RTM · Internal Medicine
RTM Qualifying Diagnoses
for Internal Medicine.
266 ICD-10-CM codes cover internal medicine patients for Remote Therapeutic Monitoring (RTM).
Qualifying Codes
ICD-10 codes for internal medicine.
Endocrine and metabolic
Cystic fibrosis and metabolic developmental disorders
E84, E70, E71, E72, E74, E75, E76, E77, E79, E80183 codes in familyrpmccmpcmrtmLung function and oxygenation for cystic fibrosis, with weight as a nutritional marker.
Cystic fibrosis and metabolic developmental disorders
E84, E70, E71, E72, E74, E75, E76, E77, E79, E80183 codes in familyrpmccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Cystic Fibrosis and Other Metabolic Developmental Disorders · Devices: Spirometer or peak flow meter, Pulse oximeter, Connected weight scale
This family runs to 183 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within E84, E70, E71, E72, E74, E75, E76, E77, E79, E80.
Respiratory
COPD, emphysema and bronchiectasis
J40, J41, J42, J43, J44, J4718 codesrpmccmpcmrtmOxygen saturation is the primary signal, with symptom scores and inhaler adherence supporting RTM.
COPD, emphysema and bronchiectasis
J40, J41, J42, J43, J44, J4718 codesrpmccmpcmrtmCMS chronic condition · CCW category: Chronic Obstructive Pulmonary Disease · Devices: Pulse oximeter, Spirometer or peak flow meter
Read the copd, emphysema and bronchiectasis monitoring guide
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| J40 | Bronchitis, not specified as acute or chronic | rpmccmpcmrtm | not risk adjusted |
| J41.0 | Simple chronic bronchitis | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J41.1 | Mucopurulent chronic bronchitis | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J41.8 | Mixed simple and mucopurulent chronic bronchitis | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J42 | Unspecified chronic bronchitis | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J43.0 | Unilateral pulmonary emphysema [MacLeod's syndrome] | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J43.1 | Panlobular emphysema | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J43.2 | Centrilobular emphysema | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J43.8 | Other emphysema | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J43.9 | Emphysema, unspecified | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J44.0 | Chronic obstructive pulmonary disease with (acute) lower respiratory infection | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J44.1 | Chronic obstructive pulmonary disease with (acute) exacerbation | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J44.81 | Bronchiolitis obliterans and bronchiolitis obliterans syndrome | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J44.89 | Other specified chronic obstructive pulmonary disease | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J44.9 | Chronic obstructive pulmonary disease, unspecified | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J47.0 | Bronchiectasis with acute lower respiratory infection | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J47.1 | Bronchiectasis with (acute) exacerbation | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
| J47.9 | Bronchiectasis, uncomplicated | rpmccmpcmrtm | HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders |
Asthma
J4518 codesrpmccmrtmPeak flow and symptom frequency. Inhaler adherence and technique are the classic RTM targets.
