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ICD10Data
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Questionable As Principal Diagnosis ICD-10-CM Codes
Questionable As Principal Diagnosis ICD-10-CM Codes
The following 27 ICD-10-CM codes are not usually sufficient justification for admission to an acute care hospital when used as a principal diagnosis.
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E11.9 Type 2 diabetes mellitus without complications
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E13.9 Other specified diabetes mellitus without complications
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E66.09 Other obesity due to excess calories
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E66.1 Drug-induced obesity
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E66.8 Other obesity
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E66.9 Obesity, unspecified
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H61.20 Impacted cerumen, unspecified ear
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H61.21 Impacted cerumen, right ear
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H61.22 Impacted cerumen, left ear
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H61.23 Impacted cerumen, bilateral
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I10 Essential (primary) hypertension
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I44.4 Left anterior fascicular block
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I44.5 Left posterior fascicular block
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I44.60 Unspecified fascicular block
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I44.69 Other fascicular block
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I44.7 Left bundle-branch block, unspecified
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I45.0 Right fascicular block
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I45.10 Unspecified right bundle-branch block
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I45.19 Other right bundle-branch block
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R03.0 Elevated blood-pressure reading, without diagnosis of hypertension
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R97.20 Elevated prostate specific antigen [PSA]
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R97.21 Rising PSA following treatment for malignant neoplasm of prostate
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Z21 Asymptomatic human immunodeficiency virus [HIV] infection status
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Z45.010 Encounter for checking and testing of cardiac pacemaker pulse generator [battery]
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Z45.018 Encounter for adjustment and management of other part of cardiac pacemaker
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Z45.02 Encounter for adjustment and management of automatic implantable cardiac defibrillator
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Z45.09 Encounter for adjustment and management of other cardiac device
ICD-10-CM Code E11.9
Type 2 diabetes mellitus without complications
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code E13.9
Other specified diabetes mellitus without complications
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code E66.09
Other obesity due to excess calories
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code E66.1
Drug-induced obesity
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Use Additional- code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)
ICD-10-CM Code E66.8
Other obesity
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code E66.9
Obesity, unspecified
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code H61.20
Impacted cerumen, unspecified ear
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code H61.21
Impacted cerumen, right ear
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code H61.22
Impacted cerumen, left ear
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code H61.23
Impacted cerumen, bilateral
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I10
Essential (primary) hypertension
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Includes- high blood pressure
- hypertension (arterial) (benign) (essential) (malignant) (primary) (systemic)
Type 1 Excludes- hypertensive disease complicating pregnancy, childbirth and the puerperium (O10-O11, O13-O16)
Type 2 Excludes- essential (primary) hypertension involving vessels of brain (I60-I69)
- essential (primary) hypertension involving vessels of eye (H35.0-)
ICD-10-CM Code I44.4
Left anterior fascicular block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I44.5
Left posterior fascicular block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I44.60
Unspecified fascicular block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Applicable To- Left bundle-branch hemiblock NOS
ICD-10-CM Code I44.69
Other fascicular block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I44.7
Left bundle-branch block, unspecified
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I45.0
Right fascicular block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code I45.10
Unspecified right bundle-branch block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Applicable To- Right bundle-branch block NOS
ICD-10-CM Code I45.19
Other right bundle-branch block
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
ICD-10-CM Code R03.0
Elevated blood-pressure reading, without diagnosis of hypertension
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Note- This category is to be used to record an episode of elevated blood pressure in a patient in whom no formal diagnosis of hypertension has been made, or as an isolated incidental finding.
ICD-10-CM Code R97.20
Elevated prostate specific antigen [PSA]
2017 - New Code 2018 2019 2020 2021 2022 2023 Billable/Specific Code Adult Dx (15-124 years) Male Dx Questionable As Admission Dx
ICD-10-CM Code R97.21
Rising PSA following treatment for malignant neoplasm of prostate
2017 - New Code 2018 2019 2020 2021 2022 2023 Billable/Specific Code Adult Dx (15-124 years) Male Dx Questionable As Admission Dx
ICD-10-CM Code Z21
Asymptomatic human immunodeficiency virus [HIV] infection status
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Questionable As Admission Dx
Code First- Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)
Type 1 Excludes- acquired immunodeficiency syndrome (B20)
- contact with human immunodeficiency virus [HIV] (Z20.6)
- exposure to human immunodeficiency virus [HIV] (Z20.6)
- human immunodeficiency virus [HIV] disease (B20)
- inconclusive laboratory evidence of human immunodeficiency virus [HIV] (R75)
ICD-10-CM Code Z45.010
Encounter for checking and testing of cardiac pacemaker pulse generator [battery]
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code POA Exempt Questionable As Admission Dx
Applicable To- Encounter for replacing cardiac pacemaker pulse generator [battery]
ICD-10-CM Code Z45.018
Encounter for adjustment and management of other part of cardiac pacemaker
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code POA Exempt Questionable As Admission Dx
Type 1 Excludes- presence of other part of cardiac pacemaker (Z95.0)
ICD-10-CM Code Z45.02
Encounter for adjustment and management of automatic implantable cardiac defibrillator
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code POA Exempt Questionable As Admission Dx
Applicable To- Encounter for adjustment and management of automatic implantable cardiac defibrillator with synchronous cardiac pacemaker
- Encounter for adjustment and management of cardiac resynchronization therapy defibrillator (CRT-D)
ICD-10-CM Code Z45.09
Encounter for adjustment and management of other cardiac device
2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code POA Exempt Questionable As Admission Dx
