Code List: CMS66v5, Functional Status Assessment for Total Knee Replacement

MicroMD uses the following code lists to determine a patient’s inclusion in this measure. To search for your code, simply press Ctrl + F on your keyboard, enter your code in the search field and press Enter on your keyboard.

Item	Codes
Encounter Codes
Encounter, Performed: Face-to-Face Interaction: SNOMED	12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 87790002, 90526000
Encounter, Performed: Office Visit: CPT	99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Encounter, Performed: Outpatient Consultation: CPT	99241, 99242, 99243, 99244, 99245
Encounter, Performed: Postoperative Visit: CPT	99024
Knee Replacement Procedure Codes
Procedure, Performed: Primary TKA Procedure: CPT	27447
Procedure, Performed: Primary TKA Procedure: SNOMED	Primary cemented total knee replacement (procedure), Conversion to cemented total knee replacement (procedure), Primary uncemented total knee replacement (procedure), Conversion to uncemented total knee replacement (procedure), Total prosthetic replacement of knee joint using cement (procedure), Total prosthetic replacement of knee joint not using cement (procedure), Total arthroplasty of knee, geomedic or polycentric (procedure), Replacement of total knee joint (procedure), Total replacement of left knee joint (procedure), Total replacement of right knee joint (procedure). 179344006, 179345007, 179351002, 179352009, 265170009, 265172001, 392237008, 430698003, 443681002, 443682009
Functional Status Codes
Functional Status, Result: Functional Status Assessment for Knee Replacement: LOINC	71955-9, 71956-7, 71957-5, 71958-3, 71959-1, 71960-9, 71961-7, 71962-5, 71963-3, 71964-1, 71965-8, 71966-6, 71967-4, 71968-2, 71969-0, 71970-8, 71971-6, 71972-4, 71973-2, 71974-0, 71975-7, 71976-5, 71977-3, 71978-1, 71979-9, 71980-7, 71981-5, 71982-3, 71983-1, 71984-9, 71985-6, 71986-4, 71987-2, 71988-0, 71989-8, 71990-6, 71991-4, 71992-2, 71993-0, 71994-8, 71995-5, 71996-3, 71997-1, 71998-9, 71999-7, 72000-3, 72001-1, 72002-9, 72003-7, 72004-5, 72005-2, 72006-0, 72007-8, 72008-6, 72009-4, 72010-2, 72011-0, 72012-8, 72013-6, 72014-4, 72015-1, 72016-9, 72017-7, 72018-5, 72019-3, 72020-1, 72021-9, 72022-7, 72023-5, 72024-3, 72025-0, 72026-8, 72027-6, 72028-4, 72098-7, 72099-5, 72100-1, 72101-9, 72102-7
Exclusion Diagnosis Codes
Diagnosis: Fracture – Lower Body: ICD-9	808.0, 808.1, 808.2, 808.3, 808.41, 808.42, 808.43, 808.44, 808.49, 808.51, 808.52, 808.53, 808.54, 808.59, 808.8, 808.9, 820.00, 820.01, 820.02, 820.03, 820.09, 820.10, 820.11, 820.12, 820.13, 820.19, 820.20, 820.21, 820.22, 820.30, 820.31, 820.32, 820.8, 820.9, 821.00, 821.01, 821.10, 821.11, 821.20, 821.21, 821.22, 821.23, 821.29, 821.30, 821.31, 821.32, 821.33, 821.39, 822.0, 822.1, 823.00, 823.01, 823.02, 823.10, 823.11, 823.12, 823.20, 823.21, 823.22, 823.30, 823.31, 823.32, 823.40, 823.41, 823.42, 823.80, 823.81, 823.82, 823.90, 823.91, 823.92
