Tech Notes: Conditions
Hospital Discharge Data:
The conditions are based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code of the principal diagnosis. The following table provides the conditions and the ICD-9-CM codes associated with the condition. These groupings are from CMS's Quality of Care Surveillance System1, in which groupings from the National Center for Health Statistics (NCHS) were adapted to reflect the health care patterns of the elderly population of Medicare.
| Condition | ICD-9-CM codes |
| All | 001.x - 999.9, V01-V82.9 |
| Stroke | 430.x - 438.x |
| Acute myocardial infarction (AMI) | 410.x |
| Congestive heart failure (CHF) | 428.0 |
| Diabetes | 250.x |
| Pneumonia and influenza | 480.x - 487.x |
| Injuries: | |
| Hip fracture | 820.x |
| All other fractures | 800.x - 819.x and 821.x - 829.x |
| All injuries | 800.x - 999.x |
| Cancers: | |
| Lung cancer | 162.x |
| Prostate cancer | 185.x |
| Colon cancer | 153.x - 154.x |
| Breast cancer | 174.x - 175.x |
| All cancer | 140.x - 239.x |
If no conditions are selected on the query page, then all discharges are included in the returned table.
Influenza Immunization Data:
To be included in the number immunized portion (numerator) of the flu immunization rate, the beneficiary had to have a claim for the influenza virus vaccine and its administration. This includes Current Procedural Terminology (CPT) codes 90724 (influenza virus vaccine) and G0008 (administration of influenza virus vaccine).
1. Dicker RC, Ordin DL, Han LF, Campbell MK. Introducing the Medicare quality of care surveillance system. Quality resume, no.1. Baltimore, Maryland: Health care Financing Administration, 1997.