Asthma
J4518 codesrpmccmrtmCMS chronic condition · CCW category: Asthma · Devices: Spirometer or peak flow meter, Pulse oximeter, Patient-reported outcome app (RTM)
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| J45.20 | Mild intermittent asthma, uncomplicated | rpmccmrtm | not risk adjusted |
| J45.21 | Mild intermittent asthma with (acute) exacerbation | rpmccmrtm | not risk adjusted |
| J45.22 | Mild intermittent asthma with status asthmaticus | rpmccmrtm | not risk adjusted |
| J45.30 | Mild persistent asthma, uncomplicated | rpmccmrtm | not risk adjusted |
| J45.31 | Mild persistent asthma with (acute) exacerbation | rpmccmrtm | not risk adjusted |
| J45.32 | Mild persistent asthma with status asthmaticus | rpmccmrtm | not risk adjusted |
| J45.40 | Moderate persistent asthma, uncomplicated | rpmccmrtm | not risk adjusted |
| J45.41 | Moderate persistent asthma with (acute) exacerbation | rpmccmrtm | not risk adjusted |
| J45.42 | Moderate persistent asthma with status asthmaticus | rpmccmrtm | not risk adjusted |
| J45.50 | Severe persistent asthma, uncomplicated | rpmccmrtm | HCC 279 · Severe Persistent Asthma |
| J45.51 | Severe persistent asthma with (acute) exacerbation | rpmccmrtm | HCC 279 · Severe Persistent Asthma |
| J45.52 | Severe persistent asthma with status asthmaticus | rpmccmrtm | HCC 279 · Severe Persistent Asthma |
| J45.901 | Unspecified asthma with (acute) exacerbationlow specificity | rpmccmrtm | not risk adjusted |
| J45.902 | Unspecified asthma with status asthmaticuslow specificity | rpmccmrtm | not risk adjusted |
| J45.909 | Unspecified asthma, uncomplicatedlow specificity | rpmccmrtm | not risk adjusted |
| J45.990 | Exercise induced bronchospasm | rpmccmrtm | not risk adjusted |
| J45.991 | Cough variant asthma | rpmccmrtm | not risk adjusted |
| J45.998 | Other asthma | rpmccmrtm | not risk adjusted |
Neurologic and cognitive
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmGait, activity and fall detection, with therapy adherence tracked under RTM.
Parkinson's disease and secondary parkinsonism
G20, G21, G23, G24, G2545 codesccmpcmrtmCMS chronic condition · CCW category: Parkinson's Disease and Secondary Parkinsonism · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
G20 alone is no longer valid. Code to G20.A1, G20.A2, G20.B1, G20.B2 or G20.C.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G20.A1 | Parkinson's disease without dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.A2 | Parkinson's disease without dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B1 | Parkinson's disease with dyskinesia, without mention of fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.B2 | Parkinson's disease with dyskinesia, with fluctuations | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G20.C | Parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.0 | Malignant neuroleptic syndrome | ccmpcmrtm | not risk adjusted |
| G21.11 | Neuroleptic induced parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.19 | Other drug induced secondary parkinsonism | ccmpcmrtm | not risk adjusted |
| G21.2 | Secondary parkinsonism due to other external agents | ccmpcmrtm | not risk adjusted |
| G21.3 | Postencephalitic parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.4 | Vascular parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.8 | Other secondary parkinsonism | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G21.9 | Secondary parkinsonism, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.0 | Hallervorden-Spatz disease | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.1 | Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski] | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.2 | Striatonigral degeneration | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.3 | Hypomyelination with atrophy of the basal ganglia and cerebellum | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.8 | Other specified degenerative diseases of basal ganglia | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G23.9 | Degenerative disease of basal ganglia, unspecified | ccmpcmrtm | HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia |
| G24.01 | Drug induced subacute dyskinesia | ccmpcmrtm | not risk adjusted |
| G24.02 | Drug induced acute dystonia | ccmpcmrtm | not risk adjusted |