Diagnosis: Fracture – Lower Body: ICD-10	M97.01XA, M97.01XD, M97.01XS, M97.02XA, M97.02XD, M97.02XS, M97.11XA, M97.11XD, M97.11XS, M97.12XA, M97.12XD, M97.12XS, M97.21XA, M97.21XD, M97.21XS, M97.22XA, M97.22XD, M97.22XS, M97.31XA, M97.31XD, M97.31XS, M97.32XA, M97.32XD, M97.32XS, M97.41XA, M97.41XD, M97.41XS, M97.42XA, M97.42XD, M97.42XS, S32.301A, S32.301B, S32.301D, S32.301G, S32.301K, S32.301S, S32.302A, S32.302B, S32.302D, S32.302G, S32.302K, S32.302S, S32.309A, S32.309B, S32.309D, S32.309G, S32.309K, S32.309S, S32.311A, S32.311B, S32.311D, S32.311G, S32.311K, S32.311S, S32.312A, S32.312B, S32.312D, S32.312G, S32.312K, S32.312S, S32.313A, S32.313B, S32.313D, S32.313G, S32.313K, S32.313S, S32.314A, S32.314B, S32.314D, S32.314G, S32.314K, S32.314S, S32.315A, S32.315B, S32.315D, S32.315G, S32.315K, S32.315S, S32.316A, S32.316B, S32.316D, S32.316G, S32.316K, S32.316S, S32.391A, S32.391B, S32.391D, S32.391G, S32.391K, S32.391S, S32.392A, S32.392B, S32.392D, S32.392G, S32.392K, S32.392S, S32.399A, S32.399B, S32.399D, S32.399G, S32.399K, S32.399S, S32.401A, S32.401B, S32.401D, S32.401G, S32.401K, S32.401S, S32.402A, S32.402B, S32.402D, S32.402G, S32.402K, S32.402S, S32.409A, S32.409B, S32.409D, S32.409G, S32.409K, S32.409S, S32.411A, S32.411B, S32.411D, S32.411G, S32.411K, S32.411S, S32.412A, S32.412B, S32.412D, S32.412G, S32.412K, S32.412S, S32.413A, S32.413B, S32.413D, S32.413G, S32.413K, S32.413S, S32.414A, S32.414B, S32.414D, S32.414G, S32.414K, S32.414S, S32.415A, S32.415B, S32.415D, S32.415G, S32.415K, S32.415S, S32.416A, S32.416B, S32.416D, S32.416G, S32.416K, S32.416S, S32.421A, S32.421B, S32.421D, S32.421G, S32.421K, S32.421S, S32.422A, S32.422B, S32.422D, S32.422G, S32.422K, S32.422S, S32.423A, S32.423B, S32.423D, S32.423G, S32.423K, S32.423S, S32.424A, S32.424B, S32.424D, S32.424G, S32.424K, S32.424S, S32.425A, S32.425B, S32.425D, S32.425G, S32.425K, S32.425S, S32.426A, S32.426B, S32.426D, S32.426G, S32.426K, S32.426S, S32.431A, S32.431B, S32.431D, S32.431G, S32.431K, S32.431S, S32.432A, S32.432B, S32.432D, S32.432G, S32.432K, S32.432S, S32.433A, S32.433B, S32.433D, S32.433G, S32.433K, S32.433S, S32.434A, S32.434B, S32.434D, S32.434G, S32.434K, S32.434S, S32.435A, S32.435B, S32.435D, S32.435G, S32.435K, S32.435S, S32.436A, S32.436B, S32.436D, S32.436G, S32.436K, S32.436S, S32.441A, S32.441B, S32.441D, S32.441G, S32.441K, S32.441S, S32.442A, S32.442B, S32.442D, S32.442G, S32.442K, S32.442S, S32.443A, S32.443B, S32.443D, S32.443G, S32.443K, S32.443S, S32.444A, S32.444B, S32.444D, S32.444G, S32.444K, S32.444S, S32.445A, S32.445B, S32.445D, S32.445G, S32.445K, S32.445S, S32.446A, S32.446B, S32.446D, S32.446G, S32.446K, S32.446S, S32.451A, S32.451B, S32.451D, S32.451G, S32.451K, S32.451S, S32.452A, S32.452B, S32.452D, S32.452G, S32.452K, S32.452S, S32.453A, S32.453B, S32.453D, S32.453G, S32.453K, S32.453S, S32.454A, S32.454B, S32.454D, S32.454G, S32.454K, S32.454S, S32.455A, S32.455B, S32.455D, S32.455G, S32.455K, S32.455S, S32.456A, S32.456B, S32.456D, S32.456G, S32.456K, S32.456S, S32.461A, S32.461B, S32.461D, S32.461G, S32.461K, S32.461S, S32.462A, S32.462B, S32.462D, S32.462G, S32.462K, S32.462S, S32.463A, S32.463B, S32.463D, S32.463G, S32.463K, S32.463S, S32.464A, S32.464B, S32.464D, S32.464G, S32.464K, S32.464S, S32.465A, S32.465B, S32.465D, S32.465G, S32.465K, S32.465S, S32.466A, S32.466B, S32.466D, S32.466G, S32.466K, S32.466S, S32.471A, S32.471B, S32