| Condition | Type of Code | Codes |
|---|---|---|
| Type 1 diabetes mellitus | ICD-9-CM diagnosis | 250.x1, 250.x3 |
| Gestational diabetes | ICD-9-CM diagnosis | 648.8x |
| Pregnancy | ICD-9-CM diagnosis | 630.xx-648.7x, 648.9x-679.xx, V22.xx-V23.xx, V27.xx, V28.xx, V61.6x-V61.7x, V72.42, V91.xx |
| ICD-9-CM procedure | 72.xx-75.xx | |
| MS-DRG | 765, 766, 767, 768, 770, 774, 775, 777, 778, 779 | |
| CPT | 57022, 58605, 58611, 59000-59899, 76801-76828, 76941, 83661-83664, S0612, S0613, S2400-S2405, S2409, S2411, S8055, 01965, 01966, 0500F, 0501F, 0503F | |
| Bariatric surgery | CPT | 43644, 43645, 43842, 43843, 43845, 43846, 43847, S2083 |
| ICD-9-CM procedure codes ONLY IF also 1 of ICD-9-CM diagnosis codes or MS-DRG codes listed below | 44.95, 44.96, 44.97, 44.98, 44.38, 44.68, 44.31, 44.39, 43.82, 43.89 | |
| ICD-9-CM diagnosis | 278.00, 278.01, V77.8 | |
| MS-DRG | 288 (only prior to October 1, 2007), 619, 620, 621 | |
| Cancer | ICD-9-CM diagnosis | 140.xx-172.xx, 176.xx-184.xx, 188.xx-195.xx, 199.2, 200.xx-209.xx |
| Cardiovascular disease | ||
| Atherosclerosis | ICD-9-CM diagnosis | 440.xx, 437.0x, 414.0x, 414.2x, 414.3x, 414.4x, 433.00, 433.10, 433.20, 433.30, 433.80, 433.90 |
| Stroke | ICD-9-CM diagnosis | 430.xx, 431.xx, 433.x1, 434.xx, 436.xx |
| Myocardial infarction | ICD-9-CM diagnosis | 410.xx |
| Unstable angina pectoris | ICD-9-CM diagnosis | 411.1x |
| Heart failure | ICD-9-CM diagnosis | 428.xx |
| Percutaneous coronary intervention | ICD-9-CM procedure | 00.66, 36.06, 36.07, 17.55 |
| CPT (all years) | 92980, 92981, 92982, 92984, 92995, 92996 | |
| CPT (year 2013 onwards) | 92920, 92921, 92924, 92925, 92928, 92929, 92933, 92934, 92937, 92938, 92941, 92943, 92944 | |
| HCPCS | G0290, G0291 | |
| Coronary artery bypass graft | ICD-9-CM procedure | 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19 |
| CPT | 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33530, 33533, 33534, 33535, 33536 | |
| HCPCS | S2205, S2206, S2207, S2208, S2209 | |
| Peripheral vascular disease | ICD-9-CM diagnosis | 441.xx, 443.9x, 785.4x, v43.4x |
| ICD-9-CM procedure | 38.48 | |
| Microvascular disease | ||
| Diabetic nephropathy | ICD-9-CM diagnosis | 250.4 |
| Diabetic retinopathy | ICD-9-CM diagnosis | 350.5, 362.0x |
| Diabetic peripheral neuropathy | ICD-9-CM diagnosis | 250.6, 357.2x |
| Hypertension | ICD-9-CM diagnosis | 401.xx, 402.xx, 403.xx, 404.xx, 405.xx |
| Dyslipidemia | ICD-9-CM diagnosis | 272.xx |
| Depression | ICD-9-CM diagnosis | 296.2x, 296.3x, 311.xx |
| Hypoglycemia | ICD-9-CM diagnosis | 251.0x, 251.1x, 251.2x, 250.8x |
| Antidiabetes Medication Classes | Generic Names | |
| Alpha-glucosidase inhibitors | Acarbose, Miglitol | |
| Biguanides | Metformin Hydrochloride | |
| Dipeptidyl peptidase-4 (DPP-4) inhibitors | Alogliptin Benzoate, Linagliptin, Saxagliptin Hydrochloride, Sitagliptin Phosphate | |
