2026 ICD-10-CM Diagnosis Code C78.89Secondary malignant neoplasm of other digestive organs

ICD-10-CM CodesC00–D49C76-C80C78

ICD-10-CM C78.89
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

C78.89 is a billable ICD-10-CM diagnosis code for secondary malignant neoplasm of other digestive organs. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 374 through 376. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Secondary malignancies.

Code Identity

ICD-10-CM Code
C78.89
Billable Status
Yes — Valid for Submission
Code Describes
Secondary malignant neoplasm of other digestive organs
Short Description
Secondary malignant neoplasm of other digestive organs
Same as the full description in the CMS dataset.
Parent Code
Secondary malignant neoplasm of other and unspecified digestive organs

Code Classification

ChapterC00–D49Neoplasms
SectionC76-C80Malignant neoplasms of ill-defined, other secondary and unspecified sites
CategoryC78Secondary malignant neoplasm of respiratory and digestive organs
This CodeC78.89Secondary malignant neoplasm of other digestive organs

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acinar cell carcinoma of pancreas
  • Cystadenocarcinoma of pancreas
  • Lymphoma finding
  • Lymphoma involves spleen
  • Malignant melanoma metastatic to pancreas
  • Malignant neoplasm of ampulla of Vater
  • Malignant neoplasm of body of pancreas
  • Malignant neoplasm of cardio-esophageal junction of stomach
  • Malignant neoplasm of cervical esophagus
  • Malignant neoplasm of exocrine pancreas
  • Malignant neoplasm of fundus of stomach
  • Malignant neoplasm of greater curvature of stomach
  • Malignant neoplasm of head of pancreas
  • Malignant neoplasm of lesser curvature of stomach
  • Malignant neoplasm of middle third of esophagus
  • Malignant neoplasm of pyloric antrum
  • Malignant neoplasm of pylorus of stomach
  • Malignant neoplasm of tail of pancreas
  • Malignant neoplasm of tonsil
  • Malignant neoplasm of tonsillar fossa
  • Metastatic acinar cell carcinoma to pancreas
  • Metastatic adenocarcinoma to pancreatic duct
  • Metastatic carcinoma to abdominal part of esophagus
  • Metastatic carcinoma to ampulla of Vater
  • Metastatic carcinoma to biliary tract
  • Metastatic carcinoma to body of pancreas
  • Metastatic carcinoma to body of stomach
  • Metastatic carcinoma to cardia of stomach
  • Metastatic carcinoma to cervical part of esophagus
  • Metastatic carcinoma to common bile duct
  • Metastatic carcinoma to duodenum
  • Metastatic carcinoma to endocrine pancreas
  • Metastatic carcinoma to extrahepatic bile duct
  • Metastatic carcinoma to fundus of stomach
  • Metastatic carcinoma to gallbladder
  • Metastatic carcinoma to gallbladder and extrahepatic biliary tract
  • Metastatic carcinoma to greater curve of stomach
  • Metastatic carcinoma to head of pancreas
  • Metastatic carcinoma to lesser curve of stomach
  • Metastatic carcinoma to lower third of esophagus
  • Metastatic carcinoma to middle third of esophagus
  • Metastatic carcinoma to pancreas
  • Metastatic carcinoma to pyloric antrum
  • Metastatic carcinoma to pylorus
  • Metastatic carcinoma to stomach
  • Metastatic carcinoma to tail of pancreas
  • Metastatic carcinoma to thoracic part of esophagus
  • Metastatic carcinoma to upper third of esophagus
  • Metastatic cystadenocarcinoma to pancreas
  • Metastatic HER2 positive gastroesophageal junction cancer
  • Metastatic infiltrating duct carcinoma to pancreas
  • Metastatic malignant melanoma to digestive organ
  • Metastatic malignant neoplasm to abdominal esophagus
  • Metastatic malignant neoplasm to ampulla of Vater
  • Metastatic malignant neoplasm to biliary tract
  • Metastatic malignant neoplasm to body of pancreas
  • Metastatic malignant neoplasm to body of stomach
  • Metastatic malignant neoplasm to cardia of stomach
  • Metastatic malignant neoplasm to cervical esophagus
