Code List: CMS66v6, Functional Status Assessment for Total Knee Replacement

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Item	Codes
Encounter Codes
Encounter, Performed: Face-to-Face Interaction: SNOMED	12843005, 18170008, 19681004, 87790002, 90526000, 185349003, 185463005, 185465003, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006
Encounter, Performed: Office Visit: CPT	99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Outpatient Consultation: CPT	99241, 99242, 99243, 99244, 99245
Encounter, Performed: Postoperative Visit: CPT	99024
Knee Replacement Procedure Codes
Procedure, Performed: Primary TKA Procedure: CPT	27447
Procedure, Performed: Primary TKA Procedure: SNOMED	179344006, 179345007, 179351002, 179352009, 265170009, 265172001, 392237008, 430698003, 443681002, 443682009
Functional Status Codes
Assessment, Performed: Functional Status Assessment for Knee Replacement: LOINC	71970-8, 71971-6, 71972-4, 71969-0, 72012-8, 72009-4, 72013-6, 72016-9, 72010-2, 72014-4, 72017-7, 72011-0, 72021-9, 72018-5, 72015-1, 72022-7, 72019-3, 72023-5, 72026-8, 72020-1, 72024-3, 72027-6, 72028-4, 72025-0, 72098-7, 72101-9, 72099-5, 72102-7, 72100-1
Exclusion Diagnosis Codes
Diagnosis: Fracture – Lower Body: ICD-10	S12.000A, S12.000B, S12.001A, S12.001B, S12.030A, S12.030B, S12.031A, S12.031B, S12.040A, S12.040B, S12.041A, S12.041B, S12.090A, S12.090B, S12.091A, S12.091B, S12.100A, S12.100B, S12.101A, S12.101B, S12.110A, S12.110B, S12.111A, S12.111B, S12.112A, S12.112B, S12.120A, S12.120B, S12.121A, S12.121B, S12.130A, S12.130B, S12.131A, S12.131B, S12.14XA, S12.14XB, S12.150A, S12.150B, S12.151A, S12.151B, S12.190A, S12.190B, S12.191A, S12.191B, S12.200A, S12.200B, S12.201A, S12.201B, S12.230A, S12.230B, S12.231A, S12.231B, S12.24XA, S12.24XB, S12.250A, S12.250B, S12.251A, S12.251B, S12.290A, S12.290B, S12.291A, S12.291B, S12.300A, S12.300B, S12.301A, S12.301B, S12.330A, S12.330B, S12.331A, S12.331B, S12.34XA, S12.34XB, S12.350A, S12.350B, S12.351A, S12.351B, S12.390A, S12.390B, S12.391A, S12.391B, S12.400A, S12.400B, S12.401A, S12.401B, S12.430A, S12.430B, S12.431A, S12.431B, S12.44XA, S12.44XB, S12.450A, S12.450B, S12.451A, S12.451B, S12.490A, S12.490B, S12.491A, S12.491B, S12.500A, S12.500B, S12.501A, S12.501B, S12.530A, S12.530B, S12.531A, S12.531B, S12.54XA, S12.54XB, S12.550A, S12.550B, S12.551A, S12.551B, S12.590A, S12.590B, S12.591A, S12.591B, S12.600A, S12.600B, S12.601A, S12.601B, S12.630A, S12.630B, S12.631A, S12.631B, S12.64XA, S12.64XB, S12.650A, S12.650B, S12.651A, S12.651B, S12.690A, S12.690B, S12.691A, S12.691B, S12.8XXA, S12.9XXA, S22.20XA, S22.20XB, S22.21XA, S22.21XB, S22.22XA, S22.22XB, S22.23XA, S22.23XB, S22.24XA, S22.24XB, S22.31XA, S22.31XB, S22.32XA, S22.32XB, S22.39XA, S22.39XB, S22.41XA, S22.41XB, S22.42XA, S22.42XB, S22.43XA, S22.43XB, S22.49XA, S22.49XB, S22.5XXA, S22.5XXB, S22.9XXA, S22.