.471D, S32.471G, S32.471K, S32.471S, S32.472A, S32.472B, S32.472D, S32.472G, S32.472K, S32.472S, S32.473A, S32.473B, S32.473D, S32.473G, S32.473K, S32.473S, S32.474A, S32.474B, S32.474D, S32.474G, S32.474K, S32.474S, S32.475A, S32.475B, S32.475D, S32.475G, S32.475K, S32.475S, S32.476A, S32.476B, S32.476D, S32.476G, S32.476K, S32.476S, S32.481A, S32.481B, S32.481D, S32.481G, S32.481K, S32.481S, S32.482A, S32.482B, S32.482D, S32.482G, S32.482K, S32.482S, S32.483A, S32.483B, S32.483D, S32.483G, S32.483K, S32.483S, S32.484A, S32.484B, S32.484D, S32.484G, S32.484K, S32.484S, S32.485A, S32.485B, S32.485D, S32.485G, S32.485K, S32.485S, S32.486A, S32.486B, S32.486D, S32.486G, S32.486K, S32.486S, S32.491A, S32.491B, S32.491D, S32.491G, S32.491K, S32.491S, S32.492A, S32.492B, S32.492D, S32.492G, S32.492K, S32.492S, S32.499A, S32.499B, S32.499D, S32.499G, S32.499K, S32.499S, S32.501A, S32.501B, S32.501D, S32.501G, S32.501K, S32.501S, S32.502A, S32.502B, S32.502D, S32.502G, S32.502K, S32.502S, S32.509A, S32.509B, S32.509D, S32.509G, S32.509K, S32.509S, S32.511A, S32.511B, S32.511D, S32.511G, S32.511K, S32.511S, S32.512A, S32.512B, S32.512D, S32.512G, S32.512K, S32.512S, S32.519A, S32.519B, S32.519D, S32.519G, S32.519K, S32.519S, S32.591A, S32.591B, S32.591D, S32.591G, S32.591K, S32.591S, S32.592A, S32.592B, S32.592D, S32.592G, S32.592K, S32.592S, S32.599A, S32.599B, S32.599D, S32.599G, S32.599K, S32.599S, S32.601A, S32.601B, S32.601D, S32.601G, S32.601K, S32.601S, S32.602A, S32.602B, S32.602D, S32.602G, S32.602K, S32.602S, S32.609A, S32.609B, S32.609D, S32.609G, S32.609K, S32.609S, S32.611A, S32.611B, S32.611D, S32.611G, S32.611K, S32.611S, S32.612A, S32.612B, S32.612D, S32.612G, S32.612K, S32.612S, S32.613A, S32.613B, S32.613D, S32.613G, S32.613K, S32.613S, S32.614A, S32.614B, S32.614D, S32.614G, S32.614K, S32.614S, S32.615A, S32.615B, S32.615D, S32.615G, S32.615K, S32.615S, S32.616A, S32.616B, S32.616D, S32.616G, S32.616K, S32.616S, S32.691A, S32.691B, S32.691D, S32.691G, S32.691K, S32.691S, S32.692A, S32.692B, S32.692D, S32.692G, S32.692K, S32.692S, S32.699A, S32.699B, S32.699D, S32.699G, S32.699K, S32.699S, S32.89XA, S32.89XB, S32.89XD, S32.89XG, S32.89XK, S32.89XS, S32.9XXA, S32.9XXB, S32.9XXD, S32.9XXG, S32.9XXK, S32.9XXS, S72.001A, S72.001B, S72.001C, S72.001D, S72.001E, S72.001F, S72.001G, S72.001H, S72.001J, S72.001K, S72.001M, S72.001N, S72.001P, S72.001Q, S72.001R, S72.001S, S72.002A, S72.002B, S72.002C, S72.002D, S72.002E, S72.002F, S72.002G, S72.002H, S72.002J, S72.002K, S72.002M, S72.002N, S72.002P, S72.002Q, S72.002R, S72.002S, S72.009A, S72.009B, S72.009C, S72.009D, S72.009E, S72.009F, S72.009G, S72.009H, S72.009J, S72.009K, S72.009M, S72.009N, S72.009P, S72.009Q, S72.009R, S72.009S, S72.011A, S72.011B, S72.011C, S72.011D, S72.011E, S72.011F, S72.011G, S72.011H, S72.011J, S72.011K, S72.011M, S72.011N, S72.011P, S72.011Q, S72.011R, S72.011S, S72.012A, S72.012B, S72.012C, S72.012D, S72.012E, S72.012F, S72.012G, S72.012H, S72.012J, S72.012K, S72.012M, S72.012N, S72.012P, S72.012Q, S72.012R, S72.012S, S72.019A, S72.019B, S72.019C, S72.019D, S72.019E, S72.019F, S72.019G, S72.019H, S72.019J, S72.019K, S72.019M, S72.019N, S72.019P, S72.019