  • Metastatic malignant neoplasm to common bile duct
  • Metastatic malignant neoplasm to cystic duct
  • Metastatic malignant neoplasm to diaphragm
  • Metastatic malignant neoplasm to duodenum
  • Metastatic malignant neoplasm to esophagus
  • Metastatic malignant neoplasm to extrahepatic bile ducts
  • Metastatic malignant neoplasm to fundus of stomach
  • Metastatic malignant neoplasm to gallbladder
  • Metastatic malignant neoplasm to gastrointestinal tract
  • Metastatic malignant neoplasm to greater curvature of stomach
  • Metastatic malignant neoplasm to head of pancreas
  • Metastatic malignant neoplasm to intestinal tract
  • Metastatic malignant neoplasm to islets of Langerhans
  • Metastatic malignant neoplasm to lateral wall of oropharynx
  • Metastatic malignant neoplasm to lesser curvature of stomach
  • Metastatic malignant neoplasm to lower third of esophagus
  • Metastatic malignant neoplasm to middle third of esophagus
  • Metastatic malignant neoplasm to muscle of abdomen
  • Metastatic malignant neoplasm to muscle of thorax
  • Metastatic malignant neoplasm to muscle of trunk
  • Metastatic malignant neoplasm to pancreas
  • Metastatic malignant neoplasm to pancreatic duct
  • Metastatic malignant neoplasm to pyloric antrum
  • Metastatic malignant neoplasm to pylorus
  • Metastatic malignant neoplasm to respiratory and digestive systems
  • Metastatic malignant neoplasm to small intestine
  • Metastatic malignant neoplasm to spleen
  • Metastatic malignant neoplasm to stomach
  • Metastatic malignant neoplasm to tail of pancreas
  • Metastatic malignant neoplasm to thoracic esophagus
  • Metastatic malignant neoplasm to tonsil
  • Metastatic malignant neoplasm to tonsillar fossa
  • Metastatic malignant neoplasm to upper third of esophagus
  • Metastatic malignant neoplasm to Waldeyer's ring
  • Metastatic mucinous cystadenocarcinoma to pancreas
  • Metastatic squamous cell carcinoma to stomach
  • Metastatic undifferentiated carcinoma to esophagus
  • Metastatic undifferentiated carcinoma to stomach
  • Mucinous cystadenocarcinoma of pancreas
  • Neoplasm of body of pancreas
  • Neoplasm of cystic duct
  • Neoplasm of diaphragm
  • Neoplasm of exocrine pancreas
  • Neoplasm of head of pancreas
  • Neoplasm of muscle of abdomen
  • Neoplasm of muscle of thorax
  • Neoplasm of tail of pancreas
  • Neoplasm of tonsillar fossa
  • Pancreatic ductal adenocarcinoma
  • Secondary carcinoma of gastrointestinal tract
  • Squamous cell carcinoma of stomach
  • Tumor invades beyond pancreatic capsule to adjacent structures AND/OR organs
  • Tumor invades beyond pancreatic capsule to bile duct
  • Tumor invades beyond pancreatic capsule to spleen
  • Tumor invades beyond pancreatic capsule to stomach
  • Undifferentiated carcinoma of esophagus
  • Undifferentiated carcinoma of stomach

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Code Also

  • exocrine pancreatic insufficiency K86.81

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR NEO070
Secondary malignancies
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Ampulla of Vater

    a dilation of the duodenal papilla that is the opening of the juncture of the common bile duct and the main pancreatic duct, also known as the hepatopancreatic ampulla.
  • Esophagogastric Junction

    the area covering the terminal portion of esophagus and the beginning of stomach at the cardiac orifice.
  • Barrett Esophagus

    a condition with damage to the lining of the lower esophagus resulting from chronic acid reflux (esophagitis, reflux). through the process of metaplasia, the squamous cells are replaced by a columnar epithelium with cells resembling those of the intestine or the salmon-pink mucosa of the stomach. barrett's columnar epithelium is a marker for severe reflux and precursor to adenocarcinoma of the esophagus.
  • Esophageal Motility Disorders

