11,600 11,600
3,480 3,480 3,480 3,480 3,480 3,480
8,120 8,120 8,120 8,120 8,120 8,120
Page 80 of 111
Q89.4 Q89.7 Q89.8 Q89.9 I80.0 I80.1 I80.2 I80.3 I80.8 I80.9 I81 I82.0 I82.1 I82.2 I82.3 I82.8 I82.9 E15 E16.0
DESCRIPTION
Conjoined twins; Craniopagus; Dicephaly; Double monster; Pygopagus; Thoracopagus Multiple congenital malformations, not elsewhere classified; Monster NOS; Multiple congenital anomalies NOS; Multiple congenital deformities NOS Other specified congenital malformations Congenital malformation, unspecified; Congenital anomaly NOS; Congenital deformity NOS Phlebitis and thrombophlebitis of superficial vessels of lower extremities Phlebitis and thrombophlebitis of femoral vein Phlebitis and thrombophlebitis of other deep vessels of lower extremities; Deep vein thrombosis NOS Phlebitis and thrombophlebitis of lower extremities, unspecified; Embolism or thrombosis of lower extermity NOS Phlebitis and thrombophlebitis of other sites Phlebitis and thrombophlebitis of unspecified site Portal vein thrombosis; Portal (vein) obstruction Budd-Chiari syndrome Thrombophlebitis migrans Embolism and thrombosis of vena cava Embolism and thrombosis of renal vein Embolism and thrombosis of other specified veins Embolism and thrombosis of unspecified vein Nondiabetic hypoglycaemic coma; Nondiabetic hypoglycaemic coma; Drug-induced insulin coma in nondiabetic; Hyperinsulinism with hypoglycaemic coma; Hypoglycaemic coma NOS Drug-induced hypoglycaemia without coma Other hypoglycaemia; Functional nonhyperinsulinaemic hypoglycaemia; Hyperinsulinism NOS; Functional Hyperinsulinism; Hyperplasia of pancreatic islet beta cells NOS; Posthypoglycaemic coma encephalopathy Increased secretion of glucagon; Hyperplasia of pancreatic endocrine cells with glucagon excess; Hyperplasia of pancreatic endocrine cells with glucagon excess Abnormal secretion of gastrin; Hypergastrinaemia Other specified disorders of pancreatic internal secretion; Increased secretion from endocrine pancreas of growth hormone-releasing hormone; Increased secretion from endocrine pancreas of pancreatic polypeptide; Increased secretion from endocrine pancrea
GROUP
OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF GLUCOSE REGULATION OTHER DISORDERS OF GLUCOSE REGULATION
Case Rate 11,600 11,600 11,600 11,600 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 12,400 8,100 8,100
Professional Fee 3,480 3,480 3,480 3,480 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 3,720 2,430 2,430
Health Care Institution Fee 8,120 8,120 8,120 8,120 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 8,680 5,670 5,670
E16.1
OTHER DISORDERS OF GLUCOSE REGULATION
8,100
2,430
5,670
E16.3 E16.4
OTHER DISORDERS OF GLUCOSE REGULATION OTHER DISORDERS OF GLUCOSE REGULATION
8,100 8,100
2,430 2,430
5,670 5,670
E16.8
OTHER DISORDERS OF GLUCOSE REGULATION
8,100
2,430
5,670
E16.9 N82.0 N83.0 N83.3 N83.6 N83.7 N85.7 N89.7 Q51.2 Q51.3 Q51.8 Q52.1 Q52.2 Q52.3 Q52.8 N47
Disorder of pancreatic internal secretion, unspecified; Isletcell hyperplasia NOS; Pancreatic endocrine cell hyperplasia OTHER DISORDERS OF GLUCOSE REGULATION NOS OTHER DISORDERS OF THE FEMALE GENITAL Vesicovaginal fistula TRACT Follicular cyst of ovary; Cyst of graafian follicle; OTHER DISORDERS OF THE FEMALE GENITAL Haemorrhagic follicular cyst of ovary TRACT OTHER DISORDERS OF THE FEMALE GENITAL Acquired atrophy of ovary and fallopian tube TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematosalpinx TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematoma of broad ligament TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematometra; Haematosalpinx with haematometra TRACT Haematocolpos; Haematocolpos with haematometra or OTHER DISORDERS OF THE FEMALE GENITAL haematosalpinx TRACT OTHER DISORDERS OF THE FEMALE GENITAL Other doubling of uterus' Doubling of uterus NOS TRACT OTHER DISORDERS OF THE FEMALE GENITAL Bicornate uterus TRACT Other congenital malformations of uterus and cervix; OTHER DISORDERS OF THE FEMALE GENITAL Hypoplasia of uterus and cervix TRACT OTHER DISORDERS OF THE FEMALE GENITAL Doubling of vagina; Septate vagina TRACT OTHER DISORDERS OF THE FEMALE GENITAL Congenital rectovaginal fistula TRACT OTHER DISORDERS OF THE FEMALE GENITAL Imperforate hymen TRACT Other specified congenital malformations of female OTHER DISORDERS OF THE FEMALE GENITAL genitalia TRACT Redundant prepuce, phimosis and paraphimosis; Adherent OTHER DISORDERS OF THE MALE GENITAL TRACT prepuce; Tight foreskin Other specified disorders of penis; Atrophyof corpus cavernosum and penis ; Hypertrophy of corpus cavernosum OTHER DISORDERS OF THE MALE GENITAL TRACT and penis ; Thrombosis of corpus cavernosum and penis
8,100 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 6,400
2,430 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 1,920
5,670 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 4,480
N48.8
6,400
1,920
4,480
Page 81 of 111
N50.0 Atrophy of testis Vascular disorders of male genital organs; Haematocele of male genital organs NOS; Haemorrhage of male genital organs;, Thrombosis of male genital organs
DESCRIPTION
GROUP
OTHER DISORDERS OF THE MALE GENITAL TRACT
Case Rate 6,400
N50.1
6,400
1,920
4,480
N50.8
Other specified disorders of male genital organs; Atrophy of scrotum, seminal vesicle, spermatic cord, testis [except atrophy], tunica vaginalis and vas deferens; Hypertrophy of OTHER DISORDERS OF THE MALE GENITAL TRACT scrotum, seminal vesicle, spermatic cord, testis [except atrophy], tunica vag Absence and aplasia of testis; Monorchism Hypoplasia of testis and scrotum; Fusion of testes Other congenital malformations of testis and scrotum; Congenital malformation of testis or scrotum NOS; Polyorchism; Retractile testis; Testis migrans Other congenital malformations of vas deferens, epididymis, seminal vesicles and prostate; Absence or aplasia of prostate; Absence or aplasia of spermatic cord; Congenital malformation of vas deferens, epididymis, seminal vesicles or prostate NOS Other congenital malformations of penis; Congenital malformation of penis NOS; Curvature of penis (lateral); Hypoplasia of penis OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE MALE GENITAL TRACT
6,400
1,920
4,480
Q55.0 Q55.1
6,400 6,400
1,920 1,920
4,480 4,480
Q55.2
6,400
1,920
4,480
Q55.4
6,400
1,920
4,480
Q55.6
6,400
1,920
4,480
Q55.9
Congenital malformation of male genital organ, unspecified; Congenital anomalyNOS of male genital organ OTHER DISORDERS OF THE MALE GENITAL TRACT ; Congenital deformity NOS of male genital organ Male pseudohermaphroditism, not elsewhere classified; Male pseudohermaphroditism NOS Pseudohermaphroditism, unspecified Idiopathic peripheral autonomic neuropathy; Carotid sinus syncope Familial dysautonomia [Riley-Day] Horner's syndrome; Bernard(-Horner) syndrome Multi-system degeneration; Neurogenic orthostatic hypotension [Shy-Drager] Autonomic dysreflexia Disorder of autonomic nervous system, unspecified; acquired hydrocephalus OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM
6,400
1,920
4,480
Q56.1 Q56.3 G90.0 G90.1 G90.2 G90.3 G90.4 G90.9 G93.0 G93.2 G93.3 G93.4 G93.7 G93.8 G93.9 G94.8* G95.0
6,400 6,400 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800
1,920 1,920 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740
4,480 4,480 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060
Cerebral cysts; Arachnoid cyst; Porencephalic cyst, acquired OTHER DISORDERS OF THE NERVOUS SYSTEM Benign intracranial hypertension Postviral fatigue syndrome; Benign myalgic encephalomyelitis Encephalopathy, unspecified Reye's syndrome Other specified disorders of brain Disorder of brain, unspecified OTHER SPECIFIED DISORDERS OF BRAIN IN DISEASES CLASSIFIED ELSEWHERE Syringomyelia and syringobulbia Vascular myelopathies; Acute infarction of spinal cord (embolic)(nonembolic); Arterial thrombosis of spinal cord; Haematomyelia; Nonpyogenic intraspinal phlebitis and thrombophlebitis; Oedema of spinal cord; Subacute necrotic myelopathy Cord compression, unspecified Other specified diseases of spinal cord; Cord bladder NOS; elopathy drug-induced; Myelopathy radiation-induced Disease of spinal cord, unspecified; Myelopathy NOS Cerebrospinal fluid leak Disorders of meninges, not elsewhere classified; Cerebral Meningeal adhesions; Spinal Meningeal adhesions Other specified disorders of central nervous system Disorder of central nervous system, unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM
G95.1
OTHER DISORDERS OF THE NERVOUS SYSTEM
15,800
4,740
11,060
G95.2 G95.8 G95.9 G96.0 G96.1 G96.8 G96.9 G98 P90 P91.1 P91.2 P94.1 P94.2 P94.9
OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM
15,800 15,800 15,800 15,800 15,800 15,800 15,800 15,800 12,000 12,000 12,000 12,000 12,000 12,000
4,740 4,740 4,740 4,740 4,740 4,740 4,740 4,740 3,600 3,600 3,600 3,600 3,600 3,600
11,060 11,060 11,060 11,060 11,060 11,060 11,060 11,060 8,400 8,400 8,400 8,400 8,400 8,400
OTHER DISORDERS OF NERVOUS SYSTEM, NOT ELSEWHERE OTHER DISORDERS OF THE NERVOUS SYSTEM CLASSIFIED; NERVOUS SYSTEM DISORDER NOS Convulsions of newborn Acquired periventricular cysts of newborn Neonatal cerebral leukomalacia Congenital hypertonia Congenital hypotonia; Nonspecific floppy baby syndrome Disorder of muscle tone of newborn, unspecified OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN
Page 82 of 111
P96.5 P96.8 P96.9 E06.0 E06.1 E06.2 E06.3
DESCRIPTION
Complications of intrauterine procedures, not elsewhere classified Other specified conditions originating in the perinatal period Condition originating in the perinatal period, unspecified; Congenital debility NOS Acute thyroiditis; Abscess of thyroid; Pyogenic Thyroiditis; Suppurative Thyroiditis Subacute thyroiditis; de Quervain Thyroiditis; Giant-Cell Thyroiditis; Granulomatous Thyroiditis; Nonsuppurative Thyroiditis Chronic thyroiditis with transient thyrotoxicosis Autoimmune thyroiditis; Hashimoto's thyroiditis ; Transient hashitoxicosis; Lymphadenoid goitre; lymphocytic thyroiditis; Struma lymphomatosa
GROUP
OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID
Case Rate 12,000 12,000 12,000 8,500 8,500 8,500 8,500
Professional Fee 3,600 3,600 3,600 2,550 2,550 2,550 2,550
Health Care Institution Fee 8,400 8,400 8,400 5,950 5,950 5,950 5,950
E06.5 E06.9 E07.0 E07.1 E07.8 E25.9 E28.8 E29.1 E29.9 E31.0 E31.1 E31.9 E32.0 E32.8 E32.9 E34.0 E34.8 E34.9 N25.0
Other chronic thyroiditis; Chronic Thyroiditis NOS; Chronic OTHER DISORDERS OF THE THYROID Fibrous Thyroiditis; Ligneous Thyroiditis; Riedel Thyroiditis Thyroiditis, unspecified OTHER DISORDERS OF THE THYROID Hypersecretion of calcitonin; C-cell hyperplasia of thyroid; OTHER DISORDERS OF THE THYROID Hypersecretion of thyrocalcitonin Dyshormogenetic goitre; Familial dyshormogenetic goitre; OTHER DISORDERS OF THE THYROID Pendred's syndrome Other specified disorders of thyroid; Abnormality of thyroidOTHER DISORDERS OF THE THYROID binding globulin; Haemorrhage of thyroid; Infarction of thyroid; Sick-euthyroid syndrome Adrenogenital disorder, unspecified; Adrenogenital OTHER ENDOCRINE DISORDERS syndrome NOS Other ovarian dysfunction OTHER ENDOCRINE DISORDERS Testicular hypofunction; Defective biosynthesis of testicular androgen NOS; 5-a-Reductase deficiency (with male OTHER ENDOCRINE DISORDERS pseudohermaphroditism); Testicular hypogonadism NOS Testicular dysfunction, unspecified Autoimmune polyglandular failure Polyglandular hyperfunction Polyglandular dysfunction, unspecified Persistent hyperplasia of thymus; Hypertrophy of thymus Other diseases of thymus Disease of thymus, unspecified Carcinoid syndrome Other specified endocrine disorders; Pineal gland dysfunction; Progeria Endocrine disorder, unspecified; Endocrine Disturbance NOS; Hormone Disturbance NOS Renal osteodystrophy; Azotaemic osteodystrophy; Phosphate-losing tubular disorders; Renal rickets; Renal short stature Other disorders resulting from impaired renal tubular function; Lightwood-Albright syndrome; Renal tubular acidosis NOS; Secondary hyperparathyroidism of renal origin Disorder resulting from impaired renal tubular function, unspecified Cyst of kidney, acquired; Multiple cyst of kidney, acquired; Solitary cyst of kidney, acquired Pleural plaque without asbestos; Pleural plaque NOS; Pleural thickening Chylous effusion; Chyliform effusion Fibrothorax Other specified pleural conditions; Hydrothorax Pleural condition, unspecified Diseases of bronchus, not elsewhere classified; Broncholithiasis; Calcification of bronchus; Stenosis of bronchus; Ulcer of bronchus; Tracheobronchial collapse; Tracheobronchial dyskinesia Other disorders of lung; Calcification of lung; Acquired cystic lung disease; Lung disease NOS; Pulmolithiasis OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER NEPHROPATHY
8,500 8,500 8,500 8,500 8,500 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 9,500
2,550 2,550 2,550 2,550 2,550 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 2,850
5,950 5,950 5,950 5,950 5,950 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 6,650
N25.8
OTHER NEPHROPATHY
9,500
2,850
6,650
N25.9 N28.1 J92.9 J94.0 J94.1 J94.8 J94.9 J98.0
OTHER NEPHROPATHY OTHER NEPHROPATHY OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER RESPIRATORY DISORDERS
9,500 9,500 13,500 13,500 13,500 13,500 13,500 10,200
2,850 2,850 4,050 4,050 4,050 4,050 4,050 3,060
6,650 6,650 9,450 9,450 9,450 9,450 9,450 7,140
J98.4
OTHER RESPIRATORY DISORDERS
10,200
3,060
7,140
J98.5
Diseases of mediastinum, not elsewhere classified; Fibrosis of mediastinum; Hernia of mediastinum; Retraction of OTHER RESPIRATORY DISORDERS mediastinum; Mediastinitis of mediastinum Disorders of diaphragm; Diaphragmatitis; Paralysis of diaphragm; Relaxation of diaphragm Other specified respiratory disorders Respiratory disorder, unspecified; Chronic respiratory disease NOS Yaws, unspecified Intermediate lesions of pinta; Erythematous plaques of carate pinta; Hyperchromic lesions of carate pinta; Hyperkeratosis of carate pinta; Pintids of carate pinta Relapsing fever, unspecified OTHER RESPIRATORY DISORDERS OTHER RESPIRATORY DISORDERS OTHER RESPIRATORY DISORDERS OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES
10,200
3,060
7,140
J98.6 J98.8 J98.9 A66.9 A67.1 A68.9
10,200 10,200 10,200 8,800 8,800 8,800
3,060 3,060 3,060 2,640 2,640 2,640
7,140 7,140 7,140 6,160 6,160 6,160
Page 83 of 111
Necrotizing ulcerative stomatitis; Cancrum oris; Fusospirochaetal gangrene; Noma; Stomatitis gangrenosa Other Vincent's infections; Fusospirochaetal pharyngitis ; Acute Necrotizing Ulcerative gingivitis; Acute Necrotizing Ulcerative Gingivostomatitis; Spirochaetal stomatitis, Trench mouth; Vincent's angina; Vincents gingivitis Lyme disease; Erythema chronicum migrans due to Borrelia burgdorferi Spirochaetal infection, unspecified Acute serous otitis media; Acute and subacute secretory otitis media Other acute nonsuppurative otitis media; Acute otitis media; S ubacute otitis media; Acute Mucoid allergic otitis media; Subacute mucoid allergic otitis media; Acute allergic Sanguinous otitis media; Subacute Sanguinous allergic otitis media; Acute a Chronic mucoid otitis media; Glue ear; Otitis media, chronic mucinous; Otitis media, chronic secretory; Otitis media, chronic transudative Other chronic nonsuppurative otitis media; Otitis media, chronic allergic; Otitis media, chronic exudative; Otitis media, chronic nonsuppurative NOS; Otitis media, chronic seromucinous; Otitis media, chronic with effusion (nonpurulent) Nonsuppurative otitis media, unspecified; Allergic Otitis media ; Catarrhal Otitis media; Exudative Otitis media ; Mucoid Otitis media ; Secretory Otitis media ; Seromucinous otitis media; Serous Otitis media; Transudative Otitis media; Otitis media with Acute suppurative otitis media Chronic tubotympanic suppurative otitis media; Benign chronic suppurative otitis media; Chronic tubotympanic disease Chronic atticoantral suppurative otitis media; Chronic atticoantral disease Other chronic suppurative otitis media; Chronic suppurative otitis media NOS Suppurative otitis media, unspecified; Purulent otitis media NOS Otitis media, unspecified; Otitis media NOS; Acute Otitis media NOS; Chronic Otitis media NOS Corpus luteum cyst; Haemorrhagic corpus luteum cyst Other and unspecified ovarian cysts; Retention of ovary; Simple cyst of ovary Acute salpingitis and oophoritis Chronic salpingitis and oophoritis; Hydrosalpinx Salpingitis and oophoritis, unspecified Acute inflammatory disease of uterus Chronic inflammatory disease of uterus Inflammatory disease of uterus, unspecified Inflammatory disease of cervix uteri; Cervicitis with or without erosion or ectropion; Endocervicitis with or without erosion or ectropion; Exocervicitis with or without erosion or ectropion Acute parametritis and pelvic cellulitis; Acute abcess of broad ligament; Acute abscess of parametrium; Acute pelvic cellulitis, female Chronic parametritis and pelvic cellulitis Unspecified parametritis and pelvic cellulitis Female acute pelvic peritonitis Female chronic pelvic peritonitis Female pelvic peritonitis, unspecified Female pelvic peritoneal adhesions Other specified female pelvic inflammatory diseases Female pelvic inflammatory disease, unspecified; Female pelvic infection or inflammation NOS Female pelvic inflammatory disorders in other diseases classified elsewhere Genital tract and pelvic infection following abortion and ectopic and molar pregnancy; Endometritis; Oophoritis; Parametritis; Pelvic peritonitis; Salpingitis; Salpingooophoritis; Sepsis; Septic shock; Septicaemia Mittelschmerz Dyspareunia Vaginismus Premenstrual tension syndrome Primary dysmenorrhoea Secondary dysmenorrhoea Dysmenorrhoea, unspecified
GROUP
Case Rate 8,800
A69.0
OTHER SPIROCHAETAL DISEASES
A69.1
OTHER SPIROCHAETAL DISEASES
8,800
2,640
6,160
A69.2 A69.9 H65.0
OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES OTITIS MEDIA
8,800 8,800 7,800
2,640 2,640 2,340
6,160 6,160 5,460
H65.1
OTITIS MEDIA
7,800
2,340
5,460
H65.2 H65.3
Chronic serous otitis media; Chronic tubotympanal catarrh OTITIS MEDIA OTITIS MEDIA
7,800 7,800
2,340 2,340
5,460 5,460
H65.4
OTITIS MEDIA
7,800
2,340
5,460
H65.9
