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2018 Clinical Quality Measure Scoring Guide

Clinical quality measures, or CQMs, are statistics that seek to quantify the quality of services performed by health care providers. These statistics involve data related to a provider’s ability to deliver certain services or their compliance with long-term health care goals. Electronic versions of these measures, known as eCQMs, are automatically tracked by certified EHR technology based on actions a provider might take within the system. eCQMs represent an efficient and more accurate way to submit data for the Quality performance category of the Merit-based Incentive Payment System (MIPS). The purpose of this document is to describe how each of the measures tracked by RevolutionEHR is scored. To locate the MIPS - Quality scorecard, navigate to Reports > Administration > Providers > MIPS – Quality:

2018 Clinical Quality Measure Scoring Guide February 23, 2018 2

Table of Contents

Diabetes: Eye Exam (CMS131v6) ............................................................................................ 3

Closing the Referral Loop: Receipt of Specialist Report (CMS50v6) .......................................... 4

Documentation of Current Medications in the Medical Record (CMS68v7) .............................. 5

Use of High-Risk Medications in the Elderly (CMS156v6) ......................................................... 6

Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Surgery (CMS133v6) .......... 7

Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures (CMS132v6) ............................................................................................ 9

POAG: Optic Nerve Evaluation (CMS143v6) .......................................................................... 11

Diabetic Retinopathy: Macular Edema and Severity (CMS167v6) .......................................... 12

Diabetic Retinopathy: Communication with Physician Managing Diabetes Care (CMS142v6) 13

Appendix A: ICD Codes Included in Diabetes: Eye Exam ........................................................ 15

Appendix B: High-Risk Medications for the Elderly ................................................................ 32

Appendix C: High-Risk Medications for the Elderly with Days Supply Criteria ........................ 50

Appendix D: SNOMED Codes for Cataract Surgery ................................................................ 51

Appendix E: SNOMED Codes for Operative Procedures Related to Cataract Surgery Complications ...................................................................................................................... 53

Appendix F: ICD Codes Included in POAG: Optic Nerve Head Evaluation ................................ 56

Appendix G: ICD Codes Included in Diabetic Retinopathy Measures ...................................... 58

Appendix H: Clinical Exception Codes: Medical Reason ......................................................... 74

Appendix I: Clinical Exception Codes: Patient Reason ............................................................ 75


Diabetes: Eye Exam (CMS131v6) Denominator: Patients ≥ 18 and < 75years of age with diabetes and a visit during the performance period.

• Exclusion: patients who were in Hospice care during the measurement year

Numerator: Patients in the denominator who had at least one of the following:

1. A retinal or dilated eye exam by an eye care professional in the performance period

• A “retinal or dilated examination” is an encounter where the Fundus test is used to document at least one value

2. A negative retinal exam (no evidence of retinopathy) by an eye care professional < 12 months prior to the performance period

• “No evidence of retinopathy” is a Fundus test where both the following are true for both eyes:

• “Diab Ret Grd” is “None”; and

• “DME Y/N” is “N”

Notes:

• “Visit” is an encounter with at least one service from the following list of CPT codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99337, 99385, 99386, 99387, 99395, 99396, 99397, 92002, 92004, 92012, 92014, G0438, G0439

• “Patients who were in Hospice care during the measurement year” is a patient with a SNOMED code of 385763009 – Hospice care (regime/therapy) or 385765002 – Hospice care management (procedure)

• “Diabetes” ICD codes can be found in Appendix A


Closing the Referral Loop: Receipt of Specialist Report (CMS50v6) Denominator: Number of patients who were both referred by one provider to another during the performance period as documented in the Referrals component and who had a visit during the performance period. Numerator: Number of patients in denominator for whom the referring provider received a report from the provider to whom the patient was referred

• “Received a report” requires the “Report Received” box in the Referrals component to be checked

Notes • “Visit” is an encounter with at least one service with CPT code: 99201, 99202, 99203, 99204, 99205, 99212,

99213, 99214, 99215, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99385, 99386, 99387, 99381, 99382, 99383, 99384, 92002, 92004, 92012, 92014


Documentation of Current Medications in the Medical Record (CMS68v7) Denominator: All visits occurring during the 12-month performance period for patients aged 18 years and older before the start of the period.

• An exception is available for medical reasons where the patient is in an urgent or emergent situation where time is of the essence and the delay of treatment would jeopardize the patient’s health status.

Numerator: Eligible professional attests to documenting, updating or reviewing the patient's current medications using all immediate resources available on the date of the encounter.

• “Attests to documenting” requires the provider to select “Review” on the Medications screen in the encounter prior to signing

Notes

• “Visit” is an encounter with at least one service with CPT code: 90791, 90792, 90832, 90834, 90837, 90839, 92002, 92004, 92012, 92014, 92507, 92508, 92526, 92541, 92542, 92544, 92545, 92547, 92548, 92550, 92557, 92567, 92568, 92570, 92585, 92588, 92626, 96116, 96150, 96151, 96152, 97001, 97002, 97003, 97004, 97532, 97802, 97803, 97804, 98960, 98961, 98962, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99495, 99496, 59400, 59510, 59610, 59618, 99024, 99221, 99222, 99223, 99281, 99282, 99283, 99284, 99285, G0101, G0108, G0270, G0402, G0438, G0439

• Allowed Clinical Exception SNOMED codes:

183932001 Procedure contraindicated (situation)

397745006 Medical contraindication (finding)

407563006 Treatment not tolerated (situation)

428119001 Procedure not indicated (situation)


Use of High-Risk Medications in the Elderly (CMS156v6) Denominator: Patients 65 years and older who had a visit during the performance period.

• Exclusion: patients who were in Hospice care during the measurement year

Numerator 1: Patients with an order for at least one high-risk medication during the performance period OR an order for at least one high-risk medication with days supply criteria with a cumulative medication duration > 90 days during the performance period. Numerator 2: Patients with at least two orders for the same high-risk medication during the performance period OR at least two orders for the same high-risk medication with days supply criteria with a cumulative medication duration > 90 days during the performance period. Notes:

• A lower score indicates better quality

• Measure pertains to medications prescribed by the doctor being measured, not those medications prescribed by others

• “Visit” is an encounter with at least one service with CPT code: 92002, 92012, 92004, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99337, 99385, 99386, 99387, 99395, 99396, 99397, 92002, 92004, 92012, 92014, G0438, G0439

• “Cumulative medication duration” is an individual's total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.

Example: a patient has an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.

• “Patients who were in Hospice care during the measurement year” is a patient with a SNOMED code of 385763009 – Hospice care (regime/therapy) or 385765002 – Hospice care management (procedure)

• “High-risk medications” are listed in Appendix B

• “High-risk medications with days supply criteria” are listed in Appendix C


Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Surgery (CMS133v6)

Denominator: All patients aged 18 years and older who had cataract surgery during but greater than 92 days prior to the end of the performance period as documented within the Surgery History component.

• Exclusion: Patients with significant ocular conditions that impact the visual outcome of surgery Numerator: Patients who had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following cataract surgery.

Notes

• “Cataract surgery” is a surgery with SNOMED code from Appendix D logged in Surgery History:

• “Significant ocular conditions that impact the visual outcome or surgery” must start prior to surgical date and be active on day of surgery. They include:

Acute and Subacute Iridocyclitis, Pathologic Myopia, Retinal Detachment with Retinal Defect, Retinal Vascular Occlusion, Purulent Endophthalmitis, Certain Types of Iridocyclitis, Glaucoma Associated with Congenital Anomalies, Dystrophies, and Systemic Syndromes, Chronic Iridocyclitis, Choroidal Degenerations, Optic Neuritis, Other Background Retinopathy and Retinal Vascular Changes, Other Corneal Deformities, Cloudy Cornea, Other Retinal Disorders, Prior Penetrating Keratoplasty, Other and Unspecified forms of Chorioretinitis and Retinochoroiditis, Amblyopia, Corneal Edema, Nystagmus and other Irregular Eye Movements, Moderate or Severe Impairment, Better Eye, Profound Impairment Lesser Eye, Hereditary Choroidal Dystrophies, Hereditary Retinal Dystrophies, Burn Confined to Eye and Adnexa, Scleritis and Episcleritis, Other Disorders of Sclera, Focal Chorioretinitis and Focal Retinochoroiditis, Degenerative Disorders of Globe, Degeneration of Macula and Posterior Pole, Disseminated Chorioretinitis and Disseminated Retinochoroiditis, Diabetic Macular Edema, Uveitis, Profound Impairment, Both Eyes, Other Proliferative Retinopathy, Cataract Secondary to Ocular Disorders, Disorders of Visual Cortex, Choroidal Detachment, Disorders of Optic Chiasm, Injury to Optic Nerve and Pathways, Choroidal Hemorrhage and Rupture, Other Disorders of Optic Nerve, Glaucoma, Chorioretinal


Scars, Hereditary Corneal Dystrophies, Central Corneal Ulcer, Corneal Opacity and other Disorders of Cornea, Optic Atrophy, Open Wound of Eyeball, Other Endophthalmitis, Separation of Retinal Layers, Diabetic Retinopathy, Visual Field Defects

• Visual acuity of 20/40 or better” is an encounter where the VA of OU, OD, or OS is 20/40 or better in any of the following tests:

Final Refraction with Prism Refraction - Distance Refraction - Nearpoint Technical Refraction Aided Visual Acuity Uncorrected Visual Acuity

• Per CMS guidance: “This measure is to be reported by the clinician performing the cataract surgery procedure. Clinicians who provide only preoperative or postoperative management of cataract patients are not eligible for this measure.”

To account for this, RevolutionEHR will only score the measure for the provider appearing in the patient’s Demographics if he/she is also the provider listed as the surgeon in the Surgery History component. This will prevent the measure from being scored for ODs.


Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures (CMS132v6) Denominator: All patients aged 18 years and older who had cataract surgery during the performance period as documented in the Surgery History component and no significant ocular conditions impacting the surgical complication rate.

• Exclusion: patients with any one of a specified list of significant ocular conditions that impact the surgical complication rate

Numerator: Patients who had one or more specified operative procedures for any of the following major complications within 30 days following cataract surgery: retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence as documented in the Surgery History component.

Notes

• A lower score indicates better quality

• “Cataract surgery” is a surgery with a SNOMED code from Appendix D logged in Surgery History:

• Surgical procedures that count in the numerator for “retained nuclear fragments, endophthalmitis, dislocated or wrong power IOL, retinal detachment, or wound dehiscence” refer to procedures with a SNOMED code from Appendix E logged in Surgery History

• “Significant ocular conditions that impact the surgical complication rate” that count toward denominator exclusions include any of the following:

o Diagnoses made prior to and still active on day of surgery:

▪ Acute and Subacute Iridocyclitis, Adhesions and Disruptions of Iris and Ciliary Body, Central Corneal Ulcer, Burn Confined to Eye and Adnexa, Pseudoexfoliation Syndrome, Senile Cataract, Hypotony of Eye, Cataract Secondary to Ocular Disorders, High Hyperopia, Injury to Optic Nerve and Pathways, Cataract (congenital), Cysts of Iris, Ciliary Body, and Anterior Chamber, Glaucoma, Cataract, Mature or Hypermature,


Traumatic Cataract, Cataract, Posterior Polar, Pathologic Myopia, Open Wound of Eyeball, Certain Types of Iridocyclitis, Vascular Disorders of Iris and Ciliary Body, Hereditary Corneal Dystrophies, Enophthalmos, Uveitis, Chronic Iridocyclitis, Corneal Opacity and other Disorders of Cornea, Cloudy Cornea, Posterior Lenticonus, Aphakia and other Disorders of Lens, Corneal Edema, Retrolental Fibroplasias, Anomalies of Pupillary Function.

o Medication Rx written prior to surgical date and active on day of surgery:

RxNORM

Code

Description

1100691 {30 (Prazosin 5 MG Oral Capsule) } Pack

197625 Doxazosin 1 MG Oral Tablet




198141 Prazosin 5 MG Oral Capsule

199797 Prazosin 1 MG Oral Tablet



260376 Terazosin 10 MG Oral Capsule

312481 Polythiazide 0.5 MG / Prazosin 1 MG Oral Capsule








636360 24 HR Doxazosin 4 MG Extended Release Oral Tablet

636361 24 HR Doxazosin 8 MG Extended Release Oral Tablet

861132 24 HR Alfuzosin hydrochloride 10 MG Extended Release Oral Tablet

861402 Phenoxybenzamine Hydrochloride 10 MG Oral Capsule

863669 Tamsulosin hydrochloride 0.4 MG Oral Capsule

996097 Dutasteride 0.5 MG / Tamsulosin hydrochloride 0.4 MG Oral Capsule

o Surgery with SNOMED code 87021001 (Mechanical vitrectomy by pars plana approach) prior to

cataract surgery

• Per CMS guidance: “This measure is to be reported by the clinician performing the cataract surgery procedure. Clinicians who provide only preoperative or postoperative management of cataract patients are not eligible for this measure.”

