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CMS144v6 Code List

Code List: CMS144v6, Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

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Item Codes
Active Diagnosis Codes
Diagnosis: Heart Failure: ICD-9 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20, 428.21, 428.22, 428.23, 428.30, 428.31, 428.32, 428.33, 428.40, 428.41, 428.42, 428.43, 428.9
Diagnosis: Heart Failure: ICD-10 I11.0, I13.0, I13.2, I50.1, I50.20, I50.21, I50.22, I50.23, I50.30, I50.31, I50.32, I50.33, I50.40, I50.41, I50.42, I50.43, I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84, I50.89, I50.9
Diagnosis: Heart Failure: SNOMED 10091002, 10335000, 10633002, 111283005, 128404006, 194767001, 194779001, 194781004, 195111005, 195112003, 195114002, 206586007, 233924009, 25544003, 277639002, 314206003, 359617009, 359620001, 364006, 367363000, 410431009, 417996009, 418304008, 42343007, 424404003, 426012001, 426263006, 426611007, 43736008, 441481004, 441530006, 44313006, 46113002, 48447003, 5053004, 5148006, 5375005, 56675007, 60856006, 66989003, 74960003, 77737007, 80479009, 82523003, 83105008, 84114007, 85232009, 88805009, 90727007, 92506005
Left Ventricular Systolic Dysfunction Diagnosis Codes
Diagnosis: Left ventricular systolic dysfunction: SNOMED 134401001
Diagnosis: Moderate or Severe LVSD: SNOMED 981000124106, 991000124109
Ejection Fraction LOINC Codes
Diagnostic Study, Performed: Ejection Fraction: LOINC 8808-8, 8809-6, 8806-2, 8810-4, 8807-0, 8811-2, 8812-0, 10230-1, 18044-8, 18048-9, 18045-5, 18049-7, 18043-0, 18046-3, 18047-1, 77892-8, 77889-4, 77890-2, 77891-0, 79990-8, 79991-6, 79992-4, 79993-2
Encounter Codes
Encounter, Performed: Care Services in Long-Term Residential Facility: CPT 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
Encounter, Performed: Discharge Services – Hospital Inpatient: CPT 99238, 99239
Encounter, Performed: Face-to-Face Interaction: SNOMED 12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Encounter, Performed: Home Healthcare Services: CPT 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Encounter, Performed: Nursing Facility Visit: CPT 99304, 99305, 99306, 99307, 99308, 99309, 99310
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: Patient Provider Interaction: SNOMED 11797002, 12843005, 18170008, 185316007, 185317003, 185318008, 185320006, 185321005, 185349003, 185463005, 185465003, 19681004, 207195004, 270424005, 270427003, 270430005, 308335008, 308720009, 386473003, 390906007, 401267002, 401271004, 406547006, 438515009, 438516005, 439708006, 445450000, 448337001, 4525004, 87790002, 90526000
Medications/Ingredients
Medication, Active: Beta Blocker Therapy for LVSD: Description (RXNORM code) 24 HR carvedilol phosphate 10 MG Extended Release Oral Capsule (860510); 24 HR carvedilol phosphate 20 MG Extended Release Oral Capsule (860516); 24 HR carvedilol phosphate 40 MG Extended Release Oral Capsule (860522); 24 HR carvedilol phosphate 80 MG Extended Release Oral Capsule (860532); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 100 MG Extended Release Oral Tablet (866452); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 25 MG Extended Release Oral Tablet (866461); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 50 MG Extended Release Oral Tablet (866472); 24 HR metoprolol succinate 100 MG Extended Release Oral Tablet (866412); 24 HR metoprolol succinate 200 MG Extended Release Oral Tablet (866419); 24 HR metoprolol succinate 25 MG Extended Release Oral Tablet (866427); 24 HR metoprolol succinate 50 MG Extended Release Oral Tablet (866436); Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854908); Bisoprolol Fumarate 10 MG Oral Tablet (854901); Bisoprolol Fumarate 2.5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854916); Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854919); Bisoprolol Fumarate 5 MG Oral Tablet (854905); carvedilol 12.5 MG Oral Tablet (200032); carvedilol 25 MG Oral Tablet (200033); carvedilol 3.125 MG Oral Tablet (686924); carvedilol 6.25 MG Oral Tablet (200031)