OTITIS MEDIA
7,800
2,340
5,460
H66.0 H66.1 H66.2 H66.3 H66.4 H66.9 N83.1 N83.2 N70.0 N70.1 N70.9 N71.0 N71.1 N71.9 N72
OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OVARIAN CYSTS OVARIAN CYSTS PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES
7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,900 9,000 9,000 9,000 9,000 9,000 9,000 9,000
2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,370 2,700 2,700 2,700 2,700 2,700 2,700 2,700
5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,530 6,300 6,300 6,300 6,300 6,300 6,300 6,300
N73.0 N73.1 N73.2 N73.3 N73.4 N73.5 N73.6 N73.8 N73.9 N74.8*
PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES
9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000 9,000
2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700 2,700
6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300 6,300
O08.0
PELVIC INFLAMMATORY DISEASES
9,000
2,700
6,300
N94.0 N94.1 N94.2 N94.3 N94.4 N94.5 N94.6
PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN
4,800 4,800 4,800 4,800 4,800 4,800 4,800
1,440 1,440 1,440 1,440 1,440 1,440 1,440
3,360 3,360 3,360 3,360 3,360 3,360 3,360
Page 84 of 111
Gastric ulcer, acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with hemorrhage Gastric ulcer, acute/ Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with perforation Gastric ulcer, acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with both haemorrhage and perforation Gastric/ Peptic/ Pyloric ulcer/ erosion, chronic or unspecified with haemorrhage Gastric/ Peptic/ Pyloric ulcer/ erosion, chronic or unspecified with perforation Gastric/ Peptic/ Pyloric ulcer/ erosion, chronic or unspecified with both haemorrhage and perforation Duodenal ulcer, acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer with haemorrhage Duodenal ulcer, acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer with perforation Chronic Duodenal/ Postpyloric ulcer/ erosion, or unspecified with haemorrhage Chronic Duodenal/ Postpyloric ulcer/ erosion, or unspecified with perforation Chronic Duodenal/ Postpyloric ulcer/ erosion, or unspecified with both haemorrhage and perforation Acute Peptic ulcer/ Gastroduodenal ulcer NOS, site unspecified, with haemorrhage Acute Peptic ulcer / Gastroduodenal ulcer, site unspecified, with perforation Acute Peptic/ Gastroduodenal ulcer, site unspecified, with both haemorrhage and perforation Chronic or unspecified Peptic/ Gastroduodenal ulcer, site unspecified, with haemorrhage Chronic or unspecified Peptic/ Gastroduodenal ulcer, site unspecified with perforation Chronic or unspecified Peptic/ Gastroduodenal ulcer, site unspecified, with both haemorrhage and perforation Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal
GROUP
Case Rate 12,800
K25.0
PEPTIC ULCER DISEASE WITH HEMORRHAGE
K25.1
12,800
3,840
8,960
K25.2 K25.4 K25.5 K25.6 K26.0
PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE
12,800 12,800 12,800 12,800 12,800
3,840 3,840 3,840 3,840 3,840
8,960 8,960 8,960 8,960 8,960
K26.1 K26.4 K26.5 K26.6 K27.0 K27.1 K27.2 K27.4 K27.5 K27.6
PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE
12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800
3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840
8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960
K28.0
12,800
3,840
8,960
K28.1
12,800
3,840
8,960
K28.2
12,800
3,840
8,960
K28.3
12,800
3,840
8,960
K28.4
Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Acute haemorrhagic gastritis; Acute erosive gastritis with haemorrhage PEPTIC ULCER DISEASE WITH HEMORRHAGE
12,800
3,840
8,960
K28.5
12,800
3,840
8,960
K28.6
12,800
3,840
8,960
K29.0
12,800
3,840
8,960
Page 85 of 111
Gastric ulcer, acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer without haemorrhage or perforation Gastric/ Peptic/ Pyloric ulcer/ erosion, chronic without haemorrhage or perforation Gastric/ Peptic/ Pyloric ulcer/ erosion, unspecified as acute or chronic, without haemorrhage or perforation Duodenal ulcer, acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer without haemorrhage or perforation Chronic Duodenal/ Postpyloric ulcer/ erosion, without haemorrhage or perforation Duodenal/ Postpyloric ulcer/ erosion, unspecified as acute or chronic, without haemorrhage or perforation Acute Peptic/ Gastroduodenal ulcer, site unspecified, without haemorrhage or perforation Chronic Peptic/ Gastroduodenal ulcer, site unspecified, without haemorrhage or perforation Peptic/ Gastroduodenal ulcer, unspecified as acute or chronic, without haemorrhage or perforation Chronic Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stom Unspecified as acute or chronic Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal pepti Other acute gastritis Alcoholic gastritis Chronic superficial gastritis Chronic atrophic gastritis; Gastric atrophy
GROUP
Case Rate 6,100 6,100 6,100 6,100 6,100 6,100 6,100 6,100 6,100
Professional Fee 1,830 1,830 1,830 1,830 1,830 1,830 1,830 1,830 1,830
Health Care Institution Fee 4,270 4,270 4,270 4,270 4,270 4,270 4,270 4,270 4,270
K25.3 K25.7 K25.9 K26.3 K26.7 K26.9 K27.3 K27.7 K27.9
PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE
K28.7
PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE
6,100
1,830
4,270
K28.9
PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE
6,100
1,830
4,270
K29.1 K29.2 K29.3 K29.4 K29.5 K29.6 K29.7 K29.8 K29.9 P23.0 P23.1 P23.2 P23.3 P23.4 P23.5 P23.6 P23.9 P35.0 P35.1 P35.2 P35.3 P35.8 P35.9 P37.0 P37.1 P37.3 P37.5 P37.8 P37.9 P38 P39.0 P39.1 P39.2
PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE
6,100 6,100 6,100 6,100 6,100 6,100 6,100 6,100 6,100 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700 12,700
1,830 1,830 1,830 1,830 1,830 1,830 1,830 1,830 1,830 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810 3,810
4,270 4,270 4,270 4,270 4,270 4,270 4,270 4,270 4,270 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890 8,890
Chronic gastritis, unspecified; Chronic Antral gastritis; PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE Chronic Fundal gastritis Other gastritis; Giant hypertrophic gastritis; Granulomatous PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE gastritis; Menetrier's disease Gastritis, unspecified Duodenitis Gastroduodenitis, unspecified Congenital pneumonia due to viral agent Congenital pneumonia due to Chlamydia Congenital pneumonia due to staphylococcus Congenital pneumonia due to streptococcus, group B Congenital pneumonia due to Escherichia coli Congenital pneumonia due to Pseudomonas Congenital pneumonia due to other bacterial agents; Haemophilus influenzae; Klebsiella pneumonia; Mycoplasma; Streptococcus, except group B Congenital pneumonia Congenital rubella syndrome; Congenital rubella pneumonitis Congenital cytomegalovirus infection Congenital herpesviral [herpes simplex] infection Congenital viral hepatitis Other congenital viral diseases; Congenital varicella [chickenpox] Congenital viral disease, unspecified Congenital tuberculosis Congenital toxoplasmosis; Hydrocephalus due to congenital toxoplasmosis Congenital falciparum malaria Neonatal candidiasis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS
Other specified congenital infectious and parasitic diseases PERINATAL INFECTIONS Congenital infectious and parasitic disease, unspecified Omphalitis of newborn with or without mild haemorrhage Neonatal infective mastitis Neonatal conjunctivitis and dacryocystitis; Neonatal chlaydial conjunctivitis; Ophthalmia neonatorum NOS Intra-amniotic infection of fetus, not elsewhere classified PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS
Page 86 of 111
P39.3 P39.4 P39.8 P39.9
DESCRIPTION
Neonatal urinary tract infection Neonatal skin infection; Neonatal pyoderma Other specified infections specific to the perinatal period Infection specific to the perinatal period, unspecified
GROUP
PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS
Case Rate 12,700 12,700 12,700 12,700
K66.0
Peritoneal adhesions; Adhesions of abdominal wall; Adhesions of diaphragm; Adhesions of intestine; Adhesions PERITONEAL DISORDERS of male pelvis; MesentericAdhesions; Adhesions of omentum; Adhesions of stomach; Adhesive bands Other specified disorders of peritoneum Disorder of peritoneum, unspecified PERITONEAL DISORDERS PERITONEAL DISORDERS
10,800
3,240
7,560
K66.8 K66.9
10,800 10,800
3,240 3,240
7,560 7,560
K65.0
Acute peritonitis; Abdominopelvic abscess; Mesenteric abscess; Abscess of omentum; Abscess of peritoneum; Retrocaecal abscess; Retroperitoneal abscess; PERITONITIS Subdiaphragmatic abscess; Subhepatic abscess; Subphrenic abscess; Acute Generalized peritonitis; Acute Other peritonitis; Chronic proliferative peritonitis; Mesentric fat necrosis; Mesentric saponification; Peritonitis due to bile; Peritonitis due to urine Peritonitis, unspecified Other phakomatoses, not elsewhere classified; PeutzJeghers Syndrome; Sturge-Weber(-Dimitri)Syndrome; von Hippel-Lindau Syndrome Phakomatosis, unspecified; Hamartosis NOS Pleural effusion, not elsewhere classified; Pleurisy with effusion Pleural effusion in conditions classified elsewhere HIV DISEASE RESULTING IN PNEUMOCYSTIS CARINII PNEUMONIA Adenoviral pneumonia, high risk Respiratory syncytial virus pneumonia, high risk Parainfluenza virus pneumonia, high risk Human metapneumovirus pneumonia, high risk Viral pneumonia, high risk Pneumonia [bronchopneumonia]due to Streptococcus pneumoniae, high risk Pneumonia [bronchopneumonia] due to Haemophilus influenzae, high risk Pneumonia due to Klebsiella pneumoniae, high risk Pneumonia due to Pseudomonas, high risk Pneumonia due to staphylococcus, high risk Pneumonia due to streptococcus, group B, high risk Pneumonia due to other streptococci, high risk Pneumonia due to Escherichia coli, high risk Pneumonia due to other aerobic Gram-negative bacteria; Pneumonia due to Serratia marcescens, high risk Pneumonia due to Mycoplasma pneumoniae, high risk Bacterial pneumonia [bronchopneumonia], high risk Chlamydial pneumonia, high risk Bronchopneumonia, high risk Lobar pneumonia, high risk Hypostatic pneumonia, high risk Community-acquired pneumonia IV (This classification utilized the American Thoracic Society recommendation. This is equivalent to CAP, high risk in the Philippine Clinical Practice Guidelines on the Diagnosis, Empiric Management, and Prevention of Communityacquired Pneumonia in Immunocompetent Adults, 2010 update) Nosocomial pneumonia Pneumonia in typhoid fever Pneumonia in salmonella infection Pneumonia in tularemia Pneumonia in anthrax Pulmonary mycobacterial infection; Infection due to Mycobacterium avium, Mycobacterium intracellulare [Battey bacillus]; Mycobacterium kansasii Pneumonia in whooping cough due to Bordatella pertusis Pneumonia in whooping cough due to Bordatella parapertusis Pneumonia in whooping cough due to Bordatella species other than pertusis or parapertusis Pneumonia in whooping cough Pneumonia in actinomycoses Legionnaires' disease Pneumonia in nocardiosis Pneumonia in gonorrhea Pneumonia in spirochaetal Pneumonia in ornithosis PERITONITIS PERITONITIS PHAKOMATOSES PHAKOMATOSES PLEURAL EFFUSION PLEURAL EFFUSION PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK
14,700
4,410
10,290
K65.8 K65.9 Q85.8 Q85.9 J90 J91* B20.6 J12.03 J12.13 J12.23 J12.33 J12.93 J13.3 J14.3 J15.03 J15.13 J15.23 J15.33 J15.43 J15.53 J15.63 J15.73 J15.93 J16.03 J18.03 J18.13 J18.23
14,700 14,700 10,800 10,800 14,200 14,200 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000
4,410 4,410 3,240 3,240 4,260 4,260 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600
10,290 10,290 7,560 7,560 9,940 9,940 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400
J18.93
PNEUMONIA HIGH RISK
32,000
9,600
22,400
J18.99, Y95 A01.0+ J17.0* A02.2+ J17.0* A21.2+ J17.0* A22.1+ J17.0* A31.0 A37.0+ J17.0* A37.1+ J17.0* A37.8+ J17.0* A37.9+ J17.0* A42.0+ J17.0* A48.1 A53.0+ J17.0* A54.8+ J17.0* A69.8+ J17.8* A70+ J17.8*
PNEUMONIA HIGH RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE
RISK RISK RISK RISK
32,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000
9,600 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500
22,400 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500
PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK
Page 87 of 111
A78+ J17.8* B01.2+ J17.1* B05.2+ J17.1* B06.8+ J17.1* B25.0+ J17.1* B37.1+ J17.2* B38.0+ J17.2* B38.1+ J17.2* B38.2+ J17.2* B39.0+ J17.2* B39.1+ J17.2* B39.2+ J17.2* B39.9+ J17.2* B44.0+ J17.2* B44.1+ J17.2* B58.3+ J17.3* B65.0+ J17.3* B65.1+ J17.3* B65.2+ J17.3* B65.8+ J17.3* B65.9+ J17.3* B77.8+ J17.3* I00+ J17.8* J12.02 J12.12 J12.22 J12.32 J12.92 J13.2 J14.2 J15.02 J15.12 J15.22 J15.32 J15.42 J15.52 J15.62 J15.72 J15.92 J16.02 J18.02 J18.12 J18.22
DESCRIPTION
Pneumonia in Q fever Pneumonia in varicella Pneumonia in measles Pneumonia in rubella Pneumonia in cytomegalovirus disease Pneumonia in candidiasis Pneumonia in acute pulmonary coccidiomycosis Pneumonia in chronic pulmonary coccidiomycosis Pneumonia in pulmonary coccidioidomycosis Pneumonia in acute pulmonary histoplasmosis capsulati Pneumonia in chronic pulmonary histoplasmosis capsulati Pneumonia in pulmonary histoplasmosis capsulati Pneumonia in histoplasmosis Pneumonia in invasive pulmonary aspergillosis Pneumonia in other pulmonary aspergillosis Pneumonia in taxoplasmosis Pneumonia in schistosomiasis due to Schistosoma hematobium
GROUP
PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK RISK RISK
Case Rate 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000
Professional Fee 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500
Health Care Institution Fee 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500
PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK
PNEUMONIA MODERATE RISK
Pneumonia in schistosomiasis due to Schistosoma mansoni PNEUMONIA MODERATE RISK Pneumonia in schistosomiasis due to Schistosoma japonicum Pneumonia in schistosomiasis due to Schistosoma intercalatum; mattheei; mekongi Pneumonia in schistosomiasis Pneumonia in ascariasis Pneumonia in rheumatic fever Adenoviral pneumonia, moderate risk Respiratory syncytial virus pneumonia, moderate risk Parainfluenza virus pneumonia, moderate risk Human metapneumovirus pneumonia, moderate risk Viral pneumonia, moderate risk Pneumonia [bronchopneumonia] due to Streptococcus pneumoniae, moderate risk Pneumonia [bronchopneumonia]due to Haemophilus influenzae, moderate risk Pneumonia due to Klebsiella pneumoniae, moderate risk Pneumonia due to Pseudomonas, moderate risk Pneumonia due to staphylococcus, moderate risk Pneumonia due to streptococcus, group B, moderate risk Pneumonia due to other streptococci, moderate risk Pneumonia due to Escherichia coli, moderate risk Pneumonia due to other aerobic Gram-negative bacteria; Pneumonia due to Serratia marcescens, moderate risk Pneumonia due to Mycoplasma pneumoniae, moderate risk Bacterial pneumonia [bronchopneumonia], moderate risk Chlamydial pneumonia, moderate risk Bronchopneumonia, moderate risk Lobar pneumonia, moderate risk Hypostatic pneumonia, moderate risk Community-acquired pneumonia III (This classification utilized the American Thoracic Society recommendation. This is equivalent to CAP, moderate risk in the Philippine Clinical Practice Guidelines on the Diagnosis, Empiric Management, and Prevention of Community- acquired Pneumonia in Immunocompetent Adults, 2010 update) Spontaneous tension pneumothorax Other spontaneous pneumothorax Other pneumothorax Pneumothorax, unspecified Poisoning by Otheropioids; Poisoning by Codeine; Poisoning by Morphine Poisoning by Other synthetic narcotics; Poisoning by Pethidine Poisoning by Other and unspecified narcotics Poisoning by Cannabis (derivatives) Poisoning by Other and unspecified psychodysleptics [hallucinogens]; Poisoning by Mescaline; Poisoning by Psilocin; Poisoning by Psilocybine Poisoning by Inhaled anaesthetics Poisoning by Intravenous anaesthetics; Thiobarbiturates PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK RISK
PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK
J18.92
PNEUMONIA MODERATE RISK
15,000
4,500
10,500
J93.0 J93.1 J93.8 J93.9 T40.2 T40.4 T40.6 T40.7 T40.9 T41.0 T41.1
PNEUMOTHORAX PNEUMOTHORAX PNEUMOTHORAX PNEUMOTHORAX POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
15,300 15,300 15,300 15,300 6,700 6,700 6,700 6,700 6,700 6,700 6,700
4,590 4,590 4,590 4,590 2,010 2,010 2,010 2,010 2,010 2,010 2,010
10,710 10,710 10,710 10,710 4,690 4,690 4,690 4,690 4,690 4,690 4,690
Page 88 of 111
T41.3 T41.5 T42.0 T42.1 T42.2 T42.3 T42.4 T42.6
DESCRIPTION
Poisoning by Local anaesthetics Poisoning by Therapeutic gases; Carbon dioxide; Oxygen Poisoning by Hydantoin derivatives Poisoning by Iminostilbenes; Carbamazepine Poisoning by Succinimides and oxazolidinediones Poisoning by Barbiturates Poisoning by Benzodiazepines Poisoning by Other antiepileptic and sedativehypnoticdrugs; Poisoning by Methaqualone;Poisoning by Valproic acid
GROUP
POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
Case Rate 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700
T42.7
Poisoning by Antiepileptic and sedative-hypnotic drugs, POISONING CAUSED BY ANESTHETICS AND DRUGS unspecified; Poisoning by Draught sleeping NOS; Poisoning AFFECTING THE NERVOUS SYSTEM by Sleeping drug NOS;Poisoning by Sleeping tablet NOS Poisoning by Antiparkinsonism drugs and other central muscle-tone depressants; Poisoning by Amantadine Poisoning by Other and unspecified antidepressants POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
6,700
2,010
4,690
T42.8 T43.2 T43.3 T43.4 T43.5 T43.6 T43.9 T44.1 T44.2
6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700
2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010
4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690
POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Phenothiazine antipsychotics and neuroleptics AFFECTING THE NERVOUS SYSTEM Poisoning by Butyrophenone and thioxanthene POISONING CAUSED BY ANESTHETICS AND DRUGS neuroleptics AFFECTING THE NERVOUS SYSTEM Poisoning by Other and unspecified antipsychotics and POISONING CAUSED BY ANESTHETICS AND DRUGS neuroleptics AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Psychostimulants with abuse potential AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Psychotropic drug, unspecified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Other parasympathomimetics [cholinergics] AFFECTING THE NERVOUS SYSTEM Poisoning by Ganglionic blocking drugs, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS classified AFFECTING THE NERVOUS SYSTEM Poisoning by Other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, not elsewhere classified; Poisoning byPapaverine Poisoning by Predominantly -adrenoreceptor agonists, not elsewhere classified; Poisoning by Metaraminol Poisoning by Predominantly -adrenoreceptor agonists, not elsewhere classified Poisoning by -Adrenoreceptor antagonists, not elsewhere classified Poisoning by -Adrenoreceptor antagonists, not elsewhere classified Poisoning by Other and unspecified drugs primarily affecting the autonomic nervous system; Drug stimulating both -and -adrenoreceptors Poisoning by Antiallergic and antiemetic drugs POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
T44.3
6,700
2,010
4,690
T44.4 T44.5 T44.6 T44.7 T44.9 T45.0 T45.1 T45.2 T45.3 T50.7 Y46.2
6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700
2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010
4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690
Y46.6
Y47.0
Y47.1
Y47.9
Poisoning by Antineoplastic and immunosuppressive drugs; POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Antineoplastic antibiotics; Poisoning by AFFECTING THE NERVOUS SYSTEM Cytarabine POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Vitamins, not elsewhere classified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Enzymes, not elsewhere classified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Analeptics and opioid receptor antagonists AFFECTING THE NERVOUS SYSTEM Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Hydantoin derivatives Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Other and unspecified antiepileptics Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Barbiturates, not elsewhere classified Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Benzodiazepines Drugs, medicaments and biological substances causing adverse effects in therapeutic POISONING CAUSED BY ANESTHETICS AND DRUGS use: Sedative, hypnotic and antianxiety drug, AFFECTING THE NERVOUS SYSTEM unspecified;sleeping draught NOS;sleeping drug NOS;sleeping tablet NOS
6,700
2,010
4,690
6,700
2,010
4,690
6,700
2,010
4,690
6,700
2,010
4,690
Page 89 of 111
Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other antipsychotics and neuroleptics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Psychodysleptics [hallucinogens] Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, not elsewhere classified;papaverine Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Beta-adrenoreceptor antagonists, not elsewhere classified Poisoning by Penicillins Poisoning by Cefalosporins and other -lactam antibiotics Poisoning by Chloramphenicol group Poisoning by Macrolides Poisoning by Tetracyclines Poisoning by Aminoglycosides; Streptomycin Poisoning by Rifamycins Poisoning by Other systemic antibiotics Poisoning by Systemic antibiotic, unspecified Poisoning by Sulfonamides Poisoning by Antimycobacterial drugs Poisoning by Antimalarials and drugs acting on other blood protozoa Poisoning by Anthelminthics Poisoning by Antiviral drugs Poisoning by Other specified systemic anti-infectives and antiparasitics; Poisoning by Hydroxyquinoline derivatives Poisoning by Systemic anti-infective and antiparasitic, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Penicillins Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Cefalosporins and other betalactam antibiotics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Chloramphenicol group Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Tetracyclines Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Rifamycins Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Other systemic antibiotics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Systemic antibiotic, unspecified Sulfonamides Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Antimycobacterial drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Antiviral drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Other specified systemic anti-infectives and antiparasitics; hydroxyquinoline derivatives Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic anti-infective and antiparasitic, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Local antifungal, anti-infective and anti-inflammatory drugs, not elsewhere classified Poisoning by Salicylates Poisoning by 4-Aminophenol derivatives Poisoning by Other nonsteroidal anti-inflammatory drugs [NSAID]
GROUP
POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
Case Rate 6,700
Y49.5
Y49.6
6,700
2,010
4,690
Y51.3
POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM
6,700
2,010
4,690
Y51.7 T36.0 T36.1 T36.2 T36.3 T36.4 T36.5 T36.6 T36.8 T36.9 T37.0 T37.1 T37.2 T37.4 T37.5 T37.8 T37.9 Y40.0
POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS
6,700 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300
2,010 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190
4,690 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110
Y40.1
POISONING CAUSED BY ANTIBIOTICS
7,300
2,190
5,110
Y40.2
7,300
2,190
5,110
Y40.4
7,300
2,190
5,110
Y40.6
7,300
2,190
5,110
Y40.8
7,300
2,190
5,110
Y40.9 Y41.0 Y41.1
POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS
7,300 7,300 7,300
2,190 2,190 2,190
5,110 5,110 5,110
Y41.5
7,300
2,190
5,110
Y41.8
7,300
2,190
5,110
Y41.9
7,300
2,190
5,110
Y56.0
POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS
7,300
2,190
5,110
T39.0 T39.1 T39.3
7,400 7,400 7,400
2,220 2,220 2,220
5,180 5,180 5,180
Page 90 of 111
T39.8 T39.9 Y45.8
DESCRIPTION
Poisoning by Other nonopioid analgesics and antipyretics, not elsewhere classified Poisoning by Nonopioid analgesic, antipyretic and antirheumatic, unspecified Other analgesics and antipyretics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Analgesic, antipyretic and anti-inflammatory drug, unspecified Poisoning by Cardiac-stimulant glycosides and drugs of similar action Poisoning by Calcium-channel blockers Poisoning by Other antidysrhythmic drugs, not elsewhere classified Poisoning by Coronary vasodilators, not elsewhere classified; Poisoning by Dipyridamole Poisoning by Other antihypertensive drugs, not elsewhere classified; Poisoning by Clonidine;Poisoning by Guanethidine; Poisoning by Rauwolfia Poisoning by Antihyperlipidaemic and antiarteriosclerotic drugs Poisoning by Peripheral vasodilators;Poisoning by Nicotimic acid (derivatives) Poisoning by Other and unspecified agents primarily affecting the cardiovascular system Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Cardiac-stimulant glycosides and drugs of similar action
GROUP
POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS
Case Rate 7,400 7,400 7,400
Y45.9
7,400
2,220
5,180
T46.0 T46.1 T46.2 T46.3
12,500 12,500 12,500 12,500
3,750 3,750 3,750 3,750
8,750 8,750 8,750 8,750
T46.5
POISONING CAUSED BY CARDIOVASCULAR DRUGS
12,500
3,750
8,750
T46.6 T46.7 T46.9
POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS
12,500 12,500 12,500
3,750 3,750 3,750
8,750 8,750 8,750
Y52.0
POISONING CAUSED BY CARDIOVASCULAR DRUGS
12,500
3,750
8,750
Y52.2
Drugs, medicaments and biological substances causing adverse effects in therapeutic POISONING CAUSED BY CARDIOVASCULAR DRUGS use: Other antidysrhythmic drugs, not elsewhere classified Poisoning by Antitussives Poisoning by Expectorants Poisoning by Anti-common-cold drugs Poisoning by Antiasthmatics, not elsewhere classified; adrenoreceptor agonists used in asthma theraphy; Poisoning by Salbutamol Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Antitussives Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Expectorants Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Antiasthmatics, not elsewhere classified: aminophylline, salbutamol, theobromine;theophylline Poisoning by Mineralocorticoids and their antagonists Poisoning by Loop [high-ceiling] diuretics Poisoning by Carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics;Poisoning by Acetazolamide Poisoning by Drugs affecting uric acid metabolism Poisoning by Other and unspecified drugs, medicaments and biological substances; Poisoning by Acidifying agents; Poisoning by Alkalizing agents; Poisoning by Immunoglobulin; Poisoning by Immunologicals; Poisoning by Lipotropic drugs; Poisoning by Parathy Poisoning by HistamineH2-receptor antagonists POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM
12,500
3,750
8,750
T48.3 T48.4 T48.5 T48.6
6,200 6,200 6,200 6,200
1,860 1,860 1,860 1,860
4,340 4,340 4,340 4,340
Y55.3
6,200
1,860
4,340
Y55.4
6,200
1,860
4,340
Y55.6
POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM
6,200
1,860
4,340
T50.0 T50.1 T50.2 T50.4
6,300 6,300 6,300 6,300
1,890 1,890 1,890 1,890
4,410 4,410 4,410 4,410
T50.9
POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM
6,300
1,890
4,410
T47.0 T47.1 T47.2 T47.3 T47.4 T47.5
POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Stimulant laxatives DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Saline and osmotic laxatives DRUGS Poisoning by Other laxatives; Poisoning by Intestinal atonia POISONING CAUSED BY GASTROINTESTINAL drugs DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Digestants DRUGS Poisoning by Other antacids and anti-gastric-secretion drugs
8,300 8,300 8,300 8,300 8,300 8,300
2,490 2,490 2,490 2,490 2,490 2,490
5,810 5,810 5,810 5,810 5,810 5,810
Page 91 of 111
T47.6 T47.8 T47.9 T48.1
DESCRIPTION
Poisoning by Antidiarrhoeal drugs Poisoning by Other agents primarily affecting the gastrointestinal system Poisoning by Agent primarily affecting the gastrointestinal system, unspecified Poisoning by Skeletal muscle relaxants [neuromuscular blocking agents] Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other agents primarily affecting the gastrointestinal system Poisoning by Iron and its compounds Poisoning by Anticoagulants Poisoning by Fibrinolysis-affecting drugs Poisoning by Anticoagulant antagonists, vitamin K and other coagulants Poisoning by Other primarily systemic and haematological agents; Poisoning by Liver preparations and other antianaemic agents; Poisoning by Natural blood and blood products; Poisoning by Plasma substitute Primarily systemic and haematological agent, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Anticoagulants Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Anticoagulant antagonists, vitamin K and other coagulants Poisoning by Glucocorticoids and synthetic analogues Poisoning by Thyroid hormones and substitutes Poisoning by Antithyroid drugs Poisoning by Insulin and oral hypoglycaemic [antidiabetic] drugs Poisoning by Oral contraceptives; Poisoning by Multipleand-single-ingredient preparations Poisoning by Other estrogens and progestogens; Mixtures and substitutes Poisoning by Antigonadotrophins, antiestrogens, antiandrogens, not elsewhere classified; Poisoning by Tamoxifen Poisoning by Androgens and anabolic congeners Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Glucocorticoids and synthetic analogues Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Antithyroid drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Insulin and oral hypoglycaemic [antidiabetic] drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Oral contraceptives;multiple-and single-ingredient preparations Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other estrogens and progestogens;mixtures and substitutes Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Salicylates Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Propionic acid derivatives;propanoic acid derivatives Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other nonsteroidal anti-inflammatory drugs [NSAID] Drugs, medicaments and biological substances causing adverse effects in therapeutic use: 4-Aminophenol derivatives Toxic effect of Ethanol;Toxic effect of Ethyl alcohol
GROUP
POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS
Case Rate 8,300 8,300 8,300 8,300
Y53.8 T45.4 T45.5 T45.6 T45.7
8,300 7,300 7,300 7,300 7,300
2,490 2,190 2,190 2,190 2,190
5,810 5,110 5,110 5,110 5,110
T45.8
POISONING CAUSED BY HEMATOLOGIC AGENTS
7,300
2,190
5,110
T45.9 Y44.2
POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS
7,300 7,300
2,190 2,190
5,110 5,110
Y44.3
POISONING CAUSED BY HEMATOLOGIC AGENTS
7,300
2,190
5,110
T38.0 T38.1 T38.2 T38.3 T38.4 T38.5 T38.6 T38.7 Y42.0
POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES
8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500
2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550
5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950
Y42.2
POISONING CAUSED BY HORMONES
8,500
2,550
5,950
Y42.3
8,500
2,550
5,950
Y42.4
8,500
2,550
5,950
Y42.5
8,500
2,550
5,950
Y45.1
8,500
2,550
5,950
Y45.2
8,500
2,550
5,950
Y45.3
8,500
2,550
5,950
Y45.5 T51.0 T51.2 T51.3
POISONING CAUSED BY HORMONES POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS
8,500 6,400 6,400 6,400
2,550 1,920 1,920 1,920
5,950 4,480 4,480 4,480
Toxic effect of 2-Propanol; Toxic effect of Isoprophyl aclohol Toxic effect of Fusel oil; Toxic effect of Amyl alcohol; Toxic POISONING CAUSED BY ORGANIC SUBSTANCES effect of Butyl alcohol [1-butanol]; Toxic effect of Propyl AND HEAVY METALS alcohol [1-proponol]
Page 92 of 111
T51.8 T51.9
DESCRIPTION
Toxic effect of Other alcohols Toxic effect of Alcohol, unspecified Toxic effect of Petroleum products; Toxic effect of Gasoline [petrol]; Toxic effect of Kerosine [paraffin oil]; Toxic effect of Paraffin wax; Toxic effect of Petroleum ether; Toxic effect of Petroleum naphtha; Toxic effect of Petroleum spirits Toxic effect of Homologues of benzene; Toxic effect of Toluene [methylbenzene]; Toxic effect of Xylene [dimethylbenzene] Toxic effect of Ketones
GROUP
POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS
Case Rate 6,400 6,400
T52.0
6,400
1,920
4,480
T52.2 T52.4 T52.8 T52.9 T53.0 T53.1 T53.4 T53.6 T53.9 T54.1 T54.2
POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS
6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400
1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920
4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480
T54.3 T54.9 T55 T56.0 T56.1 T56.5 T56.8 T57.0 T57.1 T57.3 T57.8 T57.9 T58 T59.0 T59.2 T59.3 T59.4 T59.7 T59.8 T59.9 T60.0 T60.1 T60.2 T60.3 T60.4
POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other organic solvents AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Organic solvent, unspecified AND HEAVY METALS Toxic effect of Carbon tetrachloride;Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES Tetrachloromethane AND HEAVY METALS Toxic effect of Chloroform; Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES Trichloromethane AND HEAVY METALS Toxic effect of Dichloromethane;Toxic effect of Methylene POISONING CAUSED BY ORGANIC SUBSTANCES chloride AND HEAVY METALS Toxic effect of Other halogen derivatives of aliphatic POISONING CAUSED BY ORGANIC SUBSTANCES hydrocarbons AND HEAVY METALS Toxic effect of Halogen derivative of aliphatic and aromatic POISONING CAUSED BY ORGANIC SUBSTANCES hydrocarbons, unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other corrosive organic compounds AND HEAVY METALS Toxic effect of Corrosive acids and acid-like substances; POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Acid hydrochlorie;Toxic effect of Acid AND HEAVY METALS sulfurie Toxic effect of Corrosive alkalis and alkali-like substances; POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Potassium hydroxide;Toxic effect of Sodium AND HEAVY METALS hydroxide POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Corrosive substance, unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of soaps and detergents AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Lead and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Mercury and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Zinc and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other metals AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Arsenic and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Phosphorus and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Hydrogen cyanide AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other specified in organic substances AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Inorganic substance, unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of carbon monoxide from all sources AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Nitrogen oxides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Formal dehyde AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Lacrimogenic gas; Toxic effect of Tear gas AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Chlorine gas AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Carbon dioxide AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other specified gases, fumes and vapours AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Gases, fumes and vapours, unspecified AND HEAVY METALS Toxic effect of Organophosphate and carbamate POISONING CAUSED BY ORGANIC SUBSTANCES insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Halogenated insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Herbicides and fungicides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Rodenticides; Toxic effect of Thallium AND HEAVY METALS
6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400 6,400
1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920 1,920
4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480 4,480
Page 93 of 111
T60.8 T60.9 T65.0
DESCRIPTION
