ICD-10 · PDGM grouping
M85 Other disorders of bone density and structure
All 169 codes in the M85 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
ICD-10-CM FY2027 · CMS grouper v07.2.26
Codes in family
169
Can lead a claim
111
Cannot lead a claim
58
What CMS assigns to M85
111 of the 169 codes group to Musculoskeletal Rehabilitation; 58 are assigned no clinical group. None of the 169 is assigned a comorbidity subgroup. 111 of the 169 can lead a claim.
Every code in M85
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| M85.0 Fibrous dysplasia (monostotic) | ||||
| M85.00 | Fibrous dysplasia (monostotic), unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.01 Fibrous dysplasia (monostotic), shoulder | ||||
| M85.011 | Fibrous dysplasia (monostotic), right shoulder | Can lead a claim | E | None |
| M85.012 | Fibrous dysplasia (monostotic), left shoulder | Can lead a claim | E | None |
| M85.019 | Fibrous dysplasia (monostotic), unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.02 Fibrous dysplasia (monostotic), upper arm | ||||
| M85.021 | Fibrous dysplasia (monostotic), right upper arm | Can lead a claim | E | None |
| M85.022 | Fibrous dysplasia (monostotic), left upper arm | Can lead a claim | E | None |
| M85.029 | Fibrous dysplasia (monostotic), unspecified upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.03 Fibrous dysplasia (monostotic), forearm | ||||
| M85.031 | Fibrous dysplasia (monostotic), right forearm | Can lead a claim | E | None |
| M85.032 | Fibrous dysplasia (monostotic), left forearm | Can lead a claim | E | None |
| M85.039 | Fibrous dysplasia (monostotic), unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.04 Fibrous dysplasia (monostotic), hand | ||||
| M85.041 | Fibrous dysplasia (monostotic), right hand | Can lead a claim | E | None |
| M85.042 | Fibrous dysplasia (monostotic), left hand | Can lead a claim | E | None |
| M85.049 | Fibrous dysplasia (monostotic), unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.05 Fibrous dysplasia (monostotic), thigh | ||||
| M85.051 | Fibrous dysplasia (monostotic), right thigh | Can lead a claim | E | None |
| M85.052 | Fibrous dysplasia (monostotic), left thigh | Can lead a claim | E | None |
| M85.059 | Fibrous dysplasia (monostotic), unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.06 Fibrous dysplasia (monostotic), lower leg | ||||
| M85.061 | Fibrous dysplasia (monostotic), right lower leg | Can lead a claim | E | None |
| M85.062 | Fibrous dysplasia (monostotic), left lower leg | Can lead a claim | E | None |
| M85.069 | Fibrous dysplasia (monostotic), unspecified lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.07 Fibrous dysplasia (monostotic), ankle and foot | ||||
| M85.071 | Fibrous dysplasia (monostotic), right ankle and foot | Can lead a claim | E | None |
| M85.072 | Fibrous dysplasia (monostotic), left ankle and foot | Can lead a claim | E | None |
| M85.079 | Fibrous dysplasia (monostotic), unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.08 | Fibrous dysplasia (monostotic), other site | Can lead a claim | E | None |
| M85.09 | Fibrous dysplasia (monostotic), multiple sites | Can lead a claim | E | None |
| M85.1 Skeletal fluorosis | ||||
| M85.10 | Skeletal fluorosis, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.11 Skeletal fluorosis, shoulder | ||||
| M85.111 | Skeletal fluorosis, right shoulder | Can lead a claim | E | None |
| M85.112 | Skeletal fluorosis, left shoulder | Can lead a claim | E | None |
| M85.119 | Skeletal fluorosis, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.12 Skeletal fluorosis, upper arm | ||||
| M85.121 | Skeletal fluorosis, right upper arm | Can lead a claim | E | None |
| M85.122 | Skeletal fluorosis, left upper arm | Can lead a claim | E | None |
| M85.129 | Skeletal fluorosis, unspecified upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.13 Skeletal fluorosis, forearm | ||||
| M85.131 | Skeletal fluorosis, right forearm | Can lead a claim | E | None |
| M85.132 | Skeletal fluorosis, left forearm | Can lead a claim | E | None |
| M85.139 | Skeletal fluorosis, unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.14 Skeletal fluorosis, hand | ||||
| M85.141 | Skeletal fluorosis, right hand | Can lead a claim | E | None |
| M85.142 | Skeletal fluorosis, left hand | Can lead a claim | E | None |
| M85.149 | Skeletal fluorosis, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.15 Skeletal fluorosis, thigh | ||||
| M85.151 | Skeletal fluorosis, right thigh | Can lead a claim | E | None |
| M85.152 | Skeletal fluorosis, left thigh | Can lead a claim | E | None |
| M85.159 | Skeletal fluorosis, unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.16 Skeletal fluorosis, lower leg | ||||
| M85.161 | Skeletal fluorosis, right lower leg | Can lead a claim | E | None |
| M85.162 | Skeletal fluorosis, left lower leg | Can lead a claim | E | None |
