The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

/ TEXAS DEPARTMENT OF STATE HEALTH SERVICES
KIRK COLE
INTERIM COMMISSIONER / P.O. Box 149347
Austin, Texas 78714-9347
1-888-963-7111
TTY: 1-800-735-2989

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and ICD-10-PCS (inpatient procedure code) code sets will replace ICD-9-CM codes that are used to report medical diagnoses and inpatient procedures. The Centers for Medicare & Medicaid Services (CMS) effective date for ICD-10 code sets is October 1, 2015.

ICD-10 implementation will affect diagnosis and inpatient procedure coding for all entities that are covered by the Health Insurance Portability and Accountability Act (HIPAA). Health-care providers, payers, clearinghouses, and billing services must be prepared to comply with the ICD-10 implementation.

Beginning October 1, 2015, Kidney Health Care (KHC) will require providers to document the medical diagnosis codes and descriptors from the ICD-10-CM when preparing eligibilitydocumentation on behalf of KHC clients. The current ICD-9 code used for program eligibility and the ICD-10 equivalent is:

1

An Equal Opportunity Employer and Provider

‘585.6’ End stage renal disease

‘N18.6’ End Stage Renal Disease

1

An Equal Opportunity Employer and Provider

In addition, providers billing on the UB-04 for hospital services, will be required to utilize ICD-10- PCS codes when billing for access surgery related hospitalization and in-patient hemodialysis. The current ICD-9 codes and the ICD-10 equivalents are:

