Claim Diagnosis Code

CLM_DGNS_CD

A CODE IDENTIFYING AN INTERNATIONAL CLASSIFICATION OF DISEASES, CLINICAL MODIFICATION (ICD_CM) DIAGNOSIS RELEVANT TO THE SERVICE BEING PROVIDED OR THE REASON FOR THE SERVICE.

Field Metadata

FHIR Resource: ExplanationOfBenefit
FHIRPath: ExplanationOfBenefit.diagnosis.diagnosis.coding.code
Coverage / Claim Type: Carrier
DME
HHA
Hospice
Inpatient
Outpatient
SNF
Source View: V2_MDCR_CLM_PROD
Source Column: CLM_DGNS_CD
Sources: FISS
MCS
NCH
VMS
Profiles: Basis
Regular
CMS

Example

M48.062

Notes

There are rare, rare, instances where these will be ICD-9 codes.

Mappings

CCLF

CCLF1.PRNCPL_DGNS_CD
CCLF1.ADMTG_DGNS_CD
CCLF4.CLM_DGNS_CD
CCLF5.CLM_DGNS_1_CD
CCLF5.CLM_DGNS_2_CD
CCLF5.CLM_DGNS_3_CD
CCLF5.CLM_DGNS_4_CD
CCLF5.CLM_DGNS_5_CD
CCLF5.CLM_DGNS_6_CD
CCLF5.CLM_DGNS_7_CD
CCLF5.CLM_DGNS_8_CD
CCLF5.CLM_DGNS_9_CD
CCLF5.CLM_DGNS_10_CD
CCLF5.CLM_DGNS_11_CD
CCLF5.CLM_DGNS_12_CD

CCW

FST_DGNS_E_CD
RSN_VISIT_CD1
RSN_VISIT_CD2
RSN_VISIT_CD3
ICD_DGNS_CD1
ICD_DGNS_CD2
ICD_DGNS_CD3
ICD_DGNS_CD4
ICD_DGNS_CD5
ICD_DGNS_CD6
ICD_DGNS_CD7
ICD_DGNS_CD8
ICD_DGNS_CD9
ICD_DGNS_CD10
ICD_DGNS_CD11
ICD_DGNS_CD12
ICD_DGNS_CD13
ICD_DGNS_CD14
ICD_DGNS_CD15
ICD_DGNS_CD16
ICD_DGNS_CD17
ICD_DGNS_CD18
ICD_DGNS_CD19
ICD_DGNS_CD20
ICD_DGNS_CD21
ICD_DGNS_CD22
ICD_DGNS_CD23
ICD_DGNS_CD24
ICD_DGNS_CD25
ICD_DGNS_E_CD1
ICD_DGNS_E_CD2
ICD_DGNS_E_CD3
ICD_DGNS_E_CD4
ICD_DGNS_E_CD5
ICD_DGNS_E_CD6
ICD_DGNS_E_CD7
ICD_DGNS_E_CD8
ICD_DGNS_E_CD9
ICD_DGNS_E_CD10
ICD_DGNS_E_CD11
ICD_DGNS_E_CD12
PRNCPAL_DGNS_CD