Appendix Table A. Diagnostic and Procedure Codes to Identify Immunocompromising Conditions for Assessment of Risk
Condition / Code Type / Code(s) / DescriptionHIV / Diagnosis
ICD-9-CM / 042 / Human immunodeficiency virus (HIV) disease
V08 / Asymptomatic HIV infections status
079.53 / HIV-2 infection
Malignant neoplasms / Diagnosis
ICD-9-CM / 140.x-172.x / Malignant neoplasms
174.x-195.x / Malignant neoplasms
196.x-199.x / Secondary and unspecified malignancies
200.xx, 202.xx / Lymphomas
201.xx / Hodgkin's Disease
203.xx / Multiple myeloma
204.xx-208.xx / Leukemia
209.0x-209.3x, 209.7x / Malignant carcinoid tumors of small intestine, appendix, large intestine, rectum, other sites; malignant poorly differentiated neuroendocrine tumors; secondary neuroendocrine tumors
238.4-238.7x / Polycythemia vera, histiocytic and mast cells, plasma cells, other lymphatic and hemotopoietic tissues
511.81 / Malignant pleural effusion
960.7 / Poisoning by antineoplastic antibiotics
963.1 / Poisoning by antineoplastic/immunosuppressive agent
999.81 / Extravasation of vesicant chemotherapy
V58.1x / Encounter for antineoplastic chemotherapy and immunotherapy
V66.2 / Convalescence and palliative care following chemotherapy
V67.2 / Cancer chemotherapy follow-up
E930.7 / Adverse effect – antineoplastic antibiotics
E933.1 / Adverse effect – antineoplastic/immunosuppressive
Procedure
ICD-9 / 00.10 / Implant chemotherapeutic agent
00.15 / High-dose infusion, interleukin-2
99.25 / Injection/infusion of cancer chemotherapeutic substance
99.28 / Immunotherapy (BRM) as antineoplastic agent
Procedure
CPT/ HCPCS / 0519F / Planned chemotherapy regimen
3300F-3312F / Cancer staging
3315F-3316F / Estrogen/progesterone receptor-positive and receptor-negative breast cancer
3317F-3318F / Pathology report documenting malignancy
3350F / Mammogram assessment category of "known biopsy proven malignancy", documented (RAD)
4163F / Patient counseling at a minimum on all of the following treatment options for clinically localized prostate cancer: active surveillance, AND interstitial prostate brachytherapy, AND external beam radiotherapy, AND radical prostatectomy, provided prior to initiation of treatment (PRCA)
4164F / Adjuvant (ie, in combination with external beam radiotherapy to the prostate for prostate cancer) hormonal therapy (gonadotropin-releasing hormone [GnRH] agonist or antagonist) prescribed/administered (PRCA)
4180F / Adjuvant chemotherapy referred, prescribed, or previously received for Stage III colon cancer (ONC)
51720 / Bladder instillation of anticarcinogenic agent (including retention time)
61517 / Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure)
90586 / Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use
96400-96450 / Chemotherapy administration
96542 / Chemotherapy injection
C8953-C8955 / Chemotherapy administration
C9235 / Chemotherapy drugs
C9414-C9415 / Chemotherapy drugs
C9417-C9433 / Chemotherapy drugs
C9435-C9437 / Chemotherapy drugs
G0355-G0356 / Chemotherapy administration
G0359-G0362 / Chemotherapy administration
G3001 / Chemotherapy drug
J0128, J0594, C1178, J0894, J3315 / Chemotherapy drugs
J8510-J8530, J8560-J8565, J8600-J8610, J8700-J8999 / Chemotherapy drugs
Q0083-Q0085 / Chemotherapy administration
Q0163-Q0181 / Antiemetics for use during chemotherapy
Q2017 / Chemotherapy drugs
S0108, S0116, S0156, S0170, S0172, S0175-S0178, S0182, S0187 / Chemotherapy drugs
S9329-S9331 / Home infusion, chemotherapy
S9559 / Home injectable therapy, interferon
Nephrotic syndrome / Diagnosis
ICD-9-CM / 581.xx / Nephrotic syndrome
Chronic renal failure, including end-stage renal disease / Diagnosis
ICD-9-CM / 285.21 / Anemia in chronic renal disease
403.01, 403.11, 403.91 / Hypertensive chronic kidney disease malignant or benign or unspecified, with kidney disease stage V or ESRD
