Check a code against the MCE lists
Enter an ICD-10-CM or ICD-10-PCS code to see every MCE v44 list it is on, with its CC or MCC level and POA-exempt status. Add a principal diagnosis to test a secondary code's CC exclusion as well; the same check runs on the FY2027 CC/MCC list.
Try E11.9 (questionable admission), D63.0 (manifestation), G81.00 (unspecified laterality), A33 (newborn age edit). Codes can be typed with or without the dot.
The 20 MCE edits at a glance
Edits without a list are logic checks on the claim fields (validity, duplicates, age, sex and discharge status); list sizes count every code entry in the edit's v44 lists.
| Edit | Edit name | Status | Listed codes |
|---|---|---|---|
| 1 | Invalid diagnosis or procedure code | Active | — |
| 2 | External causes of morbidity codes as principal diagnosis | Active | 7,461 (V00-Y99) |
| 3 | Duplicate of PDX | Active | — |
| 4 | Age conflict | Active | 3,612 |
| 5 | Sex conflict | Deactivated 10/01/2024 | — |
| 6 | Manifestation code as principal diagnosis | Active | 422 |
| 7 | Non-specific principal diagnosis | Discontinued 10/01/2007 | — |
| 8 | Questionable admission | Active | 57 |
| 9 | Unacceptable principal diagnosis | Active | 2,667 |
| 10 | Non-specific O.R. procedure | Discontinued 10/01/2007 | — |
| 11 | Non-covered procedure | Active | 286 |
| 12 | Open biopsy check | Discontinued 10/01/2010 | — |
| 13 | Bilateral procedure | Discontinued ICD-10 implementation | — |
| 14 | Invalid age | Active | — |
| 15 | Invalid sex | Active | — |
| 16 | Invalid discharge status | Active | — |
| 17 | Limited coverage | Active | 49 |
| 18 | Wrong procedure performed | Active | 3 |
| 19 | Procedure inconsistent with LOS | Active | 1 |
| 20 | Unspecified code | Active | 3,476 |
Each edit and its code lists
Edit 1. Invalid diagnosis or procedure code
Every diagnosis, including the admitting diagnosis, and every procedure is checked against the table of valid ICD-10-CM and ICD-10-PCS codes; a code that is not in the table is invalid. The FY2027 code files are the list.
Edit 2. External causes of morbidity codes as principal diagnosis
External cause codes (V, W, X and Y codes) describe how an injury happened, not the injury itself, so they cannot be the principal diagnosis.
FY2027 ICD-10-CM has 7,461 external cause codes, every one of them barred as principal diagnosis by this edit.
Edit 3. Duplicate of PDX
A secondary diagnosis coded the same as the principal diagnosis is reported as a duplicate of the principal diagnosis.
Edit 4. Age conflict
A diagnosis that is clinically impossible at the patient's age points to an error in the diagnosis or the age. The MCE carries four age lists: perinatal and newborn diagnoses (age 0 only), pediatric diagnoses (0 through 17), maternity diagnoses (9 through 64) and adult diagnoses (15 through 124).
The maternity list is the largest age list (2,587 codes, mostly chapter 15 pregnancy codes); an obstetric code on a claim for a patient younger than 9 or older than 64 triggers the edit.