Medication, Allergy: Beta Blocker Therapy Ingredient: Description (RXNORM code) Acebutolol (149); Atenolol (1202); Betaxolol (1520); Bisoprolol (19484); Carteolol (2116); carvedilol (20352); Labetalol (6185); Metoprolol (6918); Nadolol (7226); Pindolol (8332); Propranolol (8787); Timolol (10600)
Medication, Intolerance: Beta Blocker Therapy: Description (RXNORM code) 24 HR carvedilol phosphate 10 MG Extended Release Oral Capsule (860510); 24 HR carvedilol phosphate 20 MG Extended Release Oral Capsule (860516); 24 HR carvedilol phosphate 40 MG Extended Release Oral Capsule (860522); 24 HR carvedilol phosphate 80 MG Extended Release Oral Capsule (860532); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 100 MG Extended Release Oral Tablet (866452); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 25 MG Extended Release Oral Tablet (866461); 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 50 MG Extended Release Oral Tablet (866472); 24 HR metoprolol succinate 100 MG Extended Release Oral Tablet (866412); 24 HR metoprolol succinate 200 MG Extended Release Oral Tablet (866419); 24 HR metoprolol succinate 25 MG Extended Release Oral Tablet (866427); 24 HR metoprolol succinate 50 MG Extended Release Oral Tablet (866436); 24 HR Propranolol Hydrochloride 120 MG Extended Release Oral Capsule (856460); 24 HR Propranolol Hydrochloride 160 MG Extended Release Oral Capsule (856481); 24 HR Propranolol Hydrochloride 60 MG Extended Release Oral Capsule (856535); 24 HR Propranolol Hydrochloride 80 MG Extended Release Oral Capsule (856569); Acebutolol Hydrochloride 100 MG Oral Capsule (998693); Acebutolol Hydrochloride 200 MG / Hydrochlorothiazide 12.5 MG Oral Tablet (998694); Acebutolol Hydrochloride 200 MG Oral Capsule (998689); Acebutolol Hydrochloride 400 MG Oral Capsule (998685); Acebutolol Hydrochloride 400 MG Oral Tablet (998695); Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet (197382); Atenolol 100 MG Oral Tablet (197379); Atenolol 25 MG Oral Tablet (197380); Atenolol 50 MG / Chlorthalidone 12.5 MG Oral Tablet (152916); Atenolol 50 MG / Chlorthalidone 25 MG Oral Tablet (197383); Atenolol 50 MG Oral Tablet (197381); Bendroflumethiazide 5 MG / Nadolol 40 MG Oral Tablet (198000); Bendroflumethiazide 5 MG / Nadolol 80 MG Oral Tablet (198001); Betaxolol Hydrochloride 10 MG Oral Tablet (1297753); Betaxolol Hydrochloride 20 MG Oral Tablet (1297757); Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854908); Bisoprolol Fumarate 10 MG Oral Tablet (854901); Bisoprolol Fumarate 2.5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854916); Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet (854919); Bisoprolol Fumarate 5 MG Oral Tablet (854905); carvedilol 12.5 MG Oral Tablet (200032); carvedilol 25 MG Oral Tablet (200033); carvedilol 3.125 MG Oral Tablet (686924); carvedilol 6.25 MG Oral Tablet (200031); Clopamide 5 MG / Pindolol 10 MG Oral Tablet (199717); Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet (866479); Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet (866482); Hydrochlorothiazide 25 MG / Pindolol 10 MG Oral Tablet (245854); Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet (856422); Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet (856429); Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet (866491); Hydrochlorothiazide 50 MG / Pindolol 10 MG Oral Tablet (245855); Labetalol hydrochloride 100 MG Oral Tablet (896758); Labetalol hydrochloride 200 MG Oral Tablet (896762); Labetalol hydrochloride 300 MG Oral Tablet (896766); Labetalol hydrochloride 400 MG Oral Tablet (896983); Labetalol hydrochloride 50 MG Oral Tablet (896987); Metoprolol Tartrate 100 MG Oral Tablet (866511); Metoprolol Tartrate 25 MG Oral Tablet (866924); Metoprolol Tartrate 50 MG Oral Tablet (866514); Nadolol 20 MG Oral Tablet (198006); Nadolol 40 MG Oral Tablet (198007); Nadolol 