404.02-404.03, 404.12-404.13, 404.92-404.93 / Hypertensive heart and kidney disease, malignant or benign or unspecified, with kidney disease stage V or ESRD
458.21 / Hypotension of hemodialysis
582.xx-583.xx / Chronic glomerulonephritis, Nephritis and nephropathy, not specified as acute or chronic
585.5-585.6 / Chronic kidney disease, stage V or ESRD
586 / Renal failure, unspecified
588.0 / Renal osteodystrophy
588.8x-588.9 / Other specified or unspecified disorders resulting from impaired renal function
593.71-593.73 / Vesicoureteral reflux with reflux nephropathy, bilateral or NOS
792.5 / Cloudy hemodialysis (peritoneal) dialysis effluent
996.56 / Mechanical complication due to peritoneal dialysis catheter
996.73 / Other complications due to renal dialysis device, implant, graft
V45.1x / Renal dialysis status
V56.xx / Encounter for dialysis and dialysis catheter care
E879.1 / Kidney dialysis (cause of abnormal reaction or later complication)
Chronic renal failure, including end-stage renal disease / Procedure
ICD-9 / 38.95 / Venous catheterization for renal dialysis
39.27 / Arteriovenostomy for renal dialysis
39.42 / Revision of arteriovenous shunt for renal dialysis
39.95 / Hemodialysis
54.98 / Peritoneal dialysis
Procedure
CPT, HCPCS / 90918-90999, G0308-G0327 / Hemodialysis procedures, ESRD-related services, dialysis training, hemoperfusion
93990 / Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)
99512 / Home visit for hemodialysis
0505F / Hemodialysis plan of care documented (ESRD, P-ESRD)
0507F / Peritoneal dialysis plan of care documented (ESRD)
4052F-4055F / Hemodialysis , peritoneal dialysis
A4690 / Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
E1510, E1590- E1594 / Dialysis equipment
E1630 / Reciprocating peritoneal dialysis system
E1632 / Wearable artificial kidney, each
E1635 / Compact (portable) travel hemodialyzer system
G0257 / Unscheduled or emergency dialysis treatment for an ESRD patient in a hospital outpatient department that is not certified as an ESRD facility
G8075-G8085 / ESRD patient needs
G8487-G8488, G8495 / CKD measures group/ESRD reporting
S9335, S9339 / Home therapy, dialysis
Organ transplantation / Diagnosis ICD-9-CM / V42.0, V42.1, V42.6, V42.7, V42.81-V42.84 / Organs replaced by transplant
V996.8x / Complication of transplantation
Organ transplantation / Procedure ICD-9 / 33.5x / Lung transplant
33.6 / Combined heart-lung transplant
37.51 / Heart transplant
41.0x / Bone marrow or hematopoietic stem cell transplant
46.97 / Transplant of intestine
50.5x / Liver transplant
52.80-52.83 / Transplant of pancreas
52.85-52.86 / Allotransplantation of cells of islets of Langerhans (pancreas, not otherwise specified)
55.69 / Kidney transplant
Procedure
CPT/HCPCS / 32851-32854 / Lung transplant
33935 / Heart-lung transplant
33945 / Heart transplant
38240-38242 / Bone marrow transplant
44135-44137 / Intestinal transplant
47135, 47136 / Liver transplant
48554, 48556 / Pancreas transplant
50360-50365, 50380 / Kidney transplant
0141T-0143T, G0341-G0343 / Pancreatic islet cell transplantation
S2053 / Transplantation of small intestine and liver allografts
S2054 / Transplantation of multivisceral organs
S2065 / Simultaneous pancreas kidney transplantation
S2102 / Islet cell tissue transplant from pancreas; allogeneic
S2142 / Cord blood-derived stem-cell transplantation, allogeneic
S2150 / Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications including pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre- and posttransplant care in the global definition
S2152 / Solid organ(s), complete or segmental, single organ or combination of organs; deceased or living donor (s), procurement, transplantation, and related complications; including: drugs; supplies; hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services, and the number of days of pre and posttransplant care in the global definition