Skip to main content
  • Notice of Privacy Incident
  • Medicaid Provider Termination Alert: Revalidation deadlines are approaching. Failure by providers to revalidate will lead to termination and payment suspension. Check your account now at https://impact.illinois.gov/ to learn if your required revalidation is due this month. More revalidation information here.
Elizabeth M. Whitehorn, Director

Hospital Acquired Conditions

 

Printer Friendly Version

Effective for Inpatient Admissions On and After July 1, 2012

HAC Diagnosis Codes

 
Foreign Object Retained After Surgery
  • 998.4
  • 998.7
Air Embolism
  • 999.1
Blood Incompatibility
  • 999.60
  • 999.61
  • 999.62
  • 999.63
  • 999.69
Pressure Ulcers States III and IV
  • 707.23
  • 707.24

Falls and Trauma:

  • Fracture Dislocation
  • Intracranial Injury
  • Crushing Injury
  • Burn
  • Other Injuries

Codes within these ranges:

  • 800-829
  • 830-839
  • 850-854
  • 925-929
  • 940-949
  • 991-994
Catheter-Associated Urinary Tract Infection (UTI)
  • 996.64

Also excludes the following from acting as a complication or comorbidity or major complication or comorbidity:

  • 112.2
  • 590.10
  • 590.11
  • 590.2
  • 590.3
  • 590.80
  • 590.81
  • 595.0
  • 597.0
  • 599.0
Vascular Catheter-Associated Infection
  • 999.31

Manifestations of Poor Glycemic Control:

  • Diabetic Ketoacidosis
  • Nonketotic Hyperosmolar Coma
  • Hypoglycemic Coma
  • Secondary Diabetes with Ketoacidosis
  • Secondary Diabetes with Hyperosmolarity

  • 250.10-250.13

  • 250.20-250.23

  • 251.0

  • 249.10-249.11

  • 249.20-249.21
Surgical Site Infection, Mediastinitis, following Coronary Artery Bypass Graft (CABG)

  • 519.2

And one of the following procedure codes:

  • 36.10-36.19

Surgical Site Following Certain Orthopedic Procedures:

  • Spine
  • Neck
  • Shoulder
  • Elbow

  • 996.67

  • 998.59

And of the following procedure codes:

  • 81.01-81.08

  • 81.23-81.24

  • 81.31-81.38

  • 81.83

  • 81.85

Surgical Site Infection Following Bariatric Surgery for Obesity:

  • Laparoscopic Gastric Bypass
  • Gastroenterostomy
  • Laparoscopic Gastric Restrictive Surgery

Principal Diagnosis –

  • 278.01

  • 539.01

  • 539.81

  • 998.59

And one of the following procedure codes:

  • 44.38

  • 44.39

  • 44.95

Deep Vein Thrombosis and Pulmonary Embolism Following Certain Orthopedic Procedures:

  • Total Knee Replacement
  • Hip Replacement 415.11

  • 415.13

  • 415.19

  • 453.40-453.42

And one of the following procedure codes:

  • 00.85-00.87

  • 81.51-81.52

  • 81.54