Q, S72.019R, S72.019S, S72.021A, S72.021B, S72.021C, S72.021D, S72.021F, S72.021G, S72.021H, S72.021J, S72.021K, S72.021M, S72.021N, S72.021P, S72.021Q, S72.021R, S72.021S, S72.022A, S72.022B, S72.022C, S72.022D, S72.022E, S72.022F, S72.022G, S72.022H, S72.022J, S72.022K, S72.022M, S72.022N, S72.022P, S72.022Q, S72.022R, S72.022S, S72.023A, S72.023B, S72.023C, S72.023D, S72.023E, S72.023F, S72.023G, S72.023H, S72.023J, S72.023K, S72.023M, S72.023N, S72.023P, S72.023Q, S72.023R, S72.023S, S72.024A, S72.024B, S72.024C, S72.024D, S72.024E, S72.024F, S72.024G, S72.024H, S72.024J, S72.024K, S72.024M, S72.024N, S72.024P, S72.024Q, S72.024R, S72.024S, S72.025A, S72.025B, S72.025C, S72.025D, S72.025E, S72.025F, S72.025G, S72.025H, S72.025J, S72.025K, S72.025M, S72.025N, S72.025P, S72.025Q, S72.025R, S72.025S, S72.026A, S72.026B, S72.026C, S72.026D, S72.026E, S72.026F, S72.026G, S72.026H, S72.026J, S72.026K, S72.026M, S72.026N, S72.026P, S72.026Q, S72.026R, S72.026S, S72.031A, S72.031B, S72.031C, S72.031D, S72.031E, S72.031F, S72.031G, S72.031H, S72.031J, S72.031K, S72.031M, S72.031N, S72.031P, S72.031Q, S72.031R, S72.031S, S72.032A, S72.032B, S72.032C, S72.032D, S72.032E, S72.032F, S72.032G, S72.032H, S72.032J, S72.032K, S72.032M, S72.032N, S72.032P, S72.032Q, S72.032R, S72.032S, S72.033A, S72.033B, S72.033C, S72.033D, S72.033E, S72.033F, S72.033G, S72.033H, S72.033J, S72.033K, S72.033M, S72.033N, S72.033P, S72.033Q, S72.033R, S72.033S, S72.034A, S72.034B, S72.034C, S72.034D, S72.034E, S72.034F, S72.034G, S72.034H, S72.034J, S72.034K, S72.034M, S72.034N, S72.034P, S72.034Q, S72.034R, S72.034S, S72.035A, S72.035B, S72.035C, S72.035D, S72.035E, S72.035F, S72.035G, S72.035H, S72.035J, S72.035K, S72.035M, S72.035N, S72.035P, S72.035Q, S72.035R, S72.035S, S72.036A, S72.036B, S72.036C, S72.036D, S72.036E, S72.036F, S72.036G, S72.036H, S72.036J, S72.036K, S72.036M, S72.036N, S72.036P, S72.036Q, S72.036R, S72.036S, S72.041A, S72.041B, S72.041C, S72.041D, S72.041E, S72.041F, S72.041G, S72.041H, S72.041J, S72.041K, S72.041M, S72.041N, S72.041P, S72.041Q, S72.041R, S72.041S, S72.042A, S72.042B, S72.042C, S72.042D, S72.042E, S72.042F, S72.042G, S72.042H, S72.042J, S72.042K, S72.042M, S72.042N, S72.042P, S72.042Q, S72.042R, S72.042S, S72.043A, S72.043B, S72.043C, S72.043D, S72.043E, S72.043F, S72.043G, S72.043H, S72.043J, S72.043K, S72.043M, S72.043N, S72.043P, 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S99.101B, S99.101D, S99.101G, S99.101K, S99.101P, S99.101S, S99.102A, S99.102B, S99.102D, S99.102G, S99.102K, S99.102P, S99.102S, S99.109A, S99.109B, S99.109D, S99.109G, S99.109K, S99.109P, S99.109S, S99.111A, S99.111B, S99.111D, S99.111G, S99.111K, S99.111P, S99.111S, S99.112A, S99.112B, S99.112D, S99.112G, S99.112K, S99.112P, S99.112S, S99.119A, S99.119B, S99.119D, S99.119G, S99.119K, S99.119P, S99.119S, S99.121A, S99.121B, S99.121D, S99.121G, S99.121K, S99.121P, S99.121S, S99.122A, S99.122B, S99.122D, S99.122G, S99.122K, S99.122P, S99.122S, S99.129A, S99.129B, S99.129D, S99.129G, S99.129K, S99.129P, S99.129S, S99.131A, S99.131B, S99.131D, S99.131G, S99.131K, S99.131P, S99.131S, S99.132A, S99.132B, S99.132D, S99.132G, S99.132K, S99.132P, S99.132