About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Magnetic Resonance Angiography L34424.
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 1,335 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 70544 | HCPCS | Covered |
| 70545 | HCPCS | Covered |
| 70546 | HCPCS | Covered |
| 70547 | HCPCS | Covered |
| 70548 | HCPCS | Covered |
| 70549 | HCPCS | Covered |
| C8900 | HCPCS | Covered |
| C8901 | HCPCS | Covered |
| C8902 | HCPCS | Covered |
| C8909 | HCPCS | Covered |
| C8910 | HCPCS | Covered |
| C8911 | HCPCS | Covered |
| C8912 | HCPCS | Covered |
| C8913 | HCPCS | Covered |
| C8914 | HCPCS | Covered |
| C8918 | HCPCS | Covered |
| C8919 | HCPCS | Covered |
| C8920 | HCPCS | Covered |
| C8931 | HCPCS | Covered |
| C8932 | HCPCS | Covered |
| C8933 | HCPCS | Covered |
| C8934 | HCPCS | Covered |
| C8935 | HCPCS | Covered |
| C8936 | HCPCS | 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 |
| 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 |
| C75.4 | ICD10CM | Covered |
| C75.5 | ICD10CM | Covered |
| C79.31 | ICD10CM | Covered |
| C79.32 | ICD10CM | Covered |
| C79.40 | ICD10CM | Covered |
| C79.49 | ICD10CM | Covered |
| D18.02 | ICD10CM | Covered |
| D18.09 | 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 |
| D33.4 | ICD10CM | Covered |
| D33.7 | ICD10CM | Covered |
| D35.5 | ICD10CM | Covered |
| D35.6 | ICD10CM | Covered |
| D49.511 | ICD10CM | Covered |
| D49.512 | ICD10CM | Covered |
| D49.519 | ICD10CM | Covered |
| D49.59 | ICD10CM | Covered |
| D49.81 | ICD10CM | Covered |
| D69.59 | ICD10CM | Covered |
| D78.31 | ICD10CM | Covered |
| D78.32 | ICD10CM | Covered |
| D78.33 | ICD10CM | Covered |
| D78.34 | ICD10CM | Covered |
| E08.51 | ICD10CM | Covered |
| E08.52 | ICD10CM | Covered |
| E09.51 | ICD10CM | Covered |
| E09.52 | ICD10CM | Covered |
| E10.51 | ICD10CM | Covered |
| E10.52 | ICD10CM | Covered |
| E10.59 | ICD10CM | Covered |
| E11.51 | ICD10CM | Covered |
| E11.52 | ICD10CM | Covered |
| E11.59 | ICD10CM | Covered |
| E13.51 | ICD10CM | Covered |
| E13.52 | ICD10CM | Covered |
| E13.59 | 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 |
| F03.90 | ICD10CM | Covered |
| F07.89 | ICD10CM | Covered |
| F48.2 | ICD10CM | Covered |
| G08 | ICD10CM | Covered |
| G31.80 | ICD10CM | Covered |
| G31.85 | ICD10CM | Covered |
| G31.86 | ICD10CM | Covered |
| G31.87 | ICD10CM | Covered |
| G43.001 | ICD10CM | Covered |
| G43.009 | ICD10CM | Covered |
| G43.011 | ICD10CM | Covered |
| G43.019 | ICD10CM | Covered |
| G43.101 | ICD10CM | Covered |
| G43.109 | ICD10CM | Covered |
| G43.111 | ICD10CM | Covered |
| G43.119 | ICD10CM | Covered |
| G43.401 | ICD10CM | Covered |
| G43.409 | ICD10CM | Covered |
| G43.411 | ICD10CM | Covered |
| G43.419 | ICD10CM | Covered |
| G43.501 | ICD10CM | Covered |
| G43.509 | ICD10CM | Covered |
| G43.511 | ICD10CM | Covered |
| G43.519 | ICD10CM | Covered |
| G43.601 | ICD10CM | Covered |
| G43.609 | ICD10CM | Covered |
| G43.611 | ICD10CM | Covered |
| G43.619 | ICD10CM | Covered |
| G43.701 | ICD10CM | Covered |
| G43.709 | ICD10CM | Covered |
| G43.711 | ICD10CM | Covered |
| G43.719 | ICD10CM | Covered |
| G43.801 | ICD10CM | Covered |
| G43.809 | ICD10CM | Covered |
| G43.811 | ICD10CM | Covered |
| G43.819 | ICD10CM | Covered |
| G43.821 | ICD10CM | Covered |
| G43.829 | ICD10CM | Covered |
| G43.831 | ICD10CM | Covered |
| G43.839 | ICD10CM | Covered |
| G43.909 | ICD10CM | Covered |
| G43.919 | ICD10CM | Covered |
| G43.A0 | ICD10CM | Covered |
| G43.A1 | ICD10CM | Covered |
| G43.B0 | ICD10CM | Covered |
| G43.B1 | ICD10CM | Covered |
| G43.C0 | ICD10CM | Covered |
| G43.C1 | ICD10CM | Covered |
| G43.D0 | ICD10CM | Covered |
| G43.D1 | ICD10CM | Covered |
| G43.E01 | ICD10CM | Covered |
| G43.E09 | ICD10CM | Covered |