    disorders affecting the motor function of the upper esophageal sphincter; lower esophageal sphincter; the esophagus body, or a combination of these parts. the failure of the sphincters to maintain a tonic pressure may result in gastric reflux of food and acid into the esophagus (gastroesophageal reflux). other disorders include hypermotility (spastic disorders) and markedly increased amplitude in contraction (nutcracker esophagus).
  • Esophageal Mucosa

    circular innermost layer of the esophagus wall that mediates esophageal peristalsis which pushes ingested food bolus toward the stomach.
  • Esophageal Neoplasms

    tumors or cancer of the esophagus.
  • Esophagus

    the muscular membranous segment between the pharynx and the stomach in the upper gastrointestinal tract.
  • Acalculous Cholecystitis

    inflammation of the gallbladder wall in the absence of gallstones.
  • Biliary Dyskinesia

    a motility disorder characterized by biliary colic, absence of gallstones, and an abnormal gallbladder ejection fraction. it is caused by gallbladder dyskinesia and/or sphincter of oddi dysfunction.
  • Cholecystitis

    inflammation of the gallbladder; generally caused by impairment of bile flow, gallstones in the biliary tract, infections, or other diseases.
  • Gallbladder

    a storage reservoir for bile secretion. gallbladder allows the delivery of bile acids at a high concentration and in a controlled manner, via the cystic duct to the duodenum, for degradation of dietary lipid.
  • Gallbladder Diseases

    diseases of the gallbladder. they generally involve the impairment of bile flow, gallstones in the biliary tract, infections, neoplasms, or other diseases.
  • Gallbladder Emptying

    a process whereby bile is delivered from the gallbladder into the duodenum. the emptying is caused by both contraction of the gallbladder and relaxation of the sphincter mechanism at the choledochal terminus.
  • Gallbladder Neoplasms

    tumors or cancer of the gallbladder.
  • Carcinoma, Pancreatic Ductal

    carcinoma that arises from the pancreatic ducts. it accounts for the majority of cancers derived from the pancreas.
  • Cystic Fibrosis

    an autosomal recessive genetic disease of the exocrine glands. it is caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator expressed in several organs including the lung, the pancreas, the biliary system, and the sweat glands. cystic fibrosis is characterized by epithelial secretory dysfunction associated with ductal obstruction resulting in airway obstruction; chronic respiratory infections; pancreatic insufficiency; maldigestion; salt depletion; and heat prostration.
  • Insulin Infusion Systems

    portable or implantable devices for infusion of insulin. includes open-loop systems which may be patient-operated or controlled by a pre-set program and are designed for constant delivery of small quantities of insulin, increased during food ingestion, and closed-loop systems which deliver quantities of insulin automatically based on an electronic glucose sensor.
  • Islets of Langerhans

    irregular microscopic structures consisting of cords of endocrine cells that are scattered throughout the pancreas among the exocrine acini. each islet is surrounded by connective tissue fibers and penetrated by a network of capillaries. there are four major cell types. the most abundant beta cells (50-80%) secrete insulin. alpha cells (5-20%) secrete glucagon. pp cells (10-35%) secrete pancreatic polypeptide. delta cells (~5%) secrete somatostatin.
  • Nesidioblastosis

    an inherited autosomal recessive syndrome characterized by the disorganized formation of new islets in the pancreas and congenital hyperinsulinism. it is due to focal hyperplasia of pancreatic islet cells budding off from the ductal structures and forming new islets of langerhans. mutations in the islet cells involve the potassium channel gene kcnj11 or the atp-binding cassette transporter gene abcc8, both on chromosome 11.
  • Pancreas

    a nodular organ in the abdomen that contains a mixture of endocrine glands and exocrine glands. the small endocrine portion consists of the islets of langerhans secreting a number of hormones into the blood stream. the large exocrine portion (exocrine pancreas) is a compound acinar gland that secretes several digestive enzymes into the pancreatic ductal system that empties into the duodenum.
  • Pancreas Divisum