9XXB, S32.10XA, S32.10XB, S32.110A, S32.110B, S32.111A, S32.111B, S32.112A, S32.112B, S32.119A, S32.119B, S32.120A, S32.120B, S32.121A, S32.121B, S32.122A, S32.122B, S32.129A, S32.129B, S32.130A, S32.130B, S32.131A, S32.131B, S32.132A, S32.132B, S32.139A, S32.139B, S32.14XA, S32.14XB, S32.15XA, S32.15XB, S32.16XA, S32.16XB, S32.17XA, S32.17XB, S32.19XA, S32.19XB, S32.2XXA, S32.2XXB, S32.301A, S32.301B, S32.301D, S32.301G, S32.301K, S32.301S, S32.302A, S32.302B, S32.302D, S32.302G, S32.302K, S32.302S, S32.309A, S32.309B, S32.309D, S32.309G, S32.309K, S32.309S, S32.311A, S32.311B, S32.311D, S32.311G, S32.311K, S32.311S, S32.312A, S32.312B, S32.312D, S32.312G, S32.312K, S32.312S, S32.313A, S32.313B, S32.313D, S32.313G, S32.313K, S32.313S, S32.314A, S32.314B, S32.314D, S32.314G, S32.314K, S32.314S, S32.315A, S32.315B, S32.315D, S32.315G, S32.315K, S32.315S, S32.316A, S32.316B, S32.316D, S32.316G, S32.316K, S32.316S, S32.391A, S32.391B, S32.391D, S32.391G, S32.391K, S32.391S, S32.392A, S32.392B, S32.392D, S32.392G, S32.392K, S32.392S, S32.399A, S32.399B, S32.399D, S32.399G, S32.399K, S32.399S, S32.401A, S32.401B, S32.401D, S32.401G, S32.401K, S32.401S, S32.402A, S32.402B, S32.402D, S32.402G, S32.402K, S32.402S, S32.409A, S32.409B, S32.409D, S32.409G, S32.409K, S32.409S, S32.411A, S32.411B, S32.411D, S32.411G, S32.411K, S32.411S, S32.412A, S32.412B, S32.412D, S32.412G, S32.412K, S32.412S, S32.413A, S32.413B, S32.413D, S32.413G, S32.413K, S32.413S, S32.414A, S32.414B, S32.414D, S32.414G, S32.414K, S32.414S, S32.415A, S32.415B, S32.415D, S32.415G, S32.415K, S32.415S, S32.416A, S32.416B, S32.416D, S32.416G, S32.416K, S32.416S, S32.421A, S32.421B, S32.421D, S32.421G, S32.421K, S32.421S, S32.422A, S32.422B, S32.422D, S32.422G, S32.422K, S32.422S, S32.423A, S32.423B, S32.423D, S32.423G, S32.423K, S32.423S, S32.424A, S32.424B, S32.424D, S32.424G, S32.424K, S32.424S, S32.425A, S32.425B, S32.425D, S32.425G, S32.425K, S32.425S, S32.426A, S32.426B, S32.426D, S32.426G, S32.426K, S32.426S, S32.431A, S32.431B, S32.431D, S32.431G, S32.431K, S32.431S, S32.432A, S32.432B, S32.432D, S32.432G, S32.432K, S32.432S, S32.433A, S32.433B, S32.433D, S32.433G, S32.433K, S32.433S, S32.434A, S32.434B, S32.434D, S32.434G, S32.434K, S32.434S, S32.435A, S32.435B, S32.435D, S32.435G, S32.435K, S32.435S, S32.436A, S32.436B, S32.436D, S32.436G, S32.436K, S32.436S, S32.441A, S32.441B, S32.441D, S32.441G, S32.441K, S32.441S, S32.442A, S32.442B, S32.442D, S32.442G, S32.442K, S32.442S, S32.443A, S32.443B, S32.443D, S32.443G, S32.443K, S32.443S, S32.444A, S32.444B, S32.444D, S32.444G, S32.444K, S32.444S, S32.445A, S32.445B, S32.445D, S32.445G, S32.445K, S32.445S, S32.446A, S32.446B, S32.446D, S32.446G, S32.446K, S32.446S, S32.451A, S32.451B, S32.451D, S32.451G, S32.451K, S32.451S, S32.452A, S32.452B, S32.452D, S32.452G, S32.452K, S32.452S, S32.453A, S32.453B, S32.453D, S32.453G, S32.453K, S32.453S, S32.454A, S32.454B, S32.454D, S32.454G, S32.454K, S32.454S, S32.455A, S32.455B, S32.455D, S32.455G, S32.455K, S32.455S, S32.456A, S32.456B, S32.456D, S32.456G, S32.456K, S32.456S, S32.461A, S32.461B, S32.461D, S32.461G, S32.461K, S32.461S, S32.462A, S32.462B, S32.462D, S32.462G, S32.462K, S32.462S, S32.463A, S32.463B, S32.463D, S32.463G, S32.463K, S32.463S, S32.464A, S32.464B, S32.464D, S32.464G, S32.464K, S32.464S, S32.465A, S32.465B, S32.465D, S32.465G, S32.465K, S32.465S, S32.466A, S32.466B, S32.466D, S32.466G, S32.466K, S32.466S, S32.471A, S32.471B, S32.471D, S32.471G, S32.471K, S32.471S, S32.472A, S32.472B, S32.472D, S32.472G, S32.472K, S32.472S, S32.473A, S32.473B, S32.473D, S32.473G, S32.473K, S32.473S, S32.474A, S32.474B, S32.474D, S32.474G, S32.474K, S32.474S, S32.475A, S32.475B, S32.475D, S32.475G, S32.475K, S32.475S, S32.476A, S32.476B, S32.476D, S32.476G, S32.476K, S32.476S, S32.481A, S32.481B, S32.481D, S32.481G, S32.481K, S32.481S, S32.482A, S32.482B, S32.482D, S32.482G, S32.482K, S32.482S, S32.483A, S32.483B, S32.483D, S32.483G, S32.483K, S32.483S, S32.484A, S32.484B, S32.484D, S32.484G, S32.484K, S32.484S, S32.485A, S32.485B, S32.485D, S32.485G, S32.485K, S32.485S, S32.486A, S32.486B, S32.486D, S32.486G, S32.486K, S32.486S, S32.491A, S32.491B, S32.491D, S32.491G, S32.491K, S32.491S, S32.492A, S32.492B, S32.492D, S32.492G, S32.492K, S32.492S, S32.499A, S32.499B, S32.499D, S32.499G, S32.499K, S32.499S, S32.501A, S32.501B, S32.501D, S32.501G, S32.501K, S32.501S, S32.502A, S32.502B, S32.502D, S32.502G, S32.502K, S32.502S, S32.509A, S32.509B, S32.509D, S32.509G, S32.509K, S32.509S, S32.511A, S32.511B, S32.511D, S32.511G, S32.511K, S32.511S, S32.512A, S32.512B, S32.512D, S32.512G, S32.512K, S32.512S, S32.519A, S32.519B, S32.519D, S32.519G, S32.519K, S32.519S, S32.591A, S32.591B, S32.591D, S32.591G, S32.591K, S32.591S, S32.592A, S32.592B, S32.592D, S32.592G, S32.592K, S32.592S, S32.599A, S32.599B, S32.599D, S32.599G, S32.599K, S32.599S, S32.601A, S32.601B, S32.601D, S32.601G, S32.601K, S32.601S, S32.602A, S32.602B, S32.602D, S32.602G, S32.602K, S32.602S, S32.609A, S32.609B, S32.609D, S32.609G, S32.609K, S32.609S, S32.611A, S32.611B, S32.611D, S32.611G, S32.611K, S32.611S, S32.612A, S32.612B, S32.612D, S32.612G, S32.612K, S32.612S, S32.613A, S32.613B, S32.613D, S32.613G, S32.613K, S32.613S, S32.614A, S32.614B, S32.614D, S32.614G, S32.614K, S32.614S, S32.615A, S32.615B, S32.615D, S32.615G, S32.615K, S32.615S, S32.616A, S32.616B, S32.616D, S32.616G, S32.616K, S32.616S, S32.691A, S32.691B, S32.691D, S32.691G, S32.691K, S32.691S, S32.692A, S32.692B, S32.692D, S32.692G, S32.692K, S32.692S, S32.699A, S32.699B, S32.699D, S32.699G, S32.699K, S32.699S, S32.810A, S32.810B, S32.811A, S32.811B, S32.82XA, S32.82XB, S32.89XA, S32.89XB, S32.89XD, S32.89XG, S32.89XK, S32.89XS, S32.9XXA, S32.9XXB, S32.9