| G43.E11 | ICD10CM | Covered |
| G43.E19 | ICD10CM | Covered |
| G45.1 | ICD10CM | Covered |
| G45.2 | ICD10CM | Covered |
| G45.3 | ICD10CM | Covered |
| G45.8 | ICD10CM | Covered |
| G45.9 | ICD10CM | Covered |
| G46.0 | ICD10CM | Covered |
| G46.1 | ICD10CM | Covered |
| G46.2 | ICD10CM | Covered |
| G50.0 | ICD10CM | Covered |
| G50.1 | ICD10CM | Covered |
| G50.8 | ICD10CM | Covered |
| G50.9 | ICD10CM | Covered |
| G81.01 | ICD10CM | Covered |
| G81.02 | ICD10CM | Covered |
| G81.03 | ICD10CM | Covered |
| G81.04 | ICD10CM | Covered |
| G81.11 | ICD10CM | Covered |
| G81.12 | ICD10CM | Covered |
| G81.13 | ICD10CM | Covered |
| G81.14 | ICD10CM | Covered |
| G93.1 | ICD10CM | Covered |
| G93.89 | ICD10CM | Covered |
| H02.431 | ICD10CM | Covered |
| H02.432 | ICD10CM | Covered |
| H02.433 | ICD10CM | Covered |
| H34.01 | ICD10CM | Covered |
| H34.02 | ICD10CM | Covered |
| H34.03 | ICD10CM | Covered |
| H34.11 | ICD10CM | Covered |
| H34.12 | ICD10CM | Covered |
| H34.13 | ICD10CM | Covered |
| H34.211 | ICD10CM | Covered |
| H34.212 | ICD10CM | Covered |
| H34.213 | ICD10CM | Covered |
| H34.231 | ICD10CM | Covered |
| H34.232 | ICD10CM | Covered |
| H34.233 | ICD10CM | Covered |
| H34.821 | ICD10CM | Covered |
| H34.822 | ICD10CM | Covered |
| H34.823 | ICD10CM | Covered |
| H34.9 | ICD10CM | Covered |
| H47.011 | ICD10CM | Covered |
| H47.012 | ICD10CM | Covered |
| H47.013 | ICD10CM | Covered |
| H47.41 | ICD10CM | Covered |
| H47.42 | ICD10CM | Covered |
| H47.43 | ICD10CM | Covered |
| H47.49 | ICD10CM | Covered |
| H47.531 | ICD10CM | Covered |
| H47.532 | ICD10CM | Covered |
| H47.641 | ICD10CM | Covered |
| H47.642 | ICD10CM | Covered |
| H53.121 | ICD10CM | Covered |
| H53.122 | ICD10CM | Covered |
| H53.123 | ICD10CM | Covered |
| H53.131 | ICD10CM | Covered |
| H53.132 | ICD10CM | Covered |
| H53.133 | ICD10CM | Covered |
| H53.2 | ICD10CM | Covered |
| H53.451 | ICD10CM | Covered |
| H53.452 | ICD10CM | Covered |
| H53.453 | ICD10CM | Covered |
| H53.461 | ICD10CM | Covered |
| H53.462 | ICD10CM | Covered |
| H53.47 | ICD10CM | Covered |
| H59.331 | ICD10CM | Covered |
| H59.332 | ICD10CM | Covered |
| H59.333 | ICD10CM | Covered |
| H59.339 | ICD10CM | Covered |
| H59.341 | ICD10CM | Covered |
| H59.342 | ICD10CM | Covered |
| H59.343 | ICD10CM | Covered |
| H59.349 | ICD10CM | Covered |
| H59.351 | ICD10CM | Covered |
| H59.352 | ICD10CM | Covered |
| H59.353 | ICD10CM | Covered |
| H59.359 | ICD10CM | Covered |
| H59.361 | ICD10CM | Covered |
| H59.362 | ICD10CM | Covered |
| H59.363 | ICD10CM | Covered |
| H59.369 | ICD10CM | Covered |
| H90.A11 | ICD10CM | Covered |
| H90.A12 | ICD10CM | Covered |
| H90.A21 | ICD10CM | Covered |
| H90.A22 | ICD10CM | Covered |
| H90.A31 | ICD10CM | Covered |
| H90.A32 | ICD10CM | Covered |
| H93.011 | ICD10CM | Covered |
| H93.012 | ICD10CM | Covered |
| H93.013 | ICD10CM | Covered |
| H93.A1 | ICD10CM | Covered |
| H93.A2 | ICD10CM | Covered |
| H93.A3 | ICD10CM | Covered |
| H93.A9 | ICD10CM | Covered |
| H95.51 | ICD10CM | Covered |
| H95.52 | ICD10CM | Covered |
| H95.53 | ICD10CM | Covered |
| H95.54 | ICD10CM | Covered |
| I10 | ICD10CM | Covered |
| I12.0 | ICD10CM | Covered |
| I12.9 | ICD10CM | Covered |
| I15.0 | ICD10CM | Covered |
| I15.8 | ICD10CM | Covered |
| I26.01 | ICD10CM | Covered |
| I26.02 | ICD10CM | Covered |
| I26.03 | ICD10CM | Covered |
| I26.04 | ICD10CM | Covered |
| I26.09 | ICD10CM | Covered |
| I26.90 | ICD10CM | Covered |
| I26.92 | ICD10CM | Covered |
| I26.93 | ICD10CM | Covered |
| I26.94 | ICD10CM | Covered |
| I26.95 | ICD10CM | Covered |
| I26.96 | ICD10CM | Covered |
| I26.99 | ICD10CM | Covered |
| I27.0 | ICD10CM | Covered |
| I27.20 | ICD10CM | Covered |
| I27.21 | ICD10CM | Covered |
| I27.22 | ICD10CM | Covered |
