[Code of Federal Regulations]
[Title 45, Volume 1]
[Revised as of October 1, 2001]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR162.1002]

[Page 679-680]
 
                        TITLE 45--PUBLIC WELFARE
 
                    SUBTITLE A--DEPARTMENT OF HEALTH
                           AND HUMAN SERVICES
 
PART 162--ADMINISTRATIVE REQUIREMENTS--Table of Contents
 
                          Subpart J--Code Sets
 
Sec. 162.1002  Medical data code sets.

    The Secretary adopts the following code set maintaining 
organization's code sets as the standard medical data code sets:
    (a) International Classification of Diseases, 9th Edition, Clinical 
Modification, (ICD-9-CM), Volumes 1 and 2 (including The Official ICD-9-
CM Guidelines for Coding and Reporting), as maintained

[[Page 680]]

and distributed by HHS, for the following conditions:
    (1) Diseases.
    (2) Injuries.
    (3) Impairments.
    (4) Other health problems and their manifestations.
    (5) Causes of injury, disease, impairment, or other health problems.
    (b) International Classification of Diseases, 9th Edition, Clinical 
Modification, Volume 3 Procedures (including The Official ICD-9-CM 
Guidelines for Coding and Reporting), as maintained and distributed by 
HHS, for the following procedures or other actions taken for diseases, 
injuries, and impairments on hospital inpatients reported by hospitals:
    (1) Prevention.
    (2) Diagnosis.
    (3) Treatment.
    (4) Management.
    (c) National Drug Codes (NDC), as maintained and distributed by HHS, 
in collaboration with drug manufacturers, for the following:
    (1) Drugs
    (2) Biologics.
    (d) Code on Dental Procedures and Nomenclature, as maintained and 
distributed by the American Dental Association, for dental services.
    (e) The combination of Health Care Financing Administration Common 
Procedure Coding System (HCPCS), as maintained and distributed by HHS, 
and Current Procedural Terminology, Fourth Edition (CPT-4), as 
maintained and distributed by the American Medical Association, for 
physician services and other health care services. These services 
include, but are not limited to, the following:
    (1) Physician services.
    (2) Physical and occupational therapy services.
    (3) Radiologic procedures.
    (4) Clinical laboratory tests.
    (5) Other medical diagnostic procedures.
    (6) Hearing and vision services.
    (7) Transportation services including ambulance.
    (f) The Health Care Financing Administration Common Procedure Coding 
System (HCPCS), as maintained and distributed by HHS, for all other 
substances, equipment, supplies, or other items used in health care 
services. These items include, but are not limited to, the following:
    (1) Medical supplies.
    (2) Orthotic and prosthetic devices.
    (3) Durable medical equipment.