Effective Dates: 10/05/2021 - Present Previous | Next

TN 26 (10-21)

DI 26510.015 Completing Item 16A and 16B (Primary and Secondary Diagnosis, Body System Code, and Impairment Code) on the SSA-831 Disability Determination and Transmittal

A. Citing a diagnosis

Correct diagnosis coding is essential for statistical analysis, case studies, and answering public inquiries. The following principles apply when citing a diagnosis:

•

The diagnosis should identify the underlying cause (i.e., etiology) and disabling manifestation.
•

If the underlying cause is unknown, the diagnosis should identify the disabling manifestation.
•

You must include the codes most relevant to the determination.
•

The electronic claims analysis tool (eCAT) allows for documenting multiple codes as “other” impairment within the case file.

1. Disability examiner (DE) and medical or psychological consultant (MC/PC) team determinations

The reviewing MC/PC and DE team determines the diagnosis and its nomenclature. They provide the diagnosis based on a review of all the medical evidence in file and choose the terminology used on the determination form. The MC/PC completes or reviews the diagnosis. The MC/PC is responsible for diagnosis terminology and accuracy.

2. Non-team determinations

When the DE alone is responsible for the determination, the DE is responsible for diagnosis terminology and accuracy.

B. Block 16A. Primary Diagnosis and Block 16B. Secondary Diagnosis on Form SSA-831

Block 16A. and 16B. on the SSA-831 contain entries for a:

•

primary and a secondary diagnosis,
•

2-digit primary body system identifying code, and
•

4-digit primary and a secondary impairment identifying code – based on a simplified version of the International Classification of Diseases (ICD) full code.

C. Determining the primary and secondary diagnoses

Complete items 16A and 16B as follows:

1. Diagnosis code based on medical evidence

Evaluate all of the medical evidence in the file, and determine diagnoses for the period reviewed. Enter the diagnosis of the claimant's primary and secondary impairment (if any) at the established onset date (EOD) in an allowance or at the alleged onset date (AOD) in a denial. Include other diagnoses present at the time of adjudication in the determination rationale.

2. Primary diagnosis or Item 16A

The primary diagnosis in an allowance refers to the basic condition that rendered the person disabled, or in a denial, the one that the evidence shows to have the most significant effect on the person's ability to work.

When the case is a denial, and no diagnosis is established, enter “none established.” Use impairment code “0000” when there is no medical evidence in the file. Use impairment code “6490” when medical evidence in the file is not sufficient to establish a diagnosis.

a. Drug addiction and alcoholism (DAA) materiality

When the case is a denial because DAA is material, enter the appropriate code for “alcoholism” (3030 – Substance Addiction or Psychoactive Substance Dependence Disorders (Alcohol)) or “drug addiction” (3040 – Substance Addiction or Psychoactive Substance Dependence Disorders (Drugs)) as the primary impairment. When the case is an allowance because DAA is not material, enter the mental or physical impairment that would be disabling, absent the effects of DAA, as the primary diagnosis.

b. Statutory blindness

IMPORTANT: A claimant has statutory blindness only if the visual disorder meets Listing 2.02 or 2.03A for adults, or Listing 102.02 or 102.03A for children.

Use the term “Statutory Blindness” as the primary diagnosis.

1.

Enter body system “02” and impairment code “3694” in the blocks provided.
2.

In Item 16B (Secondary Diagnosis), show the underlying cause of the blindness and the corresponding diagnosis code.
3.

Enter “Statutory Blindness” as the secondary diagnosis when the basis of the EOD is a different impairment and that impairment’s onset date is before the onset date of statutory blindness.

3. Secondary diagnosis or Item 16B

When the evidence does not include a secondary diagnosis or no medical evidence is in the file, enter "0000" and “none” will show in block 16B. Use impairment code "6490" when medical evidence in the file is not sufficient to establish a diagnosis. The secondary diagnosis in all determinations is the most significant diagnosis following the primary diagnosis in severity, except in the following situations.

a. Symptomatic human immunodeficiency virus (HIV) infection

If the primary diagnosis is symptomatic HIV infection, enter the diagnosis of the most significant HIV-related complication as the secondary diagnosis. If there is no HIV-related complication, enter the most significant diagnosis following the primary diagnosis.

b. DAA is present but not material

When DAA is present but not material, enter “alcoholism” or “drug addiction,” as appropriate, as the secondary diagnosis.

c. Statutory blindness

Enter “Statutory Blindness” as the secondary diagnosis when the basis of the EOD (Item 15A) is not statutory blindness and the impairment’s onset date is before the onset date of statutory blindness.

1.

In Item 16A (Primary Diagnosis), enter the diagnosis of the other impairment at the established onset date. Enter the related body system code and diagnosis code.
2.

In Item 16B (Secondary Diagnosis), enter “Statutory Blindness” as the secondary diagnosis and show diagnosis code 3694. Because item 16B can only show “Statutory Blindness,” you cannot include the underlying cause on the. However, if eCAT is used, show the underlying cause as “Other” impairment.

REMINDER: For additional instructions about completing Item 18 (Case of Blindness), see DI 26510.025.

D. Body system coding

Body system coding of the primary diagnosis is required for all determinations, favorable or unfavorable.

•

Obtain the appropriate body system code number for the primary diagnosis from DI 26510.015F in this section.
•

Enter the 2-digit body-system code number in the designated space following the primary diagnosis in Item 16A.

E. Impairment coding

You must code the primary and secondary diagnosis for all determinations, favorable or unfavorable.

•

Select codes, as appropriate, from the predetermined lists in DI 26510.015G.1. through DI 26510.015G.4. in this section.
•

Use the code on List 1, 2, or 3 that most accurately identifies the impairment.
•

Whenever symptomatic HIV (code 0430) is used as the primary diagnosis, use a code from List 4 (also shown on List 5 under “Diagnostic Categories” as “(Secondary Diagnosis for HIV-0430)” for “Body System” 14) as the secondary diagnosis for all favorable or unfavorable determinations, except as noted under DI 26510.015G.4. in this section.
•

Never use a code from List 4 or List 5 as a primary diagnosis. We designated these codes to use as a secondary diagnosis for HIV on Lists 4 and 5. Only use as a secondary diagnosis when the primary diagnosis is symptomatic HIV (code 0430).

To complete the impairment code number entry on the SSA-831, enter the appropriate 4-digit impairment code in the designated space following the primary diagnosis in Item 16A and the secondary diagnosis in Item 16B.

The five lists developed for ease of reference are:

List 1 – Adult listing (part A) impairment codes when the adult listings are applicable and impairment severity meets adult listing criteria. Also, use this list in “medical equals” determinations. (See DI 26510.015G.1. in this section.)

List 2 – Childhood listing (part B) impairment codes when childhood listings are applicable and impairment severity meets childhood listing criteria. Also, use this list in “medical equals” determinations. (See DI 26510.015G.2. in this section.)

List 3 – General list of impairment codes when an impairment is less than listing or medical equivalent severity. Use this list in unfavorable adult and childhood determinations and favorable functional equals or medical and vocational determinations. List 3 also provides codes for special situations described in DI 26510.015G.3. in this section.

List 4 – Impairment codes for symptomatic HIV infection secondary complications. (See DI 26510.015G.4. in this section.)