| I27.23 | ICD10CM | Covered |
| I27.24 | ICD10CM | Covered |
| I27.29 | ICD10CM | Covered |
| I27.81 | ICD10CM | Covered |
| I27.82 | ICD10CM | Covered |
| I27.83 | ICD10CM | Covered |
| I27.840 | ICD10CM | Covered |
| I27.841 | ICD10CM | Covered |
| I27.848 | ICD10CM | Covered |
| I27.849 | ICD10CM | Covered |
| I27.89 | ICD10CM | Covered |
| I27.9 | ICD10CM | Covered |
| I28.1 | ICD10CM | Covered |
| I42.1 | ICD10CM | Covered |
| I42.2 | ICD10CM | Covered |
| I60.01 | ICD10CM | Covered |
| I60.02 | ICD10CM | Covered |
| I60.11 | ICD10CM | Covered |
| I60.12 | ICD10CM | Covered |
| I60.2 | ICD10CM | Covered |
| I60.31 | ICD10CM | Covered |
| I60.32 | ICD10CM | Covered |
| I60.4 | ICD10CM | Covered |
| I60.51 | ICD10CM | Covered |
| I60.52 | ICD10CM | Covered |
| I60.6 | ICD10CM | Covered |
| I60.8 | ICD10CM | Covered |
| I60.9 | ICD10CM | Covered |
| I61.0 | ICD10CM | Covered |
| I61.1 | ICD10CM | Covered |
| I61.2 | ICD10CM | Covered |
| I61.3 | ICD10CM | Covered |
| I61.4 | ICD10CM | Covered |
| I61.5 | ICD10CM | Covered |
| I61.6 | ICD10CM | Covered |
| I61.8 | ICD10CM | Covered |
| I61.9 | ICD10CM | Covered |
| I62.00 | ICD10CM | Covered |
| I62.01 | ICD10CM | Covered |
| I62.02 | ICD10CM | Covered |
| I62.03 | ICD10CM | Covered |
| I62.9 | ICD10CM | Covered |
| I63.011 | ICD10CM | Covered |
| I63.012 | ICD10CM | Covered |
| I63.013 | ICD10CM | Covered |
| I63.02 | ICD10CM | Covered |
| I63.031 | ICD10CM | Covered |
| I63.032 | ICD10CM | Covered |
| I63.033 | ICD10CM | Covered |
| I63.09 | ICD10CM | Covered |
| I63.111 | ICD10CM | Covered |
| I63.112 | ICD10CM | Covered |
| I63.113 | ICD10CM | Covered |
| I63.12 | ICD10CM | Covered |
| I63.131 | ICD10CM | Covered |
| I63.132 | ICD10CM | Covered |
| I63.133 | ICD10CM | Covered |
| I63.19 | ICD10CM | Covered |
| I63.211 | ICD10CM | Covered |
| I63.212 | ICD10CM | Covered |
| I63.213 | ICD10CM | Covered |
| I63.22 | ICD10CM | Covered |
| I63.231 | ICD10CM | Covered |
| I63.232 | ICD10CM | Covered |
| I63.233 | ICD10CM | Covered |
| I63.29 | ICD10CM | Covered |
| I63.311 | ICD10CM | Covered |
| I63.312 | ICD10CM | Covered |
| I63.313 | ICD10CM | Covered |
| I63.321 | ICD10CM | Covered |
| I63.322 | ICD10CM | Covered |
| I63.323 | ICD10CM | Covered |
| I63.331 | ICD10CM | Covered |
| I63.332 | ICD10CM | Covered |
| I63.333 | ICD10CM | Covered |
| I63.341 | ICD10CM | Covered |
| I63.342 | ICD10CM | Covered |
| I63.343 | ICD10CM | Covered |
| I63.39 | ICD10CM | Covered |
| I63.411 | ICD10CM | Covered |
| I63.412 | ICD10CM | Covered |
| I63.413 | ICD10CM | Covered |
| I63.421 | ICD10CM | Covered |
| I63.422 | ICD10CM | Covered |
| I63.423 | ICD10CM | Covered |
| I63.431 | ICD10CM | Covered |
| I63.432 | ICD10CM | Covered |
| I63.433 | ICD10CM | Covered |
| I63.441 | ICD10CM | Covered |
| I63.442 | ICD10CM | Covered |
| I63.443 | ICD10CM | Covered |
| I63.49 | ICD10CM | Covered |
| I63.511 | ICD10CM | Covered |
| I63.512 | ICD10CM | Covered |
| I63.513 | ICD10CM | Covered |
| I63.521 | ICD10CM | Covered |
| I63.522 | ICD10CM | Covered |
| I63.523 | ICD10CM | Covered |
| I63.531 | ICD10CM | Covered |
| I63.532 | ICD10CM | Covered |
| I63.533 | ICD10CM | Covered |
| I63.541 | ICD10CM | Covered |
| I63.542 | ICD10CM | Covered |
| I63.543 | ICD10CM | Covered |
| I63.59 | ICD10CM | Covered |
| I63.6 | ICD10CM | Covered |
| I63.81 | ICD10CM | Covered |
| I63.89 | ICD10CM | Covered |
| I63.9 | ICD10CM | Covered |
| I65.01 | ICD10CM | Covered |
| I65.02 | ICD10CM | Covered |
| I65.03 | ICD10CM | Covered |
| I65.1 | ICD10CM | Covered |
| I65.21 | ICD10CM | Covered |
| I65.22 | ICD10CM | Covered |
| I65.23 | ICD10CM | Covered |
| I65.8 | ICD10CM | Covered |
| I66.01 | ICD10CM | Covered |
| I66.02 | ICD10CM | Covered |
| I66.03 | ICD10CM | Covered |
| I66.11 | ICD10CM | Covered |
| I66.12 | ICD10CM | Covered |