80 MG Oral Tablet (198008); nebivolol 10 MG Oral Tablet (751612); nebivolol 2.5 MG Oral Tablet (751618); nebivolol 20 MG Oral Tablet (827073); nebivolol 5 MG Oral Tablet (387013); Oxprenolol 160 MG Extended Release Oral Tablet (199787); Oxprenolol 20 MG Oral Tablet (199494); Oxprenolol 40 MG Oral Tablet (199495); Oxprenolol 80 MG Oral Tablet (199786); Penbutolol Sulfate 20 MG Oral Tablet (1191185); Pindolol 10 MG Oral Tablet (198104); Pindolol 15 MG Oral Tablet (199277); Pindolol 5 MG Oral Tablet (198105); Propranolol Hydrochloride 10 MG Oral Tablet (856448); Propranolol Hydrochloride 160 MG Oral Tablet (856713); Propranolol Hydrochloride 20 MG Oral Tablet (856457); Propranolol Hydrochloride 4 MG/ML Oral Solution (856724); Propranolol Hydrochloride 4.28 MG/ML Oral Solution (1495058); Propranolol Hydrochloride 40 MG Oral Tablet (856519); Propranolol Hydrochloride 60 MG Oral Tablet (856556); Propranolol Hydrochloride 8 MG/ML Oral Solution (856733); Propranolol Hydrochloride 80 MG Oral Tablet (856578); Sotalol Hydrochloride 100 MG Oral Tablet (904561); Sotalol Hydrochloride 120 MG Oral Tablet (1923422); Sotalol Hydrochloride 160 MG Oral Tablet (1923424); Sotalol Hydrochloride 240 MG Oral Tablet (904589); Sotalol Hydrochloride 5 MG/ML Oral Solution (1593725); Sotalol Hydrochloride 80 MG Oral Tablet (1923426); Timolol 10 MG Oral Tablet (198284); Timolol 20 MG Oral Tablet (198285); Timolol 5 MG Oral Tablet (198286)
Exceptions: Allergy and Other Diagnoses
Diagnosis: Allergy to Beta Blocker Therapy: SNOMED 293962009, 293963004, 293964005, 293965006, 293966007, 293967003, 293968008, 293969000, 293970004, 293971000, 293972007, 293973002, 293974008, 293975009, 293976005, 293977001, 293978006, 293979003, 293980000, 293981001, 293982008, 293983003, 293984009
Diagnosis: Arrhythmia: ICD-9 427.89, 427.9
Diagnosis: Arrhythmia: ICD-10 I49.8, I49.9
Diagnosis: Arrhythmia: SNOMED 10164001, 10626002, 11157007, 11849007, 13640000, 17338001, 17366009, 17869006, 184004, 195060002, 195069001, 195071001, 195072008, 195083004, 233891009, 233892002, 233893007, 233894001, 233895000, 233904005, 233915000, 233922008, 233923003, 234172002, 251161003, 251162005, 251163000, 251164006, 251165007, 251166008, 251167004, 251168009, 251170000, 251172008, 251173003, 251174009, 251175005, 251176006, 251177002, 251178007, 251179004, 251180001, 251181002, 251182009, 251186007, 251187003, 251188008, 26950008, 27337007, 276796006, 284470004, 287057009, 29320008, 309809007, 33413000, 36083008, 38274001, 39260000, 39357005, 40593004, 406461004, 418341009, 418818005, 419752005, 421869004, 422348008, 429243003, 44808001, 47830009, 49982000, 55475008, 59272004, 60423000, 61277005, 63232000, 63593006, 69730002, 71908006, 72654001, 74390002, 74615001, 75532003, 81681009, 81898007, 88412007
Diagnosis: Asthma: ICD-9 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82, 493.90, 493.91, 493.92
Diagnosis: Asthma: ICD-10 J45.20, J45.21, J45.22, J45.30, J45.31, J45.32, J45.40, J45.41, J45.42, J45.50, J45.51, J45.52, J45.901, J45.902, J45.909, J45.990, J45.991, J45.998
Diagnosis: Asthma: SNOMED 11641008, 12428000, 13151001, 195949008, 195967001, 195977004, 225057002, 233672007, 233678006, 233679003, 233683003, 233688007, 266361008, 281239006, 30352005, 304527002, 31387002, 370218001, 370219009, 370220003, 370221004, 389145006, 405944004, 407674008, 409663006, 423889005, 424199006, 424643009, 425969006, 426656000, 426979002, 427295004, 427603009, 427679007, 442025000, 55570000, 56968009, 59786004, 63088003, 707445000, 707446004, 707447008, 708038006, 708090002, 708093000, 708094006, 708095007, 708096008, 85761009, 92807009, 93432008
Diagnosis: Bradycardia: ICD-9 427.81, 427.89
Diagnosis: Bradycardia: ICD-10 I49.5, I49.8, R00.1
Diagnosis: Bradycardia: SNOMED 251162005, 29894000, 397841007, 44602002, 49044005, 49710005
Diagnosis: Hypotension: ICD-9 458.0, 458.1, 458.21, 458.29, 458.8, 458.9
Diagnosis: Hypotension: ICD-10 I95.0, I95.1, I95.2, I95.3, I95.81, I95.89, I95.9
