https://bphc.hrsa.gov/sites/default/files/bphc/datareporting/pdf/2021-uds-manual.pdf

TABLE 6A: SELECTED DIAGNOSES AND SERVICES RENDERED
Calendar Year: January 1, 2021, through December 31, 2021

Line	Diagnostic Category	ICD-10-CM Code
	Selected Infectious and Parasitic Diseases
1–2	Symptomatic/Asymptomatic human immunodeficiency virus (HIV)	B20, B97.35, O98.7-, Z21
3	Tuberculosis	A15- through A19-, O98.0
4	Sexually transmitted infections	A50- through A64-
4a	Hepatitis B	B16.0 through B16.2, B16.9, B17.0, B18.0, B18.1, B19.1-, O98.4-
4b	Hepatitis C	B17.1-, B18.2, B19.2-
4c	Novel coronavirus (SARS-CoV-2) disease	U07.1
	Selected Diseases of the Respiratory System
5	Asthma	J45-
6	Chronic lower respiratory diseases	J40 (count only when code U07.1 is not present), J41- through J44-, J47-
6a	Acute respiratory illness due to novel coronavirus (SARS-CoV-2) disease	J12.89, J20.8, J40, J22, J98.8, J80 (count only when code U07.1 is present)
	Selected Other Medical Conditions
7	Abnormal breast findings, female	C50.01-, C50.11-, C50.21-, C50.31-, C50.41-, C50.51-, C50.61-, C50.81-, C50.91-, C79.81, D05-, D48.6-, D49.3, N60-, N63-, R92-
8	Abnormal cervical findings	C53-, C79.82, D06-, R87.61-, R87.629, R87.810, R87.820
9	Diabetes mellitus	E08- through E13-, O24- (exclude O24.41-)
10	Heart disease (selected)	I01-, I02- (exclude I02.9), I20- through I25-, I27-, I28-, I30- through I52-
11	Hypertension	I10- through I16-, O10-, O11-
12	Contact dermatitis and other eczema	L23- through L25-, L30- (excludeL30.1, L30.3, L30.4, L30.5), L58-
13	Dehydration	E86-
14	Exposure to heat or cold	T33-, T34-, T67-, T68-, T69-, W92-, W93-
14a	Overweight and obesity	E66-, Z68- (exclude Z68.1, Z68.20 through Z68.24, Z68.51, Z68.52)
	Selected Childhood Conditions (limited to ages 0 through 17)
15	Otitis media and Eustachian tube disorders	H65- through H69-
16	Selected perinatal/neonatal medical conditions	A33-, P19-, P22- through P29- (exclude P29.3), P35- through P96- (exclude P54-, P91.6-, P92-, P96.81), R78.81, R78.89
17	Lack of expected normal physiological development (such as delayed milestone, failure to gain weight, failure to thrive); nutritional deficiencies in children only. Does not include sexual or mental development.	E40- through E46-, E50- through E63-, P92-, R62- (exclude R62.7), R63.3
	Selected Mental Health Conditions, Substance Use Disorders, and Exploitations
18	Alcohol-related disorders	F10-, G62.1, O99.31-
19	Other substance-related disorders (excluding tobacco use disorders)	F11- through F19- (exclude F17-), G62.0, O99.32-
19a	Tobacco use disorder	F17-, O99.33-
20a	Depression and other mood disorders	F30- through F39-
20b	Anxiety disorders, including posttraumatic stress disorder (PTSD)	F06.4, F40- through F42-, F43.0, F43.1-, F93.0
20c	Attention deficit and disruptive behavior disorders	F90- through F91-
20d	Other mental disorders, excluding drug or alcohol dependence	F01- through F09- (exclude F06.4), F20- through F29-, F43- through F48- (exclude F43.0- and F43.1-), F50- through F99- (exclude F55-, F84.2, F90-, F91-, F93.0, F98-), O99.34-, R45.1, R45.2, R45.5, R45.6, R45.7, R45.81, R45.82, R48.0
20e	Human trafficking	T74.5- through T74.6-, T76.5- through T76.6-, Z04.81, Z04.82, Z62.813, Z91.42
20f	Intimate partner violence	T74.11, T74.21, T74.31, Z69.11, Y07.0