S, S99.139A, S99.139B, S99.139D, S99.139G, S99.139K, S99.139P, S99.139S, S99.141A, S99.141B, S99.141D, S99.141G, S99.141K, S99.141P, S99.141S, S99.142A, S99.142B, S99.142D, S99.142G, S99.142K, S99.142P, S99.142S, S99.149A, S99.149B, S99.149D, S99.149G, S99.149K, S99.149P, S99.149S, S99.191A, S99.191B, S99.191D, S99.191G, S99.191K, S99.191P, S99.191S, S99.192A, S99.192B, S99.192D, S99.192G, S99.192K, S99.192P, S99.192S, S99.199A, S99.199B, S99.199D, S99.199G, S99.199K, S99.199P, S99.199S
Diagnosis: Fracture – Lower Body: SNOMED	1705000, 5913000, 6628008, 7687006, 9344009, 12746007, 13695006, 15474008, 17616007, 19652000, 20100009, 22234005, 22802006, 23900009, 25415003, 26442006, 26938002, 28012007, 28359007, 28576007, 30060003, 30489009, 30905007, 33118001, 36127009, 36417005, 39408006, 41191003, 45455009, 46272008, 47848000, 51037009, 52450003, 54441004, 59556008, 59639009, 59962009, 60214001, 62125005, 64455005, 66483005, 66926007, 69830008, 71220005, 71620000, 76911006, 77598002, 77803008, 79484004, 79978005, 80756009, 82640004, 84320000, 86731008, 87173003, 89820008, 91037003, 111643005, 111644004, 111645003, 111646002, 127287001, 208146001, 208147005, 208148000, 208149008, 208150008, 208151007, 208155003, 208156002, 208157006, 208158001, 208159009, 208160004, 208164008, 208165009, 208166005, 208168006, 208172005, 208173000, 208174006, 208181004, 208182006, 208183001, 208184007, 208185008, 208192003, 208193008, 208194002, 208195001, 208197009, 208202002, 208204001, 208205000, 208207008, 208521006, 208523009, 208524003, 208526001, 208528000, 208529008, 208530003, 208531004, 208534007, 208536009, 208537000, 208540000, 208541001, 208542008, 208543003, 208544009, 208548007, 208550004, 208551000, 208552007, 208555009, 208557001, 208558006, 208559003, 208562000, 208578003, 208579006, 208580009, 208581008, 208582001, 208587007, 208588002, 208589005, 208590001, 208591002, 208596007, 208597003, 208598008, 208600002, 208601003, 208602005, 208603000, 208604006, 208605007, 208606008, 208610006, 208611005, 208612003, 208613008, 208614002, 208615001, 208619007, 208620001, 208621002, 208622009, 208623004, 208624005, 208625006, 208627003, 208629000, 208631009, 208632002, 208637008, 208731002, 209335002, 209336001, 209337005, 209338000, 209344001, 209345000, 209346004, 209347008, 209390009, 209395004, 209405008, 263067005, 263096006, 263216001, 263220002, 263221003, 263222005, 263225007, 263226008, 263227004, 263228009, 263229001, 263231005, 263232003, 263233008, 263234002, 263235001, 263236000, 263237009, 263238004, 263239007, 271963003, 275338001, 275339009, 275340006, 275341005, 275342003, 275343008, 281533006, 301034006, 301757009, 302034009, 307178006, 307727005, 308153009, 359817006, 359820003, 361118003, 361119006, 413876003, 413877007, 414942001, 414943006, 426382004, 426679004, 426962008, 427509002, 427584009, 427688003, 427826000, 428000009, 428020005, 428232002, 428257007, 428357005, 428512002, 428723000, 428797006, 428798001, 429186005, 429342005, 429552008, 429766001, 445311003, 445410003, 445733003, 445875009, 445899009, 446979005, 446980008, 447017008, 447139008, 447394009, 447395005
Diagnosis: Severe Dementia: SNOMED	428351000124105