List 5 – Impairment codes in numeric sequence. Use this list for ease of reference when looking for the diagnosis connected to a particular impairment code. (See DI 26510.015G.5. in this section.)

1. Primary diagnosis impairment codes

Situation	Reference
Meets, medical equals	DI 26510.015G.1. and DI 26510.015G.2.
Medical and vocational allowances Functional equals allowances Denial Special situations	DI 26510.015G.3.

2. Secondary diagnosis impairment codes

Situation	Reference
Meets, medical equals	DI 26510.015G.1. and DI 26510.015G.2.
Medical and vocational allowances Functional equals allowances Denial Special situations	DI 26510.015G.3.
Symptomatic HIV infection	DI 26510.015G.4.

F. List of body system codes

Code number	Body System
01	Musculoskeletal Disorders
02	Special Senses and Speech
03	Respiratory Disorders
04	Cardiovascular System
05	Digestive System
06	Genitourinary Disorders
07	Hematological Disorders
08	Skin Disorders
09	Endocrine Disorders
10	Congenital Disorders That Affect Multiple Body Systems
11	Neurological Disorders
12	Mental Disorders
13	Cancer
14	Immune System Disorders
19	Low Birth Weight and Failure to Thrive
20	Special/Other

G. List of impairment codes

1. Adult listing impairment codes

a.

Use this list for any condition that meets or equals a listing in part A of the Listing of Impairments (unless a code from List 2 or List 3 more accurately describes the impairment).
b.

The impairment code should match the diagnosis as closely as possible.

EXAMPLE:

•

Intellectual disability, meets Listing 12.05, code 3180;
•

Arteriosclerotic heart disease with angina pectoris and history of myocardial infarction, meets Listing 4.04, code 4140; and
•

Alzheimer’s disease meets Listing 12.02, code 2940.

Listing (Body Systems)	Diagnostic Category	Impairment Code
Musculoskeletal Disorders (01)
1.15	Disorders of the Skeletal Spine	7240
1.16	Lumbar Spinal Stenosis	7210
1.17	Osteoarthrosis and Allied Disorders	7150
1.18	Other and Unspecified Arthropathies	7160
1.19	Pathologic Fractures	7330
1.20	Amputation Due to Any Cause	9050
1.21	Soft Tissue Injury of Upper Extremity	8840
1.21	Soft Tissue Injury of Lower Extremity	8940
1.21	Burns (NOS)	9490
1.22	Fractures of Lower Limb	8270
1.23	Fractures of Upper Limb	8180
Special Senses and Speech (02)
2.02	Retinal Detachments and Defects	3610
2.02	Glaucoma	3650
2.02	Cataract	3660
2.02	Low Vision	3690
2.02	Statutory Blindness	3694
2.03	Visual Disturbances	3680
2.03A	Statutory Blindness	3694
2.04	Visual Disturbances	3680
2.07	Vertiginous Syndromes and Other Disorders of Vestibular System	3860
2.09	Loss of Voice	7840
2.10	Hearing Loss Not Treated with Cochlear Implantation	3890
2.11	Hearing Loss Treated with Cochlear Implantation	3890
Respiratory Disorders (03)
3.02	Chronic Respiratory Disorders	4960
3.03	Asthma	4930
3.04	Cystic Fibrosis	2770
3.07	Bronchiectasis	4940
3.09	Chronic Pulmonary Hypertension Due to Any Cause	4160
3.11	Lung Transplant	3250
3.14	Respiratory Failure	5180
Cardiovascular System (04)
4.02	Chronic Heart Failure	4280
4.04	Ischemic Heart Disease	4140
4.05	Recurrent Arrhythmias	4270
4.06	Symptomatic Congenital Heart Disease	7460
4.09	Heart Transplant	3750
4.10	Aneurysm of Aorta or Major Branches	4410
4.11	Chronic Venous Insufficiency	4590
4.12	Peripheral Arterial Disease	4430
Digestive System Disorders (05)
5.02	Gastrointestinal Hemorrhaging from any cause	5780
5.05	Chronic Liver Disease	5710
5.06	Inflammatory Bowel Disease (IBD)	5550
5.07	Short Bowel Syndrome (SBS)	5793
5.08	Weight Loss due to any digestive disorder	2630
5.09	Liver Transplantation	4750
Genitourinary Disorders (06)
6.03	Chronic Kidney Disease with Dialysis	5850
6.04	Kidney Transplant	9960
6.05	Chronic Kidney Disease	5880
6.06	Nephrotic Syndrome	5810
6.09	Complications of Chronic Kidney Disease	5830
Hematological Disorders (07)
7.05	Hemolytic Anemias (Including Sickle Cell, Thalassemia, and Variants)	2820
7.08	Thrombosis and Hemostasis Disorder (Including Hemophilia)	2860
7.10	Bone Marrow Failure (Including Myelofibrosis and Granulocytopenia)	2890
7.17	Hematological Disorders with BM/SC Transplantation	2840
7.18	Use the Code for the Underlying Hematological Disorder
7.18	Hemolytic Anemias (Including Sickle Cell, Thalassemia, and Variants)	2820
7.18	Thrombosis and Hemostasis Disorder (Including Hemophilia)	2860
7.18	Bone Marrow Failure (Including Myelofibrosis and Granulocytopenia)	2890
Skin Disorders (08)
8.02	Ichthyosis	6950
8.03	Bullous Disease	6940
8.04	Chronic Infections of the Skin or Mucous Membranes	1170
8.05	Dermatitis	6960
8.06	Hidradenitis Suppurativa	7050
8.07	Genetic Photosensitivity Disorders	7590
8.08	Burns	9480
Congenital Disorders That Affect Multiple Body Systems (10)
10.06	Non-Mosaic Down Syndrome	7580
Neurological Disorders (11)
11.02	Epilepsy	3450
11.04	Vascular Insult to the Brain	4380
11.05	Benign Neoplasm of Brain and Other Parts of Nervous System	2250
11.06	Parkinson's Disease	3320
11.07	Cerebral Palsy	3430
11.08	Spinal Cord Disorders	3360
11.08	Fracture of Vertebral Column with Spinal Cord Lesion	8060
11.09	Multiple Sclerosis	3400
11.10	Amyotrophic Lateral Sclerosis	3350
11.11	Post-Polio Syndrome	1380
11.12	Myoneural Disorders	3580
11.13	Muscular Dystrophies and Other Myopathies	3590
11.14	Peripheral Neuropathy	3570
11.17	Other Cerebral Degenerations	3310
11.17	Huntington Disease	3330
11.18	Traumatic Brain Injury	8540
11.20	Coma or Persistent Vegetative State	3480
11.22	Motor Neuron Disorders other than ALS	3358
Mental Disorders (12)
12.02	Neurocognitive Disorders	2940
12.03	Schizophrenia Spectrum and Other Psychotic Disorders	2950
12.04	Depression, Bipolar and Related Disorders	2960
12.05	Intellectual Disorder	3180
12.06	Anxiety and Obsessive-Compulsive Disorders	3000
12.07	Somatic Symptom and Related Disorders	3060
12.08	Personality Disorders	3010
12.08	Impulse-Control Disorders	3120
12.10	Autism Spectrum Disorders	2990
12.11	Attention Deficit/Hyperactivity Disorder	3140
12.11	Learning Disorder	3152
12.13	Eating Disorders	3070
12.15	Trauma- and Stressor-Related Disorders	3090
Cancer (13)
13.02	Soft Tissue Tumors of Head and Neck	1950
13.03	Malignant Neoplasm of Skin	1730
13.04	Malignant Neoplasm of Connective and Other Soft Tissue	1710
13.05	Lymphoma	2020
13.06	Leukemia	2070
13.07	Multiple Myeloma	2030
13.08	Malignant Neoplasm of Salivary Glands	1420
13.09	Malignant Neoplasm of Thyroid Gland	1930
13.10	Malignant Neoplasm of Breast	1740
13.11	Malignant Neoplasm of Skeletal System	1780
13.12	Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa	1700
13.13	Malignant Neoplasm of Nervous System	1910
13.14	Malignant Neoplasm of Trachea, Bronchus, or Lung	1620
13.15	Malignant Neoplasm of Pleura	1630
13.15	Malignant Neoplasm of Mediastinum)	1640
13.16	Malignant Neoplasm of Esophagus	1500
13.16	Malignant Neoplasm of Stomach	1510
13.17	Malignant Neoplasm of Small Intestine, Including Duodenum	1520
13.18	Malignant Neoplasm of Colon, Rectum or Anus	1530
13.19	Malignant Neoplasm of Liver and Intrahepatic Bile Ducts	1550
13.19	Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts	1560
13.20	Malignant Neoplasm of Pancreas	1570
13.21	Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters	1890
13.22	Malignant Neoplasm of Bladder	1880
13.23	Malignant Neoplasm of Uterus	1790
13.23	Malignant Neoplasm of Vulva or Vagina	1840
13.23	Malignant Neoplasm of Ovary and Other Uterine Adnexa	1830
13.24	Malignant Neoplasm of Prostate	1850
13.25	Malignant Neoplasm of Testis	1860
13.26	Malignant Neoplasm of Penis	1870
13.27	Malignant Neoplasm of Unspecified Site	1990
13.28	Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation	0420
13.29	Malignant Melanoma	1720
Immune System Disorders (14)
14.02	Systemic Lupus Erythematosus	7100
14.03	Systemic Vasculitis	4460
14.04	Systemic Sclerosis (Scleroderma )	7100
14.05	Polymyositis and Dermatomyositis	7100
14.06	Undifferentiated and Mixed Connective Tissue Disease	7100
14.07	Immune Deficiency Disorders, Excluding HIV Infection	2790
14.09	Inflammatory Arthritis	7140
14.09C	Ankylosing Spondylitis or Other Spondyloarthropathies	7200
14.10	Sjögren's Syndrome	7100
14.11	Symptomatic Human Immunodeficiency Virus (HIV) Infection	0430