| I66.13 | ICD10CM | Covered |
| I66.21 | ICD10CM | Covered |
| I66.22 | ICD10CM | Covered |
| I66.23 | ICD10CM | Covered |
| I66.3 | ICD10CM | Covered |
| I66.8 | ICD10CM | Covered |
| I67.0 | ICD10CM | Covered |
| I67.1 | ICD10CM | Covered |
| I67.81 | ICD10CM | Covered |
| I67.82 | ICD10CM | Covered |
| I67.841 | ICD10CM | Covered |
| I67.848 | ICD10CM | Covered |
| I67.850 | ICD10CM | Covered |
| I67.858 | ICD10CM | Covered |
| I67.89 | ICD10CM | Covered |
| I70.0 | ICD10CM | Covered |
| I70.1 | ICD10CM | Covered |
| I70.201 | ICD10CM | Covered |
| I70.202 | ICD10CM | Covered |
| I70.203 | ICD10CM | Covered |
| I70.208 | ICD10CM | Covered |
| I70.211 | ICD10CM | Covered |
| I70.212 | ICD10CM | Covered |
| I70.213 | ICD10CM | Covered |
| I70.218 | ICD10CM | Covered |
| I70.221 | ICD10CM | Covered |
| I70.222 | ICD10CM | Covered |
| I70.223 | ICD10CM | Covered |
| I70.228 | ICD10CM | Covered |
| I70.231 | ICD10CM | Covered |
| I70.232 | ICD10CM | Covered |
| I70.233 | ICD10CM | Covered |
| I70.234 | ICD10CM | Covered |
| I70.235 | ICD10CM | Covered |
| I70.238 | ICD10CM | Covered |
| I70.241 | ICD10CM | Covered |
| I70.242 | ICD10CM | Covered |
| I70.243 | ICD10CM | Covered |
| I70.244 | ICD10CM | Covered |
| I70.245 | ICD10CM | Covered |
| I70.248 | ICD10CM | Covered |
| I70.25 | ICD10CM | Covered |
| I70.261 | ICD10CM | Covered |
| I70.262 | ICD10CM | Covered |
| I70.263 | ICD10CM | Covered |
| I70.268 | ICD10CM | Covered |
| I70.291 | ICD10CM | Covered |
| I70.292 | ICD10CM | Covered |
| I70.293 | ICD10CM | Covered |
| I70.298 | ICD10CM | Covered |
| I70.301 | ICD10CM | Covered |
| I70.302 | ICD10CM | Covered |
| I70.303 | ICD10CM | Covered |
| I70.308 | ICD10CM | Covered |
| I70.311 | ICD10CM | Covered |
| I70.312 | ICD10CM | Covered |
| I70.313 | ICD10CM | Covered |
| I70.318 | ICD10CM | Covered |
| I70.321 | ICD10CM | Covered |
| I70.322 | ICD10CM | Covered |
| I70.323 | ICD10CM | Covered |
| I70.328 | ICD10CM | Covered |
| I70.331 | ICD10CM | Covered |
| I70.332 | ICD10CM | Covered |
| I70.333 | ICD10CM | Covered |
| I70.334 | ICD10CM | Covered |
| I70.335 | ICD10CM | Covered |
| I70.338 | ICD10CM | Covered |
| I70.341 | ICD10CM | Covered |
| I70.342 | ICD10CM | Covered |
| I70.343 | ICD10CM | Covered |
| I70.344 | ICD10CM | Covered |
| I70.345 | ICD10CM | Covered |
| I70.348 | ICD10CM | Covered |
| I70.35 | ICD10CM | Covered |
| I70.361 | ICD10CM | Covered |
| I70.362 | ICD10CM | Covered |
| I70.363 | ICD10CM | Covered |
| I70.368 | ICD10CM | Covered |
| I70.391 | ICD10CM | Covered |
| I70.392 | ICD10CM | Covered |
| I70.393 | ICD10CM | Covered |
| I70.398 | ICD10CM | Covered |
| I70.401 | ICD10CM | Covered |
| I70.402 | ICD10CM | Covered |
| I70.403 | ICD10CM | Covered |
| I70.408 | ICD10CM | Covered |
| I70.411 | ICD10CM | Covered |
| I70.412 | ICD10CM | Covered |
| I70.413 | ICD10CM | Covered |
| I70.418 | ICD10CM | Covered |
| I70.421 | ICD10CM | Covered |
| I70.422 | ICD10CM | Covered |
| I70.423 | ICD10CM | Covered |
| I70.428 | ICD10CM | Covered |
| I70.431 | ICD10CM | Covered |
| I70.432 | ICD10CM | Covered |
| I70.433 | ICD10CM | Covered |
| I70.434 | ICD10CM | Covered |
| I70.435 | ICD10CM | Covered |
| I70.438 | ICD10CM | Covered |
| I70.441 | ICD10CM | Covered |
| I70.442 | ICD10CM | Covered |
| I70.443 | ICD10CM | Covered |
| I70.444 | ICD10CM | Covered |
| I70.445 | ICD10CM | Covered |
| I70.448 | ICD10CM | Covered |
| I70.45 | ICD10CM | Covered |
| I70.461 | ICD10CM | Covered |
| I70.462 | ICD10CM | Covered |
| I70.463 | ICD10CM | Covered |
| I70.468 | ICD10CM | Covered |
| I70.491 | ICD10CM | Covered |
| I70.492 | ICD10CM | Covered |
| I70.493 | ICD10CM | Covered |
| I70.498 | ICD10CM | Covered |
| I70.501 | ICD10CM | Covered |
| I70.502 | ICD10CM | Covered |
| I70.503 | ICD10CM | Covered |
