ICD-10 · PDGM grouping
Y90 Evidence of alcohol involvement determined by blood alcohol level
All 10 codes in the Y90 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.
Codes in family
10
Can lead a claim
0
Cannot lead a claim
10
What CMS assigns to Y90
None of the 10 codes is assigned a clinical group. None of the 10 is assigned a comorbidity subgroup. None can lead a claim. CMS attaches a code-first note to all 10.
Code first
CMS grouper convention 172, on all 10 codes. Code first:
- any associated alcohol related disorders (F10)
Every code in Y90
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 |
|---|---|---|---|---|
| Y90.0 | Blood alcohol level of less than 20 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.1 | Blood alcohol level of 20-39 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.2 | Blood alcohol level of 40-59 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.3 | Blood alcohol level of 60-79 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.4 | Blood alcohol level of 80-99 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.5 | Blood alcohol level of 100-119 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.6 | Blood alcohol level of 120-199 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.7 | Blood alcohol level of 200-239 mg/100 ml | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.8 | Blood alcohol level of 240 mg/100 ml or more | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | None | None |
| Y90.9 | Presence of alcohol in blood, level not specified | Cannot lead a claimExternal cause of injury code not reportable as principal diagnosis | 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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