| Dopamine receptor agonists | Bromocriptine Mesylate | |
| Meglitinide analogs | Nateglinid, Repaglinide | |
| Sulfonylurea derivatives | Acetohexamide, Chlorpropamide, Glimepiride, Glipizide, Glyburide, Tolazamide, Tolbutamide, Tolbutamide Sodium | |
| Thiazolidinediones | Pioglitazone Hydrochloride, Rosiglitazone Maleate, Troglitazone | |
| Antidiabetes Medication Classes | Generic Names | |
| Insulins | Insulin Aspart, Insulin Aspart Protamine Human/Insulin Aspart, Insulin Glargine Human Recombinant Analog, Insulin Glulisine, Insulin Lispro, Insulin Nph Human Semi-Syn, Insulin Nph Human Semi-Syn/Insulin Reg Human, Semi-Syn, Insulin Reg Human Semi-Syn, Insulin Regular Human, Nph Human Insulin Isophane, Nph Human Insulin Isophane/Insulin Regular Human, Insulin Regular Human/Insulin Release Unit, Insulin Regular Human/Insulin Release Unit/Chamber/Inhaler, Insulin Detemir, Insulin Lispro Protamine & Insulin Lispro, Insulin Human Regular, Insulin Glargine Recombinant, Insulin Aspart Recombinant, Insulin Human Isophane (Nph), Insulin Human Isophane (Nph)/Insulin Human Regular, Insulin Lispro Recombinant, Insulin Lispro/Insulin Lispro Protamine, Insulin Aspart/Insulin Aspart Protamine, Insulin Isophane Nph Bf-Pk, Insulin Isophane Beef, Insulin Isophane Beef Pure, Insulin Isophane Pork Pure, Insulin Protamine Zinc Beef, Insulin Protamine Zn Beef (P), Insulin Protamine Zn Bf-Pk, Insulin Protamine Zn Pork (P), Insulin Reg Hum S-S Buff, Insulin Regular Beef-Pork, Insulin Regular Human Buffered, Insulin Zinc Beef, Insulin Zinc Ext Beef (P), Insulin Zinc Extend Human Rec, Insulin Zinc Extended Beef, Insulin Zinc Extended Bf-Pk, Insulin Zinc Human Rec, Insulin Zinc Human Semi-Syn, Insulin Zinc Prompt Beef, Insulin Zinc Prompt Bf-Pk, Insulin Zinc Prompt Pork Pure, Insulin Zinc Beef Purified, Insulin Zinc Beef Purified/Insulin Zinc Pork Purified, Insulin Zinc Beef-Pork, Insulin Zinc Pork Purified, Insulin Beef, Insulin Pork, Insulin Pork Purified, Insulin Pork Purified/Insulin Isophane Pork Pure, Insulin Pork Reg. Concentrate | |
| Glucagon-like peptide 1 receptor agonists (GLP-1 RA) | Exenatide, Exenatide Microspheres, Liraglutide | |
| Sodium glucose co-transporter 2 (SGLT2) inhibitors | Canagliflozin | |
| Antidiabetes Medication Classes | Generic Names | |
| Metformin/dipeptidyl peptidase-4 | Metformin Hydrochloride/Saxagliptin Hydrochloride, Metformin Hydrochloride/Sitagliptin Phosphate, Linagliptin/Metformin Hydrochloride, Alogliptin Benzoate/Metformin Hydrochloride | |
| Thiazolidinediones /dipeptidyl peptidase-4 | Alogliptin Benzoate/Pioglitazone Hydrochloride | |
| Dipeptidyl peptidase-4 /statins | Simvastatin/Sitagliptin Phosphate | |
| Metformin/Meglitinide | Metformin Hydrochloride/Repaglinide | |
| Metformin/ Sulfonylurea | Glipizide/Metformin Hydrochloride, Glyburide/Metformin Hydrochloride | |
