About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for CT of the Head L34417.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Showing the first 1,000 of 7,599 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 70450 | HCPCS | Covered |
| 70460 | HCPCS | Covered |
| 70470 | HCPCS | Covered |
| G2187 | HCPCS | Covered |
| G2188 | HCPCS | Covered |
| G2189 | HCPCS | Covered |
| G2190 | HCPCS | Covered |
| G2191 | HCPCS | Covered |
| G2192 | HCPCS | Covered |
| G2193 | HCPCS | Covered |
| G2194 | HCPCS | Covered |
| G2195 | HCPCS | Covered |
| A06.6 | ICD10CM | Covered |
| A17.0 | ICD10CM | Covered |
| A17.1 | ICD10CM | Covered |
| A17.81 | ICD10CM | Covered |
| A17.82 | ICD10CM | Covered |
| A17.83 | ICD10CM | Covered |
| A17.89 | ICD10CM | Covered |
| A17.9 | ICD10CM | Covered |
| A27.81 | ICD10CM | Covered |
| A39.0 | ICD10CM | Covered |
| A39.1 | ICD10CM | Covered |
| A39.2 | ICD10CM | Covered |
| A39.3 | ICD10CM | Covered |
| A39.4 | ICD10CM | Covered |
| A39.81 | ICD10CM | Covered |
| A41.9 | ICD10CM | Covered |
| A81.00 | ICD10CM | Covered |
| A81.01 | ICD10CM | Covered |
| A81.09 | ICD10CM | Covered |
| A81.1 | ICD10CM | Covered |
| A81.2 | ICD10CM | Covered |
| A81.81 | ICD10CM | Covered |
| A81.83 | ICD10CM | Covered |
| A81.89 | ICD10CM | Covered |
| A81.9 | ICD10CM | Covered |
| A82.0 | ICD10CM | Covered |
| A82.1 | ICD10CM | Covered |
| A82.9 | ICD10CM | Covered |
| A83.0 | ICD10CM | Covered |
| A83.1 | ICD10CM | Covered |
| A83.2 | ICD10CM | Covered |
| A83.3 | ICD10CM | Covered |
| A83.4 | ICD10CM | Covered |
| A83.5 | ICD10CM | Covered |
| A83.6 | ICD10CM | Covered |
| A83.8 | ICD10CM | Covered |
| A83.9 | ICD10CM | Covered |
| A84.0 | ICD10CM | Covered |
| A84.1 | ICD10CM | Covered |
| A84.9 | ICD10CM | Covered |
| A85.0 | ICD10CM | Covered |
| A85.1 | ICD10CM | Covered |
| A85.2 | ICD10CM | Covered |
| A85.8 | ICD10CM | Covered |
| A86 | ICD10CM | Covered |
| A87.0 | ICD10CM | Covered |
| A87.1 | ICD10CM | Covered |
| A87.2 | ICD10CM | Covered |
| A87.8 | ICD10CM | Covered |
| A87.9 | ICD10CM | Covered |
| A88.0 | ICD10CM | Covered |
| A88.8 | ICD10CM | Covered |
| A89 | ICD10CM | Covered |
| B00.3 | ICD10CM | Covered |
| B00.4 | ICD10CM | Covered |
| B01.11 | ICD10CM | Covered |
| B02.0 | ICD10CM | Covered |
| B02.1 | ICD10CM | Covered |
| B02.21 | ICD10CM | Covered |
| B02.22 | ICD10CM | Covered |
| B02.23 | ICD10CM | Covered |
| B02.29 | ICD10CM | Covered |
| B05.0 | ICD10CM | Covered |
| B06.01 | ICD10CM | Covered |
| B20 | ICD10CM | Covered |
| B25.0 | ICD10CM | Covered |
| B25.1 | ICD10CM | Covered |
| B25.2 | ICD10CM | Covered |
| B25.8 | ICD10CM | Covered |
| B25.9 | ICD10CM | Covered |
| B26.1 | ICD10CM | Covered |
| B26.2 | ICD10CM | Covered |
| B37.5 | ICD10CM | Covered |
| B38.4 | ICD10CM | Covered |
| B39.4 | ICD10CM | Covered |
| B44.0 | ICD10CM | Covered |
| B44.1 | ICD10CM | Covered |
| B44.2 | ICD10CM | Covered |
| B44.7 | ICD10CM | Covered |
| B44.89 | ICD10CM | Covered |
| B44.9 | ICD10CM | Covered |
| B45.0 | ICD10CM | Covered |
| B45.1 | ICD10CM | Covered |
| B45.2 | ICD10CM | Covered |
| B45.3 | ICD10CM | Covered |
| B45.7 | ICD10CM | Covered |
| B45.8 | ICD10CM | Covered |
| B45.9 | ICD10CM | Covered |
| B48.4 | ICD10CM | Covered |
| B58.2 | ICD10CM | Covered |
| B90.0 | ICD10CM | Covered |
| B94.1 | ICD10CM | Covered |
| C14.2 | ICD10CM | Covered |
| C18.9 | ICD10CM | Covered |
| C30.0 | ICD10CM | Covered |
| C30.1 | ICD10CM | Covered |
| C31.0 | ICD10CM | Covered |
| C31.1 | ICD10CM | Covered |
| C31.2 | ICD10CM | Covered |
| C31.3 | ICD10CM | Covered |
| C31.8 | ICD10CM | Covered |
| C31.9 | ICD10CM | Covered |
| C33 | ICD10CM | Covered |
| C34.01 | ICD10CM | Covered |
| C34.02 | ICD10CM | Covered |
| C34.11 | ICD10CM | Covered |
| C34.12 | ICD10CM | Covered |
| C34.2 | ICD10CM | Covered |
| C34.31 | ICD10CM | Covered |
| C34.32 | ICD10CM | Covered |
| C34.80 | ICD10CM | Covered |