| G24.09 | Other drug induced dystonia | ccmpcmrtm | not risk adjusted |
| G24.1 | Genetic torsion dystonia | ccmpcmrtm | not risk adjusted |
| G24.2 | Idiopathic nonfamilial dystonia | ccmpcmrtm | not risk adjusted |
| G24.3 | Spasmodic torticollis | ccmpcmrtm | not risk adjusted |
| G24.4 | Idiopathic orofacial dystonia | ccmpcmrtm | not risk adjusted |
| G24.5 | Blepharospasm | ccmpcmrtm | not risk adjusted |
| G24.8 | Other dystonia | ccmpcmrtm | not risk adjusted |
| G24.9 | Dystonia, unspecified | ccmpcmrtm | not risk adjusted |
| G25.0 | Essential tremor | ccmpcmrtm | not risk adjusted |
| G25.1 | Drug-induced tremor | ccmpcmrtm | not risk adjusted |
| G25.2 | Other specified forms of tremor | ccmpcmrtm | not risk adjusted |
| G25.3 | Myoclonus | ccmpcmrtm | not risk adjusted |
| G25.4 | Drug-induced chorea | ccmpcmrtm | not risk adjusted |
| G25.5 | Other chorea | ccmpcmrtm | not risk adjusted |
| G25.61 | Drug induced tics | ccmpcmrtm | not risk adjusted |
| G25.69 | Other tics of organic origin | ccmpcmrtm | not risk adjusted |
| G25.70 | Drug induced movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
| G25.71 | Drug induced akathisia | ccmpcmrtm | not risk adjusted |
| G25.79 | Other drug induced movement disorders | ccmpcmrtm | not risk adjusted |
| G25.81 | Restless legs syndrome | ccmpcmrtm | not risk adjusted |
| G25.82 | Stiff-man syndrome | ccmpcmrtm | not risk adjusted |
| G25.83 | Benign shuddering attacks | ccmpcmrtm | not risk adjusted |
| G25.89 | Other specified extrapyramidal and movement disorders | ccmpcmrtm | not risk adjusted |
| G25.9 | Extrapyramidal and movement disorder, unspecified | ccmpcmrtm | not risk adjusted |
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmFunction and fatigue tracking, with therapy adherence under RTM.
Multiple sclerosis and demyelinating disease
G35, G36, G3721 codesccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Multiple Sclerosis and Transverse Myelitis · Devices: Patient-reported outcome app (RTM), Contactless activity and fall radar
G35 alone is no longer valid as of FY2026. Code to G35.A through G35.D.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G35.A | Relapsing-remitting multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B0 | Primary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B1 | Active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.B2 | Non-active primary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C0 | Secondary progressive multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C1 | Active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.C2 | Non-active secondary progressive multiple sclerosis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G35.D | Multiple sclerosis, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.0 | Neuromyelitis optica [Devic] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.1 | Acute and subacute hemorrhagic leukoencephalitis [Hurst] | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.8 | Other specified acute disseminated demyelination | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G36.9 | Acute disseminated demyelination, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.0 | Diffuse sclerosis of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.1 | Central demyelination of corpus callosum | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.2 | Central pontine myelinolysis | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.3 | Acute transverse myelitis in demyelinating disease of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.4 | Subacute necrotizing myelitis of central nervous system | ccmpcmrtm | HCC 182 · Spinal Cord Disorders/Injuries |
| G37.5 | Concentric sclerosis [Balo] of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.81 | Myelin oligodendrocyte glycoprotein antibody disease | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.89 | Other specified demyelinating diseases of central nervous system | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
| G37.9 | Demyelinating disease of central nervous system, unspecified | ccmpcmrtm | HCC 198 · Multiple Sclerosis |
Migraine and other chronic headache
G43, G4488 codesccmrtmHeadache diary, trigger tracking and abortive-medication frequency.