| I70.508 | ICD10CM | Covered |
| I70.511 | ICD10CM | Covered |
| I70.512 | ICD10CM | Covered |
| I70.513 | ICD10CM | Covered |
| I70.518 | ICD10CM | Covered |
| I70.521 | ICD10CM | Covered |
| I70.522 | ICD10CM | Covered |
| I70.523 | ICD10CM | Covered |
| I70.528 | ICD10CM | Covered |
| I70.531 | ICD10CM | Covered |
| I70.532 | ICD10CM | Covered |
| I70.533 | ICD10CM | Covered |
| I70.534 | ICD10CM | Covered |
| I70.535 | ICD10CM | Covered |
| I70.538 | ICD10CM | Covered |
| I70.541 | ICD10CM | Covered |
| I70.542 | ICD10CM | Covered |
| I70.543 | ICD10CM | Covered |
| I70.544 | ICD10CM | Covered |
| I70.545 | ICD10CM | Covered |
| I70.548 | ICD10CM | Covered |
| I70.55 | ICD10CM | Covered |
| I70.561 | ICD10CM | Covered |
| I70.562 | ICD10CM | Covered |
| I70.563 | ICD10CM | Covered |
| I70.568 | ICD10CM | Covered |
| I70.591 | ICD10CM | Covered |
| I70.592 | ICD10CM | Covered |
| I70.593 | ICD10CM | Covered |
| I70.598 | ICD10CM | Covered |
| I70.601 | ICD10CM | Covered |
| I70.602 | ICD10CM | Covered |
| I70.603 | ICD10CM | Covered |
| I70.608 | ICD10CM | Covered |
| I70.611 | ICD10CM | Covered |
| I70.612 | ICD10CM | Covered |
| I70.613 | ICD10CM | Covered |
| I70.618 | ICD10CM | Covered |
| I70.621 | ICD10CM | Covered |
| I70.622 | ICD10CM | Covered |
| I70.623 | ICD10CM | Covered |
| I70.628 | ICD10CM | Covered |
| I70.631 | ICD10CM | Covered |
| I70.632 | ICD10CM | Covered |
| I70.633 | ICD10CM | Covered |
| I70.634 | ICD10CM | Covered |
| I70.635 | ICD10CM | Covered |
| I70.638 | ICD10CM | Covered |
| I70.641 | ICD10CM | Covered |
| I70.642 | ICD10CM | Covered |
| I70.643 | ICD10CM | Covered |
| I70.644 | ICD10CM | Covered |
| I70.645 | ICD10CM | Covered |
| I70.648 | ICD10CM | Covered |
| I70.65 | ICD10CM | Covered |
| I70.661 | ICD10CM | Covered |
| I70.662 | ICD10CM | Covered |
| I70.663 | ICD10CM | Covered |
| I70.668 | ICD10CM | Covered |
| I70.691 | ICD10CM | Covered |
| I70.692 | ICD10CM | Covered |
| I70.693 | ICD10CM | Covered |
| I70.698 | ICD10CM | Covered |
| I70.701 | ICD10CM | Covered |
| I70.702 | ICD10CM | Covered |
| I70.703 | ICD10CM | Covered |
| I70.708 | ICD10CM | Covered |
| I70.711 | ICD10CM | Covered |
| I70.712 | ICD10CM | Covered |
| I70.713 | ICD10CM | Covered |
| I70.718 | ICD10CM | Covered |
| I70.721 | ICD10CM | Covered |
| I70.722 | ICD10CM | Covered |
| I70.723 | ICD10CM | Covered |
| I70.728 | ICD10CM | Covered |
| I70.731 | ICD10CM | Covered |
| I70.732 | ICD10CM | Covered |
| I70.733 | ICD10CM | Covered |
| I70.734 | ICD10CM | Covered |
| I70.735 | ICD10CM | Covered |
| I70.738 | ICD10CM | Covered |
| I70.741 | ICD10CM | Covered |
| I70.742 | ICD10CM | Covered |
| I70.743 | ICD10CM | Covered |
| I70.744 | ICD10CM | Covered |
| I70.745 | ICD10CM | Covered |
| I70.748 | ICD10CM | Covered |
| I70.75 | ICD10CM | Covered |
| I70.761 | ICD10CM | Covered |
| I70.762 | ICD10CM | Covered |
| I70.763 | ICD10CM | Covered |
| I70.768 | ICD10CM | Covered |
| I70.791 | ICD10CM | Covered |
| I70.792 | ICD10CM | Covered |
| I70.793 | ICD10CM | Covered |
| I70.798 | ICD10CM | Covered |
| I70.90 | ICD10CM | Covered |
| I70.91 | ICD10CM | Covered |
| I70.92 | ICD10CM | Covered |
| I71.010 | ICD10CM | Covered |
| I71.011 | ICD10CM | Covered |
| I71.012 | ICD10CM | Covered |
| I71.019 | ICD10CM | Covered |
| I71.02 | ICD10CM | Covered |
| I71.03 | ICD10CM | Covered |
| I71.10 | ICD10CM | Covered |
| I71.11 | ICD10CM | Covered |
| I71.12 | ICD10CM | Covered |
| I71.13 | ICD10CM | Covered |
| I71.20 | ICD10CM | Covered |
| I71.21 | ICD10CM | Covered |
| I71.22 | ICD10CM | Covered |
| I71.23 | ICD10CM | Covered |
| I71.30 | ICD10CM | Covered |
| I71.31 | ICD10CM | Covered |
| I71.32 | ICD10CM | Covered |
| I71.33 | ICD10CM | Covered |
| I71.40 | ICD10CM | Covered |
| I71.41 | ICD10CM | Covered |