To account for this, RevolutionEHR will only score the measure for the provider appearing in the patient’s Demographics if he/she is also the provider listed as the surgeon in the Surgery History component. This will prevent the measure from being scored for ODs.


POAG: Optic Nerve Evaluation (CMS143v6) Denominator: All patients aged 18 years and older with an active diagnosis of primary open-angle glaucoma and one or more office visits during the performance period.

• An exception is available when a medical reason is provided for not performing an optic nerve head evaluation

Numerator: Patients who have an optic nerve head evaluation during one or more office visits within the performance period

Notes

• “Office visit” is an encounter with at least one service with CPT code: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 92002, 92004, 92012, 92014

• “Optic nerve evaluation” requires use of the Optic Nerve test to document each of the following for at least one eye: Vert C/D, NR Rim, Color, Margins

• Included primary open-angle glaucoma ICD codes can be found in Appendix F

• Allowed medical reason exception SNOMED codes can be found in Appendix G


Diabetic Retinopathy: Macular Edema and Severity (CMS167v6) Denominator: All patients aged 18 years and older with an active diagnosis of diabetic retinopathy and an office visit during performance period.

• An exception is available when a medical or patient reason is provided for not performing a dilated macular or fundus examination.

Numerator: Patients who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy AND the presence or absence of macular edema during one or more office visits within the performance period. Notes


• “Dilated macular or fundus exam performed” requires use of the Fundus test to document the following for at least one eye: “Diab Ret Grd” , “DME Y/N”

• “Diab Ret Grd” cannot be “None” as this represents an inconsistency between the active diagnosis of diabetic retinopathy (in Diagnosis History) and the clinical findings. In cases where active retinopathy is not present, the diagnosis should be resolved prior to signing the encounter.

• Included diabetic retinopathy ICD codes can be found in Appendix G

• Allowed medical reason exception SNOMED codes can be found in Appendix H

• Allowed patient reason exception SNOMED codes can be found in Appendix I


Diabetic Retinopathy: Communication with Physician Managing Diabetes Care (CMS142v6) Denominator: All patients aged 18 years and older with an active diagnosis of diabetic retinopathy who had an office visit and dilated macular or fundus exam performed during the performance period.

• An exception is available when a medical or patient reason is documented for not communicating the findings of the dilated macular or fundus exam to the physician who manages the ongoing care of the patient with diabetes

Numerator: Patients with documentation, at least once within the performance period, of the findings of the dilated macular or fundus exam via communication to the physician who manages the patient's diabetic care. Notes


• “Dilated macular or fundus exam performed” requires use of the Fundus test to document the following for at least one eye: “Diab Ret Grd” , “DME Y/N”

• “Diab Ret Grd” cannot be “None” as this represents an inconsistency between the active diagnosis diabetic retinopathy (in Diagnosis History) and the clinical findings. In cases where active retinopathy is not present, the diagnosis should be resolved prior to signing the encounter.

• “Communication” requires:

o use of the “Comm” button on the screen header bar within the encounter where the dilated macular or fundus exam was performed to start a letter:


o use of any of the following templates for the letter: ▪ “Diabetes Encounter Summary for PCP” ▪ “Vision Source Diabetes Encounter Summary for PCP” ▪ “Vision Source Diabetes and Glaucoma Encounter Summary for PCP”

▪ Any other communication template marked for inclusion in the measure through Admin (available for any Flex template that has been “converted” to HTML)

o the designated recipient to be a “Clinician” or “External Provider”

• Included diabetic retinopathy ICD codes can be found in Appendix G

• Allowed medical reason exception SNOMED codes can be found in Appendix H

• Allowed patient reason exception SNOMED codes can be found in Appendix I


Appendix A: ICD Codes Included in Diabetes: Eye Exam

Code Description Code

System

250.00 Diabetes mellitus without mention of complication, type II or unspecified type, not

stated as uncontrolled

ICD9CM

250.01 Diabetes mellitus without mention of complication, type I [juvenile type], not


ICD9CM

250.02 Diabetes mellitus without mention of complication, type II or unspecified type,

uncontrolled

ICD9CM

250.03 Diabetes mellitus without mention of complication, type I [juvenile type],

uncontrolled

ICD9CM

250.10 Diabetes with ketoacidosis, type II or unspecified type, not stated as uncontrolled ICD9CM

250.11 Diabetes with ketoacidosis, type I [juvenile type], not stated as uncontrolled ICD9CM

250.12 Diabetes with ketoacidosis, type II or unspecified type, uncontrolled ICD9CM

250.13 Diabetes with ketoacidosis, type I [juvenile type], uncontrolled ICD9CM

250.20 Diabetes with hyperosmolarity, type II or unspecified type, not stated as

uncontrolled

ICD9CM

250.21 Diabetes with hyperosmolarity, type I [juvenile type], not stated as uncontrolled ICD9CM

250.22 Diabetes with hyperosmolarity, type II or unspecified type, uncontrolled ICD9CM

250.23 Diabetes with hyperosmolarity, type I [juvenile type], uncontrolled ICD9CM

250.30 Diabetes with other coma, type II or unspecified type, not stated as uncontrolled ICD9CM

250.31 Diabetes with other coma, type I [juvenile type], not stated as uncontrolled ICD9CM

250.32 Diabetes with other coma, type II or unspecified type, uncontrolled ICD9CM

250.33 Diabetes with other coma, type I [juvenile type], uncontrolled ICD9CM

250.40 Diabetes with renal manifestations, type II or unspecified type, not stated as

uncontrolled

ICD9CM

250.41 Diabetes with renal manifestations, type I [juvenile type], not stated as

uncontrolled

ICD9CM

250.42 Diabetes with renal manifestations, type II or unspecified type, uncontrolled ICD9CM

250.43 Diabetes with renal manifestations, type I [juvenile type], uncontrolled ICD9CM

250.50 Diabetes with ophthalmic manifestations, type II or unspecified type, not stated as

uncontrolled

ICD9CM

250.51 Diabetes with ophthalmic manifestations, type I [juvenile type], not stated as

uncontrolled

ICD9CM


250.52 Diabetes with ophthalmic manifestations, type II or unspecified type, uncontrolled ICD9CM

250.53 Diabetes with ophthalmic manifestations, type I [juvenile type], uncontrolled ICD9CM

250.60 Diabetes with neurological manifestations, type II or unspecified type, not stated as

uncontrolled

ICD9CM

250.61 Diabetes with neurological manifestations, type I [juvenile type], not stated as

uncontrolled

ICD9CM

250.62 Diabetes with neurological manifestations, type II or unspecified type, uncontrolled ICD9CM

250.63 Diabetes with neurological manifestations, type I [juvenile type], uncontrolled ICD9CM

250.70 Diabetes with peripheral circulatory disorders, type II or unspecified type, not


ICD9CM

250.71 Diabetes with peripheral circulatory disorders, type I [juvenile type], not stated as

uncontrolled

ICD9CM

250.72 Diabetes with peripheral circulatory disorders, type II or unspecified type,

uncontrolled

ICD9CM

250.73 Diabetes with peripheral circulatory disorders, type I [juvenile type], uncontrolled ICD9CM

250.80 Diabetes with other specified manifestations, type II or unspecified type, not stated

as uncontrolled

ICD9CM

250.81 Diabetes with other specified manifestations, type I [juvenile type], not stated as

uncontrolled

ICD9CM

250.82 Diabetes with other specified manifestations, type II or unspecified type,

uncontrolled

ICD9CM

250.83 Diabetes with other specified manifestations, type I [juvenile type], uncontrolled ICD9CM

250.90 Diabetes with unspecified complication, type II or unspecified type, not stated as

uncontrolled

ICD9CM

250.91 Diabetes with unspecified complication, type I [juvenile type], not stated as

uncontrolled

ICD9CM

250.92 Diabetes with unspecified complication, type II or unspecified type, uncontrolled ICD9CM

250.93 Diabetes with unspecified complication, type I [juvenile type], uncontrolled ICD9CM

648.00 Diabetes mellitus of mother, complicating pregnancy, childbirth, or the

puerperium, unspecified as to episode of care or not applicable

ICD9CM


puerperium, delivered, with or without mention of antepartum condition

ICD9CM


puerperium, delivered, with mention of postpartum complication

ICD9CM



puerperium, antepartum condition or complication

ICD9CM


puerperium, postpartum condition or complication

ICD9CM

E10.10 Type 1 diabetes mellitus with ketoacidosis without coma ICD10CM

E10.11 Type 1 diabetes mellitus with ketoacidosis with coma ICD10CM

E10.21 Type 1 diabetes mellitus with diabetic nephropathy ICD10CM

E10.22 Type 1 diabetes mellitus with diabetic chronic kidney disease ICD10CM

E10.29 Type 1 diabetes mellitus with other diabetic kidney complication ICD10CM

E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema ICD10CM

E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular

edema

ICD10CM

E10.321 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with

macular edema

ICD10CM


macular edema, right eye

ICD10CM


macular edema, left eye

ICD10CM


macular edema, bilateral

ICD10CM


macular edema, unspecified eye

ICD10CM

E10.329 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without

macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.331 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with

macular edema

ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.339 Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy

without macular edema

ICD10CM


without macular edema, right eye

ICD10CM


without macular edema, left eye

ICD10CM


without macular edema, bilateral

ICD10CM


without macular edema, unspecified eye

ICD10CM

E10.341 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with

macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.349 Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without

macular edema

ICD10CM



ICD10CM



ICD10CM




ICD10CM



ICD10CM

E10.351 Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular

edema

ICD10CM


edema, right eye

ICD10CM


edema, left eye

ICD10CM


edema, bilateral

ICD10CM


edema, unspecified eye

ICD10CM

E10.3521 Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal

detachment involving the macula, right eye

ICD10CM


detachment involving the macula, left eye

ICD10CM


detachment involving the macula, bilateral

ICD10CM


detachment involving the macula, unspecified eye

ICD10CM


detachment not involving the macula, right eye

ICD10CM


detachment not involving the macula, left eye

ICD10CM


detachment not involving the macula, bilateral

ICD10CM


detachment not involving the macula, unspecified eye

ICD10CM

E10.3541 Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined

traction retinal detachment and rhegmatogenous retinal detachment, right eye

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, left eye

ICD10CM



traction retinal detachment and rhegmatogenous retinal detachment, bilateral

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, unspecified

eye

ICD10CM

E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye ICD10CM

E10.3552 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye ICD10CM

E10.3553 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral ICD10CM

E10.3559 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified

eye

ICD10CM

E10.359 Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular

edema

ICD10CM


edema, right eye

ICD10CM


edema, left eye

ICD10CM


edema, bilateral

ICD10CM



ICD10CM

E10.36 Type 1 diabetes mellitus with diabetic cataract ICD10CM

E10.37X1 Type 1 diabetes mellitus with diabetic macular edema, resolved following

treatment, right eye

ICD10CM


treatment, left eye

ICD10CM


treatment, bilateral

ICD10CM


treatment, unspecified eye

ICD10CM

E10.39 Type 1 diabetes mellitus with other diabetic ophthalmic complication ICD10CM

E10.40 Type 1 diabetes mellitus with diabetic neuropathy, unspecified ICD10CM

E10.41 Type 1 diabetes mellitus with diabetic mononeuropathy ICD10CM

E10.42 Type 1 diabetes mellitus with diabetic polyneuropathy ICD10CM

E10.43 Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy ICD10CM

E10.44 Type 1 diabetes mellitus with diabetic amyotrophy ICD10CM


E10.49 Type 1 diabetes mellitus with other diabetic neurological complication ICD10CM

E10.51 Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene ICD10CM

E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene ICD10CM

E10.59 Type 1 diabetes mellitus with other circulatory complications ICD10CM

E10.610 Type 1 diabetes mellitus with diabetic neuropathic arthropathy ICD10CM

E10.618 Type 1 diabetes mellitus with other diabetic arthropathy ICD10CM

E10.620 Type 1 diabetes mellitus with diabetic dermatitis ICD10CM

E10.621 Type 1 diabetes mellitus with foot ulcer ICD10CM

E10.622 Type 1 diabetes mellitus with other skin ulcer ICD10CM

E10.628 Type 1 diabetes mellitus with other skin complications ICD10CM

E10.630 Type 1 diabetes mellitus with periodontal disease ICD10CM

E10.638 Type 1 diabetes mellitus with other oral complications ICD10CM

E10.641 Type 1 diabetes mellitus with hypoglycemia with coma ICD10CM

E10.649 Type 1 diabetes mellitus with hypoglycemia without coma ICD10CM

E10.65 Type 1 diabetes mellitus with hyperglycemia ICD10CM

E10.69 Type 1 diabetes mellitus with other specified complication ICD10CM

E10.8 Type 1 diabetes mellitus with unspecified complications ICD10CM

E10.9 Type 1 diabetes mellitus without complications ICD10CM

E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-

hyperosmolar coma (NKHHC)