The first 12 of 42 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 21 (factors influencing health status and contact with health services, 35), chapter 7 (diseases of the eye and adnexa, 4), chapter 1 (certain infectious and parasitic diseases, 1). 2 of the codes are also on the FY2027 CC or MCC list. They appear in the logic of 9 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| A33 | Tetanus neonatorum |
| E84.11 | Meconium ileus in cystic fibrosis |
| H04.531 | Neonatal obstruction of right nasolacrimal duct |
| H04.532 | Neonatal obstruction of left nasolacrimal duct |
| H04.533 | Neonatal obstruction of bilateral nasolacrimal duct |
| H04.539 | Neonatal obstruction of unspecified nasolacrimal duct |
| N47.0 | Adherent prepuce, newborn |
| Z00.110 | Health examination for newborn under 8 days old |
| Z00.111 | Health examination for newborn 8 to 28 days old |
| Z05.0 | Observation and evaluation of newborn for suspected cardiac condition ruled out |
| Z05.1 | Observation and evaluation of newborn for suspected infectious condition ruled out |
| Z05.2 | Observation and evaluation of newborn for suspected neurological condition ruled out |
The first 12 of 126 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 19 (injury, poisoning and certain other consequences of external causes, 51), chapter 7 (diseases of the eye and adnexa, 25), chapter 21 (factors influencing health status and contact with health services, 21). 23 of the codes are also on the FY2027 CC or MCC list. They appear in the logic of 49 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| A48.51 | Infant botulism |
| B08.20 | Exanthema subitum [sixth disease], unspecified |
| B08.21 | Exanthema subitum [sixth disease] due to human herpesvirus 6 |
| B08.22 | Exanthema subitum [sixth disease] due to human herpesvirus 7 |
| C93.30 | Juvenile myelomonocytic leukemia, not having achieved remission |
| C93.31 | Juvenile myelomonocytic leukemia, in remission |
| C93.32 | Juvenile myelomonocytic leukemia, in relapse |
| E30.1 | Precocious puberty |
| E30.8 | Other disorders of puberty |
| F64.2 | Gender identity disorder of childhood |
| F84.3 | Other childhood disintegrative disorder |
| G93.7 | Reye's syndrome |
The first 12 of 2,587 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 15 (pregnancy, childbirth and the puerperium, 2,481), chapter 21 (factors influencing health status and contact with health services, 100), chapter 2 (neoplasms, 2). 673 of the codes are also on the FY2027 CC or MCC list.
| ICD-10-CM | Description |
|---|---|
| A34 | Obstetrical tetanus |
| C58 | Malignant neoplasm of placenta |
| D39.2 | Neoplasm of uncertain behavior of placenta |
| F53.0 | Postpartum depression |
| F53.1 | Puerperal psychosis |
| M83.0 | Puerperal osteomalacia |
| O00.00 | Abdominal pregnancy without intrauterine pregnancy |
| O00.01 | Abdominal pregnancy with intrauterine pregnancy |
| O00.101 | Right tubal pregnancy without intrauterine pregnancy |
| O00.102 | Left tubal pregnancy without intrauterine pregnancy |
| O00.109 | Unspecified tubal pregnancy without intrauterine pregnancy |
| O00.111 | Right tubal pregnancy with intrauterine pregnancy |
The first 12 of 857 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 9 (diseases of the circulatory system, 354), chapter 13 (diseases of the musculoskeletal system and connective tissue, 182), chapter 7 (diseases of the eye and adnexa, 93). 304 of the codes are also on the FY2027 CC or MCC list.
| ICD-10-CM | Description |
|---|---|
| A18.14 | Tuberculosis of prostate |
| C91.50 | Adult T-cell lymphoma/leukemia (HTLV-1-associated) not having achieved remission |
| C91.51 | Adult T-cell lymphoma/leukemia (HTLV-1-associated), in remission |
| C91.52 | Adult T-cell lymphoma/leukemia (HTLV-1-associated), in relapse |
| E28.310 | Symptomatic premature menopause |
| E28.319 | Asymptomatic premature menopause |
| F01.50 | Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety |
| F01.511 | Vascular dementia, unspecified severity, with agitation |
| F01.518 | Vascular dementia, unspecified severity, with other behavioral disturbance |
| F01.52 | Vascular dementia, unspecified severity, with psychotic disturbance |
| F01.53 | Vascular dementia, unspecified severity, with mood disturbance |
| F01.54 | Vascular dementia, unspecified severity, with anxiety |
Edit 5. Sex conflict (deactivated 10/01/2024)
Checked a diagnosis or procedure against the patient's sex. CMS deactivated the edit on October 1, 2024, so v44 carries no sex conflict list.
Edit 6. Manifestation code as principal diagnosis
Manifestation codes describe a manifestation of an underlying disease, not the disease itself, so they cannot be the principal diagnosis; the underlying condition is sequenced first.