| I71.42 | ICD10CM | Covered |
| I71.43 | ICD10CM | Covered |
| I71.50 | ICD10CM | Covered |
| I71.51 | ICD10CM | Covered |
| I71.52 | ICD10CM | Covered |
| I71.60 | ICD10CM | Covered |
| I71.61 | ICD10CM | Covered |
| I71.62 | ICD10CM | Covered |
| I71.9 | ICD10CM | Covered |
| I72.0 | ICD10CM | Covered |
| I72.1 | ICD10CM | Covered |
| I72.2 | ICD10CM | Covered |
| I72.3 | ICD10CM | Covered |
| I72.4 | ICD10CM | Covered |
| I72.5 | ICD10CM | Covered |
| I72.6 | ICD10CM | Covered |
| I72.8 | ICD10CM | Covered |
| I73.00 | ICD10CM | Covered |
| I73.01 | ICD10CM | Covered |
| I73.1 | ICD10CM | Covered |
| I73.81 | ICD10CM | Covered |
| I73.89 | ICD10CM | Covered |
| I73.9 | ICD10CM | Covered |
| I74.01 | ICD10CM | Covered |
| I74.09 | ICD10CM | Covered |
| I74.10 | ICD10CM | Covered |
| I74.11 | ICD10CM | Covered |
| I74.19 | ICD10CM | Covered |
| I74.3 | ICD10CM | Covered |
| I74.4 | ICD10CM | Covered |
| I74.5 | ICD10CM | Covered |
| I74.8 | ICD10CM | Covered |
| I75.011 | ICD10CM | Covered |
| I75.012 | ICD10CM | Covered |
| I75.021 | ICD10CM | Covered |
| I75.022 | ICD10CM | Covered |
| I75.023 | ICD10CM | Covered |
| I75.81 | ICD10CM | Covered |
| I76 | ICD10CM | Covered |
| I77.0 | ICD10CM | Covered |
| I77.1 | ICD10CM | Covered |
| I77.2 | ICD10CM | Covered |
| I77.3 | ICD10CM | Covered |
| I77.4 | ICD10CM | Covered |
| I77.5 | ICD10CM | Covered |
| I77.6 | ICD10CM | Covered |
| I77.71 | ICD10CM | Covered |
| I77.72 | ICD10CM | Covered |
| I77.73 | ICD10CM | Covered |
| I77.74 | ICD10CM | Covered |
| I77.75 | ICD10CM | Covered |
| I77.77 | ICD10CM | Covered |
| I77.79 | ICD10CM | Covered |
| I77.810 | ICD10CM | Covered |
| I77.811 | ICD10CM | Covered |
| I77.812 | ICD10CM | Covered |
| I77.819 | ICD10CM | Covered |
| I77.82 | ICD10CM | Covered |
| I77.89 | ICD10CM | Covered |
| I79.0 | ICD10CM | Covered |
| I79.1 | ICD10CM | Covered |
| I79.8 | ICD10CM | Covered |
| I80.01 | ICD10CM | Covered |
| I80.02 | ICD10CM | Covered |
| I80.03 | ICD10CM | Covered |
| I80.11 | ICD10CM | Covered |
| I80.12 | ICD10CM | Covered |
| I80.13 | ICD10CM | Covered |
| I80.201 | ICD10CM | Covered |
| I80.202 | ICD10CM | Covered |
| I80.203 | ICD10CM | Covered |
| I80.221 | ICD10CM | Covered |
| I80.222 | ICD10CM | Covered |
| I80.223 | ICD10CM | Covered |
| I80.231 | ICD10CM | Covered |
| I80.232 | ICD10CM | Covered |
| I80.233 | ICD10CM | Covered |
| I80.241 | ICD10CM | Covered |
| I80.242 | ICD10CM | Covered |
| I80.243 | ICD10CM | Covered |
| I80.249 | ICD10CM | Covered |
| I80.251 | ICD10CM | Covered |
| I80.252 | ICD10CM | Covered |
| I80.253 | ICD10CM | Covered |
| I80.259 | ICD10CM | Covered |
| I80.291 | ICD10CM | Covered |
| I80.292 | ICD10CM | Covered |
| I80.293 | ICD10CM | Covered |
| I82.0 | ICD10CM | Covered |
| I82.220 | ICD10CM | Covered |
| I82.221 | ICD10CM | Covered |
| I82.3 | ICD10CM | Covered |
| I82.601 | ICD10CM | Covered |
| I82.602 | ICD10CM | Covered |
| I82.603 | ICD10CM | Covered |
| I82.701 | ICD10CM | Covered |
| I82.702 | ICD10CM | Covered |
| I82.703 | ICD10CM | Covered |
| I82.711 | ICD10CM | Covered |
| I82.712 | ICD10CM | Covered |
| I82.713 | ICD10CM | Covered |
| I82.721 | ICD10CM | Covered |
| I82.722 | ICD10CM | Covered |
| I82.723 | ICD10CM | Covered |
| I86.2 | ICD10CM | Covered |
| I88.0 | ICD10CM | Covered |
| I88.1 | ICD10CM | Covered |
| I88.8 | ICD10CM | Covered |
| I89.0 | ICD10CM | Covered |
| I89.1 | ICD10CM | Covered |
| I89.8 | ICD10CM | Covered |
| I96 | ICD10CM | Covered |
| J95.821 | ICD10CM | Covered |
| J95.822 | ICD10CM | Covered |
| J95.860 | ICD10CM | Covered |
| J95.861 | ICD10CM | Covered |
| J95.862 | ICD10CM | Covered |
| J95.863 | ICD10CM | Covered |
| J95.87 | ICD10CM | Covered |
| J96.00 | ICD10CM | Covered |
| J96.01 | ICD10CM | Covered |
| J96.02 | ICD10CM | Covered |