Migraine and other chronic headache
G43, G4488 codesccmrtmCMS other chronic or potentially disabling condition · CCW category: Migraine and Other Chronic Headache · Devices: Patient-reported outcome app (RTM)
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G43.001 | Migraine without aura, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.009 | Migraine without aura, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.011 | Migraine without aura, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.019 | Migraine without aura, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.101 | Migraine with aura, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.109 | Migraine with aura, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.111 | Migraine with aura, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.119 | Migraine with aura, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.401 | Hemiplegic migraine, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.409 | Hemiplegic migraine, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.411 | Hemiplegic migraine, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.419 | Hemiplegic migraine, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.501 | Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.509 | Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.511 | Persistent migraine aura without cerebral infarction, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.519 | Persistent migraine aura without cerebral infarction, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.601 | Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.609 | Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.611 | Persistent migraine aura with cerebral infarction, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.619 | Persistent migraine aura with cerebral infarction, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.701 | Chronic migraine without aura, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.711 | Chronic migraine without aura, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.801 | Other migraine, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.809 | Other migraine, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.811 | Other migraine, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.819 | Other migraine, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.821 | Menstrual migraine, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.829 | Menstrual migraine, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.831 | Menstrual migraine, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.839 | Menstrual migraine, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.901 | Migraine, unspecified, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.909 | Migraine, unspecified, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.911 | Migraine, unspecified, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.919 | Migraine, unspecified, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.A0 | Cyclical vomiting, in migraine, not intractable | ccmrtm | not risk adjusted |
| G43.A1 | Cyclical vomiting, in migraine, intractable | ccmrtm | not risk adjusted |
| G43.B0 | Ophthalmoplegic migraine, not intractable | ccmrtm | not risk adjusted |
| G43.B1 | Ophthalmoplegic migraine, intractable | ccmrtm | not risk adjusted |
| G43.C0 | Periodic headache syndromes in child or adult, not intractable | ccmrtm | not risk adjusted |
| G43.C1 | Periodic headache syndromes in child or adult, intractable | ccmrtm | not risk adjusted |
| G43.D0 | Abdominal migraine, not intractable | ccmrtm | not risk adjusted |
| G43.D1 | Abdominal migraine, intractable | ccmrtm | not risk adjusted |
| G43.E01 | Chronic migraine with aura, not intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.E09 | Chronic migraine with aura, not intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G43.E11 | Chronic migraine with aura, intractable, with status migrainosus | ccmrtm | not risk adjusted |
| G43.E19 | Chronic migraine with aura, intractable, without status migrainosus | ccmrtm | not risk adjusted |
| G44.001 | Cluster headache syndrome, unspecified, intractable | ccmrtm | not risk adjusted |
| G44.009 | Cluster headache syndrome, unspecified, not intractable | ccmrtm | not risk adjusted |
| G44.011 | Episodic cluster headache, intractable | ccmrtm | not risk adjusted |
| G44.019 | Episodic cluster headache, not intractable | ccmrtm | not risk adjusted |
| G44.021 | Chronic cluster headache, intractable | ccmrtm | not risk adjusted |
| G44.029 | Chronic cluster headache, not intractable | ccmrtm | not risk adjusted |
| G44.031 | Episodic paroxysmal hemicrania, intractable | ccmrtm | not risk adjusted |
| G44.039 | Episodic paroxysmal hemicrania, not intractable | ccmrtm | not risk adjusted |
