| Condition | Codes |
|---|---|
| Interstitial cystitis | ICD-9-CM 595.1 |
| Fulguration | CPT 52214, 52224 |
| Charlson Comorbidity Index | |
| Myocardial infarction | ICD-9-CM 410, 412 |
| Congestive heart failure | ICD-9-CM 428 |
| Peripheral vascular disease | ICD-9-CM441, 443.9, 785.4, V424 |
| Cardiovascular disease | ICD-9-CM 430, 431, 432, 433, 434, 435, 436, 437, 438 |
| Chronic obstructive pulmonary disease | ICD-9-CM 490, 491, 493, 494, 495, 496, 500, 510, 502, 503, 504, 505, 506.4 |
| Dementia | ICD-9-CM 290 |
| Rheumatic disease | ICD-9-CM 725, 710.0, 710.1, 710.4, 714.0, 714.1, 714.2 |
| Peptic ulcer disease | ICD-9-CM 531,532,533,534 |
| Liver disease | ICD-9-CM 571.2, 571.4, 571.5, 571.6 |
| Liver disease, complicated | ICD-9-CM 572.2, 456.0, 456.1, 456.20, 456.21 |
| Diabetes, no complications | ICD-9-CM 250.00, 250.01, 250.02, 250.03, 250.07 |
| Diabetes, complications | ICD-9-CM 250.04, 250.05, 250.06 |
| Paralysis | ICD-9-CM 342, 244.1 |
| Renal disease | ICD-9-CM 582, 583, 585, 586, 588 |
| Cancer | ICD-9-CM 148-195, 200-208 |
| Metastatic cancer | ICD-9-CM 196, 197, 198 |
| AIDS | ICD-9-CM 042, 043, 044 |
| Comorbidities | |
| Anxiety | ICD-9-CM 300.00, 300.01, 300.02 |
| Depression | ICD-9-CM 311 |
| Migraine headache | ICD-9-CM 346 |
| Fibromyalgia | ICD-9-CM 729.1 |
| Irritable bowel syndrome | ICD-9-CM 564.1 |
| Vulvodynia | ICD-9-CM 625.7 |
| Chronic fatigue syndrome | ICD-9-CM 780.71 |
| Sicca syndrome | ICD-9-CM 710.2 |
| Insomnia | ICD-9-CM 780.52 |
| Exclusion codes | |
| Pentosan polysulfate sodium | NDC 00062980001, 00575760001, 17314930001, 50458009801, 54569512300, 54569512301, 54868452500, 54868452501, 54868452502, 54868452503, 68115088800 |
| Bladder neoplasm | ICD-9-CM 188.0-188.9 |
| Carcinoma in situ of bladder | ICD-9-CM 233.7 |
| Malignant neoplasm, bladder neck | ICD-9-CM 188.5 |
| Malignant neoplasm, prostate | ICD-9-CM 185 |
| Malignant neoplasm, urethra | ICD-9-CM 189.3 |
| Malignant neoplasm, uterus, ovaries, fallopian tubes, adnexa, & unspecified ovary related | ICD-9-CM 179.*, 180.*, 180.1, 180.8, 180.9, 182, 182.1, 182.8, 180.0, 183.2-183.5, 183.8, 183.9 |
| Radiation cystitis | ICD-9-CM 595.82 |
| Secondary malignant neoplasm, genital organs | ICD-9-CM 198.82 |
| Secondary urinary organ neoplasm | ICD-9-CM 198.1 |
| Spinal cord injury | ICD-9-CM 952.00-952.09, 952.10-952.19, 952.2, 952.3, 952.8-952.10 |
| Tuberculous cystitis | ICD-9-CM 16.10 |
| Unspecified bladder neoplasm | ICD-9-CM 239.4 |
| Unspecified neoplasm, genital organs | ICD-9-CM |
| Urethral diverticulum | ICD-9-CM 599.20 |
| Urethral stricture | ICD-9-CM 598.0, 598.01, 598.1, 598.2, 598.8, 598.9 |
| Vaginal cancer | ICD-9-CM 184.00 |
AIDS = acquired immunodeficiency syndrome; CPT = Current Procedural Terminology; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; NDC = National Drug Code.