The first 12 of 422 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 13 (diseases of the musculoskeletal system and connective tissue, 185), chapter 4 (endocrine, nutritional and metabolic diseases, 88), chapter 6 (diseases of the nervous system, 32). 127 of the codes are also on the FY2027 CC or MCC list.
| ICD-10-CM | Description |
|---|---|
| D63.0 | Anemia in neoplastic disease |
| D63.1 | Anemia in chronic kidney disease |
| D63.8 | Anemia in other chronic diseases classified elsewhere |
| D64.1 | Secondary sideroblastic anemia due to disease |
| D72.18 | Eosinophilia in diseases classified elsewhere |
| D75.81 | Myelofibrosis |
| D77 | Other disorders of blood and blood-forming organs in diseases classified elsewhere |
| D84.81 | Immunodeficiency due to conditions classified elsewhere |
| E08.00 | Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| E08.01 | Diabetes mellitus due to underlying condition with hyperosmolarity with coma |
| E08.10 | Diabetes mellitus due to underlying condition with ketoacidosis without coma |
| E08.11 | Diabetes mellitus due to underlying condition with ketoacidosis with coma |
Edit 7. Non-specific principal diagnosis (discontinued 10/01/2007)
Flagged nonspecific principal diagnoses for patients discharged alive. Discontinued as of October 1, 2007.
Edit 8. Questionable admission
Some diagnoses are not usually enough to justify an acute inpatient admission, such as an elevated blood pressure reading without a diagnosis of hypertension. Cesarean section and vaginal delivery procedures are also a questionable obstetric admission unless a secondary diagnosis records the outcome of delivery.
The full list. By ICD-10-CM chapter the largest shares are chapter 4 (endocrine, nutritional and metabolic diseases, 9), chapter 9 (diseases of the circulatory system, 9), chapter 21 (factors influencing health status and contact with health services, 5). They appear in the logic of 20 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| E11.9 | Type 2 diabetes mellitus without complications |
| E11.A | Type 2 diabetes mellitus without complications in remission |
| E13.9 | Other specified diabetes mellitus without complications |
| E66.09 | Other obesity due to excess calories |
| E66.1 | Drug-induced obesity |
| E66.811 | Obesity, class 1 |
| E66.812 | Obesity, class 2 |
| E66.89 | Other obesity not elsewhere classified |
| E66.9 | Obesity, unspecified |
| H61.20 | Impacted cerumen, unspecified ear |
| H61.21 | Impacted cerumen, right ear |
| H61.22 | Impacted cerumen, left ear |
| H61.23 | Impacted cerumen, bilateral |
| I10 | Essential (primary) hypertension |
| I44.4 | Left anterior fascicular block |
| I44.5 | Left posterior fascicular block |
| I44.60 | Unspecified fascicular block |
| I44.69 | Other fascicular block |
| I44.7 | Left bundle-branch block, unspecified |
| I45.0 | Right fascicular block |
| I45.10 | Unspecified right bundle-branch block |
| I45.19 | Other right bundle-branch block |
| R03.0 | Elevated blood-pressure reading, without diagnosis of hypertension |
| R97.20 | Elevated prostate specific antigen [PSA] |
| R97.21 | Rising PSA following treatment for malignant neoplasm of prostate |
| Z21 | Asymptomatic human immunodeficiency virus [HIV] infection status |
| Z45.010 | Encounter for checking and testing of cardiac pacemaker pulse generator [battery] |
| Z45.018 | Encounter for adjustment and management of other part of cardiac pacemaker |
| Z45.02 | Encounter for adjustment and management of automatic implantable cardiac defibrillator |
| Z45.09 | Encounter for adjustment and management of other cardiac device |
The full list. They appear in the logic of 6 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 10D00Z0 | Extraction of Products of Conception, High, Open Approach |
| 10D00Z1 | Extraction of Products of Conception, Low, Open Approach |
| 10D00Z2 | Extraction of Products of Conception, Extraperitoneal, Open Approach |
The full list. They appear in the logic of 7 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 10D07Z3 | Extraction of Products of Conception, Low Forceps, Via Natural or Artificial Opening |
| 10D07Z4 | Extraction of Products of Conception, Mid Forceps, Via Natural or Artificial Opening |
| 10D07Z5 | Extraction of Products of Conception, High Forceps, Via Natural or Artificial Opening |
| 10D07Z7 | Extraction of Products of Conception, Internal Version, Via Natural or Artificial Opening |
| 10E0XZZ | Delivery of Products of Conception, External Approach |
The full list. By ICD-10-CM chapter the largest shares are chapter 21 (factors influencing health status and contact with health services, 19). They appear in the logic of 8 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| Z37.0 | Single live birth |
| Z37.1 | Single stillbirth |
| Z37.2 | Twins, both liveborn |
| Z37.3 | Twins, one liveborn and one stillborn |
| Z37.4 | Twins, both stillborn |
| Z37.50 | Multiple births, unspecified, all liveborn |
| Z37.51 | Triplets, all liveborn |
| Z37.52 | Quadruplets, all liveborn |
| Z37.53 | Quintuplets, all liveborn |
| Z37.54 | Sextuplets, all liveborn |
| Z37.59 | Other multiple births, all liveborn |
| Z37.60 | Multiple births, unspecified, some liveborn |
| Z37.61 | Triplets, some liveborn |
| Z37.62 | Quadruplets, some liveborn |
| Z37.63 | Quintuplets, some liveborn |
| Z37.64 | Sextuplets, some liveborn |
| Z37.69 | Other multiple births, some liveborn |
| Z37.7 | Other multiple births, all stillborn |
| Z37.9 | Outcome of delivery, unspecified |
Edit 9. Unacceptable principal diagnosis
Codes that describe a circumstance influencing health status rather than a current illness or injury, and codes that are not specific manifestations, are unacceptable as the principal diagnosis. One code, Z51.89, becomes acceptable when a secondary diagnosis is also on the claim.