2. Childhood listing impairment codes

a.

Use this list for any condition that meets a listing in part B of the listing of impairments. Also use in “medical equals” cases (unless an impairment code from List 1 or List 3 more accurately describes the impairment).
b.

The impairment code should match the diagnosis as closely as possible.

For example:

•

Diabetes mellitus, meets Listing 109.08, code 2500;
•

Intellectual disability, meets Listing 112.05, code 3180; and
•

Cystic fibrosis, meets Listing 103.04, code 2770.

Listing (Body System)	Diagnostic Category	Impairment Code
Musculoskeletal Disorders (01)
101.15	Disorders of the Skeletal Spine	7240
101.16	Lumbar Spinal Stenosis	7210
101.17	Osteoarthrosis and Allied Disorders	7150
101.18	Other and Unspecified Arthropathies	7160
101.19	Pathologic Fractures	7330
101.20	Amputation Due to Any Cause	9050
101.21	Soft Tissue Injury of Upper Extremity	8840
101.21	Soft Tissue Injury of Lower Extremity	8890
101.21	Burns (NOS)	9490
101.22	Fractures of Lower Limb	8270
101.23	Fractures of Upper Limb	8180
101.24	Musculoskeletal Disorders of Infants and Toddlers	7540
Special Senses (02)
102.02	Low Vision	3690
102.02	Statutory Blindness	3694
102.03	Visual Disturbances	3680
102.03A	Statutory Blindness	3694
102.04	Visual Disturbances	3680
102.10	Hearing Loss Not Treated with Cochlear Implantation	3890
102.11	Hearing Loss Treated with Cochlear Implantation	3890
Respiratory Disorders (03)
103.02	Chronic Respiratory Disorders	4960
103.03	Asthma	4930
103.04	Cystic Fibrosis	2770
103.06	Growth Failure Due to Any Chronic Respiratory Disorder	7860
103.11	Lung Transplant	3250
103.14	Respiratory Failure	5180
Cardiovascular System (04)
104.02	Chronic Heart Failure	4280
104.02C	Growth Failure Due to Any Chronic Cardiovascular Disorder	7850
104.05	Recurrent Arrhythmias	4270
104.06	Congenital Heart Disease	7460
104.09	Heart Transplant	3750
104.13	Rheumatic Heart Disease	3910
Digestive System (05)
105.02	Gastrointestinal Hemorrhaging from any cause	5780
105.05	Chronic Liver Disease	5710
105.06	Inflammatory Bowel Disease (IBD)	5550
105.07	Short Bowel Syndrome (SBS)	5793
105.08	Growth Failure Due to Any Digestive Disorder	2630
105.09	Liver Transplantation	4750
105.10	Need for supplemental daily enteral feeding via gastrostomy	5799
Genitourinary Disorders (06)
106.03	Chronic Kidney Disease with Dialysis	5850
106.04	Kidney Transplant	9960
106.05	Chronic Kidney Disease	5880
106.06	Nephrotic Syndrome	5810
106.07	Congenital Anomalies of Urinary System	7530
106.08	Growth Failure Due to Any Chronic Renal Disease	7880
106.09	Complications of Chronic Kidney Disease	5830
Hematological Disorders (07)
107.05	Hemolytic Anemias (Including Sickle Cell, Thalassemia, and Variants)	2820
107.08	Thrombosis and Hemostasis Disorder (Including Hemophilia)	2860
107.10	Bone Marrow Failure (Including Myelofibrosis and Granulocytopenia)	2890
107.17	Hematological Disorders with BM/SC Transplantation	2840
Skin Disorders (08)
108.02	Ichthyosis	6950
108.03	Bullous Disease	6940
108.04	Chronic Infections of the Skin or Mucous Membranes	1170
108.05	Dermatitis	6960
108.06	Hidradenitis Suppurativa	7050
108.07	Genetic Photosensitivity Disorders	7590
108.08	Burns	9480
Endocrine Disorders (09)
109.08	Diabetes Mellitus	2500
Congenital Disorders That Affect Multiple Body Systems (10)
110.06	Non-Mosaic Down Syndrome	7580
110.08	Anencephalus and Catastrophic Congenital Abnormality or Disease	7400
110.08B	Cerebral Degeneration Usually Manifest in Childhood	3300
Neurological Disorders (11)
111.02	Epilepsy	3450
111.04	Vascular Insult to the Brain	4380
111.05	Benign Neoplasm of Brain and Other Parts of Nervous System	2250
111.07	Cerebral Palsy	3430
111.08	Spinal Cord Disorders	3360
111.08	Spina Bifida (Meningomyelocele)	7410
111.09	Loss of Voice (Communication Impairment)	7840
111.12	Myoneural Disorders	3580
111.13	Muscular Dystrophies and Other Myopathies	3590
111.14	Peripheral Neuropathy	3570
111.17	Other Cerebral Degenerations	3310
111.17	Huntington Disease	3330
111.18	Traumatic Brain Injury	8540
111.20	Coma or Persistent Vegetative State	3480
111.21	Multiple Sclerosis	3400
111.22	Motor Neuron Disorders Other than ALS	3358
Mental Disorders (12)
112.02	Neurocognitive Disorders	2940
112.03	Schizophrenia Spectrum and Other Psychotic Disorders	2950
112.04	Depression, Bipolar and Related Disorders	2960
112.05	Intellectual Disorder	3180
112.06	Anxiety and Obsessive-Compulsive Disorders	3000
112.07	Somatic Symptom and Related Disorders	3060
112.08	Personality Disorders	3010
112.08	Impulse Control Disorders	3120
112.10	Autism Spectrum Disorders	2990
112.11	Attention Deficit/Hyperactivity Disorder	3140
112.11	Learning Disorder	3152
112.13	Eating Disorders	3070
112.14	Developmental Disorders in Infants and Toddlers	3150
112.15	Trauma- and Stressor-Related Disorders	3090
Cancer (13)
113.03	Malignant Neoplasm of Unspecified Site	1990
113.05	Lymphoma	2020
113.06	Leukemia	2070
113.09	Malignant Neoplasm of Thyroid Gland	1930
113.12	Malignant Neoplasm of Eye	1900
113.13	Malignant Neoplasm of Nervous System	1910
113.21	Neuroblastoma	1920
113.29	Malignant Melanoma	1720
Immune System Disorders (14)
114.02	Systemic Lupus Erythematosus	7100
114.03	Systemic Vasculitis	4460
114.04	Systemic Sclerosis (Scleroderma)	7100
114.05	Polymyositis and Dermatomyositis	7100
114.06	Undifferentiated and Mixed Connective Tissue Disease	7100
114.07	Immune Deficiency Disorders, Excluding HIV Infection	2790
114.08	Human Immunodeficiency Virus (HIV) Infection	0430
114.09	Inflammatory Arthritis	7140
114.09C	Ankylosing Spondylitis or Other Spondyloarthropathies	7200
114.10	Sjögren's Syndrome	7100
114.11	Symptomatic Human Immunodeficiency Virus (HIV) Infection	0430
Low Birth Weight (LBW) and Failure to Thrive (FTT) (19)
100.04A	Low Birth Weight – Weight Under 1200 grams	7650
100.04B	Low Birth Weight – Weight 1200 - 2000 grams	7649
100.05	Failure to Thrive	7830