| J96.20 | ICD10CM | Covered |
| J96.21 | ICD10CM | Covered |
| J96.22 | ICD10CM | Covered |
| K55.011 | ICD10CM | Covered |
| K55.012 | ICD10CM | Covered |
| K55.019 | ICD10CM | Covered |
| K55.021 | ICD10CM | Covered |
| K55.022 | ICD10CM | Covered |
| K55.029 | ICD10CM | Covered |
| K55.031 | ICD10CM | Covered |
| K55.032 | ICD10CM | Covered |
| K55.039 | ICD10CM | Covered |
| K55.041 | ICD10CM | Covered |
| K55.042 | ICD10CM | Covered |
| K55.049 | ICD10CM | Covered |
| K55.051 | ICD10CM | Covered |
| K55.052 | ICD10CM | Covered |
| K55.059 | ICD10CM | Covered |
| K55.061 | ICD10CM | Covered |
| K55.062 | ICD10CM | Covered |
| K55.069 | ICD10CM | Covered |
| K55.30 | ICD10CM | Covered |
| K55.31 | ICD10CM | Covered |
| K55.32 | ICD10CM | Covered |
| K55.33 | ICD10CM | Covered |
| K85.01 | ICD10CM | Covered |
| K85.02 | ICD10CM | Covered |
| K85.81 | ICD10CM | Covered |
| K85.82 | ICD10CM | Covered |
| K85.91 | ICD10CM | Covered |
| K85.92 | ICD10CM | Covered |
| K91.30 | ICD10CM | Covered |
| K91.31 | ICD10CM | Covered |
| K91.32 | ICD10CM | Covered |
| K91.86 | ICD10CM | Covered |
| K91.870 | ICD10CM | Covered |
| K91.871 | ICD10CM | Covered |
| K91.872 | ICD10CM | Covered |
| K91.873 | ICD10CM | Covered |
| K95.09 | ICD10CM | Covered |
| K95.89 | ICD10CM | Covered |
| L03.121 | ICD10CM | Covered |
| L03.122 | ICD10CM | Covered |
| L03.123 | ICD10CM | Covered |
| L03.124 | ICD10CM | Covered |
| L03.125 | ICD10CM | Covered |
| L03.126 | ICD10CM | Covered |
| L03.212 | ICD10CM | Covered |
| L03.222 | ICD10CM | Covered |
| L03.31A | ICD10CM | Covered |
| L03.321 | ICD10CM | Covered |
| L03.322 | ICD10CM | Covered |
| L03.323 | ICD10CM | Covered |
| L03.324 | ICD10CM | Covered |
| L03.325 | ICD10CM | Covered |
| L03.326 | ICD10CM | Covered |
| L03.327 | ICD10CM | Covered |
| L03.32A | ICD10CM | Covered |
| L03.891 | ICD10CM | Covered |
| L03.898 | ICD10CM | Covered |
| L04.0 | ICD10CM | Covered |
| L04.1 | ICD10CM | Covered |
| L04.2 | ICD10CM | Covered |
| L04.3 | ICD10CM | Covered |
| L04.8 | ICD10CM | Covered |
| M31.8 | ICD10CM | Covered |
| M31.9 | ICD10CM | Covered |
| M79.A11 | ICD10CM | Covered |
| M79.A12 | ICD10CM | Covered |
| N17.0 | ICD10CM | Covered |
| N17.1 | ICD10CM | Covered |
| N17.2 | ICD10CM | Covered |
| N17.8 | ICD10CM | Covered |
| N17.9 | ICD10CM | Covered |
| N18.1 | ICD10CM | Covered |
| N18.2 | ICD10CM | Covered |
| N18.4 | ICD10CM | Covered |
| N18.5 | ICD10CM | Covered |
| N18.6 | ICD10CM | Covered |
| N18.9 | ICD10CM | Covered |
| N19 | ICD10CM | Covered |
| N99.840 | ICD10CM | Covered |
| N99.841 | ICD10CM | Covered |
| N99.85 | ICD10CM | Covered |
| Q25.21 | ICD10CM | Covered |
| Q25.29 | ICD10CM | Covered |
| Q25.40 | ICD10CM | Covered |
| Q25.41 | ICD10CM | Covered |
| Q25.42 | ICD10CM | Covered |
| Q25.43 | ICD10CM | Covered |
| Q25.44 | ICD10CM | Covered |
| Q25.45 | ICD10CM | Covered |
| Q25.46 | ICD10CM | Covered |
| Q25.47 | ICD10CM | Covered |
| Q25.48 | ICD10CM | Covered |
| Q25.49 | ICD10CM | Covered |
| Q25.5 | ICD10CM | Covered |
| Q25.6 | ICD10CM | Covered |
| Q25.71 | ICD10CM | Covered |
| Q25.72 | ICD10CM | Covered |
| Q25.79 | ICD10CM | Covered |
| Q27.32 | ICD10CM | Covered |
| Q27.39 | ICD10CM | Covered |
| Q27.8 | ICD10CM | Covered |
| Q27.9 | ICD10CM | Covered |
| Q28.2 | ICD10CM | Covered |
| Q28.3 | ICD10CM | Covered |
| Q82.0 | ICD10CM | Covered |
| Q85.03 | ICD10CM | Covered |
| Q85.09 | ICD10CM | Covered |
| Q87.82 | ICD10CM | Covered |
| Q87.83 | ICD10CM | Covered |
| Q87.84 | ICD10CM | Covered |
| Q87.85 | ICD10CM | Covered |
| Q87.86 | ICD10CM | Covered |
| Q87.87 | ICD10CM | Covered |
| Q87.88 | ICD10CM | Covered |
| R06.03 | ICD10CM | Covered |
| R06.09 | ICD10CM | Covered |
| R06.89 | ICD10CM | Covered |
| R07.1 | ICD10CM | Covered |
| R07.2 | ICD10CM | Covered |