XXD, S32.9XXG, S32.9XXK, S32.9XXS, S42.001A, S42.001B, S42.002A, S42.002B, S42.009A, S42.009B, S42.011A, S42.011B, S42.012A, S42.012B, S42.013A, S42.013B, S42.014A, S42.014B, S42.015A, S42.015B, S42.016A, S42.016B, S42.017A, S42.017B, S42.018A, S42.018B, S42.019A, S42.019B, S42.021A, S42.021B, S42.022A, S42.022B, S42.023A, S42.023B, S42.024A, S42.024B, S42.025A, S42.025B, S42.026A, S42.026B, S42.031A, S42.031B, S42.032A, S42.032B, S42.033A, S42.033B, S42.034A, S42.034B, S42.035A, S42.035B, S42.036A, S42.036B, S42.101A, S42.101B, S42.102A, S42.102B, S42.109A, S42.109B, S42.111A, S42.111B, S42.112A, S42.112B, S42.113A, S42.113B, S42.114A, S42.114B, S42.115A, S42.115B, S42.116A, S42.116B, S42.121A, S42.121B, S42.122A, S42.122B, S42.123A, S42.123B, S42.124A, S42.124B, S42.125A, S42.125B, S42.126A, S42.126B, S42.131A, S42.131B, S42.132A, S42.132B, S42.133A, S42.133B, S42.134A, S42.134B, S42.135A, S42.135B, S42.136A, S42.136B, S42.141A, S42.141B, S42.142A, S42.142B, S42.143A, S42.143B, S42.144A, S42.144B, S42.145A, S42.145B, S42.146A, S42.146B, S42.151A, S42.151B, S42.152A, S42.152B, S42.153A, S42.153B, S42.154A, S42.154B, S42.155A, S42.155B, S42.156A, S42.156B, S42.191A, S42.191B, S42.192A, S42.192B, S42.199A, S42.199B, S42.201A, S42.201B, S42.202A, S42.202B, S42.209A, S42.209B, S42.211A, S42.211B, S42.212A, S42.212B, S42.213A, S42.213B, S42.214A, S42.214B, S42.215A, S42.215B, S42.216A, S42.216B, S42.221A, S42.221B, S42.222A, S42.222B, S42.223A, S42.223B, S42.224A, S42.224B, S42.225A, S42.225B, S42.226A, S42.226B, S42.231A, S42.231B, S42.232A, S42.232B, S42.239A, S42.239B, S42.241A, S42.241B, S42.242A, S42.242B, S42.249A, S42.249B, S42.251A, S42.251B, S42.252A, S42.252B, S42.253A, S42.253B, S42.254A, S42.254B, S42.255A, S42.255B, S42.256A, S42.256B, S42.261A, S42.261B, S42.262A, S42.262B, S42.263A, S42.263B, S42.264A, S42.264B, S42.265A, S42.265B, S42.266A, S42.266B, S42.271A, S42.272A, S42.279A, S42.291A, S42.291B, S42.292A, S42.292B, S42.293A, S42.293B, S42.294A, S42.294B, S42.295A, S42.295B, S42.296A, S42.296B, S42.301A, S42.301B, S42.302A, S42.302B, S42.309A, S42.309B, S42.311A, S42.312A, S42.319A, S42.321A, S42.321B, S42.322A, S42.322B, S42.323A, S42.323B, S42.324A, S42.324B, S42.325A, S42.325B, S42.326A, S42.326B, S42.331A, S42.331B, S42.332A, S42.332B, S42.333A, S42.333B, S42.334A, S42.334B, S42.335A, S42.335B, S42.336A, S42.336B, S42.341A, S42.341B, S42.342A, S42.342B, S42.343A, S42.343B, S42.344A, S42.344B, S42.345A, S42.345B, S42.346A, S42.346B, S42.351A, S42.351B, S42.352A, S42.352B, S42.353A, S42.353B, S42.354A, S42.354B, 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Diagnosis: Fracture – Lower Body: SNOMED	1705000, 5913000, 6628008, 7687006, 9344009, 12746007, 13695006, 15474008, 17616007, 19652000, 20100009, 22234005, 22802006, 23900009, 25415003, 26442006, 26938002, 28012007, 28359007, 28576007, 30060003, 