| C34.81 | ICD10CM | Covered |
| C34.82 | ICD10CM | Covered |
| C34.91 | ICD10CM | Covered |
| C34.92 | ICD10CM | Covered |
| C41.0 | ICD10CM | Covered |
| C43.111 | ICD10CM | Covered |
| C43.112 | ICD10CM | Covered |
| C43.121 | ICD10CM | Covered |
| C43.122 | ICD10CM | Covered |
| C44.00 | ICD10CM | Covered |
| C44.02 | ICD10CM | Covered |
| C44.09 | ICD10CM | Covered |
| C44.1021 | ICD10CM | Covered |
| C44.1022 | ICD10CM | Covered |
| C44.1091 | ICD10CM | Covered |
| C44.1092 | ICD10CM | Covered |
| C44.1121 | ICD10CM | Covered |
| C44.1122 | ICD10CM | Covered |
| C44.1191 | ICD10CM | Covered |
| C44.1192 | ICD10CM | Covered |
| C44.1221 | ICD10CM | Covered |
| C44.1222 | ICD10CM | Covered |
| C44.1291 | ICD10CM | Covered |
| C44.1292 | ICD10CM | Covered |
| C44.1321 | ICD10CM | Covered |
| C44.1322 | ICD10CM | Covered |
| C44.1391 | ICD10CM | Covered |
| C44.1392 | ICD10CM | Covered |
| C44.1921 | ICD10CM | Covered |
| C44.1922 | ICD10CM | Covered |
| C44.1991 | ICD10CM | Covered |
| C44.1992 | ICD10CM | Covered |
| C44.202 | ICD10CM | Covered |
| C44.209 | ICD10CM | Covered |
| C44.222 | ICD10CM | Covered |
| C44.229 | ICD10CM | Covered |
| C44.292 | ICD10CM | Covered |
| C44.299 | ICD10CM | Covered |
| C44.300 | ICD10CM | Covered |
| C44.301 | ICD10CM | Covered |
| C44.309 | ICD10CM | Covered |
| C44.320 | ICD10CM | Covered |
| C44.321 | ICD10CM | Covered |
| C44.329 | ICD10CM | Covered |
| C44.390 | ICD10CM | Covered |
| C44.391 | ICD10CM | Covered |
| C44.399 | ICD10CM | Covered |
| C44.40 | ICD10CM | Covered |
| C44.42 | ICD10CM | Covered |
| C44.49 | ICD10CM | Covered |
| C44.500 | ICD10CM | Covered |
| C44.501 | ICD10CM | Covered |
| C44.509 | ICD10CM | Covered |
| C44.520 | ICD10CM | Covered |
| C44.521 | ICD10CM | Covered |
| C44.529 | ICD10CM | Covered |
| C44.590 | ICD10CM | Covered |
| C44.591 | ICD10CM | Covered |
| C44.599 | ICD10CM | Covered |
| C44.602 | ICD10CM | Covered |
| C44.609 | ICD10CM | Covered |
| C44.622 | ICD10CM | Covered |
| C44.629 | ICD10CM | Covered |
| C44.692 | ICD10CM | Covered |
| C44.699 | ICD10CM | Covered |
| C44.702 | ICD10CM | Covered |
| C44.709 | ICD10CM | Covered |
| C44.722 | ICD10CM | Covered |
| C44.729 | ICD10CM | Covered |
| C44.792 | ICD10CM | Covered |
| C44.799 | ICD10CM | Covered |
| C44.80 | ICD10CM | Covered |
| C44.82 | ICD10CM | Covered |
| C44.89 | ICD10CM | Covered |
| C44.92 | ICD10CM | Covered |
| C44.99 | ICD10CM | Covered |
| C45.9 | ICD10CM | Covered |
| C47.0 | ICD10CM | Covered |
| C49.0 | ICD10CM | Covered |
| C49.A0 | ICD10CM | Covered |
| C49.A1 | ICD10CM | Covered |
| C49.A2 | ICD10CM | Covered |
| C49.A3 | ICD10CM | Covered |
| C49.A4 | ICD10CM | Covered |
| C49.A5 | ICD10CM | Covered |
| C49.A9 | ICD10CM | Covered |
| C4A.111 | ICD10CM | Covered |
| C4A.112 | ICD10CM | Covered |
| C4A.121 | ICD10CM | Covered |
| C4A.122 | ICD10CM | Covered |
| C4A.4 | ICD10CM | Covered |
| C50.011 | ICD10CM | Covered |
| C50.012 | ICD10CM | Covered |
| C50.021 | ICD10CM | Covered |
| C50.022 | ICD10CM | Covered |
| C50.111 | ICD10CM | Covered |
| C50.112 | ICD10CM | Covered |
| C50.121 | ICD10CM | Covered |
| C50.122 | ICD10CM | Covered |
| C50.211 | ICD10CM | Covered |
| C50.212 | ICD10CM | Covered |
| C50.221 | ICD10CM | Covered |
| C50.222 | ICD10CM | Covered |
| C50.311 | ICD10CM | Covered |
| C50.312 | ICD10CM | Covered |
| C50.321 | ICD10CM | Covered |
| C50.322 | ICD10CM | Covered |
| C50.411 | ICD10CM | Covered |
| C50.412 | ICD10CM | Covered |
| C50.421 | ICD10CM | Covered |
| C50.422 | ICD10CM | Covered |
| C50.511 | ICD10CM | Covered |
| C50.512 | ICD10CM | Covered |
| C50.521 | ICD10CM | Covered |
| C50.522 | ICD10CM | Covered |
| C50.611 | ICD10CM | Covered |
| C50.612 | ICD10CM | Covered |
| C50.621 | ICD10CM | Covered |
| C50.622 | ICD10CM | Covered |
| C50.811 | ICD10CM | Covered |
| C50.812 | ICD10CM | Covered |
| C50.821 | ICD10CM | Covered |
| C50.822 | ICD10CM | Covered |
| C50.911 | ICD10CM | Covered |
| C50.912 | ICD10CM | Covered |
| C50.921 | ICD10CM | Covered |
| C50.922 | ICD10CM | Covered |
| C64.1 | ICD10CM | Covered |
| C64.2 | ICD10CM | Covered |
| C69.01 | ICD10CM | Covered |
| C69.02 | ICD10CM | Covered |
| C69.11 | ICD10CM | Covered |
| C69.12 | ICD10CM | Covered |
| C69.21 | ICD10CM | Covered |
| C69.22 | ICD10CM | Covered |
| C69.31 | ICD10CM | Covered |
| C69.32 | ICD10CM | Covered |
| C69.41 | ICD10CM | Covered |
| C69.42 | ICD10CM | Covered |
| C69.51 | ICD10CM | Covered |
| C69.52 | ICD10CM | Covered |
| C69.61 | ICD10CM | Covered |
| C69.62 | ICD10CM | Covered |
| C69.81 | ICD10CM | Covered |
| C69.82 | ICD10CM | Covered |
| C69.91 | ICD10CM | Covered |
| C69.92 | ICD10CM | Covered |
| C70.0 | ICD10CM | Covered |
| C70.9 | ICD10CM | Covered |
| C71.0 | ICD10CM | Covered |
| C71.1 | ICD10CM | Covered |
| C71.2 | ICD10CM | Covered |
| C71.3 | ICD10CM | Covered |
| C71.4 | ICD10CM | Covered |
| C71.5 | ICD10CM | Covered |
| C71.6 | ICD10CM | Covered |
| C71.7 | ICD10CM | Covered |
| C71.8 | ICD10CM | Covered |
| C71.9 | ICD10CM | Covered |
| C72.21 | ICD10CM | Covered |
| C72.22 | ICD10CM | Covered |
| C72.31 | ICD10CM | Covered |
| C72.32 | ICD10CM | Covered |
| C72.41 | ICD10CM | Covered |
| C72.42 | ICD10CM | Covered |
| C72.59 | ICD10CM | Covered |
| C73 | ICD10CM | Covered |
| C75.1 | ICD10CM | Covered |
| C75.2 | ICD10CM | Covered |
| C75.3 | ICD10CM | Covered |
| C76.0 | ICD10CM | Covered |
| C77.0 | ICD10CM | Covered |
| C79.31 | ICD10CM | Covered |
| C79.32 | ICD10CM | Covered |
| C79.40 | ICD10CM | Covered |
| C79.49 | ICD10CM | Covered |
| C79.51 | ICD10CM | Covered |
| C79.52 | ICD10CM | Covered |
| C7A.00 | ICD10CM | Covered |
| C7A.010 | ICD10CM | Covered |
| C7A.011 | ICD10CM | Covered |
| C7A.012 | ICD10CM | Covered |
| C7A.019 | ICD10CM | Covered |
| C7A.020 | ICD10CM | Covered |
| C7A.021 | ICD10CM | Covered |
| C7A.022 | ICD10CM | Covered |
| C7A.023 | ICD10CM | Covered |
| C7A.024 | ICD10CM | Covered |
| C7A.025 | ICD10CM | Covered |
| C7A.026 | ICD10CM | Covered |
| C7A.029 | ICD10CM | Covered |
| C7A.090 | ICD10CM | Covered |
| C7A.091 | ICD10CM | Covered |
| C7A.092 | ICD10CM | Covered |
| C7A.093 | ICD10CM | Covered |
| C7A.094 | ICD10CM | Covered |
| C7A.095 | ICD10CM | Covered |
| C7A.096 | ICD10CM | Covered |
| C7A.098 | ICD10CM | Covered |
| C7A.1 | ICD10CM | Covered |
| C7A.8 | ICD10CM | Covered |
| C7B.1 | ICD10CM | Covered |
| C80.0 | ICD10CM | Covered |
| C80.1 | ICD10CM | Covered |
| C80.2 | ICD10CM | Covered |
| C81.00 | ICD10CM | Covered |
| C81.01 | ICD10CM | Covered |
| C81.02 | ICD10CM | Covered |
| C81.03 | ICD10CM | Covered |
| C81.04 | ICD10CM | Covered |
| C81.05 | ICD10CM | Covered |
| C81.06 | ICD10CM | Covered |
| C81.07 | ICD10CM | Covered |
| C81.08 | ICD10CM | Covered |
| C81.09 | ICD10CM | Covered |
| C81.0A | ICD10CM | Covered |
| C81.10 | ICD10CM | Covered |
| C81.11 | ICD10CM | Covered |
| C81.12 | ICD10CM | Covered |
| C81.13 | ICD10CM | Covered |
| C81.14 | ICD10CM | Covered |
| C81.15 | ICD10CM | Covered |
| C81.16 | ICD10CM | Covered |
| C81.17 | ICD10CM | Covered |
| C81.18 | ICD10CM | Covered |
| C81.19 | ICD10CM | Covered |
| C81.1A | ICD10CM | Covered |
| C81.20 | ICD10CM | Covered |
| C81.21 | ICD10CM | Covered |
| C81.22 | ICD10CM | Covered |
| C81.23 | ICD10CM | Covered |
| C81.24 | ICD10CM | Covered |
| C81.25 | ICD10CM | Covered |
| C81.26 | ICD10CM | Covered |
| C81.27 | ICD10CM | Covered |
| C81.28 | ICD10CM | Covered |
| C81.29 | ICD10CM | Covered |
| C81.2A | ICD10CM | Covered |
| C81.30 | ICD10CM | Covered |
| C81.31 | ICD10CM | Covered |
| C81.32 | ICD10CM | Covered |
| C81.33 | ICD10CM | Covered |
| C81.34 | ICD10CM | Covered |
| C81.35 | ICD10CM | Covered |
| C81.36 | ICD10CM | Covered |
| C81.37 | ICD10CM | Covered |
| C81.38 | ICD10CM | Covered |
| C81.39 | ICD10CM | Covered |
| C81.3A | ICD10CM | Covered |
| C81.40 | ICD10CM | Covered |
| C81.41 | ICD10CM | Covered |
| C81.42 | ICD10CM | Covered |
| C81.43 | ICD10CM | Covered |
| C81.44 | ICD10CM | Covered |
| C81.45 | ICD10CM | Covered |
| C81.46 | ICD10CM | Covered |
| C81.47 | ICD10CM | Covered |
| C81.48 | ICD10CM | Covered |
| C81.49 | ICD10CM | Covered |
| C81.4A | ICD10CM | Covered |
| C81.70 | ICD10CM | Covered |
| C81.71 | ICD10CM | Covered |
| C81.72 | ICD10CM | Covered |
| C81.73 | ICD10CM | Covered |
| C81.74 | ICD10CM | Covered |
| C81.75 | ICD10CM | Covered |
| C81.76 | ICD10CM | Covered |
| C81.77 | ICD10CM | Covered |
| C81.78 | ICD10CM | Covered |
| C81.79 | ICD10CM | Covered |
| C81.7A | ICD10CM | Covered |
| C81.90 | ICD10CM | Covered |
| C81.91 | ICD10CM | Covered |
| C81.92 | ICD10CM | Covered |
| C81.93 | ICD10CM | Covered |
| C81.94 | ICD10CM | Covered |
| C81.95 | ICD10CM | Covered |
| C81.96 | ICD10CM | Covered |
| C81.97 | ICD10CM | Covered |
| C81.98 | ICD10CM | Covered |
| C81.99 | ICD10CM | Covered |
| C81.9A | ICD10CM | Covered |
| C82.00 | ICD10CM | Covered |
| C82.01 | ICD10CM | Covered |
| C82.02 | ICD10CM | Covered |
| C82.03 | ICD10CM | Covered |
| C82.04 | ICD10CM | Covered |
| C82.05 | ICD10CM | Covered |
| C82.06 | ICD10CM | Covered |
| C82.07 | ICD10CM | Covered |
| C82.08 | ICD10CM | Covered |
| C82.09 | ICD10CM | Covered |
| C82.0A | ICD10CM | Covered |
| C82.10 | ICD10CM | Covered |
| C82.11 | ICD10CM | Covered |
| C82.12 | ICD10CM | Covered |
| C82.13 | ICD10CM | Covered |
| C82.14 | ICD10CM | Covered |
| C82.15 | ICD10CM | Covered |
| C82.16 | ICD10CM | Covered |
| C82.17 | ICD10CM | Covered |
| C82.18 | ICD10CM | Covered |
| C82.19 | ICD10CM | Covered |
| C82.1A | ICD10CM | Covered |
| C82.20 | ICD10CM | Covered |
| C82.21 | ICD10CM | Covered |
| C82.22 | ICD10CM | Covered |
| C82.23 | ICD10CM | Covered |
| C82.24 | ICD10CM | Covered |
| C82.25 | ICD10CM | Covered |
| C82.26 | ICD10CM | Covered |
| C82.27 | ICD10CM | Covered |
| C82.28 | ICD10CM | Covered |
| C82.29 | ICD10CM | Covered |
| C82.2A | ICD10CM | Covered |
| C82.30 | ICD10CM | Covered |
| C82.31 | ICD10CM | Covered |
| C82.32 | ICD10CM | Covered |
| C82.33 | ICD10CM | Covered |
| C82.34 | ICD10CM | Covered |
| C82.35 | ICD10CM | Covered |
| C82.36 | ICD10CM | Covered |
| C82.37 | ICD10CM | Covered |
| C82.38 | ICD10CM | Covered |
| C82.39 | ICD10CM | Covered |
| C82.3A | ICD10CM | Covered |
| C82.40 | ICD10CM | Covered |
| C82.41 | ICD10CM | Covered |
| C82.42 | ICD10CM | Covered |
| C82.43 | ICD10CM | Covered |
| C82.44 | ICD10CM | Covered |
| C82.45 | ICD10CM | Covered |
| C82.46 | ICD10CM | Covered |
| C82.47 | ICD10CM | Covered |
| C82.48 | ICD10CM | Covered |
| C82.49 | ICD10CM | Covered |
| C82.4A | ICD10CM | Covered |
| C82.50 | ICD10CM | Covered |
| C82.51 | ICD10CM | Covered |
| C82.52 | ICD10CM | Covered |
| C82.53 | ICD10CM | Covered |
| C82.54 | ICD10CM | Covered |
| C82.55 | ICD10CM | Covered |
| C82.56 | ICD10CM | Covered |
| C82.57 | ICD10CM | Covered |
| C82.58 | ICD10CM | Covered |
| C82.59 | ICD10CM | Covered |
| C82.5A | ICD10CM | Covered |
| C82.60 | ICD10CM | Covered |
| C82.61 | ICD10CM | Covered |
| C82.62 | ICD10CM | Covered |
| C82.63 | ICD10CM | Covered |
| C82.64 | ICD10CM | Covered |
| C82.65 | ICD10CM | Covered |
| C82.66 | ICD10CM | Covered |
| C82.67 | ICD10CM | Covered |
| C82.68 | ICD10CM | Covered |
| C82.69 | ICD10CM | Covered |
| C82.6A | ICD10CM | Covered |
| C82.80 | ICD10CM | Covered |
| C82.81 | ICD10CM | Covered |
| C82.82 | ICD10CM | Covered |
| C82.83 | ICD10CM | Covered |
| C82.84 | ICD10CM | Covered |
| C82.85 | ICD10CM | Covered |
| C82.86 | ICD10CM | Covered |
| C82.87 | ICD10CM | Covered |
| C82.88 | ICD10CM | Covered |
| C82.89 | ICD10CM | Covered |
| C82.8A | ICD10CM | Covered |
| C82.90 | ICD10CM | Covered |
| C82.91 | ICD10CM | Covered |
| C82.92 | ICD10CM | Covered |
| C82.93 | ICD10CM | Covered |
| C82.94 | ICD10CM | Covered |
| C82.95 | ICD10CM | Covered |
| C82.96 | ICD10CM | Covered |
| C82.97 | ICD10CM | Covered |
| C82.98 | ICD10CM | Covered |
| C82.99 | ICD10CM | Covered |
| C82.9A | ICD10CM | Covered |
| C83.00 | ICD10CM | Covered |
| C83.01 | ICD10CM | Covered |
| C83.02 | ICD10CM | Covered |
| C83.03 | ICD10CM | Covered |
| C83.04 | ICD10CM | Covered |
| C83.05 | ICD10CM | Covered |
| C83.06 | ICD10CM | Covered |
| C83.07 | ICD10CM | Covered |
| C83.08 | ICD10CM | Covered |
| C83.09 | ICD10CM | Covered |
| C83.0A | ICD10CM | Covered |
| C83.10 | ICD10CM | Covered |
| C83.11 | ICD10CM | Covered |
| C83.12 | ICD10CM | Covered |
| C83.13 | ICD10CM | Covered |
| C83.14 | ICD10CM | Covered |
| C83.15 | ICD10CM | Covered |
| C83.16 | ICD10CM | Covered |
| C83.17 | ICD10CM | Covered |
| C83.18 | ICD10CM | Covered |
| C83.19 | ICD10CM | Covered |
| C83.1A | ICD10CM | Covered |
| C83.30 | ICD10CM | Covered |
| C83.31 | ICD10CM | Covered |
| C83.32 | ICD10CM | Covered |
| C83.33 | ICD10CM | Covered |
| C83.34 | ICD10CM | Covered |
| C83.35 | ICD10CM | Covered |
| C83.36 | ICD10CM | Covered |
| C83.37 | ICD10CM | Covered |
| C83.38 | ICD10CM | Covered |
| C83.390 | ICD10CM | Covered |
| C83.398 | ICD10CM | Covered |
| C83.3A | ICD10CM | Covered |
| C83.50 | ICD10CM | Covered |
| C83.51 | ICD10CM | Covered |
| C83.52 | ICD10CM | Covered |
| C83.53 | ICD10CM | Covered |
| C83.54 | ICD10CM | Covered |
| C83.55 | ICD10CM | Covered |
| C83.56 | ICD10CM | Covered |
| C83.57 | ICD10CM | Covered |
| C83.58 | ICD10CM | Covered |
| C83.59 | ICD10CM | Covered |
| C83.5A | ICD10CM | Covered |
| C83.70 | ICD10CM | Covered |
| C83.71 | ICD10CM | Covered |
| C83.72 | ICD10CM | Covered |
| C83.73 | ICD10CM | Covered |
| C83.74 | ICD10CM | Covered |
| C83.75 | ICD10CM | Covered |
| C83.76 | ICD10CM | Covered |
| C83.77 | ICD10CM | Covered |
| C83.78 | ICD10CM | Covered |
| C83.79 | ICD10CM | Covered |
| C83.7A | ICD10CM | Covered |
| C83.80 | ICD10CM | Covered |
| C83.81 | ICD10CM | Covered |
| C83.82 | ICD10CM | Covered |
| C83.83 | ICD10CM | Covered |
| C83.84 | ICD10CM | Covered |
| C83.85 | ICD10CM | Covered |
| C83.86 | ICD10CM | Covered |
| C83.87 | ICD10CM | Covered |
| C83.88 | ICD10CM | Covered |
| C83.89 | ICD10CM | Covered |
| C83.8A | ICD10CM | Covered |
| C83.90 | ICD10CM | Covered |
| C83.91 | ICD10CM | Covered |
| C83.92 | ICD10CM | Covered |
| C83.93 | ICD10CM | Covered |
| C83.94 | ICD10CM | Covered |
| C83.95 | ICD10CM | Covered |
| C83.96 | ICD10CM | Covered |
| C83.97 | ICD10CM | Covered |
| C83.98 | ICD10CM | Covered |
| C83.99 | ICD10CM | Covered |
| C83.9A | ICD10CM | Covered |
| C84.00 | ICD10CM | Covered |
| C84.01 | ICD10CM | Covered |
| C84.02 | ICD10CM | Covered |
| C84.03 | ICD10CM | Covered |
| C84.04 | ICD10CM | Covered |
| C84.05 | ICD10CM | Covered |
| C84.06 | ICD10CM | Covered |
| C84.07 | ICD10CM | Covered |
| C84.08 | ICD10CM | Covered |
| C84.09 | ICD10CM | Covered |
| C84.0A | ICD10CM | Covered |
| C84.10 | ICD10CM | Covered |
| C84.11 | ICD10CM | Covered |
| C84.12 | ICD10CM | Covered |
| C84.13 | ICD10CM | Covered |
| C84.14 | ICD10CM | Covered |
| C84.15 | ICD10CM | Covered |
| C84.16 | ICD10CM | Covered |
| C84.17 | ICD10CM | Covered |
| C84.18 | ICD10CM | Covered |
| C84.19 | ICD10CM | Covered |
| C84.1A | ICD10CM | Covered |
| C84.40 | ICD10CM | Covered |
| C84.41 | ICD10CM | Covered |
| C84.42 | ICD10CM | Covered |
| C84.43 | ICD10CM | Covered |
| C84.44 | ICD10CM | Covered |
| C84.45 | ICD10CM | Covered |
| C84.46 | ICD10CM | Covered |
| C84.47 | ICD10CM | Covered |
| C84.48 | ICD10CM | Covered |
| C84.49 | ICD10CM | Covered |
| C84.4A | ICD10CM | Covered |
| C84.60 | ICD10CM | Covered |
| C84.61 | ICD10CM | Covered |
| C84.62 | ICD10CM | Covered |
| C84.63 | ICD10CM | Covered |
| C84.64 | ICD10CM | Covered |
| C84.65 | ICD10CM | Covered |
| C84.66 | ICD10CM | Covered |
| C84.67 | ICD10CM | Covered |
| C84.68 | ICD10CM | Covered |
| C84.69 | ICD10CM | Covered |
| C84.6A | ICD10CM | Covered |
| C84.70 | ICD10CM | Covered |
| C84.71 | ICD10CM | Covered |
| C84.72 | ICD10CM | Covered |
| C84.73 | ICD10CM | Covered |
| C84.74 | ICD10CM | Covered |
| C84.75 | ICD10CM | Covered |
| C84.76 | ICD10CM | Covered |
| C84.77 | ICD10CM | Covered |
| C84.78 | ICD10CM | Covered |
| C84.79 | ICD10CM | Covered |
| C84.7A | ICD10CM | Covered |
| C84.7B | ICD10CM | Covered |
| C84.90 | ICD10CM | Covered |
| C84.91 | ICD10CM | Covered |
| C84.92 | ICD10CM | Covered |
| C84.93 | ICD10CM | Covered |
| C84.94 | ICD10CM | Covered |
| C84.95 | ICD10CM | Covered |
| C84.96 | ICD10CM | Covered |
| C84.97 | ICD10CM | Covered |
| C84.98 | ICD10CM | Covered |
| C84.99 | ICD10CM | Covered |
| C84.9A | ICD10CM | Covered |
| C84.A0 | ICD10CM | Covered |
| C84.A1 | ICD10CM | Covered |
| C84.A2 | ICD10CM | Covered |
| C84.A3 | ICD10CM | Covered |
| C84.A4 | ICD10CM | Covered |
| C84.A5 | ICD10CM | Covered |
| C84.A6 | ICD10CM | Covered |
| C84.A7 | ICD10CM | Covered |
| C84.A8 | ICD10CM | Covered |
| C84.A9 | ICD10CM | Covered |
| C84.AA | ICD10CM | Covered |
| C84.Z0 | ICD10CM | Covered |
| C84.Z1 | ICD10CM | Covered |
| C84.Z2 | ICD10CM | Covered |
| C84.Z3 | ICD10CM | Covered |
| C84.Z4 | ICD10CM | Covered |
| C84.Z5 | ICD10CM | Covered |
| C84.Z6 | ICD10CM | Covered |
| C84.Z7 | ICD10CM | Covered |
| C84.Z8 | ICD10CM | Covered |
| C84.Z9 | ICD10CM | Covered |
| C84.ZA | ICD10CM | Covered |
| C85.10 | ICD10CM | Covered |
| C85.11 | ICD10CM | Covered |
| C85.12 | ICD10CM | Covered |
| C85.13 | ICD10CM | Covered |
| C85.14 | ICD10CM | Covered |
| C85.15 | ICD10CM | Covered |
| C85.16 | ICD10CM | Covered |
| C85.17 | ICD10CM | Covered |
| C85.18 | ICD10CM | Covered |
| C85.19 | ICD10CM | Covered |
| C85.1A | ICD10CM | Covered |
| C85.20 | ICD10CM | Covered |
| C85.21 | ICD10CM | Covered |
| C85.22 | ICD10CM | Covered |
| C85.23 | ICD10CM | Covered |
| C85.24 | ICD10CM | Covered |
| C85.25 | ICD10CM | Covered |
| C85.26 | ICD10CM | Covered |
| C85.27 | ICD10CM | Covered |
| C85.28 | ICD10CM | Covered |
| C85.29 | ICD10CM | Covered |
| C85.2A | ICD10CM | Covered |
| C85.80 | ICD10CM | Covered |
| C85.81 | ICD10CM | Covered |
| C85.82 | ICD10CM | Covered |
| C85.83 | ICD10CM | Covered |
| C85.84 | ICD10CM | Covered |
| C85.85 | ICD10CM | Covered |
| C85.86 | ICD10CM | Covered |
| C85.87 | ICD10CM | Covered |
| C85.88 | ICD10CM | Covered |
| C85.89 | ICD10CM | Covered |
| C85.8A | ICD10CM | Covered |
| C85.90 | ICD10CM | Covered |
| C85.91 | ICD10CM | Covered |
| C85.92 | ICD10CM | Covered |
| C85.93 | ICD10CM | Covered |
| C85.94 | ICD10CM | Covered |
| C85.95 | ICD10CM | Covered |
| C85.96 | ICD10CM | Covered |
| C85.97 | ICD10CM | Covered |
| C85.98 | ICD10CM | Covered |
| C85.99 | ICD10CM | Covered |
| C85.9A | ICD10CM | Covered |
| C86.00 | ICD10CM | Covered |
| C86.01 | ICD10CM | Covered |
| C86.10 | ICD10CM | Covered |
| C86.11 | ICD10CM | Covered |
| C86.20 | ICD10CM | Covered |
| C86.21 | ICD10CM | Covered |
| C86.30 | ICD10CM | Covered |
| C86.31 | ICD10CM | Covered |
| C86.40 | ICD10CM | Covered |
| C86.41 | ICD10CM | Covered |
| C86.50 | ICD10CM | Covered |
| C86.51 | ICD10CM | Covered |
| C86.60 | ICD10CM | Covered |
| C86.61 | ICD10CM | Covered |
| C88.40 | ICD10CM | Covered |
| C88.41 | ICD10CM | Covered |
| C88.80 | ICD10CM | Covered |
| C88.81 | ICD10CM | Covered |
| C88.90 | ICD10CM | Covered |
| C88.91 | ICD10CM | Covered |
| C90.00 | ICD10CM | Covered |
| C90.01 | ICD10CM | Covered |
| C90.02 | ICD10CM | Covered |
| C90.10 | ICD10CM | Covered |
| C90.11 | ICD10CM | Covered |
| C90.12 | ICD10CM | Covered |
| C90.20 | ICD10CM | Covered |
| C90.21 | ICD10CM | Covered |
| C90.22 | ICD10CM | Covered |
| C90.30 | ICD10CM | Covered |
| C90.31 | ICD10CM | Covered |
| C90.32 | ICD10CM | Covered |
