Created 11/17/2023
CMS-Designated Primary Diagnosis Codes Impacting Quality Improvement Metrics
CMS has issued a specific set of primary diagnosis codes. In cases where your patient experiences hospitalization, readmission, or an emergency room visit linked to one of these diagnosis codes, it will be counted as an 'ESRD Hospitalization' in the Quality Improvement Activity (QIA).
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Primary Diagnosis Codes 2023 |
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ICD Code |
Description |
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I161 |
Hypertensive Emergency |
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I169 |
Hypertensive Crisis, Unspecified |
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I160 |
Hypertensive Urgency |
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E8770 |
Fluid overload unspecified |
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E8779 |
Other fluid overload |
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J810 |
Acute pulmonary edema |
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I509 |
Congestive Heart Failure, Unspecified |
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E8770 |
Hypervolemia |
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I5021 |
Acute systolic (congestive) heart failure |
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I5023 |
Acute on chronic systolic (congestive) heart failure |
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I5031 |
Acute diastolic (congestive) heart failure |
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I5033 |
Acute on chronic diastolic (congestive) heart failure |
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I5041 |
Acute combined systolic (congestive) and diastolic (congestive) heart failure |
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A419 |
Sepsis, unspecified organism |
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A4101 |
Sepsis due to Methicillin Susceptible Staphylococcus aureus |
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A4102 |
Sepsis due to Methicillin Resistant Staphylococcus aureus |
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T8571 |
Infection and inflammatory reaction due to peritoneal dialysis catheter |
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T8571XA |
Infection and inflammatory reaction due to peritoneal dialysis catheter, initial encounter |
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T8571XD |
Infection and inflammatory reaction due to peritoneal dialysis catheter, subsequent encounter |
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T8571XS |
Infection and inflammatory reaction due to peritoneal dialysis catheter, sequela |
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T80211 |
Bloodstream infection due to central venous catheter |
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T80211A |
Bloodstream infection due to central venous catheter, initial encounter |
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T80211D |
Bloodstream infection due to central venous catheter, subsequent encounter |
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T80211S |
Bloodstream infection due to central venous catheter, sequela |
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T827 |
Infection and Inflammatory Reaction due to Other Cardiac and Vascular Devices, Implants and Grafts |
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D631 |
Anemia of Chronic Kidney Disease |
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E162 |
Hypoglycemia, unspecified |
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E871 |
Hypo-osmolality and hyponatremia |
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E875 |
Hyperkalemia |
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E876 |
Hypokalemia |
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E8339 |
Hyper- and Hypophosphatemia |
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E8351 |
Hypocalcemia |
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E8352 |
Hypercalcemia |
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T82838 |
Hemorrhage due to vascular prosthetic devices, implants and grafts |
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T82838A |
Hemorrhage due to vascular prosthetic devices, implants and grafts, initial encounter |
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T82838D |
Hemorrhage due to vascular prosthetic devices, implants and grafts, subsequent encounter |
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T82838S |
Hemorrhage due to vascular prosthetic devices, implants and grafts, sequela |
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T82858 |
Stenosis of other vascular prosthetic devices, implants and grafts |
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T82858A |
Stenosis of other vascular prosthetic devices, implants and grafts, initial encounter |
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T82858D |
Stenosis of other vascular prosthetic devices, implants and grafts, subsequent encounter |
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T82858S |
Stenosis of other vascular prosthetic devices, implants and grafts, sequela |