The first 12 of 2,667 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 21 (factors influencing health status and contact with health services, 1,194), chapter 19 (injury, poisoning and certain other consequences of external causes, 1,062), chapter 18 (symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, 149). 120 of the codes are also on the FY2027 CC or MCC list.
| ICD-10-CM | Description |
|---|---|
| B95.0 | Streptococcus, group A, as the cause of diseases classified elsewhere |
| B95.1 | Streptococcus, group B, as the cause of diseases classified elsewhere |
| B95.2 | Enterococcus as the cause of diseases classified elsewhere |
| B95.3 | Streptococcus pneumoniae as the cause of diseases classified elsewhere |
| B95.4 | Other streptococcus as the cause of diseases classified elsewhere |
| B95.5 | Unspecified streptococcus as the cause of diseases classified elsewhere |
| B95.61 | Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere |
| B95.62 | Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere |
| B95.7 | Other staphylococcus as the cause of diseases classified elsewhere |
| B95.8 | Unspecified staphylococcus as the cause of diseases classified elsewhere |
| B96.0 | Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhere |
| B96.1 | Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere |
Edit 10. Non-specific O.R. procedure (discontinued 10/01/2007)
Flagged nonspecific operating room procedures. Discontinued as of October 1, 2007.
Edit 11. Non-covered procedure
Procedures Medicare does not pay for, either always or under the stated conditions: a pancreas transplant without a kidney transplant unless a listed diagnosis is present, autologous bone marrow and stem cell transfusions with the listed leukemias, lumbar artificial disc replacement for a beneficiary over age 60, and sterilization procedures when Z30.2 (encounter for sterilization) is a diagnosis. Sub-lists C and E are discontinued.
The first 12 of 95 codes in list order; the CSV download and the code check above cover all of them. They appear in the logic of 38 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 00F3XZZ | Fragmentation in Intracranial Epidural Space, External Approach |
| 00F4XZZ | Fragmentation in Intracranial Subdural Space, External Approach |
| 00F5XZZ | Fragmentation in Intracranial Subarachnoid Space, External Approach |
| 00F6XZZ | Fragmentation in Cerebral Ventricle, External Approach |
| 02BK0ZZ | Excision of Right Ventricle, Open Approach |
| 02BK3ZZ | Excision of Right Ventricle, Percutaneous Approach |
| 02BK4ZZ | Excision of Right Ventricle, Percutaneous Endoscopic Approach |
| 02BL0ZZ | Excision of Left Ventricle, Open Approach |
| 02BL3ZZ | Excision of Left Ventricle, Percutaneous Approach |
| 02BL4ZZ | Excision of Left Ventricle, Percutaneous Endoscopic Approach |
| 02FNXZZ | Fragmentation in Pericardium, External Approach |
| 02HA3QZ | Insertion of Implantable Heart Assist System into Heart, Percutaneous Approach |
The full list. They appear in the logic of 9 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 0FYG0Z0 | Transplantation of Pancreas, Allogeneic, Open Approach |
| 0FYG0Z1 | Transplantation of Pancreas, Syngeneic, Open Approach |
The first 12 of 85 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 4 (endocrine, nutritional and metabolic diseases, 85). 5 of the codes are also on the FY2027 CC or MCC list. They appear in the logic of 21 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| E10.10 | Type 1 diabetes mellitus with ketoacidosis without coma |
| E10.11 | Type 1 diabetes mellitus with ketoacidosis with coma |
| E10.21 | Type 1 diabetes mellitus with diabetic nephropathy |
| E10.22 | Type 1 diabetes mellitus with diabetic chronic kidney disease |
| E10.29 | Type 1 diabetes mellitus with other diabetic kidney complication |
| E10.311 | Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema |
| E10.319 | Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema |
| E10.3211 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye |
| E10.3212 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye |
| E10.3213 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral |
| E10.3219 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, unspecified eye |
| E10.3291 | Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye |
The full list. They appear in the logic of 2 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 30233G0 | Transfusion of Autologous Bone Marrow into Peripheral Vein, Percutaneous Approach |
| 30233Y0 | Transfusion of Autologous Hematopoietic Stem Cells into Peripheral Vein, Percutaneous Approach |
| 30243G0 | Transfusion of Autologous Bone Marrow into Central Vein, Percutaneous Approach |
| 30243Y0 | Transfusion of Autologous Hematopoietic Stem Cells into Central Vein, Percutaneous Approach |
The full list. By ICD-10-CM chapter the largest shares are chapter 2 (neoplasms, 11). 11 of the codes are also on the FY2027 CC or MCC list. They appear in the logic of 16 MS-DRGs.
| ICD-10-CM | Description |
|---|---|
| C91.00 | Acute lymphoblastic leukemia not having achieved remission |
| C92.00 | Acute myeloblastic leukemia, not having achieved remission |
| C92.10 | Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission |
| C92.11 | Chronic myeloid leukemia, BCR/ABL-positive, in remission |
| C92.40 | Acute promyelocytic leukemia, not having achieved remission |
| C92.50 | Acute myelomonocytic leukemia, not having achieved remission |
| C92.60 | Acute myeloid leukemia with 11q23-abnormality not having achieved remission |
| C92.A0 | Acute myeloid leukemia with multilineage dysplasia, not having achieved remission |
| C93.00 | Acute monoblastic/monocytic leukemia, not having achieved remission |
| C94.00 | Acute erythroid leukemia, not having achieved remission |
| C95.00 | Acute leukemia of unspecified cell type not having achieved remission |
The full list. They appear in the logic of 10 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 0SR20JZ | Replacement of Lumbar Vertebral Disc with Synthetic Substitute, Open Approach |
| 0SR40JZ | Replacement of Lumbosacral Disc with Synthetic Substitute, Open Approach |
The first 12 of 87 codes in list order; the CSV download and the code check above cover all of them. They appear in the logic of 8 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 0U570ZZ | Destruction of Bilateral Fallopian Tubes, Open Approach |
| 0U573ZZ | Destruction of Bilateral Fallopian Tubes, Percutaneous Approach |
| 0U574ZZ | Destruction of Bilateral Fallopian Tubes, Percutaneous Endoscopic Approach |
| 0U577ZZ | Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening |
| 0U578ZZ | Destruction of Bilateral Fallopian Tubes, Via Natural or Artificial Opening Endoscopic |
| 0UL70CZ | Occlusion of Bilateral Fallopian Tubes with Extraluminal Device, Open Approach |
| 0UL70DZ | Occlusion of Bilateral Fallopian Tubes with Intraluminal Device, Open Approach |
| 0UL70ZZ | Occlusion of Bilateral Fallopian Tubes, Open Approach |
| 0UL73CZ | Occlusion of Bilateral Fallopian Tubes with Extraluminal Device, Percutaneous Approach |
| 0UL73DZ | Occlusion of Bilateral Fallopian Tubes with Intraluminal Device, Percutaneous Approach |
| 0UL73ZZ | Occlusion of Bilateral Fallopian Tubes, Percutaneous Approach |
| 0UL74CZ | Occlusion of Bilateral Fallopian Tubes with Extraluminal Device, Percutaneous Endoscopic Approach |
Edit 12. Open biopsy check (discontinued 10/01/2010)
Checked whether a biopsy was coded as open. Discontinued as of October 1, 2010.
Edit 13. Bilateral procedure (discontinued ICD-10 implementation)
Checked bilateral joint procedures under ICD-9-CM. Discontinued with the ICD-10 implementation.
Edit 14. Invalid age
The patient's age must be between 0 and 124 years; any other value is treated as an error.