| R07.81 | ICD10CM | Covered |
| R07.82 | ICD10CM | Covered |
| R07.89 | ICD10CM | Covered |
| R09.02 | ICD10CM | Covered |
| R23.0 | ICD10CM | Covered |
| R41.844 | ICD10CM | Covered |
| R41.85 | ICD10CM | Covered |
| R47.82 | ICD10CM | Covered |
| R55 | ICD10CM | Covered |
| R56.1 | ICD10CM | Covered |
| R90.82 | ICD10CM | Covered |
| R93.0 | ICD10CM | Covered |
| R93.1 | ICD10CM | Covered |
| R93.41 | ICD10CM | Covered |
| R93.421 | ICD10CM | Covered |
| R93.422 | ICD10CM | Covered |
| R93.429 | ICD10CM | Covered |
| R93.49 | ICD10CM | Covered |
| R93.5 | ICD10CM | Covered |
| R93.6 | ICD10CM | Covered |
| R93.7 | ICD10CM | Covered |
| R93.89 | ICD10CM | Covered |
| S09.0XXA | ICD10CM | Covered |
| S09.0XXD | ICD10CM | Covered |
| S09.0XXS | ICD10CM | Covered |
| S15.001A | ICD10CM | Covered |
| S15.001D | ICD10CM | Covered |
| S15.001S | ICD10CM | Covered |
| S15.002A | ICD10CM | Covered |
| S15.002D | ICD10CM | Covered |
| S15.002S | ICD10CM | Covered |
| S15.011A | ICD10CM | Covered |
| S15.011D | ICD10CM | Covered |
| S15.011S | ICD10CM | Covered |
| S15.012A | ICD10CM | Covered |
| S15.012D | ICD10CM | Covered |
| S15.012S | ICD10CM | Covered |
| S15.021A | ICD10CM | Covered |
| S15.021D | ICD10CM | Covered |
| S15.021S | ICD10CM | Covered |
| S15.022A | ICD10CM | Covered |
| S15.022D | ICD10CM | Covered |
| S15.022S | ICD10CM | Covered |
| S15.091A | ICD10CM | Covered |
| S15.091D | ICD10CM | Covered |
| S15.091S | ICD10CM | Covered |
| S15.092A | ICD10CM | Covered |
| S15.092D | ICD10CM | Covered |
| S15.092S | ICD10CM | Covered |
| S15.101A | ICD10CM | Covered |
| S15.101D | ICD10CM | Covered |
| S15.101S | ICD10CM | Covered |
| S15.102A | ICD10CM | Covered |
| S15.102D | ICD10CM | Covered |
| S15.102S | ICD10CM | Covered |
| S15.111A | ICD10CM | Covered |
| S15.111D | ICD10CM | Covered |
| S15.111S | ICD10CM | Covered |
| S15.112A | ICD10CM | Covered |
| S15.112D | ICD10CM | Covered |
| S15.112S | ICD10CM | Covered |
| S15.121A | ICD10CM | Covered |
| S15.121D | ICD10CM | Covered |
| S15.121S | ICD10CM | Covered |
| S15.122A | ICD10CM | Covered |
| S15.122D | ICD10CM | Covered |
| S15.122S | ICD10CM | Covered |
| S15.191A | ICD10CM | Covered |
| S15.191D | ICD10CM | Covered |
| S15.191S | ICD10CM | Covered |
| S15.192A | ICD10CM | Covered |
| S15.192D | ICD10CM | Covered |
| S15.192S | ICD10CM | Covered |
| S15.201A | ICD10CM | Covered |
| S15.201D | ICD10CM | Covered |
| S15.201S | ICD10CM | Covered |
| S15.202A | ICD10CM | Covered |
| S15.202D | ICD10CM | Covered |
| S15.202S | ICD10CM | Covered |
| S15.211A | ICD10CM | Covered |
| S15.211D | ICD10CM | Covered |
| S15.211S | ICD10CM | Covered |
| S15.212A | ICD10CM | Covered |
| S15.212D | ICD10CM | Covered |
| S15.212S | ICD10CM | Covered |
| S15.221A | ICD10CM | Covered |
| S15.221D | ICD10CM | Covered |
| S15.221S | ICD10CM | Covered |
| S15.222A | ICD10CM | Covered |
| S15.222D | ICD10CM | Covered |
| S15.222S | ICD10CM | Covered |
| S15.291A | ICD10CM | Covered |
| S15.291D | ICD10CM | Covered |
| S15.291S | ICD10CM | Covered |
| S15.292A | ICD10CM | Covered |
| S15.292D | ICD10CM | Covered |
| S15.292S | ICD10CM | Covered |
| S15.301A | ICD10CM | Covered |
| S15.301D | ICD10CM | Covered |
| S15.301S | ICD10CM | Covered |
| S15.302A | ICD10CM | Covered |
| S15.302D | ICD10CM | Covered |
| S15.302S | ICD10CM | Covered |
| S15.311A | ICD10CM | Covered |
| S15.311D | ICD10CM | Covered |
| S15.311S | ICD10CM | Covered |
| S15.312A | ICD10CM | Covered |
| S15.312D | ICD10CM | Covered |
| S15.312S | ICD10CM | Covered |
| S15.321A | ICD10CM | Covered |
| S15.321D | ICD10CM | Covered |
| S15.321S | ICD10CM | Covered |
| S15.322A | ICD10CM | Covered |
| S15.322D | ICD10CM | Covered |
| S15.322S | ICD10CM | Covered |
| S15.391A | ICD10CM | Covered |