3. General list of impairment codes

a.
Use the following list for any impairment that does not meet or equal a listing in the Listing of Impairments (Part A or B). Some examples are:
- •
  
  Medical and vocational allowances;
- •
  
  Functional equals allowances;
- •
  
  Denials; and
- •
  
  Special situations; e.g., diagnosis is “none established” or diagnosis is established, but no list code of a medical nature is applicable.
b.

Find the body system for the impairment in the listings; determine the diagnostic category most appropriate to the impairment (including special or other), and use the code shown for that category.

Some examples are:

•

Diabetes mellitus, not severe, code 2500;
•

Essential hypertension, not severe, code 4010;
•

Chronic paranoid schizophrenia, severe, code 2950;
•

Grand mal epilepsy, severe, code 3450; and
•

Degenerative disc disease, L5-S1, severe, code 7240.

Impairment Codes	Diagnostic Categories
Musculoskeletal Disorders (01)
7150	Osteoarthrosis and Allied Disorders
7160	Other and Unspecified Arthropathies
7210	Lumbar Spinal Stenosis
7240	Disorders of the Skeletal Spine
3210	Arachnoiditis
7280	Disorders of Muscle, Ligament and Fascia
7300	Osteomyelitis, Periostitis and Other Infections Involving Bone
7330	Pathologic Fractures
7370	Curvature of Spine
7540	Musculoskeletal Disorders of Infants and Toddlers
8030	Fracture of Skull Without Intracranial Injury
8060	Fracture of Vertebral Column with Spinal Cord Lesion
8180	Fractures of Upper Limb
8270	Fractures of Lower Limb
8290	Other Fractures of Bones
8390	Dislocations--All Types
8480	Sprains and Strains--All Types
8840	Soft Tissue Injury of Upper Extremity
8940	Soft Tissue Injury of Lower Extremity
9050	Amputation Due to Any Cause
9490	Burns (NOS)
Special Senses and Speech (02)
3610	Retinal Detachments and Defects
3620	Other Retinal Disorders (Including Diabetic Retinopathy)
3650	Glaucoma
3660	Cataract
3680	Visual Disturbances
3690	Low Vision
3780	Strabismus and Other Disorders of Eye Movements
3860	Vertiginous Syndromes and Other Disorders of Vestibular System
3880	Other Disorders of Ear
3890	Hearing Loss
7840	Loss of Voice
Respiratory Disorders (03)
0110	Pulmonary Tuberculosis
1170	Mycotic (Fungus) Infections
1350	Sarcoidosis
1360	Other Infectious and Parasitic Disorders
2770	Disorders of Metabolism (Cystic Fibrosis)
3250	Lung Transplant
4160	Chronic Pulmonary Hypertension Due to Any Cause
4910	Chronic Bronchitis
4920	Emphysema
4930	Asthma
4940	Bronchiectasis
4960	Chronic Respiratory Disorders
5010	Asbestosis
5050	Pneumoconiosis
5180	Respiratory Failure
5190	Other Disorders of the Respiratory System
7860	Growth Failure Due to Any Chronic Respiratory Disorder
Cardiovascular System (04)
0930	Cardiovascular Syphilis
3910	Rheumatic Fever with Heart Involvement
3950	Diseases of Aortic Valve
3980	Other Rheumatic Heart Disease
4010	Essential Hypertension
4020	Hypertensive Vascular Disease
4030	Hypertensive Vascular and Renal Disease
4100	Acute Myocardial Infarction
4130	Angina Pectoris Without Ischemic Heart Disease
4140	Chronic Ischemic Heart Disease With or Without Angina
4160	Chronic Pulmonary Heart Disease (Cor Pulmonale)
4240	Valvular Heart Disease or Other Stenotic Defects, or Valvular Regurgitation
4250	Cardiomyopathy
4270	Cardiac Dysrhythmias
4280	Heart Failure
4410	Aortic Aneurysm
4430	Peripheral Vascular (Arterial) Disease
4510	Phlebitis and Thrombophlebitis
4540	Varicose Veins of Lower Extremities
4590	Other Diseases of Circulatory System
7460	Congenital Anomalies of Heart
7850	Growth Failure Due to Any Chronic Respiratory Disorder
Digestive System (05)
1360	Other Infectious and Parasitic Disorders
2630	Growth Failure Due to Any Digestive Disorder
4750	Liver Transplantation
5300	Diseases of Esophagus
5330	Peptic Ulcer (Gastric or Duodenal)
5350	Gastritis and Duodenitis
5530	Hernias
5550	Inflammatory Bowel Disease (IBD)
5690	Other Disorders of Gastrointestinal System
5710	Chronic Liver Disease
5780	Gastrointestinal Hemorrhage
5793	Short Bowel Syndrome (SBS)
5799	Need for supplemental daily enteral feeding via a gastrostomy
7500	Congenital Anomalies of Upper Alimentary Tract
Genitourinary System (06)
5810	Nephrotic Syndrome
5830	Complications of Chronic Kidney Disease
5850	Chronic Kidney Disease with Dialysis
5880	Chronic Kidney Disease
5950	Interstitial Cystitis
5990	Other Disorders of the Urinary Tract
6080	Disorders of the Male Genital Organs
6290	Disorders of the Female Genital Organs
7530	Congenital Anomalies of Urinary System
7880	Growth Failure Due to Any Chronic Renal Disease
9960	Kidney Transplant
Hematological Disorders (07)
2820	Hemolytic Anemias (Including Sickle Cell, Thalassemia, and Variants)
2840	Hematological Disorders with BM/SC Transplantation
2860	Thrombosis and Hemostasis Disorder (Including Hemophilia)
2890	Bone Marrow Failure (Including Myelofibrosis and Granulocytopenia)
Skin Disorders (08)
1170	Chronic Infections of the Skin or Mucous Membranes
6940	Bullous Disease
6950	Ichthyosis
6960	Dermatitis
7050	Hidradenitis Suppurativa
7090	Other Disorders of the Skin and Subcutaneous Tissues
7590	Genetic Photosensitivity Disorders
9480	Burns
Endocrine Disorders (09)
2460	All Disorders of Thyroid (Except Malignant Neoplasm)