Edit 15. Invalid sex
The sex field must be 0 (unknown), 1 (male) or 2 (female).
Edit 16. Invalid discharge status
The patient discharge status must be one of the valid discharge status values. Those values are UB-04 data elements maintained by the National Uniform Billing Committee and are not reproduced here.
Edit 17. Limited coverage
Procedures whose medical complexity and cost lead Medicare to limit coverage to a portion of the cost, mainly organ transplants and implantable heart assist devices. Sub-list B is discontinued.
The first 12 of 49 codes in list order; the CSV download and the code check above cover all of them. They appear in the logic of 18 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 02WA3QZ | Revision of Implantable Heart Assist System in Heart, Percutaneous Approach |
| 02WA4QZ | Revision of Implantable Heart Assist System in Heart, Percutaneous Endoscopic Approach |
| 02YA0Z0 | Transplantation of Heart, Allogeneic, Open Approach |
| 02YA0Z1 | Transplantation of Heart, Syngeneic, Open Approach |
| 02YA0Z2 | Transplantation of Heart, Zooplastic, Open Approach |
| 0BYC0Z0 | Transplantation of Right Upper Lung Lobe, Allogeneic, Open Approach |
| 0BYC0Z1 | Transplantation of Right Upper Lung Lobe, Syngeneic, Open Approach |
| 0BYC0Z2 | Transplantation of Right Upper Lung Lobe, Zooplastic, Open Approach |
| 0BYD0Z0 | Transplantation of Right Middle Lung Lobe, Allogeneic, Open Approach |
| 0BYD0Z1 | Transplantation of Right Middle Lung Lobe, Syngeneic, Open Approach |
| 0BYD0Z2 | Transplantation of Right Middle Lung Lobe, Zooplastic, Open Approach |
| 0BYF0Z0 | Transplantation of Right Lower Lung Lobe, Allogeneic, Open Approach |
Edit 18. Wrong procedure performed
External cause codes that state the wrong procedure was performed: on the correct patient, on a patient not scheduled for surgery, or on the wrong side or body part.
The full list. By ICD-10-CM chapter the largest shares are chapter 20 (external causes of morbidity, 3).
| ICD-10-CM | Description |
|---|---|
| Y65.51 | Performance of wrong procedure (operation) on correct patient |
| Y65.52 | Performance of procedure (operation) on patient not scheduled for surgery |
| Y65.53 | Performance of correct procedure (operation) on wrong side or body part |
Edit 19. Procedure inconsistent with LOS
Respiratory ventilation for more than 96 consecutive hours (5A1955Z) should be coded only when ventilation lasted more than four consecutive days of the stay.
The full list. They appear in the logic of 5 MS-DRGs.
| ICD-10-PCS | Description |
|---|---|
| 5A1955Z | Respiratory Ventilation, Greater than 96 Consecutive Hours |
Edit 20. Unspecified code
Unspecified ICD-10-CM codes for which a code exists that identifies laterality (right, left or bilateral). In the inpatient setting the laterality should rarely be impossible to document, so these codes are flagged.
The first 12 of 3,476 codes in list order; the CSV download and the code check above cover all of them. By ICD-10-CM chapter the largest shares are chapter 19 (injury, poisoning and certain other consequences of external causes, 2,835), chapter 13 (diseases of the musculoskeletal system and connective tissue, 426), chapter 12 (diseases of the skin and subcutaneous tissue, 74). 3,476 of the codes are also on the FY2027 CC or MCC list.
| ICD-10-CM | Description |
|---|---|
| G81.00 | Flaccid hemiplegia affecting unspecified side |
| G81.10 | Spastic hemiplegia affecting unspecified side |
| G81.90 | Hemiplegia, unspecified affecting unspecified side |
| G90.50 | Complex regional pain syndrome I, unspecified |
| G90.519 | Complex regional pain syndrome I of unspecified upper limb |
| G90.529 | Complex regional pain syndrome I of unspecified lower limb |
| H05.019 | Cellulitis of unspecified orbit |
| H05.029 | Osteomyelitis of unspecified orbit |
| H05.039 | Periostitis of unspecified orbit |
| H20.019 | Primary iridocyclitis, unspecified eye |
| H20.029 | Recurrent acute iridocyclitis, unspecified eye |
| H20.039 | Secondary infectious iridocyclitis, unspecified eye |
What changed in MCE v44
Chapter 2 of the v44 definitions lists 74 codes added to edit lists and 2 removed since the previous release. Most additions are new FY2027 ICD-10-CM codes: ectopic pregnancy and vanishing twin codes on the maternity age list, contact and exposure codes on the unacceptable principal diagnosis list, and osteomyelitis codes that leave the side unspecified on the unspecified code list. Z68.1 left the adult and unacceptable principal diagnosis lists when it was replaced by Z68.18 and Z68.19.
