| PPC Category |
ICD-9-CM Diagnosis and Procedures Codes |
|---|
| 1 | Stroke & Intracranial Hemorrhage |
430, 431, 432.x, 433.x1, 434.x1, 436, 997.02 |
| 2 | Extreme CNS Complications |
348.1, 348.4, 348.5, 780.01, 780.03, 997.01 |
| 3 | Acute Lung Edema & Respiratory Failure |
518.4, 518.5, 518.81, 518.84, 799.1 |
| 4 | Pneumonia, Lung Infection |
003.22, 480.1, 481, 482.0-482.2, 482.30-482.9, 483.8, 484.8,
485, 486, 510.0, 510.9, 511.1, 513.x, 519.2 |
| 5 | Aspiration Pneumonia |
507.0, 507.1, 507.8 |
| 6 | Pulmonary Embolism |
415.1x, 958.0, 958.1, 999.1 |
| 7 | Shock |
785.50, 785.51, 785.59, 995.4, 998.0 |
| 8 | Congestive Heart Failure |
415.0, 428.0, 428.1, 428.21, 428.23, 428.31, 428.33,
428.41, 428.43, 428.9 |
| 9 | Acute Myocardial Infarct |
410.x1 |
| 10 | Ventricular Fibrillation/Cardiac Arrest |
427.41, 427.42, 427.5 or Procedure code 99.60 |
| 11 | PV Complications Except Venous Thrombosis |
440.24, 443.2x, 444.0-445.89, 785.4 |
| 12 | Major GI Complications w/Transfusion
or Post-Hemorrhagic Anemia |
530.82, 531.00-531.21, 531.31-531.71, 531.91-532.71, 532.91-532.71,
532.91-533.21, 533.31-533.61, 533.91, 53400-534.21, 534.31-534.61,
534.71, 534.91, 535.x1, 537.83, 537.84, 557.0557.9, 562.02, 562.03,
562.12, 562.13, 568.81, 569.3, 569.85, 578.0, 578.9
and either 1) Procedure code: 99.00, 99.02, 99.03, 99.04, 99.08
or 2) Dx code 285.1, 790.01 |
| 13 | Major Liver Complications |
570, 572.0-572.4, 573.4 |
| 14 | Other GI Complications w/Transfusion
or Post-Hemorrhagic Anemia |
531.30, 532.30, 533.30, 534.30, 537.4, 560.2, 560.81,
560.89, 560.9, 564.2, 565.1, 566, 567.8, 567.9, 569.81, 569.82,
577.0, 596.1, 997.4
and either 1) Procedure code: 99.00, 99.02, 99.03, 99.04, 99.08
or 2) Dx code 285.1, 790.01 |
| 15 | Renal Failure W Dialysis |
584.5-584.9, 586, and Procedure code: 39.95, 54.98 |
| 16 | Post-Hemorrhagic & Other Acute Anemia w/Transfusion |
285.1, 459.0, 776.0, 790.01 and Procedure code: 99.00, 99.02, 99.03, 99.04, 99.08 |
| 17 | Decubitus Ulcer |
707.0 |
| 18 | Septicemia & Severe Infection |
003.1, 003.21, 036.0, 036.1, 036.2, 038.0-038.8, 038.9,112.5, 112.81, 112.83,
286.6, 320.00-321.2, 323.8-325, 421.x, 422.92, 567.0, 567.2, 590.2, 728.86, 995.92 |
| 19 | Post-Op Wound Infection & Deep Wound Disruption w/Procedure |
998.31, 998.51, 998.59 and Procedure Code (at least 1 day after original surgery):
54.0, 54.12, 54.19, 54.3, 54.61, 86.04 |
| 20 | Reopening Or Revision Of Surgical Site |
Procedure Codes: 01.23, 03.02, 06.02, 34.03, 35.95, 39.49, 54.0, 54.12, 54.19,
54.3, 54.61 |
| 21 | Post-Op Hemorrhage & Hematoma w/Hem Control Proc or I&D Proc |
1) 998.11 And Procedure Code: 01.23, 03.02, 06.02, 287, 34.03, 35.95, 38.81-38.83, 3
8.85-38.89, 39.41, 39.49, 39.98, 49.95, 54.0, 54.12, 57.93, 60.94, or
2) 998.12 and Procedure Code: 01.23, 03.02, 06.02, 34.03, 35.95, 39.49, 54.0, 54.12,
59.19, 61.0, 69.98, 70.14, 71.09, 86.04 |
| 22 | Post-Op Foreign Body & Inappropriate Op |
998.4, E78.10, E78.18, E78.19, E87.65 |
| 23 | Other Major Complications of Medical Care |
282.62, 253.7, 323.7, 348.30, 348.31, 348.39, 349.82, 478.3x, 799.0, 933.1,
934.x, 935.1, 997.2, 997.71, 997.72, E87.32, E87.34, E87.63 |
| 24 | Malfunction Device, Prosthesis, Graft |
996.00-996.30, 996.39, 996.4-996.56, 996.59, E87.40 |
| 25 | Infection, Inflammation & Other Compl of Device/Graft except Vascular Infection |
349.1, 996.60, 996.61, 996.63-996.72, 996.75-996.79 |
| 26 | Complications of Central Venous & Other Vascular Devices |
996.62, 996.73, 996.74 |
| 27 | Obstetrical Hemorrhage w/Transfusion |
285.1, 459.0, 666.12, 666.22, 790.01 and Procedure code: 99.00, 99.02, 99.03,
99.04, 99.08 |
| 28 | Major Obstetrical Complications |
659.31, 665.11, 669.11, 669.12, 670.02, 673.x1, 673.x2, 674.01, 674.12 or
Procedure code: 68.31, 68.39, 68.4, 68.51, 68.59,68.9 |
| 29 | Post-Op Respiratory Failure w/Tracheostomy |
Procedure Codes: 31.1, 31.21, 31.29 |