| G44.041 | Chronic paroxysmal hemicrania, intractable | ccmrtm | not risk adjusted |
| G44.049 | Chronic paroxysmal hemicrania, not intractable | ccmrtm | not risk adjusted |
| G44.051 | Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), intractable | ccmrtm | not risk adjusted |
| G44.059 | Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), not intractable | ccmrtm | not risk adjusted |
| G44.091 | Other trigeminal autonomic cephalgias (TAC), intractable | ccmrtm | not risk adjusted |
| G44.099 | Other trigeminal autonomic cephalgias (TAC), not intractable | ccmrtm | not risk adjusted |
| G44.1 | Vascular headache, not elsewhere classified | ccmrtm | not risk adjusted |
| G44.201 | Tension-type headache, unspecified, intractable | ccmrtm | not risk adjusted |
| G44.209 | Tension-type headache, unspecified, not intractable | ccmrtm | not risk adjusted |
| G44.211 | Episodic tension-type headache, intractable | ccmrtm | not risk adjusted |
| G44.219 | Episodic tension-type headache, not intractable | ccmrtm | not risk adjusted |
| G44.221 | Chronic tension-type headache, intractable | ccmrtm | not risk adjusted |
| G44.229 | Chronic tension-type headache, not intractable | ccmrtm | not risk adjusted |
| G44.301 | Post-traumatic headache, unspecified, intractable | ccmrtm | not risk adjusted |
| G44.309 | Post-traumatic headache, unspecified, not intractable | ccmrtm | not risk adjusted |
| G44.311 | Acute post-traumatic headache, intractable | ccmrtm | not risk adjusted |
| G44.319 | Acute post-traumatic headache, not intractable | ccmrtm | not risk adjusted |
| G44.321 | Chronic post-traumatic headache, intractable | ccmrtm | not risk adjusted |
| G44.329 | Chronic post-traumatic headache, not intractable | ccmrtm | not risk adjusted |
| G44.40 | Drug-induced headache, not elsewhere classified, not intractable | ccmrtm | not risk adjusted |
| G44.41 | Drug-induced headache, not elsewhere classified, intractable | ccmrtm | not risk adjusted |
| G44.51 | Hemicrania continua | ccmrtm | not risk adjusted |
| G44.52 | New daily persistent headache (NDPH) | ccmrtm | not risk adjusted |
| G44.53 | Primary thunderclap headache | ccmrtm | not risk adjusted |
| G44.59 | Other complicated headache syndrome | ccmrtm | not risk adjusted |
| G44.81 | Hypnic headache | ccmrtm | not risk adjusted |
| G44.82 | Headache associated with sexual activity | ccmrtm | not risk adjusted |
| G44.83 | Primary cough headache | ccmrtm | not risk adjusted |
| G44.84 | Primary exertional headache | ccmrtm | not risk adjusted |
| G44.85 | Primary stabbing headache | ccmrtm | not risk adjusted |
| G44.86 | Cervicogenic headache | ccmrtm | not risk adjusted |
| G44.89 | Other headache syndrome | ccmrtm | not risk adjusted |
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmPain and function scores, most often alongside diabetes management.
Polyneuropathy and nerve disorders
G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 107 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmFunction, mobility and pressure-injury surveillance.
Paralysis, cerebral palsy and spinal cord injury
G80, G81, G82, G83, G9562 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Cerebral Palsy · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 62 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G80, G81, G82, G83, G95.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmFunction tracking, with respiratory surveillance where the diaphragm is involved.
Muscular dystrophy and myopathies
G71, G72, G7340 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Muscular Dystrophy · Devices: Patient-reported outcome app (RTM), Pulse oximeter
This family runs to 40 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G71, G72, G73.
Musculoskeletal and pain
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmDisease-activity scores, function and therapy adherence.
Rheumatoid and inflammatory arthritis
M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcmCMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)
This family runs to 743 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M05, M06, M08, M12, M13, M45, M46.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmPain, function and home-exercise adherence, the standard RTM programme.
Low back pain and dorsalgia
M54, M51.1, M51.3, M47.81, M43.166 codesrtmccmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
M54.5 was deleted on 2021-10-01. Code to M54.50, M54.51 (vertebrogenic) or M54.59.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| M43.10 | Spondylolisthesis, site unspecified | rtmccm | not risk adjusted |
| M43.11 | Spondylolisthesis, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M43.12 | Spondylolisthesis, cervical region | rtmccm | not risk adjusted |
| M43.13 | Spondylolisthesis, cervicothoracic region | rtmccm | not risk adjusted |