ICD10CM

E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma ICD10CM

E11.21 Type 2 diabetes mellitus with diabetic nephropathy ICD10CM

E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease ICD10CM

E11.29 Type 2 diabetes mellitus with other diabetic kidney complication ICD10CM

E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema ICD10CM

E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular

edema

ICD10CM


macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM


macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


macular edema

ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM


macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


edema

ICD10CM


edema, right eye

ICD10CM


edema, left eye

ICD10CM


edema, bilateral

ICD10CM



ICD10CM


detachment involving the macula, right eye

ICD10CM


detachment involving the macula, left eye

ICD10CM


detachment involving the macula, bilateral

ICD10CM



detachment involving the macula, unspecified eye

ICD10CM


detachment not involving the macula, right eye

ICD10CM


detachment not involving the macula, left eye

ICD10CM


detachment not involving the macula, bilateral

ICD10CM


detachment not involving the macula, unspecified eye

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, right eye

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, left eye

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, bilateral

ICD10CM


traction retinal detachment and rhegmatogenous retinal detachment, unspecified

eye

ICD10CM

E11.3551 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye ICD10CM

E11.3552 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye ICD10CM

E11.3553 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral ICD10CM

E11.3559 Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, unspecified

eye

ICD10CM


edema

ICD10CM


edema, right eye

ICD10CM


edema, left eye

ICD10CM


edema, bilateral

ICD10CM



ICD10CM

E11.36 Type 2 diabetes mellitus with diabetic cataract ICD10CM




ICD10CM


treatment, left eye

ICD10CM



ICD10CM



ICD10CM

E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication ICD10CM

E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified ICD10CM

E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy ICD10CM

E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy ICD10CM

E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy ICD10CM

E11.44 Type 2 diabetes mellitus with diabetic amyotrophy ICD10CM

E11.49 Type 2 diabetes mellitus with other diabetic neurological complication ICD10CM

E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene ICD10CM

E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene ICD10CM

E11.59 Type 2 diabetes mellitus with other circulatory complications ICD10CM

E11.610 Type 2 diabetes mellitus with diabetic neuropathic arthropathy ICD10CM

E11.618 Type 2 diabetes mellitus with other diabetic arthropathy ICD10CM

E11.620 Type 2 diabetes mellitus with diabetic dermatitis ICD10CM

E11.621 Type 2 diabetes mellitus with foot ulcer ICD10CM

E11.622 Type 2 diabetes mellitus with other skin ulcer ICD10CM

E11.628 Type 2 diabetes mellitus with other skin complications ICD10CM

E11.630 Type 2 diabetes mellitus with periodontal disease ICD10CM

E11.638 Type 2 diabetes mellitus with other oral complications ICD10CM

E11.641 Type 2 diabetes mellitus with hypoglycemia with coma ICD10CM

E11.649 Type 2 diabetes mellitus with hypoglycemia without coma ICD10CM

E11.65 Type 2 diabetes mellitus with hyperglycemia ICD10CM

E11.69 Type 2 diabetes mellitus with other specified complication ICD10CM

E11.8 Type 2 diabetes mellitus with unspecified complications ICD10CM

E11.9 Type 2 diabetes mellitus without complications ICD10CM

E13.00 Other specified diabetes mellitus with hyperosmolarity without nonketotic

hyperglycemic-hyperosmolar coma (NKHHC)

ICD10CM

E13.01 Other specified diabetes mellitus with hyperosmolarity with coma ICD10CM


E13.10 Other specified diabetes mellitus with ketoacidosis without coma ICD10CM

E13.11 Other specified diabetes mellitus with ketoacidosis with coma ICD10CM

E13.21 Other specified diabetes mellitus with diabetic nephropathy ICD10CM

E13.22 Other specified diabetes mellitus with diabetic chronic kidney disease ICD10CM

E13.29 Other specified diabetes mellitus with other diabetic kidney complication ICD10CM

E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy with

macular edema

ICD10CM

E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy without

macular edema

ICD10CM

E13.321 Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy

with macular edema

ICD10CM


with macular edema, right eye

ICD10CM


with macular edema, left eye

ICD10CM


with macular edema, bilateral

ICD10CM


with macular edema, unspecified eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E13.331 Other specified diabetes mellitus with moderate nonproliferative diabetic

retinopathy with macular edema

ICD10CM


retinopathy with macular edema, right eye

ICD10CM


retinopathy with macular edema, left eye

ICD10CM



retinopathy with macular edema, bilateral

ICD10CM


retinopathy with macular edema, unspecified eye

ICD10CM


retinopathy without macular edema

ICD10CM


retinopathy without macular edema, right eye

ICD10CM


retinopathy without macular edema, left eye

ICD10CM


retinopathy without macular edema, bilateral

ICD10CM


retinopathy without macular edema, unspecified eye

ICD10CM

E13.341 Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy

with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


E13.351 Other specified diabetes mellitus with proliferative diabetic retinopathy with

macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


traction retinal detachment involving the macula, right eye

ICD10CM


traction retinal detachment involving the macula, left eye

ICD10CM


traction retinal detachment involving the macula, bilateral

ICD10CM


traction retinal detachment involving the macula, unspecified eye

ICD10CM


traction retinal detachment not involving the macula, right eye

ICD10CM


traction retinal detachment not involving the macula, left eye

ICD10CM


traction retinal detachment not involving the macula, bilateral

ICD10CM


traction retinal detachment not involving the macula, unspecified eye

ICD10CM


combined traction retinal detachment and rhegmatogenous retinal detachment,

right eye

ICD10CM



left eye

ICD10CM



bilateral

ICD10CM




unspecified eye

ICD10CM

E13.3551 Other specified diabetes mellitus with stable proliferative diabetic retinopathy,

right eye

ICD10CM

E13.3552 Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left

eye

ICD10CM


bilateral

ICD10CM


unspecified eye

ICD10CM

E13.359 Other specified diabetes mellitus with proliferative diabetic retinopathy without

macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E13.36 Other specified diabetes mellitus with diabetic cataract ICD10CM

E13.37X1 Other specified diabetes mellitus with diabetic macular edema, resolved following


ICD10CM


treatment, left eye

ICD10CM



ICD10CM



ICD10CM

E13.39 Other specified diabetes mellitus with other diabetic ophthalmic complication ICD10CM

E13.40 Other specified diabetes mellitus with diabetic neuropathy, unspecified ICD10CM

E13.41 Other specified diabetes mellitus with diabetic mononeuropathy ICD10CM

E13.42 Other specified diabetes mellitus with diabetic polyneuropathy ICD10CM

E13.43 Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy ICD10CM


E13.44 Other specified diabetes mellitus with diabetic amyotrophy ICD10CM

E13.49 Other specified diabetes mellitus with other diabetic neurological complication ICD10CM

E13.51 Other specified diabetes mellitus with diabetic peripheral angiopathy without

gangrene

ICD10CM

E13.52 Other specified diabetes mellitus with diabetic peripheral angiopathy with

gangrene

ICD10CM

E13.59 Other specified diabetes mellitus with other circulatory complications ICD10CM

E13.610 Other specified diabetes mellitus with diabetic neuropathic arthropathy ICD10CM

E13.618 Other specified diabetes mellitus with other diabetic arthropathy ICD10CM

E13.620 Other specified diabetes mellitus with diabetic dermatitis ICD10CM

E13.621 Other specified diabetes mellitus with foot ulcer ICD10CM

E13.622 Other specified diabetes mellitus with other skin ulcer ICD10CM

E13.628 Other specified diabetes mellitus with other skin complications ICD10CM

E13.630 Other specified diabetes mellitus with periodontal disease ICD10CM

E13.638 Other specified diabetes mellitus with other oral complications ICD10CM

E13.641 Other specified diabetes mellitus with hypoglycemia with coma ICD10CM

E13.649 Other specified diabetes mellitus with hypoglycemia without coma ICD10CM

E13.65 Other specified diabetes mellitus with hyperglycemia ICD10CM

E13.69 Other specified diabetes mellitus with other specified complication ICD10CM

E13.8 Other specified diabetes mellitus with unspecified complications ICD10CM

E13.9 Other specified diabetes mellitus without complications ICD10CM

O24.011 Pre-existing type 1 diabetes mellitus, in pregnancy, first trimester ICD10CM

O24.012 Pre-existing type 1 diabetes mellitus, in pregnancy, second trimester ICD10CM

O24.013 Pre-existing type 1 diabetes mellitus, in pregnancy, third trimester ICD10CM

O24.019 Pre-existing type 1 diabetes mellitus, in pregnancy, unspecified trimester ICD10CM

O24.02 Pre-existing type 1 diabetes mellitus, in childbirth ICD10CM

O24.03 Pre-existing type 1 diabetes mellitus, in the puerperium ICD10CM

O24.111 Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester ICD10CM

O24.112 Pre-existing type 2 diabetes mellitus, in pregnancy, second trimester ICD10CM

O24.113 Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester ICD10CM

O24.119 Pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester ICD10CM

O24.12 Pre-existing type 2 diabetes mellitus, in childbirth ICD10CM

O24.13 Pre-existing type 2 diabetes mellitus, in the puerperium ICD10CM

O24.311 Unspecified pre-existing diabetes mellitus in pregnancy, first trimester ICD10CM

O24.312 Unspecified pre-existing diabetes mellitus in pregnancy, second trimester ICD10CM


O24.313 Unspecified pre-existing diabetes mellitus in pregnancy, third trimester ICD10CM

O24.319 Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester ICD10CM

O24.32 Unspecified pre-existing diabetes mellitus in childbirth ICD10CM

O24.33 Unspecified pre-existing diabetes mellitus in the puerperium ICD10CM

O24.811 Other pre-existing diabetes mellitus in pregnancy, first trimester ICD10CM

O24.812 Other pre-existing diabetes mellitus in pregnancy, second trimester ICD10CM

O24.813 Other pre-existing diabetes mellitus in pregnancy, third trimester ICD10CM

O24.819 Other pre-existing diabetes mellitus in pregnancy, unspecified trimester ICD10CM

O24.82 Other pre-existing diabetes mellitus in childbirth ICD10CM

O24.83 Other pre-existing diabetes mellitus in the puerperium ICD10CM


Appendix B: High-Risk Medications for the Elderly

RxNORM Code Description

1000351 Estrogens, Conjugated (USP) 0.3 MG / medroxyprogesterone acetate 1.5 MG Oral Tablet



1000356 Estrogens, Conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral Tablet

1000395 {28 (Estrogens, Conjugated (USP) 0.625 MG / medroxyprogesterone acetate 2.5 MG Oral

Tablet) } Pack

1000398 {28 (Estrogens, Conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral

Tablet) } Pack

1000486 {14 (Estrogens, Conjugated (USP) 0.625 MG / medroxyprogesterone acetate 5 MG Oral

Tablet) / 14 (Estrogens, Conjugated (USP) 0.625 MG Oral Tablet) } Pack


Tablet) } Pack


Tablet) } Pack

1010696 Carbinoxamine maleate 0.8 MG/ML Oral Solution

1012904 Carbinoxamine maleate 4 MG Oral Tablet

1013619 Chlorpheniramine Maleate 3 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet

1014331 Brompheniramine Maleate 0.4 MG/ML / chlophedianol hydrochloride 2.5 MG/ML /

Pseudoephedrine Hydrochloride 6 MG/ML Oral Solution

1020477 Diphenhydramine Hydrochloride 50 MG Oral Capsule

1038876 Acetaminophen 32 MG/ML / Chlorpheniramine Maleate 0.2 MG/ML / Dextromethorphan

Hydrobromide 1 MG/ML Oral Solution

1041814 thyroid (USP) 97.5 MG Oral Tablet

1042684 Acetaminophen 33.3 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine

succinate 0.417 MG/ML Oral Solution

1042688 Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG / Dextromethorphan

Hydrobromide 10 MG / Phenylephrine Hydrochloride 5 MG Oral Capsule

1042693 Chlorpheniramine Maleate 0.4 MG/ML / Codeine Phosphate 2 MG/ML / Phenylephrine

Hydrochloride 1 MG/ML Oral Solution

1043400 Acetaminophen 21.7 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine

succinate 0.417 MG/ML Oral Solution

1046751 Acetaminophen 325 MG / Diphenhydramine Hydrochloride 25 MG / Phenylephrine

Hydrochloride 5 MG Oral Tablet

1046781 Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG / Phenylephrine Hydrochloride

5 MG Oral Tablet

1046799 {12 (Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG / Phenylephrine

Hydrochloride 5 MG Oral Tablet) / 12 (Acetaminophen 325 MG / Phenylephrine

Hydrochloride 5 MG Oral Tablet) } Pack


1046815 Atropine Sulfate 0.0194 MG / Hyoscyamine Sulfate 0.1037 MG / Phenobarbital 16.2 MG /

Scopolamine Hydrobromide 0.0065 MG Oral Tablet

1048124 12 HR Atropine Sulfate 0.04 MG / Chlorpheniramine Maleate 8 MG / Hyoscyamine Sulfate