    anatomic variants in pancreatic ducts characterized by failure of fusion of the ventral and dorsal endodermal buds. pancreas divisum results in inadequate or no communication between dorsal and ventral ducts. while most cases are asymptomatic, it may be associated with recurrent pancreatitis.
  • Pancreas Transplantation

    the transference of a pancreas from one human or animal to another.
  • Pancreas, Artificial

    devices for simulating the activity of the pancreas. they can be either electromechanical, consisting of a glucose sensor, computer, and insulin pump or bioartificial, consisting of isolated islets of langerhans in an artificial membrane.
  • Pancreas, Exocrine

    the major component (about 80%) of the pancreas composed of acinar functional units of tubular and spherical cells. the acinar cells synthesize and secrete several digestive enzymes such as trypsinogen; lipase; amylase; and ribonuclease. secretion from the exocrine pancreas drains into the pancreatic ductal system and empties into the duodenum.
  • Pancreatic Neoplasms

    tumors or cancer of the pancreas. depending on the types of islet cells present in the tumors, various hormones can be secreted: glucagon from pancreatic alpha cells; insulin from pancreatic beta cells; and somatostatin from the somatostatin-secreting cells. most are malignant except the insulin-producing tumors (insulinoma).
  • Pancrelipase

    a preparation of hog pancreatic enzymes standardized for lipase content.
  • Shwachman-Diamond Syndrome

    an inherited syndrome characterized by exocrine pancreatic insufficiency; hematologic abnormalities (e.g., bone marrow hypoplasia), and skeletal abnormalities (e.g., metaphyseal chondroplasia). germline mutations in the sbds gene are associated with shwachman-diamond syndrome.
  • Pyloric Stenosis

    narrowing of the pyloric canal with varied etiology. a common form is due to muscle hypertrophy (pyloric stenosis, hypertrophic) seen in infants.
  • Pylorus

    the region of the stomach at the junction with the duodenum. it is marked by the thickening of circular muscle layers forming the pyloric sphincter to control the opening and closure of the lumen.
  • Bariatric Surgery

    surgical procedures aimed at affecting metabolism and producing major weight reduction in patients with morbid obesity.
  • Diverticulosis, Stomach

    a pathological condition characterized by the presence of a number of gastric diverticula in the stomach.
  • Diverticulum, Stomach

    saccular, outward protrusion of all or a portion of the wall of the stomach.
  • Gastric Absorption

    uptake of substances via the stomach.
  • Gastric Antral Vascular Ectasia

    a distinct vascular lesion in the pyloric antrum that is characterized by tortuous dilated blood vessels (ectasia) radiating outward from the pylorus. the vessel pattern resembles the stripes on the surface of a watermelon. this lesion causes both acute and chronic gastrointestinal hemorrhage.
  • Gastric Dilatation

    abnormal distention of the stomach due to accumulation of gastric contents that may reach 10 to 15 liters. gastric dilatation may be the result of gastric outlet obstruction; ileus; gastroparesis; or denervation.
  • Gastric Fistula

    abnormal passage communicating with the stomach.
  • Gastric Stump

    that portion of the stomach remaining after gastric surgery, usually gastrectomy or gastroenterostomy for cancer of the stomach or peptic ulcer. it is a common site of cancer referred to as stump cancer or carcinoma of the gastric stump.
  • Gastrointestinal Contents

    the contents included in all or any segment of the gastrointestinal tract.
  • Receptor-Like Protein Tyrosine Phosphatases, Class 3

    a subclass of receptor-like protein tryosine phosphatases that contain a single cytosolic protein tyrosine phosphate domain and multiple extracellular fibronectin iii-like domains.
  • Stomach

    an organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum.
  • Stomach Diseases

    pathological processes involving the stomach.
  • Stomach Neoplasms

    tumors or cancer of the stomach.
  • Stomach Rupture

    bursting of the stomach.
  • Stomach Ulcer

    ulceration of the gastric mucosa due to contact with gastric juice. it is often associated with helicobacter pylori infection or consumption of nonsteroidal anti-inflammatory drugs (nsaids).
  • Stomach Volvulus

    twisting of the stomach that may result in gastric ischemia and gastric outlet obstruction. it is often associated with diaphragmatic hernia.
  • Stomach, Avian

    a component of the digestive system of birds which consists of the gizzard and proventriculus.
  • Stomach, Ruminant

    a component of the digestive system of ruminants which consists of the abomasum; omasum; reticulum; and rumen.
  • Lymphoma Finding

    a term that refers to clinicopathologic findings related to lymphomas.

