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CMS137v6 Code List

Code List: CMS137v6, Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

MicroMD uses the following code lists to determine a patient’s inclusion in this measure.  To search for your code, simply press Ctrl + F on your keyboard, enter your code in the search field and press Enter on your keyboard.

This user-friendly code list is provided as a courtesy to our MicroMD users.  For more in-depth information about codes and/or criteria or to compare version changes, visit the CMS eCQI Resource Center at https://ecqi.healthit.gov/ (no user account required) or the United States Health Information Knowledgebase at https://ushik.ahrq.gov/mdr/portals (requires a free user account to view codes).

Item Codes
Diagnosis Codes
Diagnosis: Alcohol and Drug Dependence: ICD-10 F10.10, F10.120, F10.121, F10.129, F10.14, F10.150, F10.151, F10.159, F10.180, F10.181, F10.182, F10.188, F10.19, F10.20, F10.220, F10.221, F10.229, F10.230, F10.231, F10.232, F10.239, F10.24, F10.250, F10.251, F10.259, F10.26, F10.27, F10.280, F10.281, F10.282, F10.288, F10.29, F11.10, F11.120, F11.121, F11.122, F11.129, F11.14, F11.150, F11.151, F11.159, F11.181, F11.182, F11.188, F11.19, F11.20, F11.220, F11.221, F11.222, F11.229, F11.23, F11.24, F11.250, F11.251, F11.259, F11.281, F11.282, F11.288, F11.29, F12.10, F12.120, F12.121, F12.122, F12.129, F12.150, F12.151, F12.159, F12.180, F12.188, F12.19, F12.20, F12.220, F12.221, F12.222, F12.229, F12.250, F12.251, F12.259, F12.280, F12.288, F12.29, F13.10, F13.120, F13.121, F13.129, F13.14, F13.150, F13.151, F13.159, F13.180, F13.181, F13.182, F13.188, F13.19, F13.20, F13.220, F13.221, F13.229, F13.230, F13.231, F13.232, F13.239, F13.24, F13.250, F13.251, F13.259, F13.26, F13.27, F13.280, F13.281, F13.282, F13.288, F13.29, F14.10, F14.120, F14.121, F14.122, F14.129, F14.14, F14.150, F14.151, F14.159, F14.180, F14.181, F14.182, F14.188, F14.19, F14.20, F14.220, F14.221, F14.222, F14.229, F14.23, F14.24, F14.250, F14.251, F14.259, F14.280, F14.281, F14.282, F14.288, F14.29, F15.10, F15.120, F15.121, F15.122, F15.129, F15.14, F15.150, F15.151, F15.159, F15.180, F15.181, F15.182, F15.188, F15.19, F15.20, F15.220, F15.221, F15.222, F15.229, F15.23, F15.24, F15.250, F15.251, F15.259, F15.280, F15.281, F15.282, F15.288, F15.29, F16.10, F16.120, F16.121, F16.122, F16.129, F16.14, F16.150, F16.151, F16.159, F16.180, F16.183, F16.188, F16.19, F16.20, F16.220, F16.221, F16.229, F16.24, F16.250, F16.251, F16.259, F16.280, F16.283, F16.288, F16.29, F18.10, F18.120, F18.121, F18.129, F18.14, F18.150, F18.151, F18.159, F18.17, F18.180, F18.188, F18.19, F18.20, F18.220, F18.221, F18.229, F18.24, F18.250, F18.251, F18.259, F18.27, F18.280, F18.288, F18.29, F19.10, F19.120, F19.121, F19.122, F19.129, F19.14, F19.150, F19.151, F19.159, F19.16, F19.17, F19.180, F19.181, F19.182, F19.188, F19.19, F19.20, F19.220, F19.221, F19.222, F19.229, F19.230, F19.231, F19.232, F19.239, F19.24, F19.250, F19.251, F19.259, F19.26, F19.27, F19.280, F19.281, F19.282, F19.288, F19.29
Diagnosis: Alcohol and Drug Dependence: SNOMED 10028000, 10327003, 10741871000119101, 10755041000119100, 10755161000119102, 1081000119105, 110281001, 11061003, 111479008, 111480006, 11387009, 125851000119106, 1383008, 145101000119102, 145841000119107, 14784000, 15167005, 15277004, 153491000119103, 153501000119105, 1686006, 18653004, 18689007, 191471000, 191475009, 191476005, 191477001, 191478006, 191480000, 191483003, 191484009, 191485005, 191486006, 191492000, 191493005, 191494004, 191495003, 191496002, 191802004, 191804003, 191805002, 191811004, 191812006, 191816009, 191819002, 