0.19 MG / Pseudoephedrine Hydrochloride 90 MG / Scopolamine Hydrobromide 0.01 MG

Extended Release Oral Tablet

1049289 1 ML Diphenhydramine Hydrochloride 50 MG/ML Prefilled Syringe

1049630 Diphenhydramine Hydrochloride 25 MG Oral Tablet

1049633 Diphenhydramine Hydrochloride 50 MG/ML Injectable Solution

1049900 Diphenhydramine Hydrochloride 12.5 MG Chewable Tablet

1049904 Diphenhydramine Hydrochloride 12.5 MG Oral Strip

1049906 Diphenhydramine Hydrochloride 2.5 MG/ML Oral Solution

1049909 Diphenhydramine Hydrochloride 25 MG Oral Capsule

1049918 Diphenhydramine Hydrochloride 25 MG Oral Strip

1052462 Acetaminophen 325 MG / Diphenhydramine Hydrochloride 12.5 MG Oral Tablet

1052467 Acetaminophen 500 MG / Diphenhydramine Hydrochloride 12.5 MG Oral Tablet

1052647 Acetaminophen 325 MG / doxylamine succinate 6.25 MG / Phenylephrine Hydrochloride 5

MG Oral Capsule


5 MG Oral Tablet

1052928 Diphenhydramine Hydrochloride 25 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet

1053624 Chlorpheniramine Maleate 1 MG / Pseudoephedrine Hydrochloride 15 MG Chewable

Tablet

1085945 Diphenhydramine Hydrochloride 50 MG Oral Tablet

1086463 Chlorpheniramine Maleate 0.8 MG/ML / Phenylephrine Hydrochloride 2 MG/ML Oral

Solution


Hydrobromide 1 MG/ML Oral Suspension


Hydrobromide 10 MG / Phenylephrine Hydrochloride 5 MG Oral Tablet

1087459 12 HR CHLORPHENIRAMINE POLISTIREX 1.6 MG/ML / HYDROCODONE POLISTIREX 2 MG/ML

Extended Release Suspension

1087607 Acetaminophen 500 MG / Diphenhydramine Hydrochloride 50 MG Oral Tablet

1088934 Chlorzoxazone 375 MG Oral Tablet


1089822 Acetaminophen 325 MG / Dextromethorphan Hydrobromide 15 MG / doxylamine succinate

6.25 MG / Pseudoephedrine Hydrochloride 30 MG Oral Capsule


Hydrobromide 15 MG / Pseudoephedrine Hydrochloride 30 MG Oral Tablet

1090443 Chlorpheniramine Maleate 4 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet

1090463 Brompheniramine Maleate 0.2 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML /

Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution

1090699 Chlorpheniramine Maleate 2 MG / Pseudoephedrine Hydrochloride 30 MG Oral Tablet


1092189 Acetaminophen 500 MG / Diphenhydramine Hydrochloride 25 MG Oral Tablet

1092373 Acetaminophen 33.3 MG/ML / Diphenhydramine Hydrochloride 1.67 MG/ML Oral Solution

1092566 {7 (24 HR Guanfacine 1 MG Extended Release Oral Tablet) / 7 (24 HR Guanfacine 2 MG

Extended Release Oral Tablet) } Pack

1093098 Diphenhydramine Hydrochloride 25 MG Disintegrating Oral Tablet

1094131 Acetaminophen 65 MG/ML / Dextromethorphan Hydrobromide 2 MG/ML /

Diphenhydramine Hydrochloride 2.5 MG/ML Oral Solution

1094350 Dextromethorphan Hydrobromide 3 MG/ML / doxylamine succinate 1.25 MG/ML /


1094355 doxylamine succinate 1.25 MG/ML / Pseudoephedrine Hydrochloride 6 MG/ML Oral

Solution


6.25 MG Oral Capsule

1098443 {10 (Acetaminophen 325 MG / Dextromethorphan Hydrobromide 10 MG / Guaifenesin 100

MG / Phenylephrine Hydrochloride 5 MG Oral Tablet) / 10 (Acetaminophen 325 MG /

Diphenhydramine Hydrochloride 25 MG / Phenylephrine Hydrochloride 5 MG Oral Tablet) }

Pack


Hydrobromide 15 MG Oral Tablet



1098498 Brompheniramine Maleate 0.2 MG/ML / Pseudoephedrine Hydrochloride 3 MG/ML Oral

Solution

1099308 Pseudoephedrine Hydrochloride 6 MG/ML / Triprolidine Hydrochloride 0.25 MG/ML Oral

Solution

1099446 Pseudoephedrine Hydrochloride 60 MG / Triprolidine Hydrochloride 2.5 MG Oral Tablet

1099659 Phenylephrine Hydrochloride 10 MG / Triprolidine Hydrochloride 2.5 MG Oral Tablet

1099668 Pseudoephedrine Hydrochloride 10 MG/ML / Triprolidine Hydrochloride 0.938 MG/ML Oral

Solution

1099788 triprolidine tannate 0.5 MG/ML Extended Release Suspension

1099872 Acetaminophen 500 MG / Diphenhydramine Citrate 38 MG Oral Tablet


1101439 doxylamine succinate 5 MG Chewable Tablet

1101446 doxylamine succinate 25 MG Oral Tablet

1101457 doxylamine succinate 1 MG/ML Oral Solution




1111065 Brompheniramine Maleate 0.8 MG/ML / chlophedianol hydrochloride 5 MG/ML /

Phenylephrine Hydrochloride 2 MG/ML Oral Solution

1112220 Chlorpheniramine Maleate 0.8 MG/ML / Hydrocodone Bitartrate 1 MG/ML /



1112864 Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG Oral Tablet


Hydrobromide 1 MG/ML / Phenylephrine Hydrochloride 0.5 MG/ML Oral Suspension

1113417 Chlorpheniramine Maleate 0.4 MG/ML / Codeine Phosphate 2 MG/ML / Pseudoephedrine

Hydrochloride 6 MG/ML Oral Solution


Hydrobromide 1.5 MG/ML Oral Solution

1114003 Chlorpheniramine Maleate 0.4 MG/ML / Codeine Phosphate 1.6 MG/ML /


1116173 CARBETAPENTANE TANNATE 60 MG / Chlorpheniramine Tannate 5 MG / EPHEDRINE

TANNATE 10 MG / Phenylephrine Tannate 10 MG Oral Tablet

1117245 Acetaminophen 500 MG / Diphenhydramine Hydrochloride 25 MG Oral Capsule

1117392 Chlorpheniramine Maleate 0.2 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML /








1149632 84 HR Estradiol 0.00313 MG/HR Transdermal System

1190580 Codeine Phosphate 1.2 MG/ML / Dexbrompheniramine maleate 0.133 MG/ML /


1190600 Dexbrompheniramine maleate 0.133 MG/ML / Dextromethorphan Hydrobromide 2 MG/ML

/ Pseudoephedrine Hydrochloride 4 MG/ML Oral Solution

1190931 Acetaminophen 650 MG / Dexbrompheniramine maleate 2 MG Oral Tablet

1192477 Brompheniramine Maleate 4 MG / Pseudoephedrine Hydrochloride 60 MG Oral Capsule


10 MG Oral Tablet

1233546 {20 (Acetaminophen 325 MG / Dextromethorphan Hydrobromide 10 MG / Phenylephrine

Hydrochloride 5 MG Oral Capsule) / 20 (Acetaminophen 325 MG / Dextromethorphan

Hydrobromide 15 MG / doxylamine succinate 6.25 MG Oral Capsule) } Pack

1233575 Acetaminophen 325 MG / Diphenhydramine Hydrochloride 12.5 MG / Phenylephrine


1234386 Dextromethorphan Hydrobromide 1 MG/ML / doxylamine succinate 0.417 MG/ML Oral

Solution

1234884 Chlorpheniramine Maleate 0.4 MG/ML / dihydrocodeine bitartrate 1.3 MG/ML /


1234941 Chlorpheniramine Maleate 0.4 MG/ML / dihydrocodeine bitartrate 0.6 MG/ML /


1242582 doxylamine succinate 25 MG Oral Capsule


1244523 Brompheniramine Maleate 1.2 MG/ML / Phenylephrine Hydrochloride 2 MG/ML Oral

Suspension




1245291 Chlorpheniramine Maleate 1 MG / Dextromethorphan Hydrobromide 5 MG /

Pseudoephedrine Hydrochloride 15 MG Chewable Tablet

1245374 {50 (Acetaminophen 500 MG / Diphenhydramine Hydrochloride 25 MG Oral Tablet) / 50

(Acetaminophen 500 MG Oral Tablet) } Pack

1245706 chlophedianol hydrochloride 4.8 MG/ML / Chlorpheniramine Maleate 0.8 MG/ML /

Phenylephrine Hydrochloride 2 MG/ML Oral Suspension

1248057 Phenylephrine Hydrochloride 1 MG/ML / Promethazine Hydrochloride 1.25 MG/ML Oral

Solution

1248354 Diphenhydramine Hydrochloride 1.67 MG/ML Oral Solution

1248750 chlophedianol hydrochloride 8 MG/ML / Chlorpheniramine Maleate 1.25 MG/ML /

Phenylephrine Hydrochloride 2.5 MG/ML Oral Suspension

1250907 Aspirin 500 MG / Diphenhydramine Citrate 38.3 MG Oral Tablet

1250983 {8 (Acetaminophen 500 MG / Chlorpheniramine Maleate 2 MG / Dextromethorphan

Hydrobromide 15 MG Oral Tablet) / 16 (Dextromethorphan Hydrobromide 10 MG /

Guaifenesin 200 MG Oral Capsule) } Pack

1251614 Butabarbital sodium 30 MG Oral Tablet

1251621 Butabarbital sodium 50 MG Oral Tablet

1251802 Brompheniramine Maleate 1 MG / Phenylephrine Hydrochloride 2.5 MG Chewable Tablet

1251811 Chlorpheniramine Maleate 1 MG / Dextromethorphan Hydrobromide 5 MG Chewable

Tablet

1291711 Acetaminophen 500 MG / Diphenhydramine Hydrochloride 25 MG / Pseudoephedrine


1293239 Dexchlorpheniramine maleate 2 MG / Pseudoephedrine Hydrochloride 60 MG Oral Tablet



1293344 Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG / Pseudoephedrine


1293487 Chlorpheniramine Tannate 9 MG / Phenylephrine Tannate 25 MG Oral Tablet

1294201 Acetaminophen 325 MG / Chlorpheniramine Maleate 2 MG / Pseudoephedrine

Hydrochloride 30 MG Oral Capsule

1294557 Diphenhydramine Hydrochloride 25 MG / Pseudoephedrine Hydrochloride 60 MG Oral

Tablet

1294607 Acetaminophen 21.7 MG/ML / Diphenhydramine Hydrochloride 0.833 MG/ML Oral

Solution


6.25 MG / Phenylephrine Hydrochloride 5 MG Oral Capsule


1297390 Chlorpheniramine Maleate 2 MG / Ibuprofen 200 MG / Pseudoephedrine Hydrochloride 30

MG Oral Tablet

1297404 {8 (Acetaminophen 325 MG / Dextromethorphan Hydrobromide 10 MG / doxylamine

succinate 6.25 MG / Phenylephrine Hydrochloride 5 MG Oral Capsule) / 12 (Acetaminophen

325 MG / Dextromethorphan Hydrobromide 10 MG / Phenylephrine Hydrochloride 5 MG

Oral Capsule) } Pack

1297517 Diphenhydramine Hydrochloride 25 MG / Magnesium Salicylate 580 MG Oral Tablet

1297947 Acetaminophen 500 MG / Diphenhydramine Citrate 38 MG Oral Powder

1298433 Dexchlorpheniramine maleate 0.2 MG/ML / Dextromethorphan Hydrobromide 3 MG/ML /


1298799 Isoxsuprine Hydrochloride 20 MG Oral Tablet

1298834 Isoxsuprine Hydrochloride 10 MG Oral Tablet


Hydrobromide 15 MG / Pseudoephedrine Hydrochloride 30 MG Oral Capsule


Hydrobromide 10 MG / Pseudoephedrine Hydrochloride 30 MG Oral Capsule

1300164 Dexbrompheniramine maleate 0.4 MG/ML / Dextromethorphan Hydrobromide 4 MG/ML /


1300195 Dexbrompheniramine maleate 0.5 MG/ML / Dextromethorphan Hydrobromide 5 MG/ML /


1303797 Dexbrompheniramine maleate 1 MG/ML / Dextromethorphan Hydrobromide 10 MG/ML /


1304105 Brompheniramine Maleate 4 MG / Dextromethorphan Hydrobromide 20 MG /

Phenylephrine Hydrochloride 10 MG Oral Tablet


5 MG Oral Capsule

1356797 Brompheniramine Maleate 4 MG / Codeine Phosphate 10 MG / Phenylephrine


1356800 Brompheniramine Maleate 4 MG / Codeine Phosphate 10 MG Oral Tablet

1356807 Brompheniramine Maleate 4 MG / Codeine Phosphate 20 MG Oral Tablet

1356812 Brompheniramine Maleate 4 MG / Dextromethorphan Hydrobromide 20 MG /

Pseudoephedrine Hydrochloride 40 MG Oral Tablet

1356815 Brompheniramine Maleate 4 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet



1356841 Brompheniramine Maleate 0.8 MG/ML / Phenylephrine Hydrochloride 2 MG/ML Oral

Solution

1356848 Brompheniramine Tannate 12 MG Chewable Tablet




Hydrobromide 1 MG/ML / Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution


1359123 Estradiol 0.5 MG / norethindrone acetate 0.1 MG Oral Tablet

1359124 {28 (Estradiol 0.5 MG / norethindrone acetate 0.1 MG Oral Tablet) } Pack

1359126 Estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet

1359127 {28 (Estradiol 1 MG / norethindrone acetate 0.5 MG Oral Tablet) } Pack

1363288 12 HR Chlorpheniramine Maleate 12 MG Extended Release Oral Tablet

1363306 Chlorpheniramine Maleate 0.4 MG/ML Oral Solution

1363309 Chlorpheniramine Maleate 4 MG Oral Tablet

1363513 Dexbrompheniramine maleate 2 MG / Pseudoephedrine Hydrochloride 60 MG Oral Tablet

1363780 12 HR Chlorpheniramine Maleate 12 MG / Pseudoephedrine Hydrochloride 120 MG