| M85.169 | Skeletal fluorosis, unspecified lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.17 Skeletal fluorosis, ankle and foot | ||||
| M85.171 | Skeletal fluorosis, right ankle and foot | Can lead a claim | E | None |
| M85.172 | Skeletal fluorosis, left ankle and foot | Can lead a claim | E | None |
| M85.179 | Skeletal fluorosis, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.18 | Skeletal fluorosis, other site | Can lead a claim | E | None |
| M85.19 | Skeletal fluorosis, multiple sites | Can lead a claim | E | None |
| M85.2 | Hyperostosis of skull | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.3 Osteitis condensans | ||||
| M85.30 | Osteitis condensans, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.31 Osteitis condensans, shoulder | ||||
| M85.311 | Osteitis condensans, right shoulder | Can lead a claim | E | None |
| M85.312 | Osteitis condensans, left shoulder | Can lead a claim | E | None |
| M85.319 | Osteitis condensans, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.32 Osteitis condensans, upper arm | ||||
| M85.321 | Osteitis condensans, right upper arm | Can lead a claim | E | None |
| M85.322 | Osteitis condensans, left upper arm | Can lead a claim | E | None |
| M85.329 | Osteitis condensans, unspecified upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.33 Osteitis condensans, forearm | ||||
| M85.331 | Osteitis condensans, right forearm | Can lead a claim | E | None |
| M85.332 | Osteitis condensans, left forearm | Can lead a claim | E | None |
| M85.339 | Osteitis condensans, unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.34 Osteitis condensans, hand | ||||
| M85.341 | Osteitis condensans, right hand | Can lead a claim | E | None |
| M85.342 | Osteitis condensans, left hand | Can lead a claim | E | None |
| M85.349 | Osteitis condensans, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.35 Osteitis condensans, thigh | ||||
| M85.351 | Osteitis condensans, right thigh | Can lead a claim | E | None |
| M85.352 | Osteitis condensans, left thigh | Can lead a claim | E | None |
| M85.359 | Osteitis condensans, unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.36 Osteitis condensans, lower leg | ||||
| M85.361 | Osteitis condensans, right lower leg | Can lead a claim | E | None |
| M85.362 | Osteitis condensans, left lower leg | Can lead a claim | E | None |
| M85.369 | Osteitis condensans, unspecified lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.37 Osteitis condensans, ankle and foot | ||||
| M85.371 | Osteitis condensans, right ankle and foot | Can lead a claim | E | None |
| M85.372 | Osteitis condensans, left ankle and foot | Can lead a claim | E | None |
| M85.379 | Osteitis condensans, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.38 | Osteitis condensans, other site | Can lead a claim | E | None |
| M85.39 | Osteitis condensans, multiple sites | Can lead a claim | E | None |
| M85.4 Solitary bone cyst | ||||
| M85.40 | Solitary bone cyst, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.41 Solitary bone cyst, shoulder | ||||
| M85.411 | Solitary bone cyst, right shoulder | Can lead a claim | E | None |
| M85.412 | Solitary bone cyst, left shoulder | Can lead a claim | E | None |
| M85.419 | Solitary bone cyst, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.42 Solitary bone cyst, humerus | ||||
| M85.421 | Solitary bone cyst, right humerus | Can lead a claim | E | None |
| M85.422 | Solitary bone cyst, left humerus | Can lead a claim | E | None |
| M85.429 | Solitary bone cyst, unspecified humerus | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.43 Solitary bone cyst, ulna and radius | ||||
| M85.431 | Solitary bone cyst, right ulna and radius | Can lead a claim | E | None |
| M85.432 | Solitary bone cyst, left ulna and radius | Can lead a claim | E | None |
| M85.439 | Solitary bone cyst, unspecified ulna and radius | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.44 Solitary bone cyst, hand | ||||
| M85.441 | Solitary bone cyst, right hand | Can lead a claim | E | None |
| M85.442 | Solitary bone cyst, left hand | Can lead a claim | E | None |
| M85.449 | Solitary bone cyst, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.45 Solitary bone cyst, pelvis | ||||
| M85.451 | Solitary bone cyst, right pelvis | Can lead a claim | E | None |
| M85.452 | Solitary bone cyst, left pelvis | Can lead a claim | E | None |
| M85.459 | Solitary bone cyst, unspecified pelvis | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.46 Solitary bone cyst, tibia and fibula | ||||
| M85.461 | Solitary bone cyst, right tibia and fibula | Can lead a claim | E | None |
| M85.462 | Solitary bone cyst, left tibia and fibula | Can lead a claim | E | None |
| M85.469 | Solitary bone cyst, unspecified tibia and fibula | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.47 Solitary bone cyst, ankle and foot | ||||
| M85.471 | Solitary bone cyst, right ankle and foot | Can lead a claim | E | None |
| M85.472 | Solitary bone cyst, left ankle and foot | Can lead a claim | E | None |