30489009, 30905007, 33118001, 36127009, 36417005, 39408006, 41191003, 45455009, 46272008, 47848000, 51037009, 52450003, 54441004, 59556008, 59639009, 59962009, 60214001, 62125005, 64455005, 66483005, 66926007, 69830008, 71220005, 71620000, 76911006, 77598002, 77803008, 79484004, 79978005, 80756009, 82640004, 84320000, 86731008, 87173003, 89820008, 91037003, 111643005, 111644004, 111645003, 111646002, 127287001, 208146001, 208147005, 208148000, 208149008, 208150008, 208151007, 208155003, 208156002, 208157006, 208158001, 208159009, 208160004, 208164008, 208165009, 208166005, 208168006, 208172005, 208173000, 208174006, 208181004, 208182006, 208183001, 208184007, 208185008, 208192003, 208193008, 208194002, 208195001, 208197009, 208202002, 208204001, 208205000, 208207008, 208521006, 208523009, 208524003, 208526001, 208528000, 208529008, 208530003, 208531004, 208536009, 208537000, 208540000, 208541001, 208542008, 208543003, 208544009, 208548007, 208550004, 208551000, 208552007, 208555009, 208557001, 208558006, 208559003, 208562000, 208578003, 208579006, 208580009, 208581008, 208582001, 208587007, 208588002, 208589005, 208590001, 208591002, 208596007, 208597003, 208598008, 208600002, 208601003, 208602005, 208603000, 208604006, 208605007, 208606008, 208610006, 208611005, 208612003, 208613008, 208614002, 208615001, 208619007, 208620001, 208621002, 208622009, 208623004, 208624005, 208625006, 208627003, 208629000, 208631009, 208632002, 208637008, 208731002, 209335002, 209336001, 209337005, 209338000, 209344001, 209345000, 209346004, 209347008, 209390009, 209395004, 209405008, 263067005, 263096006, 263216001, 263220002, 263221003, 263222005, 263225007, 263226008, 263227004, 263228009, 263229001, 263231005, 263232003, 263233008, 263234002, 263235001, 263236000, 263237009, 263238004, 263239007, 271963003, 275338001, 275339009, 275340006, 275341005, 275342003, 275343008, 281533006, 301034006, 301757009, 302034009, 307178006, 307727005, 308153009, 359817006, 359820003, 361118003, 361119006, 413876003, 413877007, 414942001, 414943006, 426382004, 426679004, 426962008, 427509002, 427584009, 427688003, 427826000, 428000009, 428020005, 428232002, 428257007, 428357005, 428512002, 428723000, 428797006, 428798001, 429186005, 429342005, 429552008, 429766001, 445311003, 445410003, 445733003, 445875009, 445899009, 446979005, 446980008, 447017008, 447139008, 447394009, 447395005, 447931000124101
Diagnosis: Severe Dementia: SNOMED	428351000124105
Hospice Exclusion Codes
Encounter, Performed: Encounter Inpatient	183452005, 32485007, 8715000
Intervention, Order: Hospice Care	385763009, 385765002
Discharge Codes to Health Care Facility for Hospice Care	428371000124100
Discharge Codes to Home for Hospice Care	428361000124107

Last updated: June 12, 2018 at 9:21 am

CMS66v6 Code List

Code List: CMS66v6, Functional Status Assessment for Total Knee Replacement