| List | Change | Code | Description |
|---|---|---|---|
| 4B | Added | K31.B | Hypertrophic pyloric stenosis, in childhood |
| 4C | Added | O00.121 | Right interstitial ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.122 | Left interstitial ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.129 | Unspecified interstitial ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.131 | Right interstitial ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.132 | Left interstitial ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.139 | Unspecified interstitial ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.31 | Cesarean scar ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.32 | Cesarean scar ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.41 | Cervical ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.42 | Cervical ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.511 | Right cornual ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.512 | Left cornual ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.519 | Unspecified cornual ectopic pregnancy without intrauterine pregnancy |
| 4C | Added | O00.521 | Right cornual ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.522 | Left cornual ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O00.529 | Unspecified cornual ectopic pregnancy with intrauterine pregnancy |
| 4C | Added | O31.40X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, not applicable or unspecified |
| 4C | Added | O31.40X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 1 |
| 4C | Added | O31.40X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 2 |
| 4C | Added | O31.40X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 3 |
| 4C | Added | O31.40X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 4 |
| 4C | Added | O31.40X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, fetus 5 |
| 4C | Added | O31.40X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, unspecified trimester, other fetus |
| 4C | Added | O31.41X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, not applicable or unspecified |
| 4C | Added | O31.41X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 1 |
| 4C | Added | O31.41X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 2 |
| 4C | Added | O31.41X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 3 |
| 4C | Added | O31.41X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 4 |
| 4C | Added | O31.41X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, fetus 5 |
| 4C | Added | O31.41X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, first trimester, other fetus |
| 4C | Added | O31.42X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, not applicable or unspecified |
| 4C | Added | O31.42X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 1 |
| 4C | Added | O31.42X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 2 |
| 4C | Added | O31.42X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 3 |
| 4C | Added | O31.42X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 4 |
| 4C | Added | O31.42X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, fetus 5 |
| 4C | Added | O31.42X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, second trimester, other fetus |
| 4C | Added | O31.43X0 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, not applicable or unspecified |
| 4C | Added | O31.43X1 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 1 |
| 4C | Added | O31.43X2 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 2 |
| 4C | Added | O31.43X3 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 3 |
| 4C | Added | O31.43X4 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 4 |
| 4C | Added | O31.43X5 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, fetus 5 |
| 4C | Added | O31.43X9 | Continuing pregnancy after vanishing twin syndrome of one fetus or more, third trimester, other fetus |
| 4D | Added | Z68.18 | Body mass index [BMI] 18.4 or less, adult |
| 4D | Added | Z68.19 | Body mass index [BMI] 18.5-19.9, adult |
| 4D | Removed | Z68.1 | |
| 9 | Added | Z68.18 | Body mass index [BMI] 18.4 or less, adult |
| 9 | Added | Z68.19 | Body mass index [BMI] 18.5-19.9, adult |
| 9 | Added | Z77.013 | Contact with and (suspected) exposure to gadolinium |
| 9 | Added | Z77.32 | Contact with and (suspected) exposure to burn pits in war theater |
| 9 | Added | Z77.33 | Contact with and (suspected) exposure to Agent Orange |
| 9 | Added | Z77.40 | Contact with and (suspected) exposure to unspecified blast overpressure |
| 9 | Added | Z77.41 | Contact with and (suspected) exposure to low-level blast overpressure |