Extended Release Oral Tablet




1366825 Acetaminophen 80 MG / Chlorpheniramine Maleate 0.5 MG / Dextromethorphan

Hydrobromide 2.5 MG / Pseudoephedrine Hydrochloride 7.5 MG Chewable Tablet

1367227 Chlorpheniramine Maleate 3.5 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet

1368963 chlophedianol hydrochloride 25 MG / Chlorpheniramine Maleate 4 MG / Phenylephrine


1369403 chlophedianol hydrochloride 2.5 MG/ML / Dexbrompheniramine maleate 0.2 MG/ML /


1369424 chlophedianol hydrochloride 2.5 MG/ML / Dexchlorpheniramine maleate 0.2 MG/ML /


1369971 chlophedianol hydrochloride 6.25 MG/ML / Dexchlorpheniramine maleate 0.5 MG/ML /


1369972 chlophedianol hydrochloride 5 MG/ML / Dexchlorpheniramine maleate 0.4 MG/ML /


1370963 12 HR Dexbrompheniramine maleate 6 MG / Pseudoephedrine sulfate 120 MG Extended

Release Oral Tablet

1372265 Chlorpheniramine Maleate 0.8 MG/ML / Hydrocodone Bitartrate 1 MG/ML Oral Solution

1372312 Acetaminophen 32 MG/ML / Chlorpheniramine Maleate 0.2 MG/ML / Phenylephrine

Hydrochloride 0.5 MG/ML Oral Suspension

1373501 Ethinyl Estradiol 0.02 MG / Levonorgestrel 0.15 MG Oral Tablet


1373503 {7 (Ethinyl Estradiol 0.01 MG Oral Tablet) / 42 (Ethinyl Estradiol 0.02 MG / Levonorgestrel

0.15 MG Oral Tablet) / 21 (Ethinyl Estradiol 0.025 MG / Levonorgestrel 0.15 MG Oral Tablet)

/ 21 (Ethinyl Estradiol 0.03 MG / Levonorgestrel 0.15 MG Oral Tablet) } Pack

1374770 12 HR Carbinoxamine maleate 0.8 MG/ML Extended Release Suspension

1375948 doxylamine succinate 10 MG / Pyridoxine Hydrochloride 10 MG Delayed Release Oral

Tablet

1421985 Chlorpheniramine Maleate 4 MG / Dextromethorphan Hydrobromide 30 MG Oral Tablet

1423711 Chlorpheniramine Maleate 0.4 MG/ML / Dextromethorphan Hydrobromide 2 MG/ML /



1424551 {20 (Acetaminophen 325 MG / Dextromethorphan Hydrobromide 10 MG / Guaifenesin 200

MG / Phenylephrine Hydrochloride 5 MG Oral Tablet) / 10 (Acetaminophen 325 MG /

Diphenhydramine Hydrochloride 25 MG / Phenylephrine Hydrochloride 5 MG Oral Tablet) }

Pack

1424850 {1 (180 ML) (Acetaminophen 32.5 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML /

Guaifenesin 20 MG/ML / Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution) / 1 (180

ML) (Acetaminophen 32.5 MG/ML / Diphenhydramine Hydrochloride 1.25 MG/ML /

Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution) } Pack

1424872 chlophedianol hydrochloride 24 MG / Chlorpheniramine Maleate 3.5 MG / Phenylephrine


1428880 {6 (Acetaminophen 650 MG / Dextromethorphan Hydrobromide 20 MG / Phenylephrine

Hydrochloride 10 MG Granules for Oral Solution) / 6 (Acetaminophen 650 MG /

Diphenhydramine Hydrochloride 25 MG / Phenylephrine Hydrochloride 10 MG Granules for

Oral Solution) } Pack

1428927 Triprolidine Hydrochloride 0.625 MG/ML Oral Solution

1429345 Chlorpheniramine Maleate 0.2 MG/ML / Phenylephrine Hydrochloride 0.5 MG/ML Oral

Solution

1440003 Codeine Phosphate 1.8 MG/ML / Dexchlorpheniramine maleate 0.2 MG/ML /


1441376 chlophedianol hydrochloride 2.5 MG/ML / Dexbrompheniramine maleate 0.2 MG/ML /


1441392 bazedoxifene 20 MG / Estrogens, Conjugated (USP) 0.45 MG Oral Tablet

1441831 doxylamine succinate 7.5 MG / Phenylephrine Hydrochloride 10 MG Oral Tablet

1483549 drospirenone 0.25 MG / Estradiol 0.5 MG Oral Tablet

1483550 {28 (drospirenone 0.25 MG / Estradiol 0.5 MG Oral Tablet) } Pack

1483552 drospirenone 0.5 MG / Estradiol 1 MG Oral Tablet

1483553 {28 (drospirenone 0.5 MG / Estradiol 1 MG Oral Tablet) } Pack




1490727 Indomethacin 20 MG Oral Capsule



153444 Estradiol 0.001 MG/MG Topical Gel

1535609 {10 (Acetaminophen 325 MG / Diphenhydramine Hydrochloride 25 MG / Phenylephrine

Hydrochloride 5 MG Oral Tablet) / 20 (Dextromethorphan Hydrobromide 10 MG /

Guaifenesin 200 MG / Phenylephrine Hydrochloride 5 MG Oral Tablet) } Pack

1535923 Chlorpheniramine Maleate 1 MG/ML / Dextromethorphan Hydrobromide 3 MG/ML /


1536840 Aspirin 325 MG / Chlorpheniramine Maleate 2 MG / Phenylephrine bitartrate 7.8 MG

Effervescent Oral Tablet


1536862 Chlorpheniramine Maleate 2 MG / Dextromethorphan Hydrobromide 10 MG /

Phenylephrine Hydrochloride 5 MG Effervescent Oral Tablet


5 MG Effervescent Oral Tablet


6.25 MG / Phenylephrine Hydrochloride 5 MG Effervescent Oral Tablet

1537029 Aspirin 325 MG / Chlorpheniramine Maleate 2 MG / Dextromethorphan Hydrobromide 10

MG / Phenylephrine bitartrate 7.8 MG Effervescent Oral Tablet






1540230 Ketorolac 2.88 MG/ML / Phenylephrine 10.16 MG/ML Ophthalmic Irrigation Solution

1546700 Acetaminophen 325 MG / Dexbrompheniramine maleate 1 MG Oral Tablet


6.25 MG / Phenylephrine Hydrochloride 5 MG Oral Tablet

1550957 Diphenhydramine Hydrochloride 25 MG / Naproxen sodium 220 MG Oral Tablet

1593110 Acetaminophen 250 MG / Aspirin 250 MG / Diphenhydramine Citrate 38 MG Oral Tablet

1595631 Acetaminophen 250 MG / Brompheniramine Maleate 2 MG Oral Tablet

1606291 {1 (118 ML) (Acetaminophen 32.5 MG/ML / Diphenhydramine Hydrochloride 1.25 MG/ML /

Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution) / 1 (118 ML) (Dextromethorphan

Hydrobromide 1 MG/ML / Guaifenesin 20 MG/ML / Phenylephrine Hydrochloride 0.5

MG/ML Oral Solution) } Pack

1657147 {8 (Acetaminophen 325 MG / Dextromethorphan Hydrobromide 10 MG / doxylamine

succinate 6.25 MG / Phenylephrine Hydrochloride 5 MG Oral Capsule) / 16 (Acetaminophen

325 MG / Dextromethorphan Hydrobromide 10 MG / Guaifenesin 200 MG / Phenylephrine

Hydrochloride 5 MG Oral Capsule) } Pack


Hydrochloride 10 MG Granules for Oral Solution

1665459 2 ML Ketorolac Tromethamine 30 MG/ML Injection


1665675 1 ML Ketorolac Tromethamine 15 MG/ML Cartridge



1665685 1 ML Meperidine Hydrochloride 100 MG/ML Injection

1665690 1.5 ML Meperidine Hydrochloride 50 MG/ML Injection


1665699 0.5 ML Meperidine Hydrochloride 50 MG/ML Injection


1673791 Chlorpheniramine Maleate 2 MG Oral Lozenge

1723740 1 ML Diphenhydramine Hydrochloride 50 MG/ML Injection


1723776 1 ML Diphenhydramine Hydrochloride 50 MG/ML Cartridge

1730190 {1 (118 ML) (Dextromethorphan Hydrobromide 1 MG/ML / Phenylephrine Hydrochloride

0.5 MG/ML Oral Solution) / 1 (118 ML) (Diphenhydramine Hydrochloride 1.25 MG/ML /

Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution) } Pack

1730192 {1 (180 ML) (Acetaminophen 32.5 MG/ML / Diphenhydramine Hydrochloride 1.25 MG/ML /

Phenylephrine Hydrochloride 0.5 MG/ML Oral Solution) / 1 (180 ML) (Dextromethorphan