| Thiazolidinediones /sulfonylurea | Glimepiride/Pioglitazone Hydrochloride, Glimepiride/Rosiglitazone Maleate | |
| Metformin/ thiazolidinediones | Metformin Hydrochloride/Pioglitazone Hydrochloride, Metformin Hydrochloride/Rosiglitazone Maleate | |
| Antidiabetes Medication Classes | Generic Names | |
| Renin-angiotensin-aldosterone system (RAAS) blocking agents | Aliskiren Hemifumarate, Azilsartan Medoxomil, Benazepril Hcl, Candesartan Cilexetil, Captopril, Enalapril Maleate, Enalaprilat Dihydrate, Eprosartan Mesylate, Fosinopril Sodium, Irbesartan, Lisinopril, Lisinopril/Dietary Supplement Comb.10, Losartan Potassium, Moexipril Hcl, Olmesartan Medoxomil, Perindopril Erbumine, Quinapril Hcl, Ramipril, Telmisartan, Trandolapril, Valsartan | |
| Beta blockers | Acebutolol Hcl, Atenolol, Betaxolol Hcl, Bisoprolol Fumarate, Carteolol Hcl, Carvedilol, Carvedilol Phosphate, Labetalol Hcl, Metoprolol Succinate, Metoprolol Tartrate, Metoprolol Tartrate/Dietary Supplement Comb.10, Nadolol, Nebivolol Hcl, Penbutolol Sulfate, Pindolol, Propranolol Hcl, Timolol Maleate | |
| Calcium channel blockers | Amlodipine Besylate, Bepridil Hcl, Clevidipine Butyrate, Diltiazem Hcl, Diltiazem Hcl In 0.9 % Sodium Chloride, Diltiazem Hcl/Dextrose 5 % In Water, Diltiazem Malate, Felodipine, Isradipine, Mibefradil Di-Hcl, Nicardipine Hcl, Nicardipine In Dextrose 5 %-Water, Nicardipine In Dextrose Iso-Osmotic, Nicardipine In Sodium Chloride Iso-Osmotic, Nifedipine, Nimodipine, Nisoldipine, Verapamil Hcl | |
| Diruetics | Acetazolamide, Bumetanide, Polythiazide | |
| Vasodilators | Diazoxide, Fenoldopam Mesylate, Hydralazine Hcl, Minoxidil, Nitroprusside Sodium, Tolazoline Hcl | |
| Peripheral vasodilators | Ethaverine Hcl, Isoxsuprine Hcl, Papaverine Hcl | |
| Central alpha-2 receptor agonists | Clonidine, Clonidine Hcl, Guanabenz Acetate, Guanfacine Hcl, Methyldopa, Methyldopate Hcl | |
| Ganglionic blocking, non-depolarizing | Mecamylamine Hcl | |
| Peripheral alpha-1 receptor blockers | Doxazosin Mesylate, Phenoxybenzamine Hcl, Phentolamine Mesylate, Prazosin Hcl, Terazosin Hcl | |
| Postganglionic blockers, antihypertensive | Guanadrel Sulfate, Guanethidine Sulfate | |
| Pulmonary antihypertensive agents | Ambrisentan, Bosentan, Epoprostenol Sodium (Arginine), Epoprostenol Sodium (Glycine), Iloprost, Nitric Oxide, Sildenafil Citrate, Tadalafil, Treprostinil, Treprostinil Sodium, Treprostinil/Nebulizer Accessories, Treprostinil/Nebulizer/Nebulizer Accessories | |
| Reserpine and derivatives | Reserpine | |
| Antidiabetes Medication Classes | Generic Names | |