Toxic effect of Other pesticides Toxic effect of Pesticide, unspecified Toxic effect of Cyanides Toxic effect of Nitro derivatives and aminoderivatives of benzene and its homologues; Toxic effect of Aniline [benzenamine]; Toxic effect of Nitrobenzene; Toxic effect of Trinitrotoluene Toxic effect of Carbondisulfide Toxic effect of Paints and dyes, not elsewhere classified Toxic effect of other specified substances Poisoning by Local astringents and local detergents Poisoning by Emollients, demulcents and protectants Poisoning by Keratolytics, keratoplastics and other hair treatment drugs and preparations Poisoning by Ophthalmological drugs and preparations; Poisoning by Eye, nose and throat anti-infectives Poisoning by Dental drugs, topically applied Othertopical agents; Spermicides Poisoning by Topical agent, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Local astringents and local detergents Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Emollients, demulcents and protectants Toxic effect of Ciguatera fish poisoning Toxic effect of Scombroid fish poisoning;Toxic effect of Histamine-like syndrome Toxic effect of Other fish and shellfish poisoning Toxic effect of other seafoods Toxic effect of unspecified seafood Toxic effect of Ingested mushrooms Toxic effect of Ingested berries Toxic effect of Other ingested (parts of) plant(s) Toxic effect of Other specified noxious substances eaten as food Toxic effect of Noxious substance eaten as food, unspecified Toxic effect of Snake venom;Toxic effect of Sea-snake venom Toxic effect of Venom of other reptiles; Toxic effect of Lizard venom Toxic effect of Venom of scorpion Toxic effect of Venom of spider Toxic effect of Venom of other arthropods;Toxic effect of Insect bite or sting, venomous Toxic effect of contact with fish Toxic effect of contact with other marine animals; Jellyfish; Sea anemone; Shellfish; Starfish Toxic effect of contact with other venomous animals; Venom of amphibian Toxic effect of contact with unspecified venomous animal Toxic effect of aflation and other mycotoxin food contaminants Toxic effect of Tobacco and nicotine Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Antiallergic and antiemetic drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Benzothiadiazine derivatives Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Agents affecting uric acid metabolism Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Oxytocic drugs;ergot alkaloids Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Otorhinolaryngological drugs and preparations Drugs, medicaments and biological substances causing adverse effects in therapeutic use: BCG vaccine Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Tetanus vaccine
GROUP
POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS
Case Rate 6,400 6,400 6,400
T65.3
6,400
1,920
4,480
T65.4 T65.6 T65.8 T49.2 T49.3 T49.4 T49.5 T49.7 T49.8 T49.9 Y56.2
6,400 6,400 6,400 5,300 5,300 5,300 5,300 5,300 5,300 5,300 5,300
1,920 1,920 1,920 1,590 1,590 1,590 1,590 1,590 1,590 1,590 1,590
4,480 4,480 4,480 3,710 3,710 3,710 3,710 3,710 3,710 3,710 3,710
Y56.3 T61.0 T61.1 T61.2 T61.8 T61.9 T62.0 T62.1 T62.2 T62.8 T62.9 T63.0 T63.1 T63.2 T63.3 T63.4 T63.5 T63.6 T63.8 T63.9 T64 T65.2 Y43.0
POISONING CAUSED BY TOPICAL AGENTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING FROM ANIMALS, INSECTS, PLANTS POISONING OTHERS
5,300 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 8,300
1,590 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 2,490
3,710 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 5,810
Y54.3
POISONING OTHERS
8,300
2,490
5,810
Y54.8
POISONING OTHERS
8,300
2,490
5,810
Y55.0
POISONING OTHERS
8,300
2,490
5,810
Y56.6
POISONING OTHERS
8,300
2,490
5,810
Y58.0
POISONING OTHERS
8,300
2,490
5,810
Y58.4
POISONING OTHERS
8,300
2,490
5,810
Page 94 of 111
Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Vaccine or biological substance, unspecified
GROUP
Case Rate 8,300
Y59.9
POISONING OTHERS
G60.0
Hereditary motor and sensory neuropathy; Disease CharcotMarie-Tooth; Disease Djerine-Sottas; Hereditary motor and sensory neuropathy, types I-IV; Hypertrophic POLYNEUROPATHIES neuropathy of infancy; Peroneal muscular atrophy axonal type; Peroneal muscular atrophy hypert Refsum's disease Neuropathy in association with hereditary ataxia Idiopathic progressive neuropathy Other hereditary and idiopathic neuropathies; Morvan's disease; Nelaton's syndrome; Sensory neuropathy dominantly inherited; Sensory neuropathy recessively inherited Hereditary and idiopathic neuropathy, unspecified Guillain-Barr syndrome; Acute post- infective polyneuritis; Acute infective polyneuritis Other inflammatory polyneuropathies Inflammatory polyneuropathy, unspecified Drug-induced polyneuropathy Alcoholic polyneuropathy Polyneuropathy due to other toxic agents Other specified polyneuropathies; Radiation-induced polyneuropathy Polyneuropathy, unspecified; Neuropathy NOS Polyneuropathy in other diseases classified elsewhere Other disorders of peripheral nervous system; Disorder of peripheral nervous system NOS Polyp of corpus uteri; Polyp of endometrium; Polyp of uterus NOS Polyp of cervix uteri; Mucous polyp of cervix Polyp of vagina Polyp of vulva; Polyp of labia Polyp of other parts of female genital tract Polyp of female genital tract, unspecified Embolism following abortion and ectopic and molar pregnancy; Embolism NOS; Air embolism; Amniotic fluid embolism; Blood-clot embolism; Pulmonary embolism; Pyaemic embolism; Septic or septicopyaemic embolism; Soap embolism Metabolic disorders following abortion and ectopic and molar pregnancy Complication following abortion and ectopic and molar pregnancy, unspecified Other intrapartum haemorrhage; Excessive intrapartum haemorrhage Rupture of uterus before on set of labour Rupture of uterus during labour; Rupture of uterus not stated as occuring before onset of labour Post partum inversion of uterus POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYPS, FEMALE GENITAL TRACT POLYPS, FEMALE GENITAL TRACT POLYPS, FEMALE GENITAL TRACT POLYPS, FEMALE GENITAL TRACT POLYPS, FEMALE GENITAL TRACT POLYPS, FEMALE GENITAL TRACT
10,600
3,180
7,420
G60.1 G60.2 G60.3 G60.8 G60.9 G61.0 G61.8 G61.9 G62.0 G62.1 G62.2 G62.8 G62.9 G63.8* G64 N84.0 N84.1 N84.2 N84.3 N84.8 N84.9
10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 5,200 5,200 5,200 5,200 5,200 5,200
3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 1,560 1,560 1,560 1,560 1,560 1,560
7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 3,640 3,640 3,640 3,640 3,640 3,640
O08.2
POST PARTUM COMPLICATIONS
9,300
2,790
6,510
O08.5 O08.9 O67.8 O71.0 O71.1 O71.2 O71.3 O71.5 O71.7 O71.8 O71.9
POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS
9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300 9,300
2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790 2,790
6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510 6,510
Obstetric laceration of cervix; Annular detachment of cervix POST PARTUM COMPLICATIONS Other obstetric injury to pelvic organs; Obstetric injury to bladder; Obstetric injury to urethra Obstetric haematoma of pelvis; Obstetric haematoma of perineum; Obstetric haematoma of vagina; Obstetric haematoma of vulva Other specified obstetric trauma Obstetric trauma, unspecified Aspiration pneumonitis due to anaesthesia during labour and delivery; Inhalation of stomach contents or secretions NOS due to anaesthesia during labour and delivery; Mendelson's syndrome due to anaesthesia during labour and delivery Cardiac complications of anaesthesia during labour and delivery; Cardiac arrest due to anaesthesia during labour and delivery; Cardiac failure due to anaesthesia during labour and delivery Other complications of anaesthesia during labour and delivery Shock during or following labour and delivery; Obstetic shock Other specified complications of labour and delivery Complication of labour and delivery, unspecified Venous complication in the puerperium, unspecified; Puerperal phlebitis NOS; Puerperal phlebopathy NOS; Puerperal thrombosis NOS Care and examination immediately after delivery Postprocedural hypothyroidism; Postirradiation hypothyroidism; Postsurgical hypothyroidism POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS
O74.0
9,300
2,790
6,510
O74.2
9,300
2,790
6,510
O74.8 O75.1 O75.8 O75.9 O87.9 Z39.0 E89.0
POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POSTPARTUM CARE FOR DELIVERIES IN TRANSIT POSTPROCEDURAL DISORDERS
9,300 9,300 9,300 9,300 9,300 2,000 10,300
2,790 2,790 2,790 2,790 2,790 600 3,090
6,510 6,510 6,510 6,510 6,510 1,400 7,210
Page 95 of 111
E89.2 E89.3 E89.4 E89.5 E89.6 E89.8 G97.1 G97.8 H59.0 H59.8 H59.9 H95.8 I97.0 I97.2
DESCRIPTION
GROUP
Case Rate 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300
Professional Fee 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090
Health Care Institution Fee 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210
Postprocedural hypoparathyroidism; Parathyroprival tetany POSTPROCEDURAL DISORDERS Postprocedural hypopituitarism; Postirradiation hypopituitarism Postprocedural ovarian failure Postprocedural testicular hypofunction Postprocedural adrenocortical hypofunction; Postprocedural adreno-medullary hypofunction Other postprocedural endocrine and metabolic disorders Other reaction to spinal and lumbar puncture Other postprocedural disorders of nervous system Vitreous syndrome following cataract surgery Other postprocedural disorders of eye and adnexa; Chorioretinal scars after surgery for detachment Postprocedural disorder of eye and adnexa, unspecified POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS
Other postprocedural disorders of ear and mastoid process POSTPROCEDURAL DISORDERS Postcardiotomy syndrome POSTPROCEDURAL DISORDERS Postmastectomy lymphoedema syndrome; Elephantiasis due to mastectomy; Obliteration of lymphatic vessels due POSTPROCEDURAL DISORDERS to mastectomy Tracheostomy malfunction; Haemorrhage from tracheostomy stoma; Obstruction of tracheostomy airway; POSTPROCEDURAL DISORDERS Sepsis of tracheostomy stoma; Tracheo-oesophageal fistula following tracheostomy Acute pulmonary insufficiency following thoracic surgery Acute pulmonary insufficiency following nonthoracic surgery Mendelson's syndrome Postprocedural subglottic stenosis Other postprocedural respiratory disorders Postprocedural respiratory disorder, unspecified Vomiting following gastrointestinal surgery Postgastric surgery syndromes; Dumping syndrome; Postgastrectomy syndrome; Postvagotomy syndrome Postsurgical malabsorption, not elsewhere classified; Postsurgical blind loop syndrome Postoperative intestinal obstruction Colostomy and enterostomy malfunction Postcholecystectomy syndrome Other postprocedural disorders of digestive system, not elsewhere classified Postprocedural disorder of digestive system, unspecified Postprocedural renal failure Postprocedural urethral stricture; Postcatheterization urethral stricture Postprocedural pelvic peritoneal adhesions Other postprocedural disorders of genitourinary system; Residual ovary syndrome Postprocedural disorder of genitourinary system, unspecified Haemorrhage and haematoma complicating a procedure, not elsewhere classified; Haemorrhage at any site resulting from a procedure Shock during or resulting from a procedure not elsewhere classified; Collapse NOS during or following a procedure; Endotoxic shock during or following a procedure; Hypovolaemic during or following a procedure; Septic shock during or following a procedure; POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS
J95.0
10,300
3,090
7,210
J95.1 J95.2 J95.4 J95.5 J95.8 J95.9 K91.0 K91.1 K91.2 K91.3 K91.4 K91.5 K91.8 K91.9 N99.0 N99.1 N99.4 N99.8 N99.9 T81.0
10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300
3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090
7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210
T81.1
POSTPROCEDURAL DISORDERS
10,300
3,090
7,210
T81.2
Accidental puncture and laceration during a procedure not elsewhere classified; Accidental perforation of blood vessel by catheter, endoscope, instrument, probe during a POSTPROCEDURAL DISORDERS procedure; Accidental perforation of nerve by catheter, endoscope, instrument, probe Disruption of operation wound, not elsewhere classified; Dehiscene of operation wound; Rupture of operation wound POSTPROCEDURAL DISORDERS
10,300
3,090
7,210
T81.3
10,300
3,090
7,210
T81.4
Infection following a procedure, not elsewhere classified; Intra-abdominal abscess postprocedural abcess; Intraabdominal stitch postprocedural abscess; Intra-abdominal POSTPROCEDURAL DISORDERS subphrenic postprocedural abcess; Intra-abdominal wound postprocedural abcess; Septica Other complications of procedures, not elsewhere classified; Complication of inhalation therapy; Emphysema POSTPROCEDURAL DISORDERS (subcutaneous) resulting from a procedure; Persistent postoperative fistula
10,300
3,090
7,210
T81.8
10,300
3,090
7,210
Page 96 of 111
Mechanical complication of heart valve prosthesis; Mechanical breakdown due to heart valve prosthesis; Displacement due to heart valve prosthesis; Failure due to heart valve prosthesis; Leakage due to heart valve prosthesis; Malposition due to heart valve Mechanical complication of cardiac electronic device; Conditions listed in T82.0 due to electrodes; Conditions listed in T82.0 due to pulse generator (battery)
GROUP
Case Rate
Professional Fee
T82.0
10,300
3,090
7,210
T82.1
10,300
3,090
7,210
T82.2
T82.3
Mechanical complication of coronary artery bypass and POSTPROCEDURAL DISORDERS valve grafts Mechanical complication of other vascular grafts; Condition listed in T82.0 due to aortic (bifurcation) graft POSTPROCEDURAL DISORDERS (replacement); Condition listed in T82.0 due to arterial (carotid) (femoral) graft (bypass) Mechanical complication of vascular dialysis catheter Mechanical complication of other cardiac and vascular devices and implants; Conditions listed in T82.0 due to arteriovenous fistula surgically created; arterivenous Shunt surgically created; Artificial heart; Ballon counterpulsation device; Infusion cat Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts Other complications of cardiac and vascular prosthetic devices, implants and grafts; Complication due to cardiac and vascular prosthetic devices, implants and grafts; Embolism due to cardiac and vascular prosthetic devices, implants and grafts; Fibrosis d Mechanical complication of other urinary devices and implants; Concditions listed in T82.0 due to Urinary electronic stimultor device; Urinary sphincter implant; Urinary stent Mechanical complication of graft of urinary organ Mechanical complication of intrauterine contraceptive device Infection and inflammatory reaction due to prosthetic device, implant and graft in urinary system Other complications of genitourinary prosthetic devices, implants and grafts Unspecified complication of genitourinary prosthetic device, implants and grafts Mechanical complication of internal joint prosthesis Mechanical complication of internal fixation device of bones of limb Mechanical complication of internal fixation device of other bones Mechanical complication of other internal orthopaedic devices, implants and grafts Infection and inflammatory reaction due to internal joint prosthesis Infection and inflammatory reaction due to internal fixation device [any site] Infection and inflammatory reaction due to other internal orthopaedic prosthetic devices, implants and grafts Other complications of internal orthopaedic prosthetic devices, implants and grafts Unspecified complication of internal orthopaedic prosthetic device, implant and graft Mechanical complication of ventricular intracranial (communicating) shunt Mechanical complication of other ocular prosthetic devices, implants and grafts Conditions listed in T82.0 due to corneal graft; Conditions listed in T82.0 due to prosthetic orbit of eye Mechanicalcomplicationofgastrointestinalprostheticdevices implantsand; Conditions listed in T82.0 due to Bile-duct prosthesis; Conditions listed in T82.0 oesophageal antireflux device Mechanical complication of other specified internal prosthetic devices, Implants and grafts; Conditions listed in T82.0 due to epidural and subdural infusion catheter; Conditions listed in T82.0 due to intraperitonael dialysis catheter; Conditions listed Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts Other complications of internal prosthetic devices, implants and grafts, not elsewhere classified Unspecified complication of internal prosthetic device, implant and graft; Complication of internal prosthetic device, implants and graft NOS POSTPROCEDURAL DISORDERS
10,300
3,090
7,210
10,300
3,090
7,210
T82.4
10,300
3,090
7,210
T82.5
10,300
3,090
7,210
T82.7
10,300
3,090
7,210
T82.8
10,300
3,090
7,210
T83.1 T83.2 T83.3 T83.5 T83.8 T83.9 T84.0 T84.1 T84.2 T84.4 T84.5 T84.6 T84.7 T84.8 T84.9 T85.0
POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS
10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300 10,300
3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090 3,090
7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210 7,210
T85.3
10,300
3,090
7,210
T85.5
10,300
3,090
7,210
T85.6
10,300
3,090
7,210
T85.7 T85.8 T85.9
POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS
10,300 10,300 10,300
3,090 3,090 3,090
7,210 7,210 7,210
Page 97 of 111
N40
Hyperplasia of prostate; Adenofibromatous hypertrophy of prostate; Adenoma (benign)of prostate ; Enlargement of prostate (benign); Fibroadenoma of prostate; Fibroma of PROSTATE DISORDERS prostate; Hypertrophy of prostate (benign); Myoma of prostate; Median bar (prostate), Acute prostatitis Chronic prostatitis Abscess of prostate Prostatocystitis Other inflammatory diseases of prostate Inflammatory disease of prostate, unspecified; Prostatitis NOS Calculus of prostate; Prostatic stone Congestion and haemorrhage of prostate Atrophy of prostate Other specified disorders of prostate Disorder of prostate, unspecified Eclampsia in the puerperium Puerperal sepsis; Puerperal endometritis; Puerperal fever; Puerperal peritonitis; Puerperal septicaemia Infection of obstetric surgical wound; Infected caesarean section wound following delivery; Infected perineal repair following delivery PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS
9,200
2,760
6,440
N41.0 N41.1 N41.2 N41.3 N41.8 N41.9 N42.0 N42.1 N42.2 N42.8 N42.9 O15.2 O85 O86.0
9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 9,200 6,800 10,600 10,600