2500	Diabetes Mellitus
2520	All Disorders of Parathyroid Gland (Except Malignant Neoplasm)
2530	All Disorders of Pituitary Gland (Except Malignant Neoplasm)
2550	All Disorders of Adrenal Glands (Except Malignant Neoplasm)
Congenital Disorders That Affect Multiple Body Systems (10)
3300	Cerebral Degenerations Usually Manifest in Childhood
7400	Anencephalus and Catastrophic Congenital Abnormality or Disease
7580	Non-Mosaic Down Syndrome
Neurological Disorders (11)
1380	Post-Polio Syndrome
2250	Benign Neoplasm of Brain and Other Parts of Nervous System
3300	Cerebral Degenerations Usually Manifest in Childhood
3310	Other Cerebral Degenerations
3320	Parkinson's Disease
3330	Huntington Disease
3350	Amyotrophic Lateral Sclerosis
3358	Motor Neuron Disorders Other than ALS
3360	Spinal Cord Disorders
3370	Disorders of Autonomic Nervous System
3400	Multiple Sclerosis
3430	Cerebral Palsy
3450	Epilepsy
3460	Migraine
3480	Coma or Persistent Vegetative State
3490	Other Disorders of the Nervous System
3540	Carpal Tunnel Syndrome
3570	Peripheral Neuropathy
3580	Myoneural Disorders
3590	Muscular Dystrophies and Other Myopathies
4380	Vascular Insult to the Brain
7410	Spina Bifida (Meningomyelocele)
7840	Loss of Voice (Communication Impairment)
8060	Fracture of Vertebral Column with Spinal Cord Lesion
8540	Traumatic Brain Injury
9070	Late Effects of Injuries to the Nervous System
Mental Disorders (12)
2940	Neurocognitive Disorders
2950	Schizophrenia Spectrum and Other Psychotic Disorders
2960	Depression, Bipolar and Related Disorders
2990	Autism Spectrum Disorders
3000	Anxiety and Obsessive-Compulsive Disorders
3010	Personality Disorders
3030	Substance Addiction Disorders (Alcohol)
3040	Substance Addiction Disorders (Drugs)
3060	Somatic Symptom and Related Disorders
3070	Eating Disorders
3090	Trauma- and Stressor-Related Disorders
3120	Impulse Control Disorders
3138	Oppositional/Defiant Disorder
3140	Attention Deficit/Hyperactivity Disorder
3150	Developmental Disorders in Infants and Toddlers
3152	Learning Disorder
3153	Speech and Language Impairment
3180	Intellectual Disorder
3195	Borderline Intellectual Functioning
7810	Tic Disorders
Cancer (13)
0420	Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation
1410	Malignant Neoplasm of Tongue
1420	Malignant Neoplasm of Salivary Glands
1500	Malignant Neoplasm of Esophagus
1510	Malignant Neoplasm of Stomach
1520	Malignant Neoplasm of Small Intestine, Including Duodenum
1530	Malignant Neoplasm of Colon, Rectum or Anus
1550	Malignant Neoplasm of Liver and Intrahepatic Bile Ducts
1560	Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts
1570	Malignant Neoplasm of Pancreas
1590	Malignant Neoplasm of Other and Ill-Defined Sites Within the Digestive Organs and Peritoneum (Abdomen)
1620	Malignant Neoplasm of Trachea, Bronchus, or Lung
1630	Malignant Neoplasm of Pleura
1640	Malignant Neoplasm of Mediastinum
1700	Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa
1710	Malignant Neoplasm of Connective and Other Soft Tissue
1720	Malignant Melanoma
1730	Malignant Neoplasm of Skin
1740	Malignant Neoplasm of Breast
1780	Malignant Neoplasm of Skeletal System
1790	Malignant Neoplasm of Uterus
1830	Malignant Neoplasm of Ovary and Other Uterine Adnexa
1840	Malignant Neoplasm of Vulva or Vagina
1850	Malignant Neoplasm of Prostate
1860	Malignant Neoplasm of Testis
1870	Malignant Neoplasm of Penis
1880	Malignant Neoplasm of Bladder
1890	Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters
1900	Malignant Neoplasm of Eye
1910	Malignant Neoplasm of Nervous System
1920	Neuroblastoma
1930	Malignant Neoplasm of Thyroid Gland
1940	Malignant Neoplasm of Other Endocrine Glands and Related Structures
1950	Soft Tissue Tumors of Head and Neck
1980	Secondary Malignant Neoplasms (Metastatic Neoplasms of Distant Sites Other Than Regional Lymph Nodes)
1990	Malignant Neoplasms of Unspecified Site
2020	Lymphoma
2030	Multiple Myeloma
2070	Leukemia
2390	Neoplasm of Unspecified or Unknown Nature
2730	Macroglobulinemia or Heavy Chain Disease
Immune System Disorders (14)
2790	Immune Deficiency Disorders, Excluding HIV Infection)
4460	Periarteritis Nodosa and Allied Conditions (Systemic Vasculitis)
7100	Diffuse Diseases of Connective Tissue (Including Systemic Lupus Erythematosus, Systemic Sclerosis (Scleroderma), Polymyositis and Dermatomyositis, Undifferentiated and Mixed Connective Tissue Disease, Sjögren’s Syndrome)
0430	Symptomatic Human Immunodeficiency Virus (HIV) Infection
0440	Asymptomatic Human Immunodeficiency Virus (HIV) Infection
2740	Gout
7140	Inflammatory Arthritis
7200	Ankylosing Spondylitis and Other Inflammatory Spondyloarthropathies
Low Birth Weight (LBW) and Failure to Thrive (FTT) (19)
7649	Low Birth Weight – Weight 1200 - 2000 grams.
7650	Low Birth Weight – Weight Under 1200 grams.
7830	Failure to Thrive
Special/Other (20)
0000	None Established (No Medical Evidence in File)
6490	None Established (Medical Evidence in File But Insufficient to Establish Diagnosis)
2480	Diagnosis Established--No Predetermined List Code of Medical Nature Applicable
2780	Obesity and Other Hyperalimentation
7290	Fibromyalgia
7590	Other Congenital Anomalies
8690	Internal Injury
8790	Other Open Wounds, Except Limbs
9330	Chronic Fatigue Syndrome (CFS)