| Antihypertensive combinations | Aliskiren Hemifumarate/Amlodipine Besylate, Aliskiren Hemifumarate/Amlodipine/Hydrochlorothiazide, Aliskiren Hemifumarate/Hydrochlorothiazide, Aliskiren/Valsartan, Amiloride Hcl/Hydrochlorothiazide, Amlodipine Besylate/Atorvastatin Calcium, Amlodipine Besylate/Benazepril Hcl, Amlodipine Besylate/Olmesartan Medoxomil, Amlodipine Besylate/Valsartan, Amlodipine Besylate/Valsartan/Hydrochlorothiazide, Atenolol/Chlorthalidone, Azilsartan Medoxomil/Chlorthalidone, Benazepril Hcl/Hydrochlorothiazide, Bisoprolol umarate/Hydrochlorothiazide, Candesartan Cilexetil/Hydrochlorothiazide, Captopril/Hydrochlorothiazide, Clonidine Hcl/Chlorthalidone, Deserpidine/Hydrochlorothiazide, Deserpidine/Methyclothiazide, Enalapril Maleate/Diltiazem Malate, Enalapril Maleate/Felodipine, Enalapril Maleate/Hydrochlorothiazide, Eprosartan Mesylate/Hydrochlorothiazide, Fosinopril Sodium/Hydrochlorothiazide, Guanethidine Sulfate/Hydrochlorothiazide, Hydralazine Hcl/Hydrochlorothiazide, Hydralazine Hcl/Reserpine/Hydrochlorothiazide, Irbesartan/Hydrochlorothiazide, Isosorbide Dinitrate/Hydralazine Hcl, Lisinopril/Hydrochlorothiazide, Losartan Potassium/Hydrochlorothiazide, Methyldopa/Chlorothiazide, Methyldopa/Hydrochlorothiazide, Metoprolol Succinate/Hydrochlorothiazide, Metoprolol Tartrate/Hydrochlorothiazide, Moexipril Hcl/Hydrochlorothiazide, Nadolol/Bendroflumethiazide, Olmesartan Medoxomil/Amlodipine Besylate/Hydrochlorothiazide, Olmesartan Medoxomil/Hydrochlorothiazide, Potassium Salicylate/Salicylamide/Caffeine, Prazosin Hcl/Polythiazide, Propranolol Hcl/Hydrochlorothiazide, Quinapril Hcl/Hydrochlorothiazide, Rauwolfia Serpentina/Bendroflumethiazide, Reserpine/Chlorothiazide, Reserpine/Hydrochlorothiazide, Reserpine/Hydroflumethiazide, Reserpine/Methyclothiazide, Reserpine/Polythiazide, Spironolactone/Hydrochlorothiazide, Telmisartan/Amlodipine Besylate, Telmisartan/Hydrochlorothiazide, Timolol Maleate/Hydrochlorothiazide, Trandolapril/Verapamil Hcl, Triamterene/Hydrochlorothiazide, Valsartan/Hydrochlorothiazide | |
| Antidiabetes Medication Classes | Generic Names | |
| Antihyperlipids | Amlodipine Besylate/Atorvastatin Calcium, Aspirin (Calcium Carb & Magnesium Buffers)/Pravastatin, Atorvastatin Calcium, Cerivastatin Sodium, Cholestyramine, Cholestyramine (With Sugar), Cholestyramine/Aspartame, Clofibrate, Colesevelam Hcl, Colesevelam Hydrochloride, Colestipol Hcl, Ezetimibe, Ezetimibe/Simvastatin, Fenofibrate, Fenofibrate Nanocrystallized, Fenofibrate Micronized, Fenofibrate Micronized, Fenofibric Acid, Fenofibric Acid (Choline), Fluvastatin Sodium, Gemfibrozil, Lecithin/Sitosterols/Niacin/Betaine/Chitosan, Lovastatin, Melatonin/Tryptophan/Valerian/Chamomile/Niacin/Inositol/B6, Niacin, Niacin/Lovastatin, Niacin/Simvastatin, Pitavastatin Calcium, Policosanol/Inositol Niacinate/Garlic, Pravastatin Sodium, Rosuvastatin Calcium, Simvastatin, Sitagliptin Phosphate/Simvastatin | |
a Codes measured over time period January 1, 2007-June 30, 2012, unless otherwise noted.
CPT = Current Procedural Terminology; HCPCS = Healthcare Common Procedure Coding System; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; MS-DRG = Medicare Severity Diagnosis-Related Group.