| M43.14 | Spondylolisthesis, thoracic region | rtmccm | not risk adjusted |
| M43.15 | Spondylolisthesis, thoracolumbar region | rtmccm | not risk adjusted |
| M43.16 | Spondylolisthesis, lumbar region | rtmccm | not risk adjusted |
| M43.17 | Spondylolisthesis, lumbosacral region | rtmccm | not risk adjusted |
| M43.18 | Spondylolisthesis, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M43.19 | Spondylolisthesis, multiple sites in spine | rtmccm | not risk adjusted |
| M47.811 | Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region | rtmccm | not risk adjusted |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M47.818 | Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M47.819 | Spondylosis without myelopathy or radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M51.14 | Intervertebral disc disorders with radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M51.15 | Intervertebral disc disorders with radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M51.17 | Intervertebral disc disorders with radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M51.34 | Other intervertebral disc degeneration, thoracic region | rtmccm | not risk adjusted |
| M51.35 | Other intervertebral disc degeneration, thoracolumbar region | rtmccm | not risk adjusted |
| M51.360 | Other intervertebral disc degeneration, lumbar region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.361 | Other intervertebral disc degeneration, lumbar region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.362 | Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.369 | Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M51.370 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only | rtmccm | not risk adjusted |
| M51.371 | Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only | rtmccm | not risk adjusted |
| M51.372 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain | rtmccm | not risk adjusted |
| M51.379 | Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain | rtmccm | not risk adjusted |
| M54.00 | Panniculitis affecting regions of neck and back, site unspecified | rtmccm | not risk adjusted |
| M54.01 | Panniculitis affecting regions of neck and back, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.02 | Panniculitis affecting regions of neck and back, cervical region | rtmccm | not risk adjusted |
| M54.03 | Panniculitis affecting regions of neck and back, cervicothoracic region | rtmccm | not risk adjusted |
| M54.04 | Panniculitis affecting regions of neck and back, thoracic region | rtmccm | not risk adjusted |
| M54.05 | Panniculitis affecting regions of neck and back, thoracolumbar region | rtmccm | not risk adjusted |
| M54.06 | Panniculitis affecting regions of neck and back, lumbar region | rtmccm | not risk adjusted |
| M54.07 | Panniculitis affecting regions of neck and back, lumbosacral region | rtmccm | not risk adjusted |
| M54.08 | Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.09 | Panniculitis affecting regions, neck and back, multiple sites in spine | rtmccm | not risk adjusted |
| M54.10 | Radiculopathy, site unspecified | rtmccm | not risk adjusted |
| M54.11 | Radiculopathy, occipito-atlanto-axial region | rtmccm | not risk adjusted |
| M54.12 | Radiculopathy, cervical region | rtmccm | not risk adjusted |
| M54.13 | Radiculopathy, cervicothoracic region | rtmccm | not risk adjusted |
| M54.14 | Radiculopathy, thoracic region | rtmccm | not risk adjusted |
| M54.15 | Radiculopathy, thoracolumbar region | rtmccm | not risk adjusted |
| M54.16 | Radiculopathy, lumbar region | rtmccm | not risk adjusted |
| M54.17 | Radiculopathy, lumbosacral region | rtmccm | not risk adjusted |
| M54.18 | Radiculopathy, sacral and sacrococcygeal region | rtmccm | not risk adjusted |
| M54.2 | Cervicalgia | rtmccm | not risk adjusted |
| M54.30 | Sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.31 | Sciatica, right side | rtmccm | not risk adjusted |
| M54.32 | Sciatica, left side | rtmccm | not risk adjusted |
| M54.40 | Lumbago with sciatica, unspecified side | rtmccm | not risk adjusted |
| M54.41 | Lumbago with sciatica, right side | rtmccm | not risk adjusted |
| M54.42 | Lumbago with sciatica, left side | rtmccm | not risk adjusted |
| M54.50 | Low back pain, unspecified | rtmccm | not risk adjusted |
| M54.51 | Vertebrogenic low back pain | rtmccm | not risk adjusted |
| M54.59 | Other low back pain | rtmccm | not risk adjusted |
| M54.6 | Pain in thoracic spine | rtmccm | not risk adjusted |
| M54.81 | Occipital neuralgia | rtmccm | not risk adjusted |
| M54.89 | Other dorsalgia | rtmccm | not risk adjusted |
| M54.9 | Dorsalgia, unspecified | rtmccm | not risk adjusted |
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiPain scores, sleep and function, with behavioural support where indicated.