Table of NeoplasmsClinical

Anatomical sites in the Table of Neoplasms that reference this code family.

SiteMalig.
Primary
Malig.
Secondary
Ca
in situ
BenignUncertainUnspec.
ampulla of VaterC24.1C78.89D01.5D13.5D37.6D49.0
antrum (Highmore) (maxillary) pyloricC16.3C78.89D00.2D13.1D37.1D49.0
bile or biliary (tract)C24.9C78.89D01.5D13.5D37.6D49.0
bile or biliary (tract) canals, interlobularC22.1C78.89D01.5D13.4D37.6D49.0
bile or biliary (tract) duct or passage (common) (cystic) (extrahepatic)C24.0C78.89D01.5D13.5D37.6D49.0
bile or biliary (tract) duct or passage (common) (cystic) (extrahepatic) interlobularC22.1C78.89D01.5D13.4D37.6D49.0
bile or biliary (tract) duct or passage (common) (cystic) (extrahepatic) intrahepatic and extrahepaticC24.8C78.89D01.5D13.5D37.6D49.0
cardia (gastric)C16.0C78.89D00.2D13.1D37.1D49.0
cardiac orifice (stomach)C16.0C78.89D00.2D13.1D37.1D49.0
cardio-esophageal junctionC16.0C78.89D00.2D13.1D37.1D49.0
cardio-esophagusC16.0C78.89D00.2D13.1D37.1D49.0
cholangioleC22.1C78.89D01.5D13.4D37.6D49.0
choledochal ductC24.0C78.89D01.5D13.5D37.6D49.0
common (bile) ductC24.0C78.89D01.5D13.5D37.6D49.0
corpus gastricC16.2C78.89D00.2D13.1D37.1D49.0
cystic (bile) duct (common)C24.0C78.89D01.5D13.5D37.6D49.0
digestive organs, system, tube, or tract NECC26.9C78.89D01.9D13.99D37.9D49.0
esophagogastric junctionC16.0C78.89D00.2D13.1D37.1D49.0
esophagusC15.9C78.89D00.1D13.0D37.8D49.0
esophagus abdominalC15.5C78.89D00.1D13.0D37.8D49.0
esophagus cervicalC15.3C78.89D00.1D13.0D37.8D49.0
esophagus distal (third)C15.5C78.89D00.1D13.0D37.8D49.0
esophagus lower (third)C15.5C78.89D00.1D13.0D37.8D49.0
esophagus middle (third)C15.4C78.89D00.1D13.0D37.8D49.0
esophagus proximal (third)C15.3C78.89D00.1D13.0D37.8D49.0
esophagus thoracicC15.4C78.89D00.1D13.0D37.8D49.0
esophagus upper (third)C15.3C78.89D00.1D13.0D37.8D49.0
extrahepatic (bile) ductC24.0C78.89D01.5D13.5D37.6D49.0
fundusC16.1C78.89D00.2D13.1D37.1D49.0
fundus stomachC16.1C78.89D00.2D13.1D37.1D49.0
gall duct (extrahepatic)C24.0C78.89D01.5D13.5D37.6D49.0
gallbladderC23C78.89D01.5D13.5D37.6D49.0
gastrocolicC26.9C78.89D01.9D13.99D37.9D49.0
gastroesophageal junctionC16.0C78.89D00.2D13.1D37.1D49.0
gastrointestinal (tract) NECC26.9C78.89D01.9D13.99D37.9D49.0
hepatic [See Also: Index to disease, by histology] duct (bile)C24.0C78.89D01.5D13.5D37.6D49.0
hepatobiliaryC24.9C78.89D01.5D13.5D37.6D49.0
insular tissue (pancreas)C25.4C78.89D01.7D13.7D37.8D49.0
intestine, intestinal tract NECC26.0C78.89D01.40D13.99D37.8D49.0
islands or islets of LangerhansC25.4C78.89D01.7D13.7D37.8D49.0
junction cardioesophagealC16.0C78.89D00.2D13.1D37.1D49.0
junction esophagogastricC16.0C78.89D00.2D13.1D37.1D49.0
