MCE3-F contains eight tab-separated fields. Only billable diagnosis codes (i.e., coded to full specificity) are included in this file since these edits should only be applied to codes that are specific. Non-specific codes should be edited out prior to this second level check. Field 1 code: ICD-9 diagnosis code Field 2 short_description: 25-character description Field 3 male: 1 male only, 0 no edit Field 4 female: 1 female only, 0 no edit Field 5 nos_or_proc: while these codes are valid in ICD-9-CM, they are 'not otherwise specified' and cannot be used Field 6 open_biopsy_ck: biopsies that can be performed as a closed procedure as well; flag record to check documentation Field 7 bilateral: when two of these codes appear together on a claim on the same joint, flag record to check if procedures have been performed on two different joints Field 8 lim_coverage: procedures whose complexity and serious nature incur extraordinary costs limited by Medicare code short_description male female nos_or_proc open_biopsy_ck bilateral lim_coverage .... 33.24 CLOSED BRONCHIAL BIOPSY 0 0 0 0 0 0 33.25 OPEN BRONCHIAL BIOPSY 0 0 0 1 0 0 33.26 CLOSED LUNG BIOPSY 0 0 0 0 0 0 33.27 CLOS ENDOSCOPIC LUNG BX 0 0 0 0 0 0 33.28 OPEN LUNG BIOPSY 0 0 0 1 0 0 33.29 BRONCH/LUNG DX PROC NEC 0 0 0 0 0 0 33.31 DESTR PHREN-LUNG COLLAPS 0 0 0 0 0 0 33.32 PNEMOTHORAX-LUNG COLLAPS 0 0 0 0 0 0 33.33 PNEUMOPERIT-LUNG COLLAPS 0 0 0 0 0 0 33.34 THORACOPLASTY 0 0 0 0 0 0 33.39 SURG COLLAPS OF LUNG NEC 0 0 0 0 0 0 33.41 BRONCHIAL LACERAT SUTURE 0 0 0 0 0 0 33.42 BRONCHIAL FISTULA CLOS 0 0 0 0 0 0 33.43 LUNG LACERATION CLOSURE 0 0 0 0 0 0 33.48 BRONCHIAL REPAIR NEC 0 0 0 0 0 0 33.49 LUNG REPAIR NEC 0 0 0 0 0 0 33.50 LUNG TRANSPLANT NOS 0 0 0 0 0 1 33.51 UNILAT LUNG TRANSPLANT 0 0 0 0 0 1 33.52 BILAT LUNG TRANSPLANT 0 0 0 0 0 1 33.6 COMB HEART/LUNG TRANSPLA 0 0 0 0 0 1 33.71 END INS/RP BRN VLV SG LB 0 0 0 0 0 0 33.72 ENDO PULM ARWY FLOW MSMT 0 0 0 0 0 0 33.73 ENDO INS/REPL BR VLV M/L 0 0 0 0 0 0 33.78 ENDO REM BRONCH DEVC/SUB 0 0 0 0 0 0 33.79 ENDO INSRT BRONC DEF/SUB 0 0 0 0 0 0 33.91 BRONCHIAL DILATION 0 0 0 0 0 0 33.92 BRONCHIAL LIGATION 0 0 0 0 0 0 33.93 PUNCTURE OF LUNG 0 0 0 0 0 0 33.98 BRONCHIAL OPERATION NEC 0 0 0 0 0 0 33.99 LUNG OPERATION NEC 0 0 0 0 0 0 34.01 INCISION OF CHEST WALL 0 0 0 0 0 0 34.02 EXPLORATORY THORACOTOMY 0 0 0 0 0 0 ..... 70.0 CULDOCENTESIS 0 1 0 0 0 0 70.11 HYMENOTOMY 0 1 0 0 0 0 70.12 CULDOTOMY 0 1 0 0 0 0 70.13 INTRALUM VAG ADHESIOLYS 0 1 0 0 0 0 70.14 VAGINOTOMY NEC 0 1 0 0 0 0 70.21 VAGINOSCOPY 0 1 0 0 0 0 70.22 CULDOSCOPY 0 1 0 0 0 0 70.23 CUL-DE-SAC BIOPSY 0 1 0 0 0 0 70.24 VAGINAL BIOPSY 0 1 0 0 0 0 70.29 VAGIN/CUL-DE-SAC DX NEC 0 1 0 0 0 0 70.31 HYMENECTOMY 0 1 0 0 0 0 .... 87.79 URINARY SYSTEM X-RAY NEC 0 0 0 0 0 0 87.81 X-RAY OF GRAVID UTERUS 0 1 0 0 0 0 87.82 GAS HYSTEROSALPINGOGRAM 0 1 0 0 0 0 87.83 DYE HYSTEROSALPINGOGRAM 0 1 0 0 0 0 87.84 PERCUTANEOUS HYSTEROGRAM 0 1 0 0 0 0 87.85 TUBE & UTERUS X-RAY NEC 0 1 0 0 0 0 87.89 FEMALE GENITAL X-RAY NEC 0 1 0 0 0 0 87.91 CONTR SEMIN VESICULOGRAM 1 0 0 0 0 0 87.92 PROSTAT/SEM VES XRAY NEC 1 0 0 0 0 0 87.93 CONTRAST EPIDIDYMOGRAM 1 0 0 0 0 0 87.94 CONTRAST VASOGRAM 1 0 0 0 0 0 87.95 EPIDIDYMIS/VAS X-RAY NEC 1 0 0 0 0 0 87.99 MALE GENITAL X-RAY NEC 1 0 0 0 0 0 88.01 C.A.T. SCAN OF ABDOMEN 0 0 0 0 0 0 88.02 ABDOMINAL TOMOGRAPHY NEC 0 0 0 0 0 0 88.03 ABDOMINAL WALL SINOGRAM 0 0 0 0 0 0 88.04 ABDOMINAL LYMPHANGIOGRAM 0 0 0 0 0 0 88.09 ABDOMINAL WALL X-RAY NEC 0 0 0 0 0 0