2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,760 2,040 3,180 3,180
6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 6,440 4,760 7,420 7,420
O86.1 O86.2 O86.3 O86.4 O86.8 O87.0 O87.1 O87.2 O87.8 O88.1 O88.2
Other infection of genital tract following delivery; Cervicitis PUERPERAL COMPLICATIONS following delivery; Vaginitis following delivery Urinary tract infection following delivery Other genitourinary tract infections following delivery; Puerperal genitourinary tract infection NOS Pyrexia of unknown origin following delivery; Puerperal infection NOS; Puerperal pyrexia NOS Other specified puerpera linfections Superficial thrombophlebitis in the puerperium Deep phlebothrombosis in the puerperium; Deep-vein thrombosis, postpartum; Pelvic thrombophlebitis, postpartum Haemorrhoids in the puerperium Other venous complications in the puerperium; Genital varices in the puerperium Amniotic fluid embolism Obstetric blood-clot embolism; Obstetric pulmonary embolism NOS; Puerperal pulmonary embolism NOS Pulmonary complications of anaesthesia during the puerperium; Aspiration pneumonitis due to anaesthesia during the puerperium; Inhalation of stomach contents or secretions NOS due to anaesthesia during the puerperium Mendelson's syndrome due to anaest PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS
10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600
3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180
7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420
O89.0
PUERPERAL COMPLICATIONS
10,600
3,180
7,420
O89.1
O89.2 O89.4 O89.8 O89.9 O90.0 O90.1 O90.2 O90.3 O90.4 O90.5 O90.8 O90.9 P20.0 P20.1 P20.9
Cardiac complications of anaesthesia during the puerperium; Cardiac arrest due to anaesthesia during the PUERPERAL COMPLICATIONS puerperium; Cardiac failure due to anaesthesia during the puerperium Central nervous system complications of anaesthesia during the puerperium; Cerebral anoxia due to anaesthesia PUERPERAL COMPLICATIONS during the puerperium Spinal and epidural anaesthesia-induced headache during PUERPERAL COMPLICATIONS the puerperium Other complications of anaesthesia during the puerperium PUERPERAL COMPLICATIONS Complication of anaesthesia during the puerperium, unspecified Disruption of caesarean section wound Disruption of perineal obstetric wound; Disruption of wound of episiotomy; Disruption of wound of perineal laceration; Secondary perineal tear Haematoma of obstetric wound Cardiomyopathy in the puerperium Postpartum acute renal failure; Hepatorenal syndrome following labour and delivery Postpartum thyroiditis Other complications of the puerperium, not elsewhere classified Complication of the puerperium, unspecified Intrauterine hypoxia first noted before onset of labour Intrauterine hypoxia first noted during labour and delivery Intrauterine hypoxia, unspecified PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN
10,600
3,180
7,420
10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,600 10,900 10,900 10,900
3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,180 3,270 3,270 3,270
7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,420 7,630 7,630 7,630
Page 98 of 111
Severe birth asphyxia; Pulse less than 100 per minute at birth and falling or steady, respiration absent or gasping, colour poor, tone absent; Asphyxia with 1-minute apgar score 0-3; White asphyxia
GROUP
Case Rate
P21.0
PULMONARY COMPLICATIONS IN THE NEWBORN
10,900
P21.1
Mild and moderate birth asphyxia; Normal respiration not established within one minute, but heart rate 100 or above, PULMONARY COMPLICATIONS IN THE NEWBORN some muscle tone present, some response to stimulation; Asphyxia with 1-minute Apgar score 4-7; Blue asphyxia Birth asphyxia, unspecified; Anoxia, NOS; Asphyxia, NOS; Hypoxia, NOS Respiratory distress syndrome of newborn; Hyaline membrane disease Transient tachypnoea of newborn Other respiratory distress of newborn Respiratory distress of newborn, unspecified Neonatal aspiration of meconium PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN
10,900
3,270
7,630
P21.9 P22.0 P22.1 P22.8 P22.9 P24.0 P24.1 P24.2 P24.3 P24.8 P24.9 P25.0 P25.1 P25.2 P25.8 P26.0 P26.1 P26.8 P26.9 P27.0 P27.1 P27.8 P27.9
10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900 10,900
3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270 3,270
7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630 7,630
Neonatal aspiration of amniotic fluid and mucus;Aspiration PULMONARY COMPLICATIONS IN THE NEWBORN of liquor (amnii) Neonatal aspiration of blood Neonatal aspiration of milk and regurgitated food Other neonatal aspiration syndromes Neonatal aspiration syndrome, unspecified; Neonatal aspiration pneumonia NOS Interstitial emphysema originating in the perinatal period Pneumothorax originating in the perinatal period Pneumomediastinum originating in the perinatal period Other conditions related to interstitial emphysema originating in the perinatal period Tracheobronchial haemorrhage originating in the perinatal period Massive pulmonary haemorrhage originating in the perinatal period Other pulmonary haemorrhages originating in the perinatal period Unspecified pulmonary haemorrhage originating in the perinatal period Wilson-Mikity syndrome; Pulmonary dysmaturity PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN
Bronchopulmonary dysplasia originating in the perinatal PULMONARY COMPLICATIONS IN THE NEWBORN period Other chronic respiratory diseases originating in the perinatal period; Congenital pulmonary fibrosis; Ventilator PULMONARY COMPLICATIONS IN THE NEWBORN lung in newborn Unspecified chronic respiratory disease originating in the PULMONARY COMPLICATIONS IN THE NEWBORN perinatal period Primary atelectasis of newborn; Primary failure to expand terminal respiratory units; Pulmonary hypoplasia PULMONARY COMPLICATIONS IN THE NEWBORN associated with short gestation; Pulmonary immaturity NOS Other and unspecified atelectasis of newborn; Atelectasis, NOS; Atelectasis, partial; Atelectasis, secondary; Resorption PULMONARY COMPLICATIONS IN THE NEWBORN atelectasis without respiratory distress syndrome Cyanotic attacks of newborn PULMONARY COMPLICATIONS IN THE NEWBORN
P28.0
10,900
3,270
7,630
P28.1
10,900
3,270
7,630
P28.2 P28.3 P28.4 P28.5 P28.8 P29.3 P29.9 I26.0 I26.9
10,900 10,900 10,900 10,900 10,900 10,900 10,900 24,300 24,300
3,270 3,270 3,270 3,270 3,270 3,270 3,270 7,290 7,290
7,630 7,630 7,630 7,630 7,630 7,630 7,630 17,010 17,010
Primary sleep apnoea of newborn; leep apnoea of newborn PULMONARY COMPLICATIONS IN THE NEWBORN NOS Other apnoea of newborn Respiratory failure of newborn Other specified respiratory conditions of newborn; congenital laryngeal stridor NOS; Snuffles in newborn PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN
Persistent fetal circulation; Delayed closure of ductus PULMONARY COMPLICATIONS IN THE NEWBORN arteriosus; Persistent pulmonary hypertension of newborn Cardiovascular disorder originating in the perinatal period, PULMONARY COMPLICATIONS IN THE NEWBORN unspecified Pulmonary embolism with mention of acute cor pulmonale; PULMONARY EMBOLISM Acute cor pulmonale NOS Pulmonary embolism without mention of acute cor PULMONARY EMBOLISM pulmonale; Pulmonary embolism NOS
Page 99 of 111
I27.0 I27.1 I27.2 I27.8 I27.9
DESCRIPTION
Primary pulmonary hypertension Kyphoscoliotic heart disease Other secondary pulmonary hypertension; Pulmonary artery hypertension Other specified pulmonary heart diseases Pulmonary heart disease, unspecified; Chronic cardiopulmonary disease; Chronic Cor pulmonale NOS
GROUP
PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE
Case Rate 14,100 14,100 14,100 14,100 14,100
N11.0
Nonobstructive reflux-associated chronic pyelonephritis; PYELONEPHRITIS Chronic Pyelonephritis associated with vesicoureteral reflux Chronic obstructive pyelonephritis; Chronic pyelonephritis associated with anomaly of [pelviureteric junction, pyeloureteric junction, ureter]; Chronic pyelonephritis associated with kinking of [pelviureteric junction, pyeloureteric junction, ureter]; Chr Other chronic tubulo-interstitial nephritis; Nonobstructive chronic pyelonephritis NOS Chronic acquired pure red cell aplasia Other acquired pure red cell aplasias Acquired pure red cell aplasia, unspecified Ischaemia and infarction of kidney; Embolism of renal artery; Obstruction of renal artery; Occlusion of renal artery; Thrombosis of renal artery; Renal infarct Renal and perinephric abscess Other cystitis; Abscess of bladder Urethral abscess; Abscess of Cowper's gland; Abscess of Littr's gland; Periurethral Abscess ; Abscess of urethral gland Coalworker's pneumoconiosis; Anthracosilicosis; Anthracosis; Coalworker's lung Pneumoconiosis due to asbestos and other mineral fibres; Asbestosis
10,900
3,270
7,630
N11.1
PYELONEPHRITIS
10,900
3,270
7,630
N11.8 D60.0 D60.8 D60.9 N28.0 N15.1 N30.8 N34.0 J60 J61 J62.0 J62.8 J63.0 J63.3 J63.4 J63.8 J64 J65 J66.2 J66.8 J67.0 J67.1 J67.5
PYELONEPHRITIS RED CELL APLASIA RED CELL APLASIA RED CELL APLASIA RENAL INFARCT RENAL/BLADDER ABSCESS RENAL/BLADDER ABSCESS RENAL/BLADDER ABSCESS
10,900 7,300 7,300 7,300 9,600 13,900 13,900 13,900 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700 14,700
3,270 2,190 2,190 2,190 2,880 4,170 4,170 4,170 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410 4,410
7,630 5,110 5,110 5,110 6,720 9,730 9,730 9,730 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290 10,290
RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis due to talc dust AGENTS Pneumoconiosis due to other dust containing silica; Silicosis RESPIRATORY CONDITIONS DUE TO EXTERNAL NOS AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Aluminosis (of lung) AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Graphite fibrosis (of lung) AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Siderosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis due to other specified inorganic dusts AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Unspecified pneumoconiosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis associated with tuberculosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Cannabinosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Airway disease due to other specific organic dusts AGENTS Farmer's lung; Harvester's lung; Haymaker's lung; Mouldy RESPIRATORY CONDITIONS DUE TO EXTERNAL hay disease AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Bagassosis; Bagasse disease; Bagasse pneumonitis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Mushroom-worker's lung AGENTS Air-conditioner and humidifier lung; Allergic alveolitis due RESPIRATORY CONDITIONS DUE TO EXTERNAL to fungi, thermophilic actinomycetees and other organisms AGENTS growing in ventilation (air-conditioning) systems Hypersensitivity pneumonitis due to other organic dusts; Cheese-washer's lung; Coffee-worker's lung; Fishmealworker's lung; Furrier's lung; Sequoiosis Hypersensitivity pneumonitis due to unspecified organic dust; Extrinsic allergic alveolitis NOS; Hypersensitivity pneumonitis NOS Bronchitis and pneumonitis due to chemicals, gases, fumes and vapours; Acute chemical bronchitis Acute pulmonary oedema due to chemicals, gases, fumes and vapours; Acute Chemical pulmonary oedema Upper respiratory inflammation due to chemicals, gases, fumes and vapours, not elsewhere classified Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapours; Reactive airways dysfunction syndrome; Hyperactive airway disease RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
J67.7
14,700
4,410
10,290
J67.8
14,700
4,410
10,290
J67.9 J68.0 J68.1 J68.2
14,700 14,700 14,700 14,700
4,410 4,410 4,410 4,410
10,290 10,290 10,290 10,290
J68.3
14,700
4,410
10,290
Page 100 of 111
Chronic respiratory conditions due to chemicals, gases, fumes and vapours; Diffuse emphysema due to inhalation of chemicals, gases, fumes and vapours; Chronic emphysema due to inhalation of chemicals, gases, fumes and vapours; Chronic obliterative bronchi Other respiratory conditions due to chemicals, gases, fumes and vapours Unspecified respiratory condition due to chemicals, gases, fumes and vapours Pneumonitis due to food and vomit; Aspiration pneumonia due to NOS; Aspiration pneumonia due to regurgitated food; Aspiration pneumonia due to gastric secretions; Aspiration pneumonia due to milk; Aspiration pneumonia due to vomit Pneumonitis due to oils and essences; Lipid pneumonia Pneumonitis due to other solids and liquids; Pneumonitis due to aspiration of blood Acute pulmonary manifestations due to radiation; Radiation pneumonitis Acute drug-induced interstitial lung disorders Drug-induced interstitial lung disorders, unspecified Respiratory conditions due to other specified external agents Respiratory conditions due to unspecified external agent Acute respiratory failure Chronic respiratory failure Respiratory failure, unspecified Central retinal artery occlusion Other retinal artery occlusions; Hollenhorst's plaque; Retinal artery occlusion; Retinal artery branch occlusion ; Retinal artery partial occlusion; Retinal microembolism Other retinal vascular occlusions; Retinal central vein occlusion ; Retinal vein occlusion incipient; Retinal vein occlusion partial; Retinal vein occlusion tributary Retinal vascular occlusion, unspecified Rheumatic fever without mention of heart involvement; Arthritis, rheumatic, acute or subacute involvement
GROUP
Case Rate
Professional Fee
J68.4
RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS
14,700
4,410
10,290
J68.8 J68.9
RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY FAILURE RESPIRATORY FAILURE RESPIRATORY FAILURE RETINAL VASCULAR OCCLUSION RETINAL VASCULAR OCCLUSION
14,700 14,700
4,410 4,410
10,290 10,290
J69.0
14,700
4,410
10,290
J69.1 J69.8 J70.0 J70.2 J70.4 J70.8 J70.9 J96.0 J96.1 J96.9 H34.1 H34.2
14,700 14,700 14,700 14,700 14,700 14,700 14,700 32,000 32,000 32,000 7,700 7,700
4,410 4,410 4,410 4,410 4,410 4,410 4,410 9,600 9,600 9,600 2,310 2,310
10,290 10,290 10,290 10,290 10,290 10,290 10,290 22,400 22,400 22,400 5,390 5,390
H34.8 H34.9 I00 I01.0 I01.1 I01.2 I01.8 I01.9 I02.0 I02.9 I05.0 I05.1 I05.2 I05.8 I05.9 I06.0 I06.1 I06.2 I06.8 I06.9 I07.0 I07.1 I07.9
RETINAL VASCULAR OCCLUSION RETINAL VASCULAR OCCLUSION RHEUMATIC FEVER
7,700 7,700 10,100 10,100 10,100 10,100 10,100 10,100 10,100 10,100 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800
2,310 2,310 3,030 3,030 3,030 3,030 3,030 3,030 3,030 3,030 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840 3,840
5,390 5,390 7,070 7,070 7,070 7,070 7,070 7,070 7,070 7,070 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960 8,960
Acute rheumatic pericarditis; Acute rheumatic pericarditis RHEUMATIC FEVER Acute rheumatic endocarditis; Acute rheumatic valvulitis Acute rheumatic myocarditis; Other acute rheumatic heart disease; Acute rheumatic pancarditis Acute rheumatic heart disease unspecified; Acute rheumatic carditis; Active rheumatic heart disease; Acute rheumatic heart disease Rheumatic chorea with heart involvement; Chorea NOS with heart involvement Rheumatic chorea without heart involvement; Rheumatic chorea NOS Mitral stenosis; Rheumatic mitral valve obstruction Rheumatic mitral insufficiency; Rheumatic mitral incompetence; Rheumatic mitral regurgitation Mitral stenosis with insufficiency; Mitral stenosis with incompetence or regurgitation Other mitral valve diseases; Mitral valve failure Mitral valve disease unspecified; Chronic mitral valve disorder NOS Rheumatic aortic stenosis; Rheumatic aortic valve obstruction Rheumatic aortic insufficiency; Rheumatic aortic incompetence; Rheumatic aortic regurgitation Rheumatic aortic stenosis with insufficiency; Rheumatic aortic stenosis with incompetence or regurgitation Other rheumatic aortic valve diseases Rheumatic aortic valve disease unspecified; Rheumatic aortic valve disease NOS Tricuspid stenosis; Rheumatic tricuspid valve stenosis RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE
Tricuspid insufficiency; Rheumatic tricuspid valve RHEUMATIC HEART DISEASE insufficiency Tricuspid valve disease unspecified; Tricuspid valve disorder RHEUMATIC HEART DISEASE NOS
Page 101 of 111
Disorders of both mitral and aortic valves; Involvement of both mitral and aortic valves whether specified as rheumatic or of unspecified origin Disorders of both mitral and tricuspid valves Disorders of both aortic and tricuspid valves Combined disorders of mitral aortic and tricuspid valves Other multiple valve diseases Multiple valve disease, unspecified Rheumatic myocarditis Rheumatic diseases of endocardium, valve unspecified; Chronic rheumatic endocarditis; Chronic rheumatic valvulitis Chronic rheumatic pericarditis; Rheumatic adherent pericardium; Chronic rheumatic mediastinopericarditis; Chronic rheumatic myopericarditis Other specified rheumatic heart diseases; Rheumatic disease of pulmonary valve Epidemic louse-borne typhus fever due to Rickettsia prowazekii; Cl assical typhus fever; Epidemic louse-borne typhus Typhus fever, unspecified Spotted fever due to Rickettsia rickettsii; Rocky Mountain spotted fever; Sao Paulo fever Trench fever ; Quintan fever; Wolhynian fever Rickettsiosis, unspecified; Rickettsial infection NOS Severe Acute Respiratory Syndrome (SARS) Scarlet fever; Scarlatina Septicaemia due to streptococcus, group A Septicaemia due to streptococcus, group B Septicaemia due to Streptococcus pneumoniae; Pneumococcal septicaemia Other streptococcal septicaemia Streptococcal septicaemia, unspecified Septicaemia due to Staphylococcus aureus Septicaemia due to other specified staphylococcus; Septicaemia due to coagulase-negative staphylococcus Septicaemia due to unspecified staphylococcus Septicaemia due to Haemophilus influenzae Septicaemia due to anaerobes Septicaemia due to other Gram-negative organisms; Gramnegative septicaemia NOS Other specified septicaemia Septicaemia, unspecified; Septic shock Toxic shock syndrome Sequelae of subarachnoid haemorrhage Sequelae of intracerebral haemorrhage Sequelae of other nontraumatic intracranial haemorrhage Sequelae of cerebral infarction Sequelae of stroke, not specified as haemorrhage or infarction