Hydrobromide 1 MG/ML / Guaifenesin 20 MG/ML / Phenylephrine Hydrochloride 0.5

MG/ML Oral Solution) } Pack

1794552 2 ML Hydroxyzine Hydrochloride 50 MG/ML Injection


1797855 Ketorolac Tromethamine 15.8 MG/ACTUAT Metered Dose Nasal Spray

1811473 1 ML Pentazocine 30 MG/ML Injection

197426 Acetaminophen 325 MG / butalbital 50 MG Oral Tablet

197446 Carisoprodol 350 MG Oral Tablet

197447 Aspirin 325 MG / Carisoprodol 200 MG Oral Tablet

197495 Chlorpropamide 100 MG Oral Tablet

197496 Chlorpropamide 250 MG Oral Tablet


197622 Dipyridamole 50 MG Oral Tablet

197647 ergoloid mesylates, USP 1 MG Oral Capsule

197657 Estradiol 0.5 MG Oral Tablet

197658 Estradiol 1 MG Oral Tablet

197659 Estradiol 2 MG Oral Tablet

197660 Estrogens, Conjugated (USP) 0.3 MG Oral Tablet



197666 Estrogens, Esterified (USP) 0.3 MG Oral Tablet




197670 Estrogens, Esterified (USP) 1.25 MG / Methyltestosterone 2.5 MG Oral Tablet

197737 Glyburide 1.25 MG Oral Tablet

197745 Guanfacine 1 MG Oral Tablet

197746 Guanfacine 2 MG Oral Tablet



197819 Indomethacin 50 MG Rectal Suppository

197928 Meprobamate 200 MG Oral Tablet

197929 Meprobamate 400 MG Oral Tablet

197930 Aspirin 325 MG / Meprobamate 200 MG Oral Tablet

197935 metaxalone 400 MG Oral Tablet


197943 Methocarbamol 500 MG Oral Tablet

197944 Methocarbamol 750 MG Oral Tablet

197956 Methyldopa 250 MG Oral Tablet

197958 Methyldopa 500 MG Oral Tablet

197960 Hydrochlorothiazide 25 MG / Methyldopa 250 MG Oral Tablet

197963 Hydrochlorothiazide 15 MG / Methyldopa 250 MG Oral Tablet

198032 Nifedipine 10 MG Oral Capsule


198083 Phenobarbital 100 MG Oral Tablet


198086 Phenobarbital 16.2 MG Oral Tablet


198270 Thioridazine 100 MG Oral Tablet



198276 thyroid (USP) 120 MG Oral Capsule

198277 thyroid (USP) 130 MG Oral Tablet



198368 Phenobarbital 65 MG/ML Injectable Solution






199340 Mephobarbital 60 MG Oral Tablet

199341 Mephobarbital 200 MG Oral Tablet

199549 Indomethacin 100 MG Rectal Suppository

199782 Nifedipine 20 MG Oral Tablet

199789 Pentazocine 50 MG Oral Tablet

199820 Trimipramine 25 MG Oral Tablet




204407 Ethinyl Estradiol 0.5 MG Oral Tablet



226597 Estradiol 0.0006 MG/MG Topical Gel



238006 Estrogens, Esterified (USP) 0.625 MG / Methyltestosterone 1.25 MG Oral Tablet



238090 Pentobarbital Sodium 50 MG/ML Injectable Solution

238133 Pentazocine 30 MG/ML Injectable Solution

238134 Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule

238135 Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet

238153 Acetaminophen 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule

238154 Acetaminophen 325 MG / butalbital 50 MG / Caffeine 40 MG Oral Tablet

239981 Chlorpheniramine 2 MG Chewable Tablet

240826 dexbrompheniramine 2 MG Oral Tablet










250485 Pentazocine 25 MG Oral Tablet

251050 Chlorpheniramine 2 MG / Phenylephrine 10 MG / phenyltoloxamine 25 MG Oral Tablet

251098 Estradiol 25 MG Drug Implant



308169 Amobarbital 200 MG Oral Capsule

308170 Amobarbital Sodium 500 MG Injection

309249 Chlorpheniramine 8 MG Extended Release Oral Capsule


309953 10 ML Dipyridamole 5 MG/ML Injection


309958 Disopyramide 100 MG Oral Capsule

309960 Disopyramide 150 MG Oral Capsule

310143 ergoloid mesylates, USP 1 MG/ML Oral Solution


310204 synthetic conjugated estrogens, A 0.625 MG Oral Tablet



310212 estropipate 0.75 MG Oral Tablet

310213 estropipate 1.5 MG Oral Tablet

310215 estropipate 3 MG Oral Tablet




310536 Glyburide 3 MG Oral Tablet



310991 Indomethacin 5 MG/ML Oral Suspension

310992 Indomethacin 75 MG Extended Release Oral Capsule

312289 Naloxone 0.5 MG / Pentazocine 50 MG Oral Tablet



312370 Phenobarbital 130 MG/ML Injectable Solution

312914 Secobarbital 100 MG Oral Capsule









313406 Ticlopidine Hydrochloride 250 MG Oral Tablet

313496 Trimipramine 100 MG Oral Capsule





314132 Nifedipine 10 MG Oral Tablet




318179 ergoloid mesylates, USP 1 MG Oral Tablet

333833 Dipyridamole 150 MG Extended Release Oral Tablet

346508 Indomethacin 1 MG/ML Injectable Solution

346713 Thioridazine 25 MG/ML Oral Suspension

346714 Thioridazine 100 MG/ML Oral Suspension




348906 Estradiol 1 MG / norgestimate 0.09 MG Oral Tablet

349271 Chlorpheniramine 2 MG / Phenylephrine 10 MG / Pyrilamine 10 MG Extended Release Oral

Tablet


351254 metaxalone 800 MG Oral Tablet


359281 12 HR Brompheniramine 6 MG Extended Release Oral Tablet

359370 Chlorpheniramine 2 MG / Phenylephrine 10 MG / Pyrilamine 10 MG Oral Tablet

402250 168 HR Estradiol 0.00188 MG/HR / Levonorgestrel 0.000625 MG/HR Transdermal System





477045 Chlorpheniramine Maleate 2 MG/ML Oral Solution

477245 Diphenhydramine Citrate 19 MG Disintegrating Oral Tablet

477587 24 HR Brompheniramine 12 MG Extended Release Oral Capsule




577154 Megestrol Acetate 125 MG/ML Oral Suspension

618368 synthetic conjugated estrogens, B 0.3 MG Oral Tablet




636793 12 HR Disopyramide 100 MG Extended Release Oral Capsule

636794 12 HR Disopyramide 150 MG Extended Release Oral Capsule

688240 Estrogens, Conjugated (USP) 0.625 MG/ML Vaginal Cream

700851 Brompheniramine Maleate 1 MG/ML Oral Solution

701393 dexchlorpheniramine 2 MG Extended Release Oral Tablet

702519 Phenobarbital 4 MG/ML Oral Solution



730794 Carisoprodol 250 MG Oral Tablet


731007 Brompheniramine 6 MG / Phenylephrine 19 MG Extended Release Oral Tablet

731032 12 HR Brompheniramine 11 MG Extended Release Oral Tablet

748832 {6 (Ethinyl Estradiol 0.03 MG / Levonorgestrel 0.05 MG Oral Tablet) / 10 (Ethinyl Estradiol

0.03 MG / Levonorgestrel 0.125 MG Oral Tablet) / 5 (Ethinyl Estradiol 0.04 MG /

Levonorgestrel 0.075 MG Oral Tablet) / 7 (Inert Ingredients 1 MG Oral Tablet) } Pack

748868 {21 (Ethinyl Estradiol 0.02 MG / Levonorgestrel 0.1 MG Oral Tablet) / 7 (Inert Ingredients 1

MG Oral Tablet) } Pack




0.15 MG Oral Tablet) } Pack

749850 {15 (Estradiol 1 MG / norgestimate 0.09 MG Oral Tablet) / 15 (Estradiol 1 MG Oral Tablet) }

Pack


751553 {28 (Ethinyl Estradiol 0.02 MG / Levonorgestrel 0.09 MG Oral Tablet) } Pack



804145 Chlorpheniramine 4 MG / Dextromethorphan 20 MG Oral Tablet


0.1 MG Oral Tablet) } Pack

828299 Cyclobenzaprine hydrochloride 7.5 MG Oral Tablet

828320 Cyclobenzaprine hydrochloride 5 MG Oral Tablet

828348 Cyclobenzaprine hydrochloride 10 MG Oral Tablet

828353 24 HR Cyclobenzaprine hydrochloride 30 MG Extended Release Oral Capsule

828358 24 HR Cyclobenzaprine hydrochloride 15 MG Extended Release Oral Capsule

834022 Ketorolac Tromethamine 10 MG Oral Tablet

835564 Imipramine Hydrochloride 25 MG Oral Tablet


835572 Imipramine pamoate 75 MG Oral Capsule





856706 Amitriptyline Hydrochloride 10 MG / Perphenazine 2 MG Oral Tablet


856762 Amitriptyline Hydrochloride 100 MG Oral Tablet

856769 Amitriptyline Hydrochloride 12.5 MG / Chlordiazepoxide 5 MG Oral Tablet



856792 Amitriptyline Hydrochloride 25 MG / Chlordiazepoxide 10 MG Oral Tablet







857291 Clomipramine Hydrochloride 10 MG Oral Tablet


857297 Clomipramine Hydrochloride 25 MG Oral Capsule




857416 Clemastine Fumarate 1.34 MG Oral Tablet

857420 12 HR Clemastine Fumarate 1.34 MG Extended Release Oral Tablet

857430 Clemastine Fumarate 0.134 MG/ML Oral Solution


857461 Clemastine Fumarate 2.68 MG Oral Tablet

857510 12 HR CHLORPHENIRAMINE POLISTIREX 4 MG / HYDROCODONE POLISTIREX 5 MG Extended

Release Oral Capsule

857512 12 HR CHLORPHENIRAMINE POLISTIREX 8 MG / HYDROCODONE POLISTIREX 10 MG

Extended Release Oral Capsule


860096 Ketorolac Tromethamine 30 MG/ML Injectable Solution

860113 1 ML Ketorolac Tromethamine 15 MG/ML Prefilled Syringe



860215 Megestrol Acetate 20 MG Oral Tablet


860225 Megestrol Acetate 40 MG/ML Oral Suspension


860771 Trimethobenzamide hydrochloride 300 MG Oral Capsule

860792 1 ML Meperidine Hydrochloride 75 MG/ML Cartridge

861447 Meperidine Hydrochloride 10 MG/ML Injectable Solution

861455 Meperidine Hydrochloride 100 MG Oral Tablet



861467 Meperidine Hydrochloride 50 MG Oral Tablet



861479 Meperidine Hydrochloride 10 MG/ML Oral Solution




861578 Meperidine Hydrochloride 50 MG / Promethazine Hydrochloride 25 MG Oral Capsule

861743 Glyburide 1.25 MG / Metformin hydrochloride 250 MG Oral Tablet

861748 Glyburide 2.5 MG / Metformin hydrochloride 500 MG Oral Tablet

861753 Glyburide 5 MG / Metformin hydrochloride 500 MG Oral Tablet

862006 24 HR Guanfacine 1 MG Extended Release Oral Tablet




882504 Diphenhydramine Hydrochloride 12.5 MG Disintegrating Oral Tablet

885205 2 ML benztropine mesylate 1 MG/ML Injection

885209 benztropine mesylate 2 MG Oral Tablet

885213 benztropine mesylate 1 MG Oral Tablet

885219 benztropine mesylate 0.5 MG Oral Tablet

889520 Acetaminophen 300 MG / butalbital 50 MG / Caffeine 40 MG Oral Capsule


895664 Diphenhydramine Citrate 38 MG / Ibuprofen 200 MG Oral Tablet

901814 Diphenhydramine Hydrochloride 25 MG / Ibuprofen 200 MG Oral Capsule

905269 Trihexyphenidyl Hydrochloride 2 MG Oral Tablet

905273 Trihexyphenidyl Hydrochloride 0.4 MG/ML Oral Solution

905283 Trihexyphenidyl Hydrochloride 5 MG Oral Tablet

968670 dexbrompheniramine 2 MG / Phenylephrine 10 MG Oral Tablet

978944 dienogest 2 MG / estradiol valerate 2 MG Oral Tablet

978946 dienogest 3 MG / estradiol valerate 2 MG Oral Tablet

978948 estradiol valerate 1 MG Oral Tablet

991042 dexchlorpheniramine 2 MG / Phenylephrine 10 MG Oral Tablet

991486 Codeine Phosphate 2 MG/ML / Promethazine Hydrochloride 1.25 MG/ML Oral Solution

991528 Dextromethorphan Hydrobromide 3 MG/ML / Promethazine Hydrochloride 1.25 MG/ML

Oral Solution

992432 Promethazine Hydrochloride 1.25 MG/ML Oral Solution

992438 Promethazine Hydrochloride 12.5 MG Oral Tablet

992441 Promethazine Hydrochloride 12.5 MG Rectal Suppository

992447 Promethazine Hydrochloride 25 MG Oral Tablet

992454 Promethazine Hydrochloride 25 MG Rectal Suppository

992460 1 ML Promethazine Hydrochloride 25 MG/ML Injection

992475 Promethazine Hydrochloride 50 MG Oral Tablet

992478 Promethazine Hydrochloride 50 MG Rectal Suppository

992858 1 ML Promethazine Hydrochloride 50 MG/ML Injection

993943 Acetaminophen 325 MG / butalbital 50 MG / Caffeine 40 MG / Codeine Phosphate 30 MG

Oral Capsule

994226 Aspirin 325 MG / Carisoprodol 200 MG / Codeine Phosphate 16 MG Oral Tablet

994237 Aspirin 325 MG / butalbital 50 MG / Caffeine 40 MG / Codeine Phosphate 30 MG Oral

Capsule

994289 Brompheniramine Maleate 0.27 MG/ML / Codeine Phosphate 1.27 MG/ML /


994402 Brompheniramine Maleate 0.4 MG/ML / Codeine Phosphate 1.5 MG/ML /


994521 12 HR Orphenadrine Citrate 100 MG Extended Release Oral Tablet

994528 Aspirin 385 MG / Caffeine 30 MG / Orphenadrine Citrate 25 MG Oral Tablet

994535 Aspirin 770 MG / Caffeine 60 MG / Orphenadrine Citrate 50 MG Oral Tablet

994541 2 ML Orphenadrine Citrate 30 MG/ML Injection

994824 Orphenadrine Hydrochloride 50 MG Oral Tablet

995211 Chlorpheniramine 4 MG / Codeine Phosphate 10 MG Oral Tablet

995214 Chlorpheniramine 4 MG / Codeine Phosphate 20 MG Oral Tablet

995218 Hydroxyzine Hydrochloride 10 MG Oral Tablet

995232 Hydroxyzine Pamoate 100 MG Oral Capsule



995241 Hydroxyzine Hydrochloride 2 MG/ML Oral Solution




995274 Hydroxyzine Pamoate 5 MG/ML Oral Suspension



995285 Hydroxyzine Hydrochloride 50 MG/ML Injectable Solution


996640 Codeine Phosphate 2 MG/ML / Pseudoephedrine Hydrochloride 6 MG/ML / Triprolidine

Hydrochloride 0.25 MG/ML Oral Solution

996757 Codeine Phosphate 2 MG/ML / Phenylephrine Hydrochloride 1 MG/ML / Promethazine


997272 Codeine Phosphate 2 MG/ML / Pseudoephedrine Hydrochloride 3 MG/ML / Triprolidine


998254 Chlorpheniramine Maleate 4 MG / Pseudoephedrine Hydrochloride 60 MG Oral Tablet


Appendix C: High-Risk Medications for the Elderly with Days Supply Criteria

RxNORM Code Description

1232194 Zolpidem tartrate 1.75 MG Sublingual Tablet

1232202 Zolpidem tartrate 3.5 MG Sublingual Tablet

1648755 NITROFURANTOIN, MACROCRYSTALS 25 MG / Nitrofurantoin, Monohydrate 75 MG Oral

Capsule

1648759 NITROFURANTOIN, MACROCRYSTALS 100 MG Oral Capsule

311989 Nitrofurantoin 5 MG/ML Oral Suspension

311991 Nitrofurantoin 50 MG Oral Tablet



313761 zaleplon 10 MG Oral Capsule

313762 zaleplon 5 MG Oral Capsule

485440 Eszopiclone 1 MG Oral Tablet



828692 Zolpidem tartrate 5 MG/ACTUAT Oral Spray

836641 Zolpidem tartrate 10 MG Sublingual Tablet

836647 Zolpidem tartrate 5 MG Sublingual Tablet

854873 Zolpidem tartrate 10 MG Oral Tablet

854876 Zolpidem tartrate 5 MG Oral Tablet

854880 Zolpidem tartrate 12.5 MG Extended Release Oral Tablet

854880 Zolpidem tartrate 6.25 MG Extended Release Oral Tablet


Appendix D: SNOMED Codes for Cataract Surgery

Code Description

10178000 Extracapsular extraction of cataract by inferior temporal route (procedure)

110473004 Cataract surgery (procedure)

112963003 Aspiration of cataract (procedure)

112964009 Extraction of cataract by rotoextraction with aspiration (procedure)

12163000 Needling of secondary cataract (procedure)

231744001 Cataract extraction, insertion of intraocular lens and trabeculectomy (procedure)

308694002 Extracapsular cataract extraction and insertion of intraocular lens (procedure)

308695001 Intracapsular cataract extraction and insertion of intraocular lens (procedure)

313999004 Small incision phacoemulsification of cataract and insertion of intraocular lens

(procedure)