	Selected Diagnostic Tests/ Screening/Preventive Services
21	HIV test	CPT-4: 86689, 86701 through 86703, 87389 through 87391, 87534 through 87539, 87806
21a	Hepatitis B test	CPT-4: 86704 through 86707, 87340, 87341, 87350
21b	Hepatitis C test	CPT-4: 86803, 86804, 87520 through 87522
21c	Novel coronavirus (SARS-CoV-2) diagnostic test	CPT-4: 87426, 87635 HCPCS: U0001, U0002, U0003, U0004 CPT PLA: 0202U, 0223U, 0225U
21d	Novel coronavirus (SARS-CoV-2) antibody test	CPT-4: 86328, 86408, 86409, 86769 CPT PLA: 0224U, 0226U
21e	Pre-Exposure Prophylaxis (PrEP)- associated management of all PrEP patients	CPT-4: 99401-99404 ICD-10: Z11.3, Z11.4, Z20.2, Z20.6, Z51.81, Z71.51, Z71.7, Z79.899 Limit to emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) or emtricitabine/tenofovir alafenamide (FTC/TAF) for PrEP
22	Mammogram	CPT-4: 77065, 77066, 77067 ICD-10: Z12.31
23	Pap test	CPT-4: 88141 through 88153, 88155, 88164 through 88167, 88174, 88175 ICD-10: Z01.41-, Z01.42, Z12.4 (exclude Z01.411 and Z01.419)
24	Selected immunizations: hepatitis A; haemophilus influenzae B (HiB); pneumococcal, diphtheria, tetanus, pertussis (DTaP) (DTP) (DT); measles, mumps, rubella (MMR); poliovirus; varicella; hepatitis B	CPT-4: 90632, 90633, 90634, 90636, 90643, 90644, 90645, 90646, 90647, 90648, 90669, 90670, 90696, 90697, 90698, 90700, 90701, 90702, 90703, 90704, 90705, 90706, 90707, 90708, 90710, 90712, 90713, 90714, 90715, 90716, 90718, 90720, 90721, 90723, 90730, 90731, 90732, 90740, 90743, 90744, 90745, 90746, 90747, 90748
24a	Seasonal flu vaccine	CPT-4: 90630, 90653 through 90657, 90658, 90661, 90662, 90672, 90673, 90674, 90682, 90685 through 90689, 90756
25	Contraceptive management	ICD-10: Z30
26	Health supervision of infant or child (ages 0 through 11)	CPT-4: 99381 through 99383, 99391 through 99393 ICD-10: Z00.1-
26a	Childhood lead test screening (9 to 72 months)	ICD-10: Z13.88 CPT-4: 83655
26b	Screening, Brief Intervention, and Referral to Treatment (SBIRT)	CPT-4: 99408, 99409 HCPCS: G0396, G0397, G0443, H0050
26c	Smoke and tobacco use cessation counseling	CPT-4: 99406, 99407 HCPCS: S9075 CPT-II: 4000F, 4001F, 4004F
26d	Comprehensive and intermediate eye exams	CPT-4: 92002, 92004, 92012, 92014
	Selected Dental Services
27	Emergency services	CDT: D0140, D9110
28	Oral exams	CDT: D0120, DO145, D0150, D0160, D0170, D0171, D0180
29	Prophylaxis—adult or child	CDT: D1110, D1120
30	Sealants	CDT: D1351
31	Fluoride treatment—adult or child	CDT: D1206, D1208 CPT-4: 99188
32	Restorative services	CDT: D21xx through D29xx
33	Oral surgery (extractions and other surgical procedures)	CDT: D7xxx
34	Rehabilitative services (Endo, Perio, Prostho, Ortho)	CDT: D3xxx, D4xxx, D5xxx, D6xxx, D8xxx

UDS Table 6A Services Rendered:

21c Novel coronavirus (SARS-CoV-2) diagnostic test CPT-4: 87426, 87635, 87636, 87637 HCPCS: U0001, U0002, U0003, U0004 CPT PLA: 0202U, 0223U, 0225U, 0240U, 0241U
21d Novel coronavirus (SARS-CoV-2) antibody test CPT-4: 86328, 86408, 86409, 86769 CPT PLA: 0224U, 0226U
24a Seasonal flu vaccine CPT-4: 90630, 90653 through 90657, 90658, 90661, 90662, 90672, 90673, 90674, 90682, 90685 through 90689, 90756
24b Coronavirus (SARS-CoV-2) vaccine CPT-I: 0001A, 0002A, 0011A, 0012A, 0021A, 0022A, 0031A,

Browser not supported