GROUP
Case Rate 12,800 12,800 12,800 12,800 12,800 12,800 12,800 12,800
I08.0 I08.1 I08.2 I08.3 I08.8 I08.9 I09.0 I09.1
RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE
I09.2
RHEUMATIC HEART DISEASE
12,800
3,840
8,960
I09.8 A75.0 A75.9 A77.0 A79.0 A79.9 U04.9 A38 A40.0 A40.1 A40.3 A40.8 A40.9 A41.0 A41.1 A41.2 A41.3 A41.4 A41.5 A41.8 A41.9 A48.3 I69.0 I69.1 I69.2 I69.3 I69.4 I69.8 B90.0 B90.8 B90.9 B94.1 B94.2 B94.8 B94.9 G09 E64.8 T90.0 T90.1 T90.2 T90.5 T90.8 T90.9 T91.0 T91.1 T91.2 T91.3
RHEUMATIC HEART DISEASE RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES SARS SCARLET FEVER SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES
12,800 7,000 7,000 7,000 7,000 7,000 8,300 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 32,000 10,300 10,300 10,300 10,300 10,300 10,300 10,700 10,700 10,700 10,700 10,700 10,700 10,700 8,000 8,800 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500
3,840 2,100 2,100 2,100 2,100 2,100 2,490 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 9,600 3,090 3,090 3,090 3,090 3,090 3,090 3,210 3,210 3,210 3,210 3,210 3,210 3,210 2,400 2,640 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550
8,960 4,900 4,900 4,900 4,900 4,900 5,810 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 22,400 7,210 7,210 7,210 7,210 7,210 7,210 7,490 7,490 7,490 7,490 7,490 7,490 7,490 5,600 6,160 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950
Sequelae of other and unspecified cerebrovascular diseases SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CENTRAL NERVOUS SYSTEM TUBERCULOSIS SEQUELAE OF TUBERCULOSIS OF OTHER ORGANS SEQUELAE OF RESPIRATORY AND UNSPECIFIED TUBERCULOSIS; SEQUELAE OF TUBERCULOSIS NOS Sequelae of viral encephalitis Sequelae of viral hepatitis Sequelae of other specified infectious and parasitic diseases Sequelae of unspecified infectious or parasitic disease Sequelae of inflammatory diseases of central nervous system Sequelae of other nutritional deficiencies Sequelae of superficial injury of head Sequelae of open wound of head Sequelae of fracture of skull and facial bones Sequelae of intra cranial injury Sequelae of other specified injuries of head Sequelae of unspecified injury of head Sequelae of superficial injury and open wound of neck and trunk Sequelae of fracture of spine Sequelae of other fracture of thorax and pelvis Sequelae of injury of spinal cord SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM SEQUELAE OF NUTRITIONAL DEFICIENCIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES
Page 102 of 111
T92.0 T92.1 T92.8 T93.0 T93.1 T93.2 T93.3 T93.8 T94.0 T94.1 T95.0 T95.2 T95.3 T95.8 T95.9 T98.2 R57.0 R57.1 R57.8 R57.9 T88.2
DESCRIPTION
Sequelae of open wound of upper limb Sequelae of fracture of arm Sequelae of other specified injuries of upper limb Sequelae of open wound of lower limb Sequelae of fracture of femur Sequelae of other fractures of lower limb Sequelae of dislocation sprain and strain of lower limb Sequelae of other specified injuries of lower limb Sequelae of injuries involving multiple body regions Sequelae of injuries, not specified by body regions
GROUP
SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES
Case Rate 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 8,500 32,000 32,000 32,000 32,000 32,000
Professional Fee 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 2,550 9,600 9,600 9,600 9,600 9,600
Health Care Institution Fee 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 5,950 22,400 22,400 22,400 22,400 22,400
Sequelae of burn, corrosion and frostbite of head and neck SEQUELAE OF TRAUMA INJURIES Sequelae of burn, corrosion and frostbite of upper limb Sequelae of burn, corrosion and frostbite of lower limb Sequelae of other specified burn corrosion and frostbite Sequelae of unspecified burn, corrosion and frostbite Sequelae of certain early complications of trauma Cardiogenic shock Hypovolaemic shock Other shock; Endotoxic shock Shock, unspecified; Failure of peripheral circulation NOS Shock due to anaesthesia; Shock due to anaesthesia in which the correct sustance was properly administered Situs inversus; Dextrocardia with situs inversus; Mirrorimage atrial arrangement with situs inversus; Situs inversus or transverses abdominalis; Situs inversus or transversus thoracis; Transposition of abdominal viscera; Transposition of thoracic visce Fracture o f vault of skull; Fracture of Frontal bone; Fracture of Parietal bone CLOSED FRACTURE OF VAULT OF SKULL/ FRONTAL BONE/ PARIETAL BONE OPEN FRACTURE OF VAULT OF SKULL/ FRONTAL BONE/ PARIETAL BONE SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SHOCK SHOCK SHOCK SHOCK SHOCK
Q89.3
SITUS INVERSUS
6,700
2,010
4,690
S02.0 S02.00 S02.01
SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES
10,700 10,700 10,700
3,210 3,210 3,210
7,490 7,490 7,490
S02.1
Fracture of base of skull: Fracture of anterior fossa, middle fossa, posterior fossa; Fracture of Occiput; Fracture of SKULL FRACTURES orbital roof; Fracture of ethmoid sinus & frontal sinus; Fracture of Sphenoid; Fracture of temporal bone CLOSED FRACTURE OF BASE OF SKULL/ ANTERIOR FOSSA/ MIDDLE FOSSA/ POSTERIOR FOSSA/ OCCIPUT/ ORBITAL ROOF/ ETHMOID SINUS/ FRONTAL SINUS/ SPHENOID/ TEMPORAL BONE OPEN FRACTURE OF BASE OF SKULL/ ANTERIOR FOSSA/ MIDDLE FOSSA/ POSTERIOR FOSSA/ OCCIPUT/ ORBITAL ROOF/ ETHMOID SINUS/ FRONTAL SINUS/ SPHENOID/ TEMPORAL BONE closed fracture of nasal bones open fracture of nasal bones Closed fracture of orbital floor Open fracture of orbital floor Closed Fracture of malar and maxillary bones Open Fracture of malar and maxillary bones Closed Fracture of tooth Closed Fracture of mandible Open Fracture of mandible Closed Multiple fractures involving skull and facial bones Open Multiple fractures involving skull and facial bones closed Fractures of other skull and facial bones including Alveolus, Orbit NOS, Palate open Fractures of other skull and facial bones including Alveolus, Orbit NOS, Palate Closed Fracture of skull and facial bones, part unspecified Open Fracture of skull and facial bones, part unspecified Sleep apnoea; Sleep apnoea, central; Sleep apnoea, obstructive Spondylolysis Spondylolisthesis Other fusion of spine; Ankylosis of spinal joint Other recurrent vertebral subluxation Torticollis Ankylosing spondylitis; Rheumatoid arthritis of spine Spinal enthesopathy; Disorder of ligamentous or muscular attachments of spine
10,700
3,210
7,490
S02.10
SKULL FRACTURES
10,700
3,210
7,490
S02.11 S02.20 S02.21 S02.30 S02.31 S02.40 S02.41 S02.50 S02.60 S02.61 S02.70 S02.71 S02.80 S02.81 S02.90 S02.91 G47.3 M43.0 M43.1 M43.2 M43.5 M43.6 M45 M46.0
SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SLEEP APNEA SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES
10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,700 10,800 8,300 8,300 8,300 8,300 8,300 8,300 8,300
3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,210 3,240 2,490 2,490 2,490 2,490 2,490 2,490 2,490
7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,490 7,560 5,810 5,810 5,810 5,810 5,810 5,810 5,810
Page 103 of 111
M46.1 M46.16 M46.19 M46.2 M46.28 M46.29 M46.3 M46.36 M46.4 M46.46 M46.47 M46.49 M46.5 M46.8 M46.87 M46.9 M46.92 M46.97 M46.98 M46.99 M47.1 M47.1+G99.2* M47.2 M47.20 M47.22 M47.26 M47.27 M47.29
DESCRIPTION
Sacroiliitis, not elsewhere classified Sacroiliitis, not elsewhere classified lumbar region Sacroiliitis, not elsewhere classified site unspecified Osteomyelitis of vertebra SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES
GROUP
Case Rate 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300
Professional Fee 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490
Health Care Institution Fee 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810
Osteomyelitis of vertebra sacral and sacrococcygeal region SPONDYLOPATHIES Osteomyelitis of vertebra site unspecified Infection of intervertebral disc (pyogenic) Infection of intervertebral disc (pyogenic) lumbar region SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES
Discitis, unspecified SPONDYLOPATHIES Discitis, unspecified lumbar region SPONDYLOPATHIES Discitis, unspecified lumbosacral region SPONDYLOPATHIES Discitis, unspecified site unspecified SPONDYLOPATHIES Other infective spondylopathies SPONDYLOPATHIES Other specified inflammatory spondylopathies SPONDYLOPATHIES Other specified inflammatory spondylopathies lumbosacral SPONDYLOPATHIES region Inflammatory spondylopathy, unspecified SPONDYLOPATHIES Inflammatory spondylopathy, unspecified cervical region Inflammatory spondylopathy, unspecified lumbosacral region Inflammatory spondylopathy, unspecified sacral and sacrococcygeal region SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES
Inflammatory spondylopathy, unspecified site unspecified SPONDYLOPATHIES Other spondylosis with myelopathy Myelopathy in Other spondylosis with myelopathy Other spondylosis with radiculopathy Other spondylosis with radiculopathy Multiple sites in spine Other spondylosis with radiculopathy cervical region Other spondylosis with radiculopathy lumbar region Other spondylosis with radiculopathy lumbosacral region Other spondylosis with radiculopathy site unspecified SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES
M47.8
Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy Multiple sites in spine Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy occipito-atlanto-axial region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy cervical region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy cervicothoracic region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy thoracic region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy thoracolumbar region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy lumbar region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy lumbosacral region
8,300
2,490
5,810
M47.80
8,300
2,490
5,810
M47.81
8,300
2,490
5,810
M47.82
8,300
2,490
5,810
M47.83
8,300
2,490
5,810
M47.84
8,300
2,490
5,810
M47.85
8,300
2,490
5,810
M47.86
8,300
2,490
5,810
M47.87
8,300
2,490
5,810
Page 104 of 111
Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy sacral and sacrococcygeal region Cervical spondylosis without myelopathy or radiculopathy; Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy; Thoracic spondylosis without myelopathy or radiculopathy site unspecified Spondylosis, unspecified Spondylosis, unspecified Multiple sites in spine Spondylosis, unspecified cervical region Spondylosis, unspecified thoracic region Spondylosis, unspecified thoracolumbar region Spondylosis, unspecified lumbar region Spondylosis, unspecified lumbosacral region Spondylosis, unspecified site unspecified Spinal stenosis; Caudal stenosis Spinal stenosis; Caudal stenosis Multiple sites in spine Spinal stenosis; Caudal stenosis cervical region Spinal stenosis; Caudal stenosis cervicothoracic region Spinal stenosis; Caudal stenosis thoracic region Spinal stenosis; Caudal stenosis thoracolumbar region Spinal stenosis; Caudal stenosis lumbar region Spinal stenosis; Caudal stenosis lumbosacral region Spinal stenosis; Caudal stenosis sacral and sacrococcygeal region Spinal stenosis; Caudal stenosis site unspecified Ankylosing hyperostosis [Forestier]; Diffuse idiopathic skeletal hyperostosis [DISH] Ankylosing hyperostosis [Forestier]; Diffuse idiopathic skeletal hyperostosis [DISH] lumbar region Kissing spine Traumatic spondylopathy Traumatic spondylopathy cervical region Fatigue fracture of vertebra; Stress fracture of vertebra Collapsed vertebra NOS; Wedging of vertebra NOS Collapsed vertebra NOS; Wedging of vertebra NOS thoracic region Collapsed vertebra NOS; Wedging of vertebra NOS lumbar region Collapsed vertebra NOS; Wedging of vertebra NOS lumbosacral region Ossification of posterior longitudinal ligament Ossification of posterior longitudinal ligament Multiple sites in spine Ossification of posterior longitudinal ligament thoracolumbar region Ossification of posterior longitudinal ligament lumbar region Ossification of posterior longitudinal ligament site unspecified Spondylopathy, unspecified Spondylopathy, unspecified cervical region Spondylopathy, unspecified thoracolumbar region Spondylopathy, unspecified lumbar region Spondylopathy, unspecified sacral and sacrococcygeal region Spondylopathy, unspecified site unspecified Pott's curvature Spondylopathy in other diseases classified elsewhere Staphylococcal scalded skin syndrome; Pemphigus neonatorum; Ritter's disease SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES STAPHYLOCCOCAL SCALDED SKIN SYNDROME
GROUP
Case Rate
Professional Fee
M47.88
8,300
2,490
5,810
M47.89
8,300
2,490
5,810
M47.9 M47.90 M47.92 M47.94 M47.95 M47.96 M47.97 M47.99 M48.0 M48.00 M48.02 M48.03 M48.04 M48.05 M48.06 M48.07 M48.08 M48.09 M48.1 M48.16 M48.2 M48.3 M48.32 M48.4 M48.5 M48.54 M48.56 M48.57 M48.8 M48.80 M48.85 M48.86 M48.89 M48.9 M48.92 M48.95 M48.96 M48.98 M48.99 M49.0* M49.8* L00 G41.0 G41.1 G41.2 G41.8 G41.9 L51.1 I60.0 I60.1 I60.2 I60.3
8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 8,300 10,200 15,600 15,600 15,600 15,600 15,600 12,300 38,000 38,000 38,000 38,000
2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 2,490 3,060 4,680 4,680 4,680 4,680 4,680 3,690 11,400 11,400 11,400 11,400
5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 5,810 7,140 10,920 10,920 10,920 10,920 10,920 8,610 26,600 26,600 26,600 26,600
Grand mal status epilepticus; Tonic-clonic status epilepticus STATUS EPILEPTICUS Petit mal status epilepticus; Epileptic absence status Complex partial status epilepticus Other status epilepticus Status epilepticus, unspecified Bullous erythema multiforme; Stevens-Johnson syndrome Subarachnoid haemorrhage from carotid siphon and bifurcation Subarachnoid haemorrhage from middle cerebral artery STATUS EPILEPTICUS STATUS EPILEPTICUS STATUS EPILEPTICUS STATUS EPILEPTICUS STEVEN JOHNSONS SYNDROME STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC
Subarachnoid haemorrhage from anterior communicating STROKE - HEMORRHAGIC artery Subarachnoid haemorrhage from posterior communicating STROKE - HEMORRHAGIC artery
Page 105 of 111
I60.4 I60.5 I60.6
DESCRIPTION
Subarachnoid haemorrhage from basilar artery Subarachnoid haemorrhage from vertebral artery Subarachnoid haemorrhage from other intracranial arteries; Multiple involvement of intracranial arteries Subarachnoid haemorrhage from intracranial artery, unspecified; Congenital ruptured berry aneurysm NOS; Subarachnoid haemorrhage from cerebral artery NOS; Subarachnoid haemorrhage from communicating artery NOS Other subarachnoid haemorrhage; Meningeal haemorrhage; Rupture of cerebral arteriovenous malformation Subarachnoid haemorrhage, unspecified Intracerebral haemorrhage in hemisphere, subcortical; Deep intracerebral haemorrhage Intracerebral haemorrhage in hemisphere, cortical; Cerebral lobe haemorrhage; Superficial intracerebral haemorrhage Intracerebral haemorrhage in hemisphere, unspecified Intracerebral haemorrhage in brain stem Intracerebral haemorrhage in cerebellum Intracerebral haemorrhage, intraventricular Intracerebral haemorrhage, multiple localized Other intracerebral haemorrhage Intracerebral haemorrhage, unspecified Acute Subdural haemorrhage; Nontraumatic Subdural haemorrhage Nontraumatic extradural haemorrhage; Nontraumatic epidural haemorrhage Intracranial haemorrhage (nontraumatic), unspecified Cerebral infarction due to thrombosis of precerebral arteries
GROUP
STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC
Case Rate 38,000 38,000 38,000
I60.7
STROKE - HEMORRHAGIC
38,000
11,400
26,600
I60.8 I60.9 I61.0 I61.1 I61.2 I61.3 I61.4 I61.5 I61.6 I61.8 I61.9 I62.0 I62.1 I62.9 I63.0 I63.1 I63.2 I63.3 I63.4 I63.5 I63.6 I63.8 I63.9 I63.9+G46.7* I64 G10 G11.0
STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - HEMORRHAGIC STROKE - INFARCTION
38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 38,000 28,000 28,000 28,000 28,000 28,000 28,000 28,000 28,000 28,000 28,000 28,000 10,400 10,400
11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 11,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 8,400 3,120 3,120
26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 26,600 19,600 19,600 19,600 19,600 19,600 19,600 19,600 19,600 19,600 19,600 19,600 7,280 7,280
Cerebral infarction due to embolism of precerebral arteries STROKE - INFARCTION Cerebral infarction due to unspecified occlusion or stenosis STROKE - INFARCTION of precerebral arteries Cerebral infarction due to thrombosis of cerebral arteries Cerebral infarction due to embolism of cerebral arteries Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries Cerebral infarction due to cerebral venous thrombosis, nonpyogenic Other cerebral infarction Cerebral infarction, unspecified Other lacunar syndrome in unspecified cerebral infarction Stroke, not specified as hemorrhage or infarction Huntington's disease; Huntington's chorea Congenital nonprogressive ataxia Early-onset cerebellar ataxia including Early-onset cerebellar ataxia with essential tremor; Early-onset cerebellar ataxia with myoclonus [Hunt's ataxia]; Earlyonset cerebellar ataxia with retained tendon reflexes; Friedreich's ataxia (autosomal recessiv Cerebellar ataxia with defective DNA repair; Ataxia telangiectasia [Louis-Bar] STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION STROKE - INFARCTION SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
G11.1
10,400
3,120
7,280
G11.3
10,400
3,120
7,280
G11.9
Hereditary ataxia, unspecified; Hereditary cerebellar ataxia SYSTEMIC ATROPHIES INVOLVING CENTRAL NOS; Hereditary cerebellar degeneration; Hereditary NERVOUS SYSTEM cerebellar disease; Hereditary cerebellar syndrome Infantile spinal muscular atrophy, type I [WerdnigHoffman] Other inherited spinal muscular atrophy; Progressive bulbar palsy of childhood [Fazio-Londe]; Spinal muscular atrophy adult form Spinal muscular atrophy childhood form, type II; Spinal muscular atrophy distal; Spinal muscular atrophy juvenile form, type Motor neuron disease; Familial motor neuron disease; AmyotrophicLateral sclerosis; Primary Lateral sclerosis ; Progressive bulbar palsy; Progressive spinal muscular atrophy Spinal muscular atrophy, unspecified SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