31705006 Extraction of cataract by rotoextraction with aspiration by posterior route (procedure)

335636001 Extraction of primary membranous cataract by phacofragmentation (procedure)

336651000 Extraction of primary membranous cataract by mechanical fragmentation (procedure)

35717002 Discission of congenital cataract (procedure)

361191005 Extraction of cataract by ultrasonic phacofragmentation (procedure)

385468004 Cataract extraction and insertion of intraocular lens (procedure)

39243005 Mechanical fragmentation of cataract with extraction by posterior route (procedure)

397544007 Complicated cataract surgery (procedure)

404628003 Intracapsular cataract extraction (procedure)

415089008 Phacoemulsification of cataract with intraocular lens implantation (procedure)

417493007 Small incision manual extracapsular cataract extraction (procedure)

418430006 Bimanual phacoemulsification of cataract with intraocular lens implantation

(procedure)

419767009 Bimanual microincisional phacoemulsification of cataract with intraocular lens

implantation (procedure)

420260004 Bimanual phacoemulsification (procedure)

420526005 Coaxial phacoemulsfication (procedure)

424945000 Torsional phacoemulsification (procedure)

446548003 Extraction of cataract and trabeculectomy (procedure)

46309001 Extraction of primary membranous cataract by excision (procedure)

46426006 Cryoextraction of cataract by inferior temporal route (procedure)

46562009 Incisional discission of secondary membranous cataract and anterior hyaloid

(procedure)

50538003 Discission of membranous cataract, primary (procedure)

5130002 Extraction of primary membranous cataract by discission (procedure)

51839008 Extraction of primary membranous cataract by needling (procedure)

54885007 Extraction of cataract (procedure)

65812008 Removal of secondary membranous cataract with iridectomy (procedure)

67760003 Extracapsular extraction of cataract by rotoextraction with aspiration (procedure)


69360005 Extracapsular extraction of cataract by mechanical fragmentation with aspiration by

posterior route (procedure)

74490003 Mechanical fragmentation of primary membranous cataract (procedure)

75814005 Erysiphake extraction of cataract by inferior temporal route (procedure)

79611007 Extracapsular extraction of cataract by curette evacuation (procedure)

82155009 Extracapsular extraction of cataract by emulsification with aspiration (procedure)

84149000 Aspiration of cataract by phacoemulsification (procedure)

85622008 Cryoextraction of cataract by intracapsular approach (procedure)

88282000 Extracapsular extraction of cataract by mechanical fragmentation with aspiration

(procedure)

89153001 Extracapsular extraction of cataract by rotoextraction with aspiration by posterior route

(procedure)

9137006 Discission of membranous cataract, secondary (procedure)


Appendix E: SNOMED Codes for Operative Procedures Related to Cataract Surgery Complications

Code Description

13767004 Removal of foreign body from choroid without use of magnet (procedure)

172426003 Removal of foreign body from cornea (procedure)

172498005 Removal of foreign body from iris (procedure)

172548007 Surgical removal of foreign body from lens (procedure)

18752000 Magnet extraction of intraocular foreign body from anterior chamber of eye (procedure)

20647004 Removal of foreign body from vitreous without use of magnet (procedure)

21491001 Removal of foreign body of ciliary body without use of magnet (procedure)

223217009 Removal of embedded foreign body from conjunctiva by incision (procedure)

224227005 Removal of subconjunctival foreign body (procedure)

225184003 Removal of embedded foreign body from conjunctiva (procedure)

287233001 Anterior chamber foreign body removal by magnet (procedure)

287236009 Conjunctival foreign body removal by incision (procedure)

287242008 Posterior chamber of eye foreign body removal by incision (procedure)

30113009 Removal of foreign body of anterior chamber of eye by incision (procedure)

31530007 Removal of foreign body of iris without use of magnet (procedure)

35552007 Repair of nonperforating laceration of cornea with removal of foreign body (procedure)

360405005 Removal of foreign body of lens by incision (procedure)

360411008 Capsulotomy of lens with removal of foreign body (procedure)

363726008 Removal of foreign body of cornea by incision (procedure)

37332006 Magnet extraction of foreign body from sclera (procedure)

37958004 Removal of foreign body of sclera by incision (procedure)

417297006 Removal of viscoelastic from anterior chamber (procedure)

430833007 Removal of rust ring from cornea (procedure)

43908008 Magnet extraction of foreign body from choroid (procedure)

444600006 Removal of magnetic foreign body from eye (procedure)

445023004 Removal of penetrating foreign body from eye by incision (procedure)

445024005 Removal of penetrating foreign body from eye using magnet (procedure)

4503005 Removal of foreign body of sclera without use of magnet (procedure)

45817009 Removal of foreign body from retina by incision (procedure)

48933009 Removal of foreign body from posterior segment of eye (procedure)

50737005 Magnet extraction of foreign body from vitreous (procedure)


51281007 Removal of superficial foreign body from conjunctiva (procedure)

53570002 Removal of foreign body from eye (procedure)

54085006 Removal of foreign body of ciliary body by incision (procedure)

54211003 Nonmagnetic extraction of foreign body from lens without extraction of lens (procedure)

54362002 Removal of intraocular foreign body from anterior segment of eye (procedure)

5671007 Magnet extraction of foreign body from ciliary body (procedure)

58689006 Magnet extraction of foreign body from lens (procedure)

61220009 Removal of foreign body of external eye, scleral nonperforating (procedure)

64340000 Removal of foreign body from retina without use of magnet (procedure)

66134002 Magnet extraction of foreign body from cornea (procedure)

67546003 Removal of penetrating foreign body from eye (procedure)

72199008 Removal of foreign body from vitreous by incision (procedure)

74948004 Magnet extraction of foreign body from retina (procedure)

75734004 Removal of foreign body from choroid by incision (procedure)

78191003 Capsulotomy of lens with removal of foreign body by magnet extraction (procedure)

78290008 Magnet extraction of foreign body from iris (procedure)

78362007 Removal of foreign body from conjunctiva (procedure)

84016007 Removal of foreign body from lens (procedure)

84542000 Removal of foreign body of anterior chamber of eye by incision with use of magnet

(procedure)

85145001 Removal of foreign body of cornea with slit lamp (procedure)

8813000 Removal of intraocular foreign body from anterior segment of eye with use of magnet

(procedure)

89788006 Magnet extraction of foreign body from posterior segment of eye (procedure)

89942008 Removal of foreign body of iris by incision (procedure)

90997007 Removal of foreign body from posterior segment of eye without use of magnet

(procedure)

9255007 Removal of foreign body from anterior chamber of eye without use of magnet

(procedure)

438601000 Lysis of adhesions of anterior segment of eye using laser (procedure)

76240002 Lysis of corneovitreal adhesions (procedure)

2536007 Injection of medication in anterior chamber of eye (procedure)

30246007 Injection of liquid in anterior chamber of eye (procedure)

4143006 Injection of anterior chamber of eye (procedure)

416773006 Injection of viscoelastic in anterior chamber of eye (procedure)


49789002 Injection of air in anterior chamber of eye (procedure)

231751005 Exchange of intraocular lens (procedure)

231752003 Repositioning of intraocular lens (procedure)

312705004 Removal of retained lens matter (procedure)

312706003 Removal of retained lens nucleus (procedure)

312707007 Removal of soft lens matter (procedure)

312714009 Relocation of intraocular lens from vitreous cavity (procedure)

46562009 Incisional discission of secondary membranous cataract and anterior hyaloid (procedure)

65812008 Removal of secondary membranous cataract with iridectomy (procedure)

9137006 Discission of membranous cataract, secondary (procedure)

231780001 Injection of perfluorocarbon liquid into vitreous (procedure)

296867007 Anterior sclerotomy with removal of vitreous (procedure)

3499006 Aspiration of vitreous with replacement (procedure)

48671003 Injection of vitreous substitute, pars plana approach (procedure)

10006000 Repair of retinal detachment with xenon arc photocoagulation (procedure)

12651006 Sclerectomy for retinal reattachment (procedure)

14707009 Lamellar resection of sclera for retinal reattachment (procedure)

172451002 Overlay scleroplasty (procedure)

172574001 Reposition plombage for detachment (procedure)

22768003 Suture of retina for reattachment (procedure)

3938007 Cerclage for retinal reattachment (procedure)

4344007 Cryopexy (procedure)

47470009 Shortening of sclera for repair of retinal detachment (procedure)

57103007 Reattachment of retina by diathermy (procedure)

68999001 Reattachment of retina by electrocoagulation (procedure)

77950003 Repair of retina for retinal detachment by cryotherapy (procedure)

78917001 Repair of retina for retinal detachment by photocoagulation (procedure)

85231002 Repair of retinal detachment by laser photocoagulation (procedure)

8920006 Repair of retina for retinal detachment (procedure)

10807008 Scleral reinforcement with graft (procedure)

67250 Scleral reinforcement (separate procedure); without graft

67255 Scleral reinforcement (separate procedure); with graft

84077007 Reinforcement of sclera (procedure)

120119003 Anterior segment of eye repair (procedure)

12868007 Revision of operative wound of anterior segment of eye (procedure)

231741009 Revision of anterior chamber (procedure)


Appendix F: ICD Codes Included in POAG: Optic Nerve Head Evaluation

Code Description Code System

365.10 Open-angle glaucoma, unspecified ICD9CM

365.11 Primary open angle glaucoma ICD9CM

365.12 Low tension open-angle glaucoma ICD9CM

365.15 Residual stage of open angle glaucoma ICD9CM

H40.10X0 Unspecified open-angle glaucoma, stage unspecified ICD10CM

H40.10X1 Unspecified open-angle glaucoma, mild stage ICD10CM

H40.10X2 Unspecified open-angle glaucoma, moderate stage ICD10CM

H40.10X3 Unspecified open-angle glaucoma, severe stage ICD10CM

H40.10X4 Unspecified open-angle glaucoma, indeterminate stage ICD10CM

H40.1110 Primary open-angle glaucoma, right eye, stage unspecified ICD10CM

H40.1111 Primary open-angle glaucoma, right eye, mild stage ICD10CM

H40.1112 Primary open-angle glaucoma, right eye, moderate stage ICD10CM

H40.1113 Primary open-angle glaucoma, right eye, severe stage ICD10CM

H40.1114 Primary open-angle glaucoma, right eye, indeterminate stage ICD10CM

H40.1120 Primary open-angle glaucoma, left eye, stage unspecified ICD10CM

H40.1121 Primary open-angle glaucoma, left eye, mild stage ICD10CM

H40.1122 Primary open-angle glaucoma, left eye, moderate stage ICD10CM

H40.1123 Primary open-angle glaucoma, left eye, severe stage ICD10CM

H40.1124 Primary open-angle glaucoma, left eye, indeterminate stage ICD10CM

H40.1130 Primary open-angle glaucoma, bilateral, stage unspecified ICD10CM

H40.1131 Primary open-angle glaucoma, bilateral, mild stage ICD10CM

H40.1132 Primary open-angle glaucoma, bilateral, moderate stage ICD10CM

H40.1133 Primary open-angle glaucoma, bilateral, severe stage ICD10CM

H40.1134 Primary open-angle glaucoma, bilateral, indeterminate stage ICD10CM

H40.1190 Primary open-angle glaucoma, unspecified eye, stage unspecified ICD10CM

H40.1191 Primary open-angle glaucoma, unspecified eye, mild stage ICD10CM

H40.1192 Primary open-angle glaucoma, unspecified eye, moderate stage ICD10CM

H40.1193 Primary open-angle glaucoma, unspecified eye, severe stage ICD10CM

H40.1194 Primary open-angle glaucoma, unspecified eye, indeterminate stage ICD10CM