ICD9
volume 3 code / Description / ICD10 PCS
Code / Description
'38.95' / Venous catheterization for renal dialysis / '05HY03Z' / Insertion of Infusion Device into Upper Vein, Open Approach
'38.95' / Venous catheterization for renal dialysis / '05HY33Z' / Insertion of Infusion Device into Upper Vein, Percutaneous Approach
'38.95' / Venous catheterization for renal dialysis / '05HY43Z' / Insertion of Infusion Device into Upper Vein, Percutaneous Endoscopic Approach
'38.95' / Venous catheterization for renal dialysis / '06HY03Z' / Insertion of Infusion Device into Lower Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03130ZD' / Bypass Right Subclavian Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03140ZD' / Bypass Left Subclavian Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03150ZD' / Bypass Right Axillary Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03160ZD' / Bypass Left Axillary Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03170ZD' / Bypass Right Brachial Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03180ZD' / Bypass Left Brachial Artery to Upper Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '03190ZF' / Bypass Right Ulnar Artery to Lower Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '031A0ZF' / Bypass Left Ulnar Artery to Lower Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '031B0ZF' / Bypass Right Radial Artery to Lower Arm Vein, Open Approach
'39.27' / Arteriovenostomy for renal dialysis / '031C0ZF' / Bypass Left Radial Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031209D' / Bypass Innominate Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031209F' / Bypass Innominate Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120AD' / Bypass Innominate Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120AF' / Bypass Innominate Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120JD' / Bypass Innominate Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120JF' / Bypass Innominate Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120KD' / Bypass Innominate Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120KF' / Bypass Innominate Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120ZD' / Bypass Innominate Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120JF' / Bypass Innominate Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03120ZF' / Bypass Innominate Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031309D' / Bypass Right Subclavian Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031309F' / Bypass Right Subclavian Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130AD' / Bypass Right Subclavian Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130AF' / Bypass Right Subclavian Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130JD' / Bypass Right Subclavian Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130JF' / Bypass Right Subclavian Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130KD' / Bypass Right Subclavian Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130KF' / Bypass Right Subclavian Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130ZD' / Bypass Right Subclavian Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03130ZF' / Bypass Right Subclavian Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031409D' / Bypass Left Subclavian Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031409F' / Bypass Left Subclavian Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140AD' / Bypass Left Subclavian Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140AF' / Bypass Left Subclavian Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140JD' / Bypass Left Subclavian Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140JF' / Bypass Left Subclavian Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140KD' / Bypass Left Subclavian Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140KF' / Bypass Left Subclavian Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03140ZD' / Bypass Left Subclavian Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031509D' / Bypass Right Axillary Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031509F' / Bypass Right Axillary Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150AD' / Bypass Right Axillary Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150AF' / Bypass Right Axillary Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150JD' / Bypass Right Axillary Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150JF' / Bypass Right Axillary Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150KD' / Bypass Right Axillary Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150KF' / Bypass Right Axillary Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150ZD' / Bypass Right Axillary Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03150ZF' / Bypass Right Axillary Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031609D' / Bypass Left Axillary Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031609F' / Bypass Left Axillary Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160AD' / Bypass Left Axillary Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160AF' / Bypass Left Axillary Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160JD' / Bypass Left Axillary Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160JF' / Bypass Left Axillary Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160KD' / Bypass Left Axillary Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160KF' / Bypass Left Axillary Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160ZD' / Bypass Left Axillary Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03160ZF' / Bypass Left Axillary Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031709D' / Bypass Right Brachial Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031709F' / Bypass Right Brachial Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170AD' / Bypass Right Brachial Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170AF' / Bypass Right Brachial Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170JD' / Bypass Right Brachial Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170JF' / Bypass Right Brachial Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170KD' / Bypass Right Brachial Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170KF' / Bypass Right Brachial Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170ZD' / Bypass Right Brachial Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03170ZF' / Bypass Right Brachial Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031809D' / Bypass Left Brachial Artery to Upper Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031809F' / Bypass Left Brachial Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180AD' / Bypass Left Brachial Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180AF' / Bypass Left Brachial Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180JD' / Bypass Left Brachial Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180JF' / Bypass Left Brachial Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180KD' / Bypass Left Brachial Artery to Upper Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180KF' / Bypass Left Brachial Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180ZD' / Bypass Left Brachial Artery to Upper Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03180ZF' / Bypass Left Brachial Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031909F' / Bypass Right Ulnar Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03190AF' / Bypass Right Ulnar Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03190JF' / Bypass Right Ulnar Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03190KF' / Bypass Right Ulnar Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '03190ZF' / Bypass Right Ulnar Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031A09F' / Bypass Left Ulnar Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031A0AF' / Bypass Left Ulnar Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031A0JF' / Bypass Left Ulnar Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031A0KF' / Bypass Left Ulnar Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031A0ZF' / Bypass Left Ulnar Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031B0KF' / Bypass Right Radial Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031B0ZF' / Bypass Right Radial Artery to Lower Arm Vein, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031C09F' / Bypass Left Radial Artery to Lower Arm Vein with Autologous Venous Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031C0AF' / Bypass Left Radial Artery to Lower Arm Vein with Autologous Arterial Tissue, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031C0JF' / Bypass Left Radial Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031C0KF' / Bypass Left Radial Artery to Lower Arm Vein with Nonautologous Tissue Substitute, Open Approach
'39.42' / Revision of arteriovenous shunt for renal dialysis / '031C0ZF' / Bypass Left Radial Artery to Lower Arm Vein, Open Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY07Z' / Removal of Autologous Tissue Substitute from Upper Artery, Open Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY0JZ' / Removal of Synthetic Substitute from Upper Artery, Open Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY0KZ' / Removal of Nonautologous Tissue Substitute from Upper Artery, Open Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY37Z' / Removal of Autologous Tissue Substitute from Upper Artery, Percutaneous Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY3JZ' / Removal of Synthetic Substitute from Upper Artery, Percutaneous Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY3KZ' / Removal of Nonautologous Tissue Substitute from Upper Artery, Percutaneous Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY47Z' / Removal of Autologous Tissue Substitute from Upper Artery, Percutaneous Endoscopic Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY4JZ' / Removal of Synthetic Substitute from Upper Artery, Percutaneous Endoscopic Approach
'39.43' / Removal of arteriovenous shunt for renal dialysis / '03PY4KZ' / Removal of Nonautologous Tissue Substitute from Upper Artery, Percutaneous Endoscopic Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03130JD' / Bypass Right Subclavian Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03140JD' / Bypass Left Subclavian Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03150JD' / Bypass Right Axillary Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03160JD' / Bypass Left Axillary Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03170JD' / Bypass Right Brachial Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03180JD' / Bypass Left Brachial Artery to Upper Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '03190JF' / Bypass Right Ulnar Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '031A0JF' / Bypass Left Ulnar Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '031B0JF' / Bypass Right Radial Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.93' / Insertion of vessel-to-vessel cannula / '031C0JF' / Bypass Left Radial Artery to Lower Arm Vein with Synthetic Substitute, Open Approach
'39.94' / Replacement of vessel-to-vessel cannula / '03WY0JZ' / Revision of Synthetic Substitute in Upper Artery, Open Approach
'39.94' / Replacement of vessel-to-vessel cannula / '03WY3JZ' / Revision of Synthetic Substitute in Upper Artery, Percutaneous Approach
'39.94' / Replacement of vessel-to-vessel cannula / '03WY4JZ' / Revision of Synthetic Substitute in Upper Artery, Percutaneous Endoscopic Approach
'39.94' / Replacement of vessel-to-vessel cannula / '03WYXJZ' / Revision of Synthetic Substitute in Upper Artery, External Approach
'39.95' / Hemodialysis / '5A1D00Z' / Performance of Urinary Filtration, Single
'39.95' / Hemodialysis / '5A1D60Z' / Performance of Urinary Filtration, Multiple
'54.93' / Creation of cutaneoperitoneal fistula / '0W1G0J4' / Bypass Peritoneal Cavity to Cutaneous with Synthetic Substitute, Open Approach
'54.93' / Creation of cutaneoperitoneal fistula / '0W1G3J4' / Bypass Peritoneal Cavity to Cutaneous with Synthetic Substitute, Percutaneous Approach
'54.93' / Creation of cutaneoperitoneal fistula / '0W1G4J4' / Bypass Peritoneal Cavity to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
'54.98' / Peritoneal dialysis / '3E1M39Z' / Irrigation of Peritoneal Cavity using Dialysate, Percutaneous Approach

Additional information is available on the CMS website at: