Diagnosis · Mapper
ICD-10 → PDGM Mapper
Look up a Home Health primary diagnosis to see its PDGM clinical group. With the CMS file loaded, every acceptable code maps exactly; otherwise the tool shows curated codes precisely and estimates the rest from the ICD-10 chapter.
Data statusBeta
- Status
- Beta
- Data year / effective
- ICD-10-CM FY2026
- Last reviewed
- June 2026
- Last updated
- June 2026
- Primary source
- ICD-10-CM (CMS/CDC); PDPM/PDGM grouper logic
- Known exclusions
- Not a substitute for the CMS grouper or payer validation
- Curated / partial mapping where the official file is not loaded
- ICD-10-CM updates annually (Oct 1)
Beta / Reference Only — not a substitute for the CMS grouper or payer validation.
Primary diagnosis
PDGM groups the 30-day period from the principal diagnosis (12 clinical groups). A code that isn't on the CMS acceptable list returns to provider — check that on the Principal Diagnosis Checker.