| C91.00 | ICD10CM | Covered |
| C91.01 | ICD10CM | Covered |
| C91.02 | ICD10CM | Covered |
| C91.10 | ICD10CM | Covered |
| C91.11 | ICD10CM | Covered |
| C91.12 | ICD10CM | Covered |
| C91.30 | ICD10CM | Covered |
| C91.31 | ICD10CM | Covered |
| C91.32 | ICD10CM | Covered |
| C91.40 | ICD10CM | Covered |
| C91.41 | ICD10CM | Covered |
| C91.42 | ICD10CM | Covered |
| C91.50 | ICD10CM | Covered |
| C91.51 | ICD10CM | Covered |
| C91.52 | ICD10CM | Covered |
| C91.60 | ICD10CM | Covered |
| C91.61 | ICD10CM | Covered |
| C91.62 | ICD10CM | Covered |
| C91.90 | ICD10CM | Covered |
| C91.91 | ICD10CM | Covered |
| C91.92 | ICD10CM | Covered |
| C91.A0 | ICD10CM | Covered |
| C91.A1 | ICD10CM | Covered |
| C91.A2 | ICD10CM | Covered |
| C91.Z0 | ICD10CM | Covered |
| C91.Z1 | ICD10CM | Covered |
| C91.Z2 | ICD10CM | Covered |
| C92.00 | ICD10CM | Covered |
| C92.01 | ICD10CM | Covered |
| C92.02 | ICD10CM | Covered |
| C92.10 | ICD10CM | Covered |
| C92.11 | ICD10CM | Covered |
| C92.12 | ICD10CM | Covered |
| C92.20 | ICD10CM | Covered |
| C92.21 | ICD10CM | Covered |
| C92.22 | ICD10CM | Covered |
| C92.30 | ICD10CM | Covered |
| C92.31 | ICD10CM | Covered |
| C92.32 | ICD10CM | Covered |
| C92.40 | ICD10CM | Covered |
| C92.41 | ICD10CM | Covered |
| C92.42 | ICD10CM | Covered |
| C92.50 | ICD10CM | Covered |
| C92.51 | ICD10CM | Covered |
| C92.52 | ICD10CM | Covered |
| C92.60 | ICD10CM | Covered |
| C92.61 | ICD10CM | Covered |
| C92.62 | ICD10CM | Covered |
| C92.90 | ICD10CM | Covered |
| C92.91 | ICD10CM | Covered |
| C92.92 | ICD10CM | Covered |
| C92.A0 | ICD10CM | Covered |
| C92.A1 | ICD10CM | Covered |
| C92.A2 | ICD10CM | Covered |
| C92.Z0 | ICD10CM | Covered |
| C92.Z1 | ICD10CM | Covered |
| C92.Z2 | ICD10CM | Covered |
| C93.00 | ICD10CM | Covered |
| C93.01 | ICD10CM | Covered |
| C93.02 | ICD10CM | Covered |
| C93.10 | ICD10CM | Covered |
| C93.11 | ICD10CM | Covered |
| C93.12 | ICD10CM | Covered |
| C93.30 | ICD10CM | Covered |
| C93.31 | ICD10CM | Covered |
| C93.32 | ICD10CM | Covered |
| C93.90 | ICD10CM | Covered |
| C93.91 | ICD10CM | Covered |
| C93.92 | ICD10CM | Covered |
| C93.Z0 | ICD10CM | Covered |
| C93.Z1 | ICD10CM | Covered |
| C93.Z2 | ICD10CM | Covered |
| C94.00 | ICD10CM | Covered |
| C94.01 | ICD10CM | Covered |
| C94.02 | ICD10CM | Covered |
| C94.20 | ICD10CM | Covered |
| C94.21 | ICD10CM | Covered |
| C94.22 | ICD10CM | Covered |
| C94.30 | ICD10CM | Covered |
| C94.31 | ICD10CM | Covered |
| C94.32 | ICD10CM | Covered |
| C94.80 | ICD10CM | Covered |
| C94.81 | ICD10CM | Covered |
| C94.82 | ICD10CM | Covered |
| C95.00 | ICD10CM | Covered |
| C95.01 | ICD10CM | Covered |
| C95.02 | ICD10CM | Covered |
| C95.10 | ICD10CM | Covered |
| C95.11 | ICD10CM | Covered |
| C95.12 | ICD10CM | Covered |
| C95.90 | ICD10CM | Covered |
| C95.91 | ICD10CM | Covered |
| C95.92 | ICD10CM | Covered |
| C96.0 | ICD10CM | Covered |
| C96.4 | ICD10CM | Covered |
| C96.9 | ICD10CM | Covered |
| C96.A | ICD10CM | Covered |
| C96.Z | ICD10CM | Covered |
| D14.0 | ICD10CM | Covered |
| D16.4 | ICD10CM | Covered |
| D18.02 | ICD10CM | Covered |
| D21.0 | ICD10CM | Covered |
| D31.60 | ICD10CM | Covered |
| D31.61 | ICD10CM | Covered |
| D31.62 | ICD10CM | Covered |
| D32.0 | ICD10CM | Covered |
| D32.9 | ICD10CM | Covered |
| D33.0 | ICD10CM | Covered |
| D33.1 | ICD10CM | Covered |
| D33.2 | ICD10CM | Covered |
| D33.3 | ICD10CM | Covered |
| D35.2 | ICD10CM | Covered |
| D35.3 | ICD10CM | Covered |
| D35.4 | ICD10CM | Covered |
| D3A.00 | ICD10CM | Covered |
| D3A.010 | ICD10CM | Covered |
| D3A.011 | ICD10CM | Covered |
| D3A.012 | ICD10CM | Covered |
| D3A.019 | ICD10CM | Covered |
| D3A.020 | ICD10CM | Covered |
| D3A.021 | ICD10CM | Covered |
| D3A.022 | ICD10CM | Covered |
| D3A.023 | ICD10CM | Covered |
| D3A.024 | ICD10CM | Covered |
| D3A.025 | ICD10CM | Covered |
| D3A.026 | ICD10CM | Covered |