junction gastroesophagealC16.0C78.89D00.2D13.1D37.1D49.0
Langerhans, islands or isletsC25.4C78.89D01.7D13.7D37.8D49.0
pancreasC25.9C78.89D01.7D13.6D37.8D49.0
pancreas bodyC25.1C78.89D01.7D13.6D37.8D49.0
pancreas duct (of Santorini) (of Wirsung)C25.3C78.89D01.7D13.6D37.8D49.0
pancreas ectopic tissueC25.7C78.89D13.6D37.8D49.0
pancreas headC25.0C78.89D01.7D13.6D37.8D49.0
pancreas islet cellsC25.4C78.89D01.7D13.7D37.8D49.0
pancreas neckC25.7C78.89D01.7D13.6D37.8D49.0
pancreas tailC25.2C78.89D01.7D13.6D37.8D49.0
prepylorusC16.4C78.89D00.2D13.1D37.1D49.0
pyloricC16.3C78.89D00.2D13.1D37.1D49.0
pyloric antrumC16.3C78.89D00.2D13.1D37.1D49.0
pyloric canalC16.4C78.89D00.2D13.1D37.1D49.0
pylorusC16.4C78.89D00.2D13.1D37.1D49.0
Santorini's ductC25.3C78.89D01.7D13.6D37.8D49.0
sphincter of OddiC24.0C78.89D01.5D13.5D37.6D49.0
spleen, splenic NECC26.1C78.89D01.7D13.99D37.8D49.0
stomachC16.9C78.89D00.2D13.1D37.1D49.0
stomach antrum (pyloric)C16.3C78.89D00.2D13.1D37.1D49.0
stomach bodyC16.2C78.89D00.2D13.1D37.1D49.0
stomach cardiaC16.0C78.89D00.2D13.1D37.1D49.0
stomach cardiac orificeC16.0C78.89D00.2D13.1D37.1D49.0
stomach corpusC16.2C78.89D00.2D13.1D37.1D49.0
stomach fundusC16.1C78.89D00.2D13.1D37.1D49.0
stomach greater curvature NECC16.6C78.89D00.2D13.1D37.1D49.0
stomach lesser curvature NECC16.5C78.89D00.2D13.1D37.1D49.0
stomach prepylorusC16.4C78.89D00.2D13.1D37.1D49.0
stomach pylorusC16.4C78.89D00.2D13.1D37.1D49.0
stomach wall NECC16.9C78.89D00.2D13.1D37.1D49.0
stomach wall NEC anterior NECC16.8C78.89D00.2D13.1D37.1D49.0
stomach wall NEC posterior NECC16.8C78.89D00.2D13.1D37.1D49.0
Vater's ampullaC24.1C78.89D01.5D13.5D37.6D49.0
Wirsung's ductC25.3C78.89D01.7D13.6D37.8D49.0

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Convert C78.89 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
197.8 Sec mal neo GI NEC
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About C78.89Overview

Is C78.89 a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report secondary malignant neoplasm of other digestive organs on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does C78.89 group to?

When secondary malignant neoplasm of other digestive organs is the principal diagnosis on an inpatient stay, it groups to MS-DRG 374, 375, 376, with relative weights from 0.9243 to 2.1387 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of C78.89?

Under the General Equivalence Mappings, secondary malignant neoplasm of other digestive organs converts to ICD-9-CM 197.8 (sec mal neo GI NEC). The mapping is approximate, so confirm the match fits the documentation.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.