191820008, 191825003, 191826002, 191829009, 191831000, 191832007, 191837001, 191838006, 191843004, 191844005, 191849000, 191850000, 191853003, 191855005, 191856006, 191865004, 191867007, 191868002, 191871005, 191873008, 191874002, 191877009, 191928000, 19303008, 19445006, 1973000, 199252002, 199253007, 199254001, 199255000, 20385005, 20876004, 21000000, 21647008, 21831000119109, 21841000119100, 230334008, 230443000, 231451006, 231458000, 231459008, 231461004, 231462006, 231467000, 231468005, 231469002, 231470001, 231472009, 231473004, 231474005, 231475006, 231477003, 231478008, 231479000, 231480002, 231481003, 231482005, 236751006, 237228001, 2403008, 25508008, 26416006, 26714005, 267206008, 268640002, 268641003, 268727002, 275471001, 27956007, 280982009, 280983004, 280984005, 280986007, 281004, 28368009, 284591009, 288281000119100, 28864000, 29212009, 29733004, 301643003, 302507002, 30310000, 304605000, 30491001, 30871003, 309279000, 310202009, 311173003, 312098001, 312936002, 313915006, 31715000, 31956009, 32009006, 32358001, 32552001, 32875003, 33845003, 33871004, 34938008, 361150008, 361151007, 363101005, 37331004, 37344009, 38247002, 39003006, 396344000, 39807006, 39951001, 403590001, 40571009, 41083005, 416073003, 416714005, 417143004, 417360004, 42344001, 425339005, 425533007, 425885002, 426001001, 426095000, 426590003, 426873000, 427205009, 427229002, 427327003, 427975003, 428219007, 428370001, 429001000124103, 429299000, 429672007, 429692000, 43497001, 434971000124109, 441527004, 441681009, 442351006, 442406005, 445273005, 46721000, 46975003, 47664006, 4863002, 5002000, 50026000, 50320000, 50722006, 50933003, 50983008, 51339003, 51443000, 51493001, 52866005, 53050002, 53936005, 5444000, 55967005, 5602001, 56194001, 57588009, 58727001, 59651006, 61104008, 61144001, 6348008, 63649001, 63983005, 64386003, 6525002, 66214007, 66590003, 69482004, 699449003, 70328006, 70340006, 703845008, 703849002, 7052005, 70655008, 7071007, 70932007, 71328000, 7200002, 73097000, 74851005, 74934004, 75122001, 75544000, 77355000, 7761000119106, 78267003, 78358001, 79578000, 80868005, 82339009, 83168008, 83367009, 84758004, 85005007, 85561006, 8635005, 87132004, 8837000, 89451009, 90755006, 90790003, 91388009, 95635002, 95661003, 95918004, 9769006
Encounter Codes
Encounter, Performed: Office Visit: CPT 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Emergency Department Visit: CPT 99281, 99282, 99283, 99284, 99285
Encounter, Performed: Detoxification Visit: SNOMED 182969009, 20093000, 23915005, 266707007, 310653000, 414054004, 414056002, 56876005, 61480009, 64297001, 67516001, 87106005
Encounter, Performed: Hospital Observation Care – Initial: CPT 99218, 99219, 99220
Encounter, Performed: Hospital Inpatient Visit – Initial: CPT 99221, 99222, 99223
Encounter, Performed: Discharge Services – Hospital Inpatient Same Day Discharge: CPT 99234, 99235, 99236
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 Codes for Alcohol and Drug Dependence Treatment and Psychotherapy
Encounter, Performed: Alcohol and Drug Dependence Treatment: SNOMED 171047005, 20093000, 23915005, 24165007, 266707007, 310653000, 313071005, 370881007, 370884004, 385989002, 386448003, 386449006, 386450006, 386451005, 408933008, 408934002, 408935001, 408936000, 408941008, 408942001, 408943006, 408944000, 408945004, 408947007, 408948002, 410419007, 413473000, 423416000, 424148004, 424407005, 424589009, 426928008, 429291000124102, 56876005, 60112009, 707166002, 720174008, 720175009, 720176005, 720177001
Encounter, Performed: Psych Visit – Psychotherapy: CPT 90832, 90834, 90837
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 8, 2018 at 2:57 pm