H40.11X0 Primary open-angle glaucoma, stage unspecified ICD10CM

H40.11X1 Primary open-angle glaucoma, mild stage ICD10CM

H40.11X2 Primary open-angle glaucoma, moderate stage ICD10CM

H40.11X3 Primary open-angle glaucoma, severe stage ICD10CM

H40.11X4 Primary open-angle glaucoma, indeterminate stage ICD10CM

H40.1210 Low-tension glaucoma, right eye, stage unspecified ICD10CM

H40.1211 Low-tension glaucoma, right eye, mild stage ICD10CM

H40.1212 Low-tension glaucoma, right eye, moderate stage ICD10CM

H40.1213 Low-tension glaucoma, right eye, severe stage ICD10CM

H40.1214 Low-tension glaucoma, right eye, indeterminate stage ICD10CM


H40.1220 Low-tension glaucoma, left eye, stage unspecified ICD10CM

H40.1221 Low-tension glaucoma, left eye, mild stage ICD10CM

H40.1222 Low-tension glaucoma, left eye, moderate stage ICD10CM

H40.1223 Low-tension glaucoma, left eye, severe stage ICD10CM

H40.1224 Low-tension glaucoma, left eye, indeterminate stage ICD10CM

H40.1230 Low-tension glaucoma, bilateral, stage unspecified ICD10CM

H40.1231 Low-tension glaucoma, bilateral, mild stage ICD10CM

H40.1232 Low-tension glaucoma, bilateral, moderate stage ICD10CM

H40.1233 Low-tension glaucoma, bilateral, severe stage ICD10CM

H40.1234 Low-tension glaucoma, bilateral, indeterminate stage ICD10CM

H40.1290 Low-tension glaucoma, unspecified eye, stage unspecified ICD10CM

H40.1291 Low-tension glaucoma, unspecified eye, mild stage ICD10CM

H40.1292 Low-tension glaucoma, unspecified eye, moderate stage ICD10CM

H40.1293 Low-tension glaucoma, unspecified eye, severe stage ICD10CM

H40.1294 Low-tension glaucoma, unspecified eye, indeterminate stage ICD10CM

H40.151 Residual stage of open-angle glaucoma, right eye ICD10CM

H40.152 Residual stage of open-angle glaucoma, left eye ICD10CM

H40.153 Residual stage of open-angle glaucoma, bilateral ICD10CM

H40.159 Residual stage of open-angle glaucoma, unspecified eye ICD10CM


Appendix G: ICD Codes Included in Diabetic Retinopathy Measures

Code Description Code System(s)

362.01 Background diabetic retinopathy ICD9CM

362.02 Proliferative diabetic retinopathy ICD9CM

362.03 Nonproliferative diabetic retinopathy NOS ICD9CM

362.04 Mild nonproliferative diabetic retinopathy ICD9CM

362.05 Moderate nonproliferative diabetic retinopathy ICD9CM

362.06 Severe nonproliferative diabetic retinopathy ICD9CM

E08.311 Diabetes mellitus due to underlying condition with unspecified diabetic


ICD10CM

E08.319 Diabetes mellitus due to underlying condition with unspecified diabetic


ICD10CM

E08.3211 Diabetes mellitus due to underlying condition with mild nonproliferative

diabetic retinopathy with macular edema, right eye

ICD10CM


diabetic retinopathy with macular edema, left eye

ICD10CM


diabetic retinopathy with macular edema, bilateral

ICD10CM


diabetic retinopathy with macular edema, unspecified eye

ICD10CM


diabetic retinopathy without macular edema

ICD10CM


diabetic retinopathy without macular edema, right eye

ICD10CM


diabetic retinopathy without macular edema, left eye

ICD10CM


diabetic retinopathy without macular edema, bilateral

ICD10CM


diabetic retinopathy without macular edema, unspecified eye

ICD10CM

E08.331 Diabetes mellitus due to underlying condition with moderate

nonproliferative diabetic retinopathy with macular edema

ICD10CM


nonproliferative diabetic retinopathy with macular edema, right eye

ICD10CM


nonproliferative diabetic retinopathy with macular edema, left eye

ICD10CM


nonproliferative diabetic retinopathy with macular edema, bilateral

ICD10CM


nonproliferative diabetic retinopathy with macular edema, unspecified

eye

ICD10CM



nonproliferative diabetic retinopathy without macular edema

ICD10CM


nonproliferative diabetic retinopathy without macular edema, right eye

ICD10CM


nonproliferative diabetic retinopathy without macular edema, left eye

ICD10CM


nonproliferative diabetic retinopathy without macular edema, bilateral

ICD10CM


nonproliferative diabetic retinopathy without macular edema,

unspecified eye

ICD10CM

E08.341 Diabetes mellitus due to underlying condition with severe


ICD10CM



ICD10CM



ICD10CM



ICD10CM



eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



unspecified eye

ICD10CM

E08.351 Diabetes mellitus due to underlying condition with proliferative diabetic


ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM


retinopathy with traction retinal detachment involving the macula, right

eye

ICD10CM


retinopathy with traction retinal detachment involving the macula, left

eye

ICD10CM


retinopathy with traction retinal detachment involving the macula,

bilateral

ICD10CM



unspecified eye

ICD10CM


retinopathy with traction retinal detachment not involving the macula,

right eye

ICD10CM



left eye

ICD10CM



bilateral

ICD10CM



unspecified eye

ICD10CM


retinopathy with combined traction retinal detachment and

rhegmatogenous retinal detachment, right eye

ICD10CM



rhegmatogenous retinal detachment, left eye

ICD10CM



rhegmatogenous retinal detachment, bilateral

ICD10CM



rhegmatogenous retinal detachment, unspecified eye

ICD10CM

E08.3551 Diabetes mellitus due to underlying condition with stable proliferative

diabetic retinopathy, right eye

ICD10CM


diabetic retinopathy, left eye

ICD10CM



diabetic retinopathy, bilateral

ICD10CM


diabetic retinopathy, unspecified eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E09.311 Drug or chemical induced diabetes mellitus with unspecified diabetic


ICD10CM

E09.319 Drug or chemical induced diabetes mellitus with unspecified diabetic


ICD10CM

E09.321 Drug or chemical induced diabetes mellitus with mild nonproliferative

diabetic retinopathy with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E09.331 Drug or chemical induced diabetes mellitus with moderate


ICD10CM



ICD10CM




ICD10CM



ICD10CM



eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



unspecified eye

ICD10CM

E09.341 Drug or chemical induced diabetes mellitus with severe nonproliferative

diabetic retinopathy with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E09.351 Drug or chemical induced diabetes mellitus with proliferative diabetic


ICD10CM



ICD10CM




ICD10CM



ICD10CM



ICD10CM


retinopathy with traction retinal detachment involving the macula, right

eye

ICD10CM


retinopathy with traction retinal detachment involving the macula, left

eye

ICD10CM



bilateral

ICD10CM



unspecified eye

ICD10CM



right eye

ICD10CM



left eye

ICD10CM



bilateral

ICD10CM



unspecified eye

ICD10CM



rhegmatogenous retinal detachment, right eye

ICD10CM



rhegmatogenous retinal detachment, left eye

ICD10CM



rhegmatogenous retinal detachment, bilateral

ICD10CM



rhegmatogenous retinal detachment, unspecified eye

ICD10CM


E09.3551 Drug or chemical induced diabetes mellitus with stable proliferative

diabetic retinopathy, right eye

ICD10CM


diabetic retinopathy, left eye

ICD10CM


diabetic retinopathy, bilateral

ICD10CM


diabetic retinopathy, unspecified eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with

macular edema

ICD10CM

E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without

macular edema

ICD10CM

E10.321 Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy

with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


E10.331 Type 1 diabetes mellitus with moderate nonproliferative diabetic


ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.341 Type 1 diabetes mellitus with severe nonproliferative diabetic


ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E10.351 Type 1 diabetes mellitus with proliferative diabetic retinopathy with

macular edema

ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


combined traction retinal detachment and rhegmatogenous retinal

detachment, right eye

ICD10CM



detachment, left eye

ICD10CM



detachment, bilateral

ICD10CM



detachment, unspecified eye

ICD10CM

E10.3551 Type 1 diabetes mellitus with stable proliferative diabetic retinopathy,

right eye

ICD10CM


left eye

ICD10CM


bilateral

ICD10CM



unspecified eye

ICD10CM

E10.359 Type 1 diabetes mellitus with proliferative diabetic retinopathy without

macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E11.311 Type 2 diabetes mellitus with unspecified diabetic retinopathy with

macular edema

ICD10CM

E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without

macular edema

ICD10CM


with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM




ICD10CM




ICD10CM




ICD10CM


right eye

ICD10CM


left eye

ICD10CM


bilateral

ICD10CM


unspecified eye

ICD10CM


macular edema

ICD10CM



ICD10CM




ICD10CM



ICD10CM



ICD10CM

E13.311 Other specified diabetes mellitus with unspecified diabetic retinopathy

with macular edema

ICD10CM

E13.319 Other specified diabetes mellitus with unspecified diabetic retinopathy


ICD10CM

E13.321 Other specified diabetes mellitus with mild nonproliferative diabetic


ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM



ICD10CM



ICD10CM



ICD10CM

E13.341 Other specified diabetes mellitus with severe nonproliferative diabetic


ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM

E13.351 Other specified diabetes mellitus with proliferative diabetic retinopathy

with macular edema

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM


with traction retinal detachment involving the macula, right eye

ICD10CM


with traction retinal detachment involving the macula, left eye

ICD10CM



with traction retinal detachment involving the macula, bilateral

ICD10CM


with traction retinal detachment involving the macula, unspecified eye

ICD10CM


with traction retinal detachment not involving the macula, right eye

ICD10CM


with traction retinal detachment not involving the macula, left eye

ICD10CM


with traction retinal detachment not involving the macula, bilateral

ICD10CM


with traction retinal detachment not involving the macula, unspecified

eye

ICD10CM


with combined traction retinal detachment and rhegmatogenous retinal


ICD10CM




ICD10CM




ICD10CM




ICD10CM

E13.3551 Other specified diabetes mellitus with stable proliferative diabetic

retinopathy, right eye

ICD10CM


retinopathy, left eye

ICD10CM


retinopathy, bilateral

ICD10CM


retinopathy, unspecified eye

ICD10CM



ICD10CM



ICD10CM



ICD10CM



ICD10CM




ICD10CM


Appendix H: Clinical Exception Codes: Medical Reason

Code Description

183932001 Procedure contraindicated (situation)

183964008 Treatment not indicated (situation)

183966005 Drug treatment not indicated (situation)

216952002 Failure in dosage (event)

266721009 Absent response to treatment (situation)

269191009 Late effect of medical and surgical care complication (disorder)

274512008 Drug therapy discontinued (situation)

31438003 Drug resistance (disorder)

35688006 Complication of medical care (disorder)

371133007 Treatment modification (procedure)

397745006 Medical contraindication (finding)

407563006 Treatment not tolerated (situation)

410534003 Not indicated (qualifier value)

410536001 Contraindicated (qualifier value)

416098002 Drug allergy (disorder)

416406003 Procedure discontinued (situation)

428119001 Procedure not indicated (situation)

445528004 Treatment changed (situation)

59037007 Drug intolerance (disorder)

62014003 Adverse reaction caused by drug (disorder)

79899007 Drug interaction (finding)


Appendix I: Clinical Exception Codes: Patient Reason

Code Description

105480006 Refusal of treatment by patient (situation)

160932005 Financial problem (finding)

160934006 Financial circumstances change (finding)

182890002 Patient requests alternative treatment (finding)

182895007 Drug declined by patient (situation)

182897004 Drug declined by patient - side effects (situation)

182900006 Drug declined by patient - patient beliefs (situation)

182902003 Drug declined by patient - cannot pay script (situation)

183944003 Procedure refused (situation)

183945002 Procedure refused for religious reason (situation)

184081006 Patient has moved away (finding)

185479006 Patient dissatisfied with result (finding)

185481008 Dissatisfied with doctor (finding)

224187001 Variable income (finding)

225928004 Patient self-discharge against medical advice (procedure)

266710000 Drugs not taken/completed (situation)

266966009 Family illness (situation)

275694009 Patient defaulted from follow-up (finding)

275936005 Patient noncompliance - general (situation)

281399006 Did not attend (finding)

310343007 Further opinion sought (finding)

373787003 Treatment delay - patient choice (finding)

385648002 Rejected by recipient (qualifier value)

406149000 Medication refused (situation)

408367005 Patient forgets to take medication (finding)

413310006 Patient non-compliant - refused access to services (situation)

413311005 Patient non-compliant - refused intervention / support (situation)

413312003 Patient non-compliant - refused service (situation)

416432009 Procedure not wanted (situation)

423656007 Income insufficient to buy necessities (finding)

424739004 Income sufficient to buy only necessities (finding)

443390004 Refused (qualifier value)

713247000 Procedure discontinued by patient (situation)

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