4. Symptomatic HIV infection and secondary diagnosis impairment codes

Whenever symptomatic HIV (code 0430) is the primary diagnosis, the secondary diagnosis should be the manifestation of HIV. First, try to select the most appropriate code from the following list as the secondary diagnosis code. Only if the manifestation of HIV is not included in this list, should you select the most appropriate code from the General List of Impairment Codes:

Diagnosis	Impairment Code
Absolute CD4 Count 50 or Less	7950
Anemia	2850
Aspergillosis	1170
Bacterial infections, multiple or recurrent	0410
Bone infection	7300
Brain atrophy	3310
Candidiasis	1120
Carcinoma of the Cervix	1800
Cardiomyopathy	4250
Coccidioidomycosis	1140
Condyloma caused by the human papillomavirus	0780
Cryptococcosis	1170
Cryptosporidiosis	0070
Cytomegalovirus Disease	0780
Diarrhea	5580
Eczema	6920
Endocarditis	4240
Genital ulcerative disease, female	6290
Genital ulcerative disease, male	6080
Granulocytopenia	2880
Immune Suppression and Growth Failure	7830
Hepatitis	5730
Herpes Simplex	0540
Herpes Zoster	0530
Histoplasmosis	1150
HIV encephalopathy	3480
HIV wasting syndrome	2630
Impaired brain growth	7420
Isosporiasis	0070
Joint infection	7110
Kaposi Sarcoma	1760
Leukoencephalopathy	0460
Lymphoid interstitial pneumonia (LIP)	5160
Lymphoma	2000
Meningitis	3220
Microcephaly	7420
Microsporidiosis	1360
Mucormycosis	1170
Multicentric Castleman Disease	2380
Mycobacterial infection, avium intracellulare, caused by M. Kansasii, or M. tuberculosis (except pulmonary tuberculosis)	0310
Nephropathy	5830
Neurological conditions	3490
Neurosyphilis	0940
Nocardiosis	0390
Pancreatitis	5770
Pelvic inflammatory disease	6140
Peripheral neuropathy	3560
Pneumocystis infection, extrapulmonary	1360
Pneumocystis Pneumonia (PCP)	1360
Pneumonia (non-PCP)	4860
Psoriasis	6960
Pulmonary Lymphoid Hyperplasia (PLH)	2850
Pulmonary Tuberculosis	0110
Salmonella Bacteremia	0030
Sepsis	0380
Septic Arthritis	7110
Sinusitis	4730
Squamous Cell Carcinoma of the Anal Canal or Anal Margin	1540
Strongyloidiasis	1270
Syphilis	0970
Thrombocytopenia	2870
Toxoplasmosis	1300
Vulvovaginal Candida	1120

5. Impairment codes in numeric sequence

Use the following list when looking for the diagnosis connected to a particular impairment code.