| D3A.029 | ICD10CM | Covered |
| D3A.090 | ICD10CM | Covered |
| D3A.091 | ICD10CM | Covered |
| D3A.092 | ICD10CM | Covered |
| D3A.093 | ICD10CM | Covered |
| D3A.094 | ICD10CM | Covered |
| D3A.095 | ICD10CM | Covered |
| D3A.096 | ICD10CM | Covered |
| D3A.098 | ICD10CM | Covered |
| D3A.8 | ICD10CM | Covered |
| D42.0 | ICD10CM | Covered |
| D42.1 | ICD10CM | Covered |
| D42.9 | ICD10CM | Covered |
| D43.0 | ICD10CM | Covered |
| D43.1 | ICD10CM | Covered |
| D43.2 | ICD10CM | Covered |
| D43.3 | ICD10CM | Covered |
| D43.4 | ICD10CM | Covered |
| D43.8 | ICD10CM | Covered |
| D43.9 | ICD10CM | Covered |
| D44.0 | ICD10CM | Covered |
| D44.10 | ICD10CM | Covered |
| D44.11 | ICD10CM | Covered |
| D44.12 | ICD10CM | Covered |
| D44.2 | ICD10CM | Covered |
| D44.3 | ICD10CM | Covered |
| D44.4 | ICD10CM | Covered |
| D44.5 | ICD10CM | Covered |
| D44.6 | ICD10CM | Covered |
| D44.7 | ICD10CM | Covered |
| D45 | ICD10CM | Covered |
| D47.Z1 | ICD10CM | Covered |
| D47.Z2 | ICD10CM | Covered |
| D49.511 | ICD10CM | Covered |
| D49.512 | ICD10CM | Covered |
| D49.519 | ICD10CM | Covered |
| D49.59 | ICD10CM | Covered |
| D49.6 | ICD10CM | Covered |
| D69.59 | ICD10CM | Covered |
| D86.0 | ICD10CM | Covered |
| D86.1 | ICD10CM | Covered |
| D86.2 | ICD10CM | Covered |
| D86.3 | ICD10CM | Covered |
| D86.81 | ICD10CM | Covered |
| D86.82 | ICD10CM | Covered |
| D86.83 | ICD10CM | Covered |
| D86.84 | ICD10CM | Covered |
| D86.85 | ICD10CM | Covered |
| D86.86 | ICD10CM | Covered |
| D86.87 | ICD10CM | Covered |
| D86.89 | ICD10CM | Covered |
| D86.9 | ICD10CM | Covered |
| E03.5 | ICD10CM | Covered |
| E15 | ICD10CM | Covered |
| E22.0 | ICD10CM | Covered |
| E22.1 | ICD10CM | Covered |
| E22.2 | ICD10CM | Covered |
| E22.8 | ICD10CM | Covered |
| E22.9 | ICD10CM | Covered |
| E23.0 | ICD10CM | Covered |
| E23.1 | ICD10CM | Covered |
| E23.2 | ICD10CM | Covered |
| E23.3 | ICD10CM | Covered |
| E23.6 | ICD10CM | Covered |
| E23.7 | ICD10CM | Covered |
| E24.0 | ICD10CM | Covered |
| E24.1 | ICD10CM | Covered |
| E24.2 | ICD10CM | Covered |
| E24.3 | ICD10CM | Covered |
| E24.4 | ICD10CM | Covered |
| E24.8 | ICD10CM | Covered |
| E24.9 | ICD10CM | Covered |
| E31.21 | ICD10CM | Covered |
| E34.4 | ICD10CM | Covered |
| E36.01 | ICD10CM | Covered |
| E36.02 | ICD10CM | Covered |
| E75.00 | ICD10CM | Covered |
| E75.01 | ICD10CM | Covered |
| E75.02 | ICD10CM | Covered |
| E75.09 | ICD10CM | Covered |
| E75.10 | ICD10CM | Covered |
| E75.11 | ICD10CM | Covered |
| E75.19 | ICD10CM | Covered |
| E75.23 | ICD10CM | Covered |
| E75.244 | ICD10CM | Covered |
| E75.25 | ICD10CM | Covered |
| E75.27 | ICD10CM | Covered |
| E75.28 | ICD10CM | Covered |
| E75.29 | ICD10CM | Covered |
| E75.4 | ICD10CM | Covered |
| E85.1 | ICD10CM | Covered |
| E85.2 | ICD10CM | Covered |
| E85.3 | ICD10CM | Covered |
| E85.4 | ICD10CM | Covered |
| E85.81 | ICD10CM | Covered |
| E85.82 | ICD10CM | Covered |
| E85.89 | ICD10CM | Covered |
| E85.9 | ICD10CM | Covered |
| E89.3 | ICD10CM | Covered |
| E89.820 | ICD10CM | Covered |
| E89.821 | ICD10CM | Covered |
| E89.822 | ICD10CM | Covered |
| E89.823 | ICD10CM | Covered |
| F01.50 | ICD10CM | Covered |
| F01.511 | ICD10CM | Covered |
| F01.518 | ICD10CM | Covered |
| F01.52 | ICD10CM | Covered |
| F01.53 | ICD10CM | Covered |
| F01.54 | ICD10CM | Covered |
| F01.A0 | ICD10CM | Covered |
| F01.A11 | ICD10CM | Covered |
| F01.A18 | ICD10CM | Covered |
| F01.A2 | ICD10CM | Covered |
| F01.A3 | ICD10CM | Covered |
| F01.A4 | ICD10CM | Covered |
| F01.B0 | ICD10CM | Covered |
| F01.B11 | ICD10CM | Covered |
| F01.B18 | ICD10CM | Covered |
| F01.B2 | ICD10CM | Covered |
| F01.B3 | ICD10CM | Covered |
| F01.B4 | ICD10CM | Covered |
| F01.C0 | ICD10CM | Covered |
| F01.C11 | ICD10CM | Covered |
| F01.C18 | ICD10CM | Covered |
| F01.C2 | ICD10CM | Covered |
| F01.C3 | ICD10CM | Covered |
| F01.C4 | ICD10CM | Covered |