| 9 | Added | Z77.42 | Contact with and (suspected) exposure to high-level blast overpressure |
| 9 | Added | Z77.49 | Contact with and (suspected) exposure to other blast overpressure |
| 9 | Added | Z86.17 | Personal history of Clostridioides difficile infection |
| 9 | Added | Z87.8901 | Personal history of social gender transition |
| 9 | Added | Z87.8902 | Personal history of medical gender transition |
| 9 | Added | Z87.8903 | Personal history of surgical gender transition |
| 9 | Added | Z87.8904 | Personal history of intersex surgery |
| 9 | Added | Z87.8909 | Personal history of unspecified gender transition |
| 9 | Added | Z87.893 | Personal history of gender detransition |
| 9 | Removed | Z68.1 | |
| 20 | Added | M86.8X19 | Other osteomyelitis, unspecified shoulder |
| 20 | Added | M86.8X29 | Other osteomyelitis, unspecified upper arm |
| 20 | Added | M86.8X39 | Other osteomyelitis, unspecified forearm |
| 20 | Added | M86.8X49 | Other osteomyelitis, unspecified hand |
| 20 | Added | M86.8X59 | Other osteomyelitis, unspecified thigh |
| 20 | Added | M86.8X69 | Other osteomyelitis, unspecified lower leg |
| 20 | Added | M86.8X79 | Other osteomyelitis, unspecified ankle and foot |
| 20 | Added | O00.129 | Unspecified interstitial ectopic pregnancy without intrauterine pregnancy |
| 20 | Added | O00.139 | Unspecified interstitial ectopic pregnancy with intrauterine pregnancy |
| 20 | Added | O00.519 | Unspecified cornual ectopic pregnancy without intrauterine pregnancy |
| 20 | Added | O00.529 | Unspecified cornual ectopic pregnancy with intrauterine pregnancy |
Download the MCE v44 lists
The MCE v44 code lists as CSV holds one row per list and code (10,573 rows): edit number, list name, ICD-10-CM or ICD-10-PCS, the code and its FY2027 title. The list of valid discharge status values for edit 16 is not included.
Where QuickIntell fits before the MCE runs
The MCE reports coding errors that a qualified coder can usually fix before the claim leaves: a manifestation code sequenced first, an age conflict, an unspecified laterality. QuickCode supports that coder review and documentation clarification on inpatient claims, and QuickRCM carries claim readiness and denial work with human review.
Frequently asked questions
What is the Medicare Code Editor?
The Medicare Code Editor (MCE) is the CMS software that checks the ICD-10-CM and ICD-10-PCS codes on an inpatient claim for errors, alongside the MS-DRG grouper. Version 44.0 applies to discharges from October 1, 2026 and defines 20 edits, 15 of them active; 9 active edits carry code lists totalling 10,573 entries.
What is an unacceptable principal diagnosis?
A code that describes a circumstance affecting health status or a non-specific manifestation rather than the condition that occasioned the admission. MCE v44 lists 2,667 such codes (edit 9); most are Z codes. Z51.89 is accepted when a secondary diagnosis is also coded.
Which MCE edits are no longer active?
Edit 5 (sex conflict) was deactivated on October 1, 2024. Edits 7 and 10 (non-specific principal diagnosis and O.R. procedure) were discontinued in 2007, edit 12 (open biopsy check) in 2010, and edit 13 (bilateral procedure) with the move to ICD-10.
What does the unspecified code edit check?
Edit 20 flags 3,476 unspecified ICD-10-CM codes for which a code exists that states the laterality. For FY2027, 11 codes were added to that list.
What changed in MCE v44?
Chapter 2 of the v44 definitions lists 74 codes added to edit lists and 2 removed: 16 added and 1 removed on list 9, 11 added on list 20, 1 added on list 4B, 44 added on list 4C, 2 added and 1 removed on list 4D.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- Definitions of Medicare Code Edits (MCE) v44.0, ICD-10 versionVersion v44.0 · effective 2026-10-01 · file fy2027-fr-definition-mce-v44.zipSHA-256 53af50dcfefa450a…
- ICD-10 MS-DRG Definitions Manual v44 (text)Version v44 · effective 2026-10-01 · file fy2027-fr-icd10-ms-drg-definitions-manual-files-v44.zipSHA-256 ae4f6c11727fe91f…
- ICD-10-CM FY2027 code descriptionsVersion FY2027 · effective 2026-10-01 · file icd10cm_codes_2027.txtSHA-256 3c0583a38ee0e848…
- ICD-10-PCS FY2027 order file (code titles)Version FY2027 · effective 2026-10-01 · file icd10pcs_order_2027.txtSHA-256 f564ff1f9cc8a000…
Disclaimer
Operational reference compiled from CMS publications. The MCE runs on the complete claim with the patient's age, sex and discharge status; check edits against your encoder and the CMS software release. Not legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.