Impairment Code	Body System	Diagnostic Categories
0000	20	None Established (No Medical Evidence in File)
0030	14	Salmonella Bacteremia (Secondary Diagnosis for HIV-0430)
0070	14	Cryptosporidiosis (Secondary Diagnosis for HIV-0430)
0070	14	Isosporiasis (Secondary Diagnosis for HIV-0430)
0110	03	Pulmonary Tuberculosis
0310	14	Mycobacterium infection avium intracellulare, caused by M. Kansasii, or M. tuberculosis (except pulmonary tuberculosis) (Secondary Diagnosis for HIV-0430)
0380	14	Sepsis (Secondary Diagnosis for HIV-0430)
0390	14	Nocardiasis (Secondary Diagnosis for HIV-0430)
0410	14	Bacterial Infections, Multiple or Recurrent (Secondary Diagnosis for HIV-0430)
0420	13	Malignant Neoplasm Treated by Bone Marrow or Stem Cell Transplantation
0430	14	Symptomatic Human Immunodeficiency Virus (HIV) Infection
0440	14	Asymptomatic Human Immunodeficiency Virus (HIV) Infection
0460	14	Leukoencephalopathy (Secondary Diagnosis for HIV-0430)
0530	14	Herpes Zoster (Secondary Diagnosis for HIV-0430)
0540	14	Herpes Simplex (Secondary Diagnosis for HIV-0430)
0780	14	Condyloma Caused by the Human Papillomavirus (Secondary Diagnosis for HIV-0430)
0780	14	Cytomegalovirus Disease (Secondary Diagnosis for HIV-0430)
0930	04	Cardiovascular Syphilis
0940	14	Neurosyphilis (Secondary Diagnosis for HIV-0430)
0970	14	Syphilis (Secondary Diagnosis for HIV-0430)
1120	14	Candidiasis (Secondary Diagnosis for HIV-0430)
1120	14	Vulvovaginal Candida (Secondary Diagnosis for HIV-0430)
1140	14	Coccidiodomycosis (Secondary Diagnosis for HIV-0430)
1150	14	Histoplasmosis (Secondary Diagnosis for HIV-0430)
1170	03	Mycobacterial, Mycotic and Other Chronic Infections of the Lung
1170	08	Chronic Infections of the Skin or Mucous Membranes
1170	14	Aspergillosis (Secondary Diagnosis for HIV-0430)
1170	14	Cryptococcosis (Secondary Diagnosis for HIV-0430)
1170	14	Mucormycosis (Secondary Diagnosis for HIV-0430)
1270	14	Strongyloidiasis (Secondary Diagnosis for HIV-0430)
1300	14	Toxoplasmosis (Secondary Diagnosis for HIV-0430)
1350	03	Sarcoidosis
1360	05	Other Infectious and Parasitic Disorders
1360	14	Micro-Sporidiosis (Secondary Diagnosis for HIV-0430)
1360	14	Pneumocystis Infection, extra-pulmonary (Secondary Diagnosis for HIV-0430)
1360	14	Pneumocystis Pneumonia (PCP) (Secondary Diagnosis for HIV-0430)
1380	11	Post-Polio Syndrome
1410	13	Malignant Neoplasm of Tongue
1420	13	Malignant Neoplasm of Salivary Glands
1500	13	Malignant Neoplasm of Esophagus
1510	13	Malignant Neoplasm of Stomach
1520	13	Malignant Neoplasm of Small Intestine, Including Duodenum
1530	13	Malignant Neoplasm of Colon, Rectum or Anus
1540	14	Squamous Cell Carcinoma of the Anal Canal or Anal Margin (Secondary Diagnosis for HIV-0430)
1550	13	Malignant Neoplasm of Liver and Intrahepatic Bile Ducts
1560	13	Malignant Neoplasm of Gallbladder and Extrahepatic Bile Ducts
1570	13	Malignant Neoplasm of Pancreas
1590	13	Malignant Neoplasm of Other and Ill-Defined Sites Within the Digestive Organs and Peritoneum (Abdomen)
1620	13	Malignant Neoplasm of Trachea, Bronchus, or Lung
1630	13	Malignant Neoplasm of Pleura
1640	13	Malignant Neoplasm of Mediastinum
1700	13	Malignant Neoplasm of Maxilla, Orbit, or Temporal Fossa
1710	13	Malignant Neoplasm of Connective and Other Soft Tissue
1720	13	Malignant Melanoma
1730	13	Malignant Neoplasm of Skin
1740	13	Malignant Neoplasm of Breast
1760	14	Kaposi’s Sarcoma (Secondary Diagnosis for HIV-0430)
1780	13	Malignant Neoplasm of Skeletal System
1790	13	Malignant Neoplasm of Uterus
1800	14	Carcinoma of the Cervix (Secondary Diagnosis for HIV-0430)
1830	13	Malignant Neoplasm of Ovary and Other Uterine Adnexa
1840	13	Malignant Neoplasm of Vulva or Vagina
1850	13	Malignant Neoplasm of Prostate
1860	13	Malignant Neoplasm of Testis
1870	13	Malignant Neoplasm of Penis
1880	13	Malignant Neoplasm of Bladder
1890	13	Malignant Neoplasm of Kidney, Adrenal Glands, or Ureters
1900	13	Malignant Neoplasm of Eye
1910	13	Malignant Neoplasm of Nervous System
1920	13	Neuroblastoma
1930	13	Malignant Neoplasm of Thyroid Gland
1940	13	Malignant Neoplasm of Other Endocrine Glands and Related Structures
1950	13	Soft Tissue Tumors of Head and Neck
1980	13	Secondary Malignant Neoplasms (Metastatic Neoplasms of Distant Sites Other Than Regional Lymph Nodes)
1990	13	Malignant Neoplasm of Unspecified Site
2000	14	Lymphoma (Secondary Diagnosis for HIV-0430)
2020	13	Lymphoma
2030	13	Multiple Myeloma
2070	13	Leukemia
2250	11	Benign Neoplasm of Brain and Other Parts of Nervous System
2380	14	Multicentric Castleman Disease (Secondary Diagnosis for HIV-0430)
2390	13	Neoplasm of Unspecified or Unknown Nature
2460	09	All Disorders of Thyroid Gland (Except Malignant Neoplasm)
2480	20	Diagnosis Established--No Predetermined List Code of Medical Nature Applicable
2500	09	Diabetes Mellitus
2520	09	All Disorders of Parathyroid Gland (Except Malignant Neoplasm)
2530	09	All Disorders of the Pituitary Gland (Except Malignant Neoplasm)
2550	09	All Disorders of Adrenal Glands (Except Malignant Neoplasm)
2630	05	Growth Failure Due to Any Digestive Disorder.
2630	14	HIV Wasting Syndrome (Secondary Diagnosis for HIV-0430)
2720	04	Hyperlipidemia
2730	13	Macroglobulinemia or Heavy Chain Disease
2740	14	Gout
2770	03	Cystic Fibrosis
2780	20	Obesity
2820	07	Hemolytic Anemias (Including Sickle Cell Thalassemia, and Variants)
2840	07	Hematological Disorders with BM/SC Transplantation.
2850	14	Anemia (Secondary Diagnosis for HIV-0430)
2850	14	Pulmonary Lymphoid Hyperplasia (PLH) (Secondary Diagnosis for HIV-0430)
2860	07	Thrombosis and Hemostasis Disorder (Including Hemophilia)
2870	14	Thrombocytopenia (Secondary Diagnosis for HIV-0430)
2880	14	Granulocytopenia (Secondary Diagnosis for HIV-0430)
2890	07	Bone Marrow Failure (Including Myelofibrosis and Granulocytopenia)
2940	12	Neurocognitive Disorders
2950	12	Schizophrenia Spectrum and Other Psychotic Disorders
2960	12	Depression, Bipolar and Related Disorders
2990	12	Autism Spectrum Disorders
3000	12	Anxiety and Obsessive-Compulsive Disorders
3010	12	Personality Disorders
3030	12	Substance Addiction Disorders (Alcohol)
3040	12	Substance Addiction Disorders (Drugs)
3060	12	Somatic Symptom and Related Disorders
3070	12	Eating Disorders
3090	12	Trauma- and Stressor-Related Disorders
3120	12	Impulse Control Disorders
3138	12	Oppositional/Defiant Disorder
3140	12	Attention Deficit/Hyperactivity Disorder
3150	12	Developmental Disorders in Infants and Toddlers
3152	12	Learning Disorder
3153	12	Speech and Language Impairment
3180	12	Intellectual Disorder
3195	12	Borderline Intellectual Functioning
3210	01	Arachnoiditis
3220	14	Meningitis (Secondary Diagnosis for HIV-0430)
3250	03	Lung Transplant
3300	10	Cerebral Degenerations Usually Manifest in Childhood
3300	11	Cerebral Degenerations Usually Manifest in Childhood
3310	11	Other Cerebral Degenerations
3310	14	Brain Atrophy (Secondary Diagnosis for HIV-0430)
3320	11	Parkinson’s Disease
3330	11	Huntington Disease
3350	11	Amyotrophic Lateral Sclerosis
3358	11	Motor Neuron Disorders Other than ALS
3360	11	Spinal Cord Disorders
3370	11	Disorders of Autonomic Nervous System