Chronic pain and fibromyalgia
M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhiCMS other chronic or potentially disabling condition · CCW category: Fibromyalgia, Chronic Pain and Fatigue · Devices: Patient-reported outcome app (RTM)
G89.4 (chronic pain syndrome) and G89.29 (other chronic pain) are secondary codes. Code the underlying condition alongside.
| Code | Official ICD-10-CM description | Programs | Risk adjustment |
|---|---|---|---|
| G89.21 | Chronic pain due to trauma | rtmccmbhi | not risk adjusted |
| G89.22 | Chronic post-thoracotomy pain | rtmccmbhi | not risk adjusted |
| G89.28 | Other chronic postprocedural pain | rtmccmbhi | not risk adjusted |
| G89.29 | Other chronic pain | rtmccmbhi | not risk adjusted |
| G89.4 | Chronic pain syndrome | rtmccmbhi | not risk adjusted |
| G93.31 | Postviral fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.32 | Myalgic encephalomyelitis/chronic fatigue syndrome | rtmccmbhi | not risk adjusted |
| G93.39 | Other post infection and related fatigue syndromes | rtmccmbhi | not risk adjusted |
| M79.7 | Fibromyalgia | rtmccmbhi | not risk adjusted |
| R52 | Pain, unspecified | rtmccmbhi | not risk adjusted |
Osteoporosis
M80, M81, M85496 codes in familyccmrtmFall risk and activity, with therapy adherence for balance and strength programmes.
Osteoporosis
M80, M81, M85496 codes in familyccmrtmCMS chronic condition · CCW category: Osteoporosis With or Without Pathological Fracture · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)
This family runs to 496 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M80, M81, M85.
Gout and crystal arthropathies
M1A, M10, M11460 codes in familyccmrtmFlare frequency and urate-lowering therapy adherence.
Gout and crystal arthropathies
M1A, M10, M11460 codes in familyccmrtmAdded by CCN Health · Devices: Patient-reported outcome app (RTM)
This family runs to 460 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M1A, M10, M11.
Other chronic and potentially disabling
Inflammatory bowel disease
K50, K51, K52.378 codes in familyccmpcmrtmSymptom and weight tracking against disease-activity indices.
Inflammatory bowel disease
K50, K51, K52.378 codes in familyccmpcmrtmAdded by CCN Health · Devices: Connected weight scale, Patient-reported outcome app (RTM)
This family runs to 78 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within K50, K51, K52.3.
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmRepositioning and mobility surveillance alongside structured wound assessment.
Pressure ulcers and chronic ulcers
L89, L97, L98.4407 codes in familyccmpcmrtmCMS other chronic or potentially disabling condition · CCW category: Pressure Ulcers and Chronic Ulcers · Devices: Contactless activity and fall radar
This family runs to 407 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within L89, L97, L98.4.
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Clinical Context
Why internal medicine practices benefit from RTM.
Internal Medicine practices can leverage RTM to improve patient outcomes through structured care management, generating $97–$220+ per patient per month in Medicare reimbursement while reducing avoidable hospitalizations.
Related Conditions
Condition monitoring guides.
FAQ
Common questions.
What ICD-10 codes qualify internal medicine patients for RTM?
CMS publishes no list of codes that qualify a patient for RTM: eligibility turns on the condition and on documented medical necessity. For internal medicine, 266 billable ICD-10-CM codes cover the conditions RTM manages, spanning 16 conditions including cystic fibrosis and metabolic developmental disorders, copd, emphysema and bronchiectasis, asthma, parkinson's disease and secondary parkinsonism, multiple sclerosis and demyelinating disease, migraine and other chronic headache.
How does CCN Health support internal medicine practices with RTM?
CCN Health provides turnkey RTM services for internal medicine practices, including patient eligibility identification, enrollment documentation, device provisioning, clinical monitoring, and full Medicare billing support.
What is the revenue potential for RTM in internal medicine?
Reimbursement varies by locality and payer contract, so see the RTM billing guide for current figures. Internal Medicine practices with a high prevalence of these conditions generally see the most benefit, particularly when RTM is combined with RPM and CCM for patients whose needs are distinct enough to document separately.
Sources & Compliance
Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.
Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.
Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.
Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.