Diagnosis: Hypotension: SNOMED 195506001, 200113008, 200114002, 230664009, 234171009, 271870002, 286963007, 371073003, 408667000, 408668005, 429561008, 45007003, 61933008, 70247006, 75181005, 77545000, 88887003
Diagnosis: Intolerance to Beta Blocker Therapy: SNOMED 292419005, 292420004, 292421000, 292424008, 292425009, 292426005, 292427001, 292428006, 292429003, 292430008, 292431007, 292432000, 292433005, 292434004, 292435003, 292436002, 292437006, 292438001, 292439009, 292440006, 292441005, 292442003, 418370000
Diagnosis: Atrioventricular Block: ICD-9 426.0, 426.12, 426.13
Diagnosis: Atrioventricular Block: ICD-10 I44.1, I44.2
Diagnosis: Atrioventricular Block: SNOMED 195042002, 233917008, 233918003, 251114004, 27885002, 28189009, 283645003, 54016002, 93130009
Diagnosis: Cardiac Pacer in Situ: ICD-9 V45.01
Diagnosis: Cardiac Pacer in Situ: ICD-10 Z95.0
Diagnosis: Cardiac Pacer in Situ: SNOMED 441509002
Device, Applied: Cardiac Pacer: SNOMED 14106009, 360127006, 360128001, 424921004, 56961003
Exceptions: Reasons for Not Providing Medication
Medication, Order not done: Medical Reason: SNOMED Absent response to treatment (266721009)
Adverse reaction caused by drug (62014003)
Complication of medical care (35688006)
Contraindicated (410536001)
Drug allergy (416098002)
Drug interaction (79899007)
Drug intolerance (59037007)
Drug resistance (31438003)
Drug therapy discontinued (274512008)
Drug treatment not indicated (183966005)
Failure in dosage (216952002)
Late effect of medical and surgical care complication (269191009)
Medical contraindication (397745006)
Not indicated (410534003)
Procedure contraindicated (183932001)
Procedure discontinued (416406003)
Procedure not indicated (428119001)
Treatment changed (445528004)
Treatment modification (371133007)
Treatment not indicated (183964008)
Treatment not tolerated (407563006)
Medication, Order not done: Patient Reason: SNOMED Did not attend (281399006)
Dissatisfied with doctor (185481008)
Drug declined by patient (182895007)
Drug declined by patient – cannot pay script (182902003)
Drug declined by patient – patient beliefs (182900006)
Drug declined by patient – side effects (182897004)
Drugs not taken/completed (266710000)
Family illness (266966009)
Financial circumstances change (160934006)
Financial problem (160932005)
Further opinion sought (310343007)
Income insufficient to buy necessities (423656007)
Income sufficient to buy only necessities (424739004)
Medication refused (406149000)
Patient defaulted from follow-up (275694009)
Patient dissatisfied with result (185479006)
Patient forgets to take medication (408367005)
Patient has moved away (184081006)
Patient noncompliance – general (275936005)
Patient non-compliant – refused access to services (413310006)
Patient non-compliant – refused intervention / support (413311005)
Patient non-compliant – refused service (413312003)
Patient requests alternative treatment (182890002)
Patient self-discharge against medical advice (225928004)
Procedure discontinued by patient (713247000)
Procedure not wanted (416432009)
Procedure refused (183944003)
Procedure refused for religious reason (183945002)
Refusal of treatment by patient (105480006)
Refused (443390004)
Rejected by recipient (385648002)
Treatment delay – patient choice (373787003)
Variable income (224187001)
Medication, Order not done: System Reason: SNOMED Appointment canceled by hospital (185335007)
Delay in receiving benefits (224198000)
Drug not available – out of stock (182856006)
Drug not available for administration (242990004)
Drug not available-off market (182857002)
Finding related to health insurance issues (419808006)
Loss of benefits (224199008)
Medical care unavailable (266756008)
Not entitled to benefits (224194003)
Patient on waiting list (270459005)
Patient transfer (107724000)
Referred to doctor (309017000)
Treatment not available (309846006)
Uninsured medical expenses (424553001)

Last updated: May 16, 2018 at 2:47 pm