10,400
3,120
7,280
G12.0
10,400
3,120
7,280
G12.1
SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
10,400
3,120
7,280
G12.2
SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM
10,400
3,120
7,280
G12.9
10,400
3,120
7,280
Page 106 of 111
PARKINSON'S DISEASE; HEMIPARKINSONISM; PARALYSIS AGITANS; PARKINSONISM OR PARKINSON'S DISEASE NOS; IDIOPATHIC PARKINSONISM OR PARKINSON'S DISEASE; PRIMARY PARKINSONISM OR PARKINSON'S DISEASE Discoid lupus erythematosus; Lupus erythematosus Subacute cutaneous lupus erythematosus Lupus erymatosus profundus; Lupus panniculitis Drug-induced systemic lupus erythematosus Other forms of systemic lupus erythematosus Systemic lupus erythematosus, unspecified Tetanus neonatorum Obstetrical tetanus Other tetanus; Tetanus NOS Tetany; Carpopedal spasm Alpha thalassaemia Beta thalassaemia; Cooley's anaemia; Severe beta thalassaemia; Thalassaemia intermedia; Thalassaemia major; Delta-beta thalassaemia Thalassaemia trait Hereditary persistence of fetal haemoglobin [HPFH] Other thalassaemias Toxic epidermal necrolysis [Lyell] Vertebro-basilar artery syndrome Hemispheric carotid artery syndrome Multiple and bilateral precerebral artery syndromes Amaurosis fugax Transient global amnesia Other transient cerebral ischaemic attacks and related syndromes Transient cerebral ischaemic attack, unspecified; Spasm of cerebral artery; Transient cerebral ischaemia NOS Subdural haemorrhage due to birth injury; Subdural haematoma (localized) due to birth injury Cerebral haemorrhage due to birth injury Intraventricular haemorrhage due to birth injury Subarachnoid haemorrhage due to birth injury Tentorial tear due to birth injury Unspecified intracranial laceration and haemorrhage due to birth injury Other specified brain damage due to birth injury Unspecified brain damage due to birth injury Birth injury to central nervous system, unspecified Cephalhaematoma due to birth injury Bruising of scalp due to birth injury Other birth injuries to scalp Birth injury to scalp, unspecified Birth injury to femur Fracture of clavicle due to birth injury Birth injuries to other parts of skeleton Birth injury to skeleton, unspecified Erb's paralysis due to birth injury Other brachial plexus birth injuries Birth injury to face; Facial congestion due to birth injury Birth injury to external genitalia Other specified birth injuries Birth injury, unspecified Tuberculosis of intrathoracic lymph nodes, confirmed bacteriologically & histologicaly; Tuberculosis of hilar lymph nodes, confirmed bacteriologically & histologicaly; Tuberculosis of mediastinal, lymph nodes, confirmed bacteriologically & histologicaly; Tuberculosis of larynx, trachea and bronchus, confirmed bacteriologically and histologically ; Tuberculosis of bronchus,confirmed bacteriologically and histologically; Tuberculosis of glottis, confirmed bacteriologically and histologically; Tuberculo
GROUP
Case Rate
Professional Fee
G20
SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS TETANUS TETANUS TETANUS TETANUS THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA TOXIC EPIDERMAL NECROLYSIS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS
10,400
3,120
7,280
L93.0 L93.1 L93.2 M32.0 M32.8 M32.9 A33 A34 A35 R29.0 D56.0 D56.1 D56.2 D56.3 D56.4 D56.8 L51.2 G45.0 G45.1 G45.2 G45.3 G45.4 G45.8 G45.9 P10.0 P10.1 P10.2 P10.3 P10.4 P10.9 P11.1 P11.2 P11.9 P12.0 P12.3 P12.8 P12.9 P13.2 P13.4 P13.8 P13.9 P14.0 P14.3 P15.4 P15.5 P15.8 P15.9
11,900 11,900 11,900 11,900 11,900 11,900 16,500 16,500 16,500 16,500 5,600 5,600 5,600 5,600 5,600 5,600 15,900 7,300 7,300 7,300 7,300 7,300 7,300 7,300 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800 13,800
3,570 3,570 3,570 3,570 3,570 3,570 4,950 4,950 4,950 4,950 1,680 1,680 1,680 1,680 1,680 1,680 4,770 2,190 2,190 2,190 2,190 2,190 2,190 2,190 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140 4,140
8,330 8,330 8,330 8,330 8,330 8,330 11,550 11,550 11,550 11,550 3,920 3,920 3,920 3,920 3,920 3,920 11,130 5,110 5,110 5,110 5,110 5,110 5,110 5,110 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660 9,660
A15.4
TUBERCULOSIS, EXTRAPULMONARY
11,900
3,570
8,330
A15.5
11,900
3,570
8,330
A15.6
A15.8
Tuberculous pleurisy, confirmed bacteriologically and histologically TUBERCULOSIS, EXTRAPULMONARY [Tuberculosis of pleura, confirmed bacteriologically and histologically; Tuberculous empyema, confirmed bacteriologically & histologically Other respiratory tuberculosis, confirmed bacteriologically and histologically; Mediastinal tuberculosis, confirmed bacteriologically and histologically; Nasopharyngeal TUBERCULOSIS, EXTRAPULMONARY tuberculosis, confirmed bacteriologically and histologically; Tuberculosis of nose,
11,900
3,570
8,330
11,900
3,570
8,330
Page 107 of 111
A16.3
Tuberculosis of intrathoracic lymph nodes, without mention of bacteriological or histological confirmation; Tuberculosis of hilar lymph nodes NOS without mention of TUBERCULOSIS, EXTRAPULMONARY bacteriological or histological confirmation; Tuberculosis of intrathoracic lymph nodes, Tuberculosis of bronchus, NOS, without mention of bacteriological or histological onfirmation; Tuberculosis of glottis, NOS, without mention of bacteriological or histological onfirmation; Tuberculosis of larynx, NOS, without mention of bacteriologic
11,900
3,570
8,330
A16.4
11,900
3,570
8,330
A16.5
A16.8
Tuberculous pleurisy, without mention of bacteriological or histological confirmation; Tuberculosis of pleura, NOS, without TUBERCULOSIS, EXTRAPULMONARY mention of bacteriological or histological confirmation; Tuberculous empyema, NOS, without mention of bacteriological or his Other respiratory tuberculosis, without mention of bacteriological or histological confirmation; Mediastinal tuberculosis, NOS without mention of bacteriological or TUBERCULOSIS, EXTRAPULMONARY histological confirmation; Nasopharyngeal tuberculosis, NOS without mention of bacteriolog Tuberculous peripheral lymphadenopathy; Tuberculous adenitis Tuberculosis of intestines, peritoneum and mesenteric glands; Tuberculosis of retroperitoneal lymph nodes Erythema tuberculous induratum, ; Lupus exedens; Lupus vulgaris; Lupus exedens, NOS; Lupus vulgaris, NOS; Scrofuloderma Acute miliary tuberculosis of a single specified site Acute miliary tuberculosis of multiple sites Acute miliary tuberculosis, unspecified Other miliary tuberculosis Miliary tuberculosis Tuberculosis of lung, confirmed by sputum microscopy with or without culture; Tuberculous Bronchiectasis, confirmed by sputum microscopy with or without culture; Tuberculous fibrosis of lung, confirmed by sputum microscopy with or without culture; Tubercu Tuberculosis of lung, confirmed by culture only; Tuberculous Bronchiectasis, confirmed by culture only; Tuberculous fibrosis of lung, confirmed by culture only; Tuberculous pneumonia, confirmed by culture only; Tuberculous pneumothorax, confirmed by cul TUBERCULOSIS, EXTRAPULMONARY TUBERCULOSIS, EXTRAPULMONARY
11,900
3,570
8,330
11,900
3,570
8,330
A18.2 A18.3
11,900 11,900
3,570 3,570
8,330 8,330
A18.4 A19.0 A19.1 A19.2 A19.8 A19.9
TUBERCULOSIS, EXTRAPULMONARY TUBERCULOSIS, MILIARY TUBERCULOSIS, MILIARY TUBERCULOSIS, MILIARY TUBERCULOSIS, MILIARY TUBERCULOSIS, MILIARY
11,900 15,100 15,100 15,100 15,100 15,100
3,570 4,530 4,530 4,530 4,530 4,530
8,330 10,570 10,570 10,570 10,570 10,570
A15.0
TUBERCULOSIS, PULMONARY
9,800
2,940
6,860
A15.1
9,800
2,940
6,860
A15.2
Tuberculosis of lung, confirmed histologically only; Tuberculous Bronchiectasis, confirmed histologically only; Tuberculous fibrosis of lung, confirmed histologically only; TUBERCULOSIS, PULMONARY Tuberculous pneumonia, confirmed histologically only; Tuberculous pneumothorax Tuberculosis of lung, confirmed by unspecified means; Tuberculous Bronchiectasis, confirmed but unspecified whether bacteriologically or histologically; Tuberculous fibrosis of lung, confirmed but unspecified whether bacteriologically or histologically Primary respiratory tuberculosis, confirmed bacteriologically and histologically Respiratory tuberculosis unspecified, confirmed bacteriologically and histologically Tuberculosis of lung, bacteriologically and histologically negative; Tuberculous Bronchiectasis , bacteriologically and histologically negative; Tuberculous fibrosis of lung, bacteriologically and histologically negative; Tuberculous pneumonia, bac Tuberculosis of lung, bacteriological and histological examination not done; Tuberculous Bronchiectasis, bacteriological and histological examination not done; Tuberculous fibrosis of lung, bacteriological and histological examination not done; Tuberculo Tuberculosis of lung, NOS, without mention of bacteriological or histological confirmation; Tuberculous bronchiectasis, NOS, without mention of bacteriological or histological confirmation; Tuberculous fibrosis of lung, NOS, without mention of bact
9,800
2,940
6,860
A15.3
9,800
2,940
6,860
A15.7 A15.9
TUBERCULOSIS, PULMONARY TUBERCULOSIS, PULMONARY
9,800 9,800
2,940 2,940
6,860 6,860
A16.0
9,800
2,940
6,860
A16.1
9,800
2,940
6,860
A16.2
9,800
2,940
6,860
Page 108 of 111
Primary respiratory tuberculosis without mention of bacteriological or histological confirmation; Primary respiratory tuberculosis NOS; Primary tuberculous complex Respiratory tuberculosis unspecified, without mention of bacteriological or histological confirmation; Respiratory tuberculosis NOS; Tuberculosis NOS Typhoid fever Paratyphoid fever A Paratyphoid fever B Paratyphoid fever C Paratyphoid fever, unspecified; Infection due to Salmonella paratyphi NOS Salmonella enteritis; Salmonellosis Salmonella septicaemia Localized salmonella infections Other specified salmonella infections Salmonella infection, unspecified Unspecified contracted kidney; Atrophy of kidney (terminal); Renal sclerosis NOS Small kidney, unilateral Small kidney, bilateral Small kidney, unspecified Other specified disorders of kidney and ureter; Hypertrophy of kidney, Megaloureter, Nephroptosis, Pyelitis cystica, Pyeloureteritis cystica, Ureteritis cystica, Ureterocele Disorder of kidney and ureter, unspecified; Nephropathy NOS; Renal disease NOS Other disorders of kidney and ureter in other diseases classified elsewhere Acute cystitis Chronic Interstitial cystitis Other chronic cystitis Trigonitis; Urethrotrigonitis Cystitis, unspecified Urinary tract infection, site not specified Cervical disc disorder with radiculopathy Other cervical disc displacement Other cervical disc degeneration Other cervical VERTEBRAL DISC DISORDERS LUMBAR AND OTHER INTERVERTEBRAL DISC DISORDERS WITH RADICULOPATHY; SCIATICA DUE TO INTERVERTEBRAL DISC DISORDER Other specified intervertebral disc displacement Lumbago due to displacement of intervertebral disc Other specified intervertebral disc degenerations Schmorl's node
GROUP
Case Rate
A16.7
9,800
A16.9 A01.0 A01.1 A01.2 A01.3 A01.4 A02.0 A02.1 A02.2 A02.8 A02.9 N26 N27.0 N27.1 N27.9 N28.8
TUBERCULOSIS, PULMONARY TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY
9,800 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 11,300 11,300 11,300 11,300 11,300
2,940 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,390 3,390 3,390 3,390 3,390
6,860 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,910 7,910 7,910 7,910 7,910
N28.9 N29.8* N30.0 N30.1 N30.2 N30.3 N30.9 N39.0 M50.1 M50.2 M50.3 M50.8 M51.1 M51.2 M51.3 M51.4 M51.8 M99.0 M99.1 M99.3 M99.5
URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS
11,300 11,300 7,500 7,500 7,500 7,500 7,500 7,500 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800 7,800
3,390 3,390 2,250 2,250 2,250 2,250 2,250 2,250 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340 2,340
7,910 7,910 5,250 5,250 5,250 5,250 5,250 5,250 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460 5,460
Other specified intervertebral VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS SEGMENTAL AND SOMATIC DYSFUNCTION, RIB CAGE Subluxation complex (vertebral) Osseous stenosis of neural canal Intervertebral disc stenosis of neural canal VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS
Page 109 of 111
M99.7 H81.0 H81.1 H81.2 H81.3 H81.4 H81.8 H81.9 H83.1 H83.2 R42 A96.0 A96.1 A98.4 A98.8 A99 B15.0 B15.9 B16.0 B16.1 B16.2 B16.9 B17.0 B17.1 B17.2 B17.8 B18.0 B18.1 B18.2 B18.8 B18.9 B19.0 B19.9 A80.1 A80.2
DESCRIPTION
Connective tissue and disc stenosis of intervertebral foramina Mnire's disease; Labyrinthine hydrops; Mnire's syndrome or vertigo Benign paroxysmal vertigo Vestibular neuronitis Other peripheral vertigo; Lermoyez' syndrome; Aural Vertigo ; Otogenic Vertigo; Peripheral NOS Vertigo Vertigo of central origin; Central positional nystagmus Other disorders of vestibular function Disorder of vestibular function, unspecified; Vertiginous syndrome NOS Labyrinthine fistula Labyrinthine dysfunction; Hypersensitivity of labyrinth; Hypofunction of labyrinth; Loss of function Of labyrinth Dizziness and giddiness; Light-headedness; Vertigo NOS
GROUP
VERTEBRAL DISC DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS
Case Rate 7,800 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 5,700 7,900 7,900 7,900 7,900 7,900 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 11,800 21,100 21,100
Professional Fee 2,340 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 1,710 2,370 2,370 2,370 2,370 2,370 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 3,540 6,330 6,330
Health Care Institution Fee 5,460 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 3,990 5,530 5,530 5,530 5,530 5,530 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 8,260 14,770 14,770
Junin haemorrhagic fever; Argentinian haemorrhagic fever VIRAL HEMORRHAGIC FEVER Machupo haemorrhagic fever; Bolivian haemorrhagic fever VIRAL HEMORRHAGIC FEVER Ebola virus disease Other specified viral haemorrhagic fevers Unspecified viral haemorrhagic fever ACUTE HEPATITIS A WITH HEPATIC COMA ACUTE HEPATITIS A WITHOUT HEPATIC COMA; HEPATITIS A (ACUTE)(VIRAL) NOS ACUTE HEPATITIS B WITH DELTA-AGENT (COINFECTION) WITH HEPATIC COMA ACUTE HEPATITIS B WITH DELTA-AGENT (COINFECTION) WITHOUT HEPATIC COMA ACUTE HEPATITIS B WITHOUT DELTA-AGENT WITH HEPATIC COMA ACUTE HEPATITIS B WITHOUT DELTA-AGENT AND WITHOUT HEPATIC COMA; HEPATITIS B (ACUTE)(VIRAL) NOS VIRAL HEMORRHAGIC FEVER VIRAL HEMORRHAGIC FEVER VIRAL HEMORRHAGIC FEVER VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS
ACUTE DELTA-(SUPER)INFECTION OF HEPATITIS B CARRIER VIRAL HEPATITIS ACUTE HEPATITIS C ACUTE HEPATITIS E OTHER SPECIFIED ACUTE VIRAL HEPATITIS; HEPATITIS NONA NON-B (ACUTE)(VIRAL) NEC CHRONIC VIRAL HEPATITIS B WITH DELTA-AGENT CHRONIC VIRAL HEPATITIS B WITHOUT DELTA-AGENT; CHRONIC (VIRAL) HEPATITIS B CHRONIC VIRAL HEPATITIS C OTHER CHRONIC VIRAL HEPATITIS CHRONIC VIRAL HEPATITIS, UNSPECIFIED UNSPECIFIED VIRAL HEPATITIS HEPATIC WITH COMA UNSPECIFIED VIRAL HEPATITIS WITHOUT HEPATIC COMA; VIRAL HEPATITIS NOS Acute paralytic poliomyelitis, wild virus, imported Acute paralytic poliomyelitis, wild virus, indigenous VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM
Page 110 of 111
A80.9 A81.0 A81.1 A81.2 A81.9 A82.0 A82.1 A82.9 A83.0 A83.2 A83.5 A83.8 A83.9 A85.2 A85.8 A86 A88.8 A89 A37.0 A37.1 A37.8 A37.9 A20.0 A20.9 A21.0 A21.1 A21.2 A21.3 A21.9 A22.0 A22.2 A22.7 A22.9 A23.1 A23.9 A24.0 A24.1 A25.9 A26.8 A26.9 A28.0 A28.1 A28.8 A28.9
DESCRIPTION
Acute poliomyelitis, unspecified Creutzfeldt-Jakob disease; Subacute spongiform encephalopathy Subacute sclerosing panencephalitis; Dawson's inclusion body encephalitis ; Van Bogaert's sclerosing leukoencephalopathy Progressive multifocal leukoencephalopathy; Multifocal leukoencephalopathy NOS Atypical virus infection of central nervous system, unspecified; Prion disease of central nervous system NOS Sylvatic rabies Urban rabies Rabies, unspecified Japanese encephalitis Eastern equine encephalitis California encephalitis; California meningoencephalitis La Crosse encephalitis Other mosquito-borne viral encephalitis Mosquito-borne viral encephalitis, unspecified Arthropod-borne viral encephalitis, unspecified; Other specified viral encephalitis; Encephalitis lethargic; Von Economo-Cruchet disease
GROUP
VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM
Case Rate 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 21,100 10,600 10,600 10,600 10,600 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700 11,700
Professional Fee 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 6,330 3,180 3,180 3,180 3,180 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510 3,510
Health Care Institution Fee 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 14,770 7,420 7,420 7,420 7,420 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190 8,190
Unspecified viral encephalitis; Viral encephalomyelitis NOS; VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM Viral meningoencephalitis NOS Other specified viral infections of central nervous system Unspecified viral infection of central nervous system Whooping cough due to Bordetella pertussis Whooping cough due to Bordetella parapertussis Whooping cough due to other Bordetella species Whooping cough, unspecified Bubonic plague Plague, unspecified Ulceroglandular tularaemia; Ophthalmic tularaemia Oculoglandular tularaemia; Ophthalmic tularaemia Pulmonary tularaemia Gastrointestinal tularaemia; Abdominal tularaemia Tularaemia, unspecified Cutaneous anthrax; Malignant carbuncle; Malignant pustule Gastrointestinal anthrax Anthrax septicaemia Anthrax, unspecified Brucellosis due to Brucella abortus Brucellosis, unspecified Glanders; Infection due to Pseudomonas mallei; Malleus Acute and fulminating melioidosis; Melioidosis pneumonia ; Melioidosis septicaemia Rat-bite fever, unspecified Other forms of erysipeloid Erysipeloid, unspecified Pasteurellosis Cat-scratch disease; Cat-scratch fever Other specified zoonotic bacterial diseases, not elsewhere classified Zoonotic bacterial disease, unspecified VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM WHOOPING COUGH WHOOPING COUGH WHOOPING COUGH WHOOPING COUGH ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES
Page 111 of 111