| M85.479 | Solitary bone cyst, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.48 | Solitary bone cyst, other site | Can lead a claim | E | None |
| M85.5 Aneurysmal bone cyst | ||||
| M85.50 | Aneurysmal bone cyst, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.51 Aneurysmal bone cyst, shoulder | ||||
| M85.511 | Aneurysmal bone cyst, right shoulder | Can lead a claim | E | None |
| M85.512 | Aneurysmal bone cyst, left shoulder | Can lead a claim | E | None |
| M85.519 | Aneurysmal bone cyst, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.52 Aneurysmal bone cyst, upper arm | ||||
| M85.521 | Aneurysmal bone cyst, right upper arm | Can lead a claim | E | None |
| M85.522 | Aneurysmal bone cyst, left upper arm | Can lead a claim | E | None |
| M85.529 | Aneurysmal bone cyst, unspecified upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.53 Aneurysmal bone cyst, forearm | ||||
| M85.531 | Aneurysmal bone cyst, right forearm | Can lead a claim | E | None |
| M85.532 | Aneurysmal bone cyst, left forearm | Can lead a claim | E | None |
| M85.539 | Aneurysmal bone cyst, unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.54 Aneurysmal bone cyst, hand | ||||
| M85.541 | Aneurysmal bone cyst, right hand | Can lead a claim | E | None |
| M85.542 | Aneurysmal bone cyst, left hand | Can lead a claim | E | None |
| M85.549 | Aneurysmal bone cyst, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.55 Aneurysmal bone cyst, thigh | ||||
| M85.551 | Aneurysmal bone cyst, right thigh | Can lead a claim | E | None |
| M85.552 | Aneurysmal bone cyst, left thigh | Can lead a claim | E | None |
| M85.559 | Aneurysmal bone cyst, unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.56 Aneurysmal bone cyst, lower leg | ||||
| M85.561 | Aneurysmal bone cyst, right lower leg | Can lead a claim | E | None |
| M85.562 | Aneurysmal bone cyst, left lower leg | Can lead a claim | E | None |
| M85.569 | Aneurysmal bone cyst, unspecified lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.57 Aneurysmal bone cyst, ankle and foot | ||||
| M85.571 | Aneurysmal bone cyst, right ankle and foot | Can lead a claim | E | None |
| M85.572 | Aneurysmal bone cyst, left ankle and foot | Can lead a claim | E | None |
| M85.579 | Aneurysmal bone cyst, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.58 | Aneurysmal bone cyst, other site | Can lead a claim | E | None |
| M85.59 | Aneurysmal bone cyst, multiple sites | Can lead a claim | E | None |
| M85.6 Other cyst of bone | ||||
| M85.60 | Other cyst of bone, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.61 Other cyst of bone, shoulder | ||||
| M85.611 | Other cyst of bone, right shoulder | Can lead a claim | E | None |
| M85.612 | Other cyst of bone, left shoulder | Can lead a claim | E | None |
| M85.619 | Other cyst of bone, unspecified shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.62 Other cyst of bone, upper arm | ||||
| M85.621 | Other cyst of bone, right upper arm | Can lead a claim | E | None |
| M85.622 | Other cyst of bone, left upper arm | Can lead a claim | E | None |
| M85.629 | Other cyst of bone, unspecified upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.63 Other cyst of bone, forearm | ||||
| M85.631 | Other cyst of bone, right forearm | Can lead a claim | E | None |
| M85.632 | Other cyst of bone, left forearm | Can lead a claim | E | None |
| M85.639 | Other cyst of bone, unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.64 Other cyst of bone, hand | ||||
| M85.641 | Other cyst of bone, right hand | Can lead a claim | E | None |
| M85.642 | Other cyst of bone, left hand | Can lead a claim | E | None |
| M85.649 | Other cyst of bone, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.65 Other cyst of bone, thigh | ||||
| M85.651 | Other cyst of bone, right thigh | Can lead a claim | E | None |
| M85.652 | Other cyst of bone, left thigh | Can lead a claim | E | None |
| M85.659 | Other cyst of bone, unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.66 Other cyst of bone, lower leg | ||||
| M85.661 | Other cyst of bone, right lower leg | Can lead a claim | E | None |
| M85.662 | Other cyst of bone, left lower leg | Can lead a claim | E | None |
| M85.669 | Other cyst of bone, unspecified lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.67 Other cyst of bone, ankle and foot | ||||
| M85.671 | Other cyst of bone, right ankle and foot | Can lead a claim | E | None |
| M85.672 | Other cyst of bone, left ankle and foot | Can lead a claim | E | None |
| M85.679 | Other cyst of bone, unspecified ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.68 | Other cyst of bone, other site | Can lead a claim | E | None |
| M85.69 | Other cyst of bone, multiple sites | Can lead a claim | E | None |
| M85.8 Other specified disorders of bone density and structure | ||||