3400	11	Multiple Sclerosis
3430	11	Cerebral Palsy
3450	11	Epilepsy
3460	11	Migraine
3480	11	Coma or Persistent Vegetative State
3480	14	HIV Encephalopathy (Secondary Diagnosis for HIV-0430)
3490	11	Other Disorders of the Nervous System
	14	Neurological Conditions (Secondary Diagnosis for HIV-0430)
3540	11	Carpal Tunnel Syndrome
3560	14	Peripheral Neuropathy (Secondary Diagnosis for HIV-0430)
3570	11	Peripheral Neuropathy
3580	11	Myoneural Disorders
3590	11	Muscular Dystrophies and Other Myopathies
3610	02	Retinal Detachments and Defects
3620	02	Other Retinal Disorders (Including Diabetic Retinopathy)
3650	02	Glaucoma
3660	02	Cataract
3680	02	Visual Disturbances
3690	02	Low Vision
3694	02	Statutory Blindness
3750	04	Cardiac Transplantation
3780	02	Strabismus and Other Disorders of Eye Movements
3860	02	Vertiginous Syndromes and Other Disorders of Vestibular System
3880	02	Other Disorders of Ear
3890	02	Hearing Loss
3910	04	Rheumatic Fever with Heart Involvement
3950	04	Diseases of Aortic Valve
3980	04	Other Rheumatic Heart Disease
4010	04	Essential Hypertension
4020	04	Hypertensive Cardiovascular Disease
4030	04	Hypertensive Vascular and Renal Disease
4100	04	Acute Myocardial Infarction
4130	04	Angina Pectoris Without Ischemic Heart Disease
4140	04	Chronic Ischemic Heart Disease With or Without Angina
4160	03	Chronic Pulmonary Hypertension Due to Any Cause
4160	04	Chronic Pulmonary Heart Disease (Cor Pulmonale)
4240	04	Valvular Heart Disease or Other Stenotic Defects or Valvular Regurgitation
4240	14	Endocarditis (Secondary Diagnosis for HIV-0430)
4250	04	Cardiomyopathy
4270	04	Cardiac Dysrhythmias (Arrhythmias)
4280	04	Heart Failure
4380	11	Vascular Insult to the Brain
4410	04	Aneurysm of Aorta or Major Branches
4430	04	Peripheral Vascular (Arterial) Disease
4460	04	Kawasaki Syndrome
4460	14	Periarteritis Nodosa and Allied Conditions (Systemic Vasculitis)
4510	04	Phlebitis and Thrombophlebitis
4540	04	Varicose Veins of Lower Extremities
4590	04	Other Diseases of Circulatory System (Venous Insufficiency)
4730	14	Sinusitis (Secondary Diagnosis for HIV-0430)
4750	05	Liver Transplant
4860	14	Pneumonia (non-PCP) (Secondary Diagnosis for HIV-0430)
4910	03	Chronic Bronchitis
4920	03	Emphysema
4930	03	Asthma
4940	03	Bronchiectasis
4960	03	Chronic Respiratory Disorders
5010	03	Asbestosis
5050	03	Pneumoconiosis
5160	14	Lymphoid Interstitial Pneumonia (LIP) (Secondary Diagnosis for HIV-0430)
5180	03	Respiratory Failure
5190	03	Other Disorders of the Respiratory System
5300	05	Diseases of Esophagus
5330	05	Peptic Ulcer (Gastric or Duodenal)
5350	05	Gastritis and Duodenitis
5530	05	Hernias
5550	05	Inflammatory Bowel Disease (IBD)
5580	14	Diarrhea (Secondary Diagnosis for HIV-0430)
5690	05	Other Disorders of Gastrointestinal System
5710	05	Chronic Liver Disease
5730	14	Hepatitis (Secondary Diagnosis for HIV-0430)
5770	14	Pancreatitis (Secondary Diagnosis for HIV-0430)
5780	05	Gastrointestinal hemorrhaging from any cause
5793	05	Short Bowel Syndrome (SBS)
5799	05	Need for supplemental daily enteral feeding via gastrostomy
5810	06	Nephrotic Syndrome
5830	14	Nephropathy (Secondary Diagnosis for HIV-0430)
5830	06	Complications of Chronic Kidney Disease
5850	06	Chronic Kidney Disease with Dialysis
5880	06	Chronic Kidney Disease
5950	06	Interstitial Cystitis
5990	06	Other Disorders of the Urinary Tract
6080	06	Disorders of the Male Genital Organs
6080	14	Genital Ulcerative Disease, Male (Secondary Diagnosis for HIV-0430)
6140	14	Pelvic Inflammatory Disease (Secondary Diagnosis for HIV-0430)
6290	06	Disorders of the Female Genital Organs
6290	14	Genital Ulcerative Disease, Female (Secondary Diagnosis for HIV-0430)
6490	20	None Established (Medical Evidence in File But Insufficient to Establish Diagnosis)
6920	14	Eczema (Secondary Diagnosis for HIV-0430)
6940	08	Bullous Disease
6950	08	Ichthyosis
6960	08	Dermatitis
6960	14	Psoriasis (Secondary Diagnosis for HIV-0430)
7050	08	Hidradenitis Suppurativa
7090	08	Other Disorders of the Skin and Subcutaneous Tissues
7100	14	Diffuse Diseases of Connective Tissue (including Systemic Lupus Erythematosus, Systemic Sclerosis (Scleroderma), Polymyositis and Dermatomyositis, Undifferentiated and Mixed Connective Tissue Disease, Sjögren's Syndrome)
7110	14	Joint Infection (Secondary Diagnosis for HIV-0430)
7110	14	Septic Arthritis (Secondary Diagnosis for HIV-0430)
7140	14	Inflammatory Arthritis
7150	01	Osteoarthrosis and Allied Disorders
7160	01	Other and Unspecified Arthropathies
7200	14	Ankylosing Spondylitis or Other Spondyloarthropathies
7210	01	Lumbar Spinal Stenosis
7240	01	Disorders of the Skeletal Spine
7280	01	Disorders of Muscle, Ligament and Fascia
7290	20	Fibromyalgia
7300	01	Osteomyelitis, Periostitis and Other Infections Involving Bone
7300	14	Bone Infection (Secondary Diagnosis for HIV-0430)
7330	01	Pathologic Fractures
7370	01	Curvature of Spine
7400	10	Anencephalus and Catastrophic Congenital Abnormality or Disease
7410	11	Spina Bifida (Meningomyelocele)
7420	14	Impaired Brain Growth (Secondary Diagnosis for HIV-0430)
7420	14	Microcephaly (Secondary Diagnosis for HIV-0430)
7460	04	Congenital Heart Disease
7500	05	Congenital Anomalies of Upper Alimentary Tract
7530	06	Congenital Anomalies of Urinary System
7540	01	Musculoskeletal Disorders of Infants and Toddlers
7580	10	Down Syndrome (Excluding Mosaic Down Syndrome)
7590	08	Genetic Photosensitivity Disorders
7590	20	Other Congenital Anomalies
7649	19	Low Birth Weight - Weight 1200 - 2000 grams
7650	19	Low Birth Weight – Weight Under 1200 grams
7800	03	Sleep-Related Breathing Disorders
7810	12	Tic Disorders
7830	14	Immune Suppression and Growth Failure (Secondary Diagnosis for HIV-0430)
7830	19	Failure to Thrive (Growth Disorders)
7840	02	Loss of Voice
7840	11	Loss of Voice (Communication Impairment)
7850	04	Growth Failure Due to Any Chronic Cardiovascular Disorder
7860	03	Growth Failure Due to Any Chronic Respiratory Disorder
7880	06	Growth Failure Due to Any Chronic Renal Disease
7950	14	Absolute CD4 Count 50 or Less (Secondary Diagnosis for HIV-0430
8030	01	Fracture of Skull Without Intracranial Injury
8060	01	Fracture of Vertebral Column with Spinal Cord Lesion
8060	11	Fracture of Vertebral Column with Spinal Cord Lesion
8180	01	Fractures of Upper Limb
8270	01	Fractures of Lower Limb
8290	01	Other Fractures of Bones
8390	01	Dislocations--All Types
8480	01	Sprains and Strains--All Types
8540	11	Traumatic Brain Injury
8690	20	Internal Injury
8790	20	Other Open Wounds, Except Limbs
8840	01	Soft Tissue Injury of Upper Extremity
8940	01	Soft Tissue Injury of Lower Extremity
9050	01	Amputation Due to Any Cause
9070	11	Late Effects of Injuries to the Nervous System
9330	20	Chronic Fatigue Syndrome (CFS)
9480	08	Burns
9490	01	Burns (NOS)
9960	06	Kidney Transplant

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0426510015

DI 26510.015 - Completing Item 16A and 16B (Primary and Secondary Diagnosis, Body System Code, and Impairment Code) on the SSA-831 Disability Determination and Transmittal - 10/05/2021
Batch run: 10/05/2021
Rev:10/05/2021

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