PhilHealth Circular No. 0035, s.2013 Annex 1 List of Medical Case Rates

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PhilHealth Circular No. 0035, s.2013 Annex 1 List of Medical Case Rates

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ANNEX 1.

LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE

Case Rate 12,000 12,000 12,000 12,000 12,000 10,000

Professional Fee 3,600 3,600 3,600 3,600 3,600 3,000

ABSCESS OF RESPIRATORY TRACT

Case Rate 6,000 6,000

Professional Fee 1,800 1,800

Health Care Institution Fee 4,200 4,200

ACUTE GASTROENTERITIS ACUTE RENAL FAILURE

ACUTE RENAL FAILURE

N17.2 N17.8 N17.9 O08.4

19,300 19,300 19,300 19,300

5,790 5,790 5,790 5,790

13,510 13,510 13,510 13,510

J80 T78.1 T78.3 T78.4 T78.8 T78.9

32,000 6,200 6,200 6,200 6,200 6,200

9,600 1,860 1,860 1,860 1,860 1,860

22,400 4,340 4,340 4,340 4,340 4,340

Health Care Institution Fee

D55.8 D55.9 D56.9

ANEMIA ANEMIA ANEMIA

10,000 10,000 10,000

3,000 3,000 3,000

7,000 7,000 7,000

D57.0 D57.1 D57.3 D57.8 D58.0 D58.1

10,000 10,000 10,000 10,000 10,000 10,000

3,000 3,000 3,000 3,000 3,000 3,000

7,000 7,000 7,000 7,000 7,000 7,000

D58.8 D58.9 D59.0

10,000 10,000 10,000

3,000 3,000 3,000

7,000 7,000 7,000

D59.2 D59.4 D59.5

10,000 10,000 10,000

3,000 3,000 3,000

7,000 7,000 7,000

D59.6 D59.8 D59.9 D60.1

10,000 10,000 10,000 10,000

3,000 3,000 3,000 3,000

7,000 7,000 7,000 7,000

ASTHMA IN ACUTE EXACERBATION

J45.10 J45.80 J45.90 J46 J98.1 M54.01 M54.06 M54.08

9,000 9,000 9,000 9,000 13,800 6,400 6,400 6,400

2,700 2,700 2,700 2,700 4,140 1,920 1,920 1,920

6,300 6,300 6,300 6,300 9,660 4,480 4,480 4,480

Professional Fee 1,920

Health Care Institution Fee 4,480

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

BACK PAIN, RADICULOPATHY, SCIATICA

I47.1 I47.2 I47.9 I48 I49.0 I49.1 I49.2 I49.3 I49.4

12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200 12,200

Case Rate 13,200 11,300 11,300 11,300

Professional Fee 3,960 3,390 3,390 3,390

Health Care Institution Fee 9,240 7,910 7,910 7,910

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CHRONIC OBSTRUCTIVE PULMONARY DISEASE