| M85.80 | Other specified disorders of bone density and structure, unspecified siteCMS: Oth disrd of bone density and structure, unspecified site | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.81 Other specified disorders of bone density and structure, shoulder | ||||
| M85.811 | Other specified disorders of bone density and structure, right shoulderCMS: Oth disrd of bone density and structure, right shoulder | Can lead a claim | E | None |
| M85.812 | Other specified disorders of bone density and structure, left shoulderCMS: Oth disrd of bone density and structure, left shoulder | Can lead a claim | E | None |
| M85.819 | Other specified disorders of bone density and structure, unspecified shoulderCMS: Oth disrd of bone density and structure, unsp shoulder | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.82 Other specified disorders of bone density and structure, upper arm | ||||
| M85.821 | Other specified disorders of bone density and structure, right upper armCMS: Oth disrd of bone density and structure, right upper arm | Can lead a claim | E | None |
| M85.822 | Other specified disorders of bone density and structure, left upper armCMS: Oth disrd of bone density and structure, left upper arm | Can lead a claim | E | None |
| M85.829 | Other specified disorders of bone density and structure, unspecified upper armCMS: Oth disrd of bone density and structure, unsp upper arm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.83 Other specified disorders of bone density and structure, forearm | ||||
| M85.831 | Other specified disorders of bone density and structure, right forearmCMS: Oth disrd of bone density and structure, right forearm | Can lead a claim | E | None |
| M85.832 | Other specified disorders of bone density and structure, left forearmCMS: Oth disrd of bone density and structure, left forearm | Can lead a claim | E | None |
| M85.839 | Other specified disorders of bone density and structure, unspecified forearmCMS: Oth disrd of bone density and structure, unspecified forearm | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.84 Other specified disorders of bone density and structure, hand | ||||
| M85.841 | Other specified disorders of bone density and structure, right handCMS: Oth disrd of bone density and structure, right hand | Can lead a claim | E | None |
| M85.842 | Other specified disorders of bone density and structure, left handCMS: Oth disrd of bone density and structure, left hand | Can lead a claim | E | None |
| M85.849 | Other specified disorders of bone density and structure, unspecified handCMS: Oth disrd of bone density and structure, unspecified hand | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.85 Other specified disorders of bone density and structure, thigh | ||||
| M85.851 | Other specified disorders of bone density and structure, right thighCMS: Oth disrd of bone density and structure, right thigh | Can lead a claim | E | None |
| M85.852 | Other specified disorders of bone density and structure, left thighCMS: Oth disrd of bone density and structure, left thigh | Can lead a claim | E | None |
| M85.859 | Other specified disorders of bone density and structure, unspecified thighCMS: Oth disrd of bone density and structure, unspecified thigh | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.86 Other specified disorders of bone density and structure, lower leg | ||||
| M85.861 | Other specified disorders of bone density and structure, right lower legCMS: Oth disrd of bone density and structure, right lower leg | Can lead a claim | E | None |
| M85.862 | Other specified disorders of bone density and structure, left lower legCMS: Oth disrd of bone density and structure, left lower leg | Can lead a claim | E | None |
| M85.869 | Other specified disorders of bone density and structure, unspecified lower legCMS: Oth disrd of bone density and structure, unsp lower leg | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.87 Other specified disorders of bone density and structure, ankle and foot | ||||
| M85.871 | Other specified disorders of bone density and structure, right ankle and footCMS: Oth disrd of bone density and structure, right ank/ft | Can lead a claim | E | None |
| M85.872 | Other specified disorders of bone density and structure, left ankle and footCMS: Oth disrd of bone density and structure, left ankle and foot | Can lead a claim | E | None |
| M85.879 | Other specified disorders of bone density and structure, unspecified ankle and footCMS: Oth disrd of bone density and structure, unsp ankle and foot | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
| M85.88 | Other specified disorders of bone density and structure, other siteCMS: Oth disrd of bone density and structure, other site | Can lead a claim | E | None |
| M85.89 | Other specified disorders of bone density and structure, multiple sitesCMS: Oth disrd of bone density and structure, multiple sites | Can lead a claim | E | None |
| M85.9 | Disorder of bone density and structure, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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