About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Total Joint Arthroplasty L33456.
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 1,205 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 27130 | HCPCS | Covered |
| 27132 | HCPCS | Covered |
| 27134 | HCPCS | Covered |
| 27137 | HCPCS | Covered |
| 27138 | HCPCS | Covered |
| 27447 | HCPCS | Covered |
| 27486 | HCPCS | Covered |
| 27487 | HCPCS | Covered |
| C40.21 | ICD10CM | Covered |
| C40.22 | ICD10CM | Covered |
| C47.21 | ICD10CM | Covered |
| C47.22 | ICD10CM | Covered |
| C49.21 | ICD10CM | Covered |
| C49.22 | ICD10CM | Covered |
| D16.21 | ICD10CM | Covered |
| D16.22 | ICD10CM | Covered |
| D21.21 | ICD10CM | Covered |
| D21.22 | ICD10CM | Covered |
| L40.50 | ICD10CM | Covered |
| M05.051 | ICD10CM | Covered |
| M05.052 | ICD10CM | Covered |
| M05.061 | ICD10CM | Covered |
| M05.062 | ICD10CM | Covered |
| M05.09 | ICD10CM | Covered |
| M05.451 | ICD10CM | Covered |
| M05.452 | ICD10CM | Covered |
| M05.461 | ICD10CM | Covered |
| M05.462 | ICD10CM | Covered |
| M05.49 | ICD10CM | Covered |
| M05.551 | ICD10CM | Covered |
| M05.552 | ICD10CM | Covered |
| M05.561 | ICD10CM | Covered |
| M05.562 | ICD10CM | Covered |
| M05.59 | ICD10CM | Covered |
| M05.751 | ICD10CM | Covered |
| M05.752 | ICD10CM | Covered |
| M05.761 | ICD10CM | Covered |
| M05.762 | ICD10CM | Covered |
| M05.79 | ICD10CM | Covered |
| M05.851 | ICD10CM | Covered |
| M05.852 | ICD10CM | Covered |
| M05.861 | ICD10CM | Covered |
| M05.862 | ICD10CM | Covered |
| M05.89 | ICD10CM | Covered |
| M06.051 | ICD10CM | Covered |
| M06.052 | ICD10CM | Covered |
| M06.061 | ICD10CM | Covered |
| M06.062 | ICD10CM | Covered |
| M06.09 | ICD10CM | Covered |
| M06.251 | ICD10CM | Covered |
| M06.252 | ICD10CM | Covered |
| M06.261 | ICD10CM | Covered |
| M06.262 | ICD10CM | Covered |
| M06.351 | ICD10CM | Covered |
| M06.352 | ICD10CM | Covered |
| M06.361 | ICD10CM | Covered |
| M06.362 | ICD10CM | Covered |
| M06.851 | ICD10CM | Covered |
| M06.852 | ICD10CM | Covered |
| M06.861 | ICD10CM | Covered |
| M06.862 | ICD10CM | Covered |
| M06.89 | ICD10CM | Covered |
| M07.651 | ICD10CM | Covered |
| M07.652 | ICD10CM | Covered |
| M08.051 | ICD10CM | Covered |
| M08.052 | ICD10CM | Covered |
| M08.061 | ICD10CM | Covered |
| M08.062 | ICD10CM | Covered |
| M08.09 | ICD10CM | Covered |
| M08.251 | ICD10CM | Covered |
| M08.252 | ICD10CM | Covered |
| M08.261 | ICD10CM | Covered |
| M08.262 | ICD10CM | Covered |
| M08.29 | ICD10CM | Covered |
| M08.451 | ICD10CM | Covered |
| M08.452 | ICD10CM | Covered |
| M08.461 | ICD10CM | Covered |
| M08.462 | ICD10CM | Covered |
| M08.851 | ICD10CM | Covered |
| M08.852 | ICD10CM | Covered |
| M08.861 | ICD10CM | Covered |
| M08.862 | ICD10CM | Covered |
| M08.89 | ICD10CM | Covered |
| M08.951 | ICD10CM | Covered |
| M08.952 | ICD10CM | Covered |
| M08.961 | ICD10CM | Covered |
| M08.962 | ICD10CM | Covered |
| M08.99 | ICD10CM | Covered |
| M12.051 | ICD10CM | Covered |
| M12.052 | ICD10CM | Covered |
| M12.061 | ICD10CM | Covered |
| M12.062 | ICD10CM | Covered |
| M12.09 | ICD10CM | Covered |
| M12.351 | ICD10CM | Covered |
| M12.352 | ICD10CM | Covered |
| M12.451 | ICD10CM | Covered |
| M12.452 | ICD10CM | Covered |
| M12.551 | ICD10CM | Covered |
| M12.552 | ICD10CM | Covered |
| M12.561 | ICD10CM | Covered |
| M12.562 | ICD10CM | Covered |
| M12.851 | ICD10CM | Covered |
| M12.852 | ICD10CM | Covered |
| M13.0 | ICD10CM | Covered |
| M13.151 | ICD10CM | Covered |
| M13.152 | ICD10CM | Covered |
| M16.0 | ICD10CM | Covered |
| M16.11 | ICD10CM | Covered |
| M16.12 | ICD10CM | Covered |
| M16.2 | ICD10CM | Covered |
| M16.31 | ICD10CM | Covered |
| M16.32 | ICD10CM | Covered |
| M16.4 | ICD10CM | Covered |
| M16.51 | ICD10CM | Covered |
| M16.52 | ICD10CM | Covered |
| M16.6 | ICD10CM | Covered |
| M16.7 | ICD10CM | Covered |
| M17.0 | ICD10CM | Covered |
| M17.11 | ICD10CM | Covered |
| M17.12 | ICD10CM | Covered |
| M17.2 | ICD10CM | Covered |
| M17.31 | ICD10CM | Covered |
| M17.32 | ICD10CM | Covered |
| M17.4 | ICD10CM | Covered |
| M17.5 | ICD10CM | Covered |
| M24.651 | ICD10CM | Covered |
| M24.652 | ICD10CM | Covered |
| M24.661 | ICD10CM | Covered |
| M24.662 | ICD10CM | Covered |
| M24.7 | ICD10CM | Covered |
| M24.851 | ICD10CM | Covered |
| M24.852 | ICD10CM | Covered |
| M25.251 | ICD10CM | Covered |
| M25.252 | ICD10CM | Covered |
| M25.261 | ICD10CM | Covered |
| M25.262 | ICD10CM | Covered |
| M25.351 | ICD10CM | Covered |
| M25.352 | ICD10CM | Covered |
| M25.361 | ICD10CM | Covered |
| M25.362 | ICD10CM | Covered |
| M25.551 | ICD10CM | Covered |
| M25.552 | ICD10CM | Covered |
| M25.561 | ICD10CM | Covered |
| M25.562 | ICD10CM | Covered |
| M80.051A | ICD10CM | Covered |
| M80.051G | ICD10CM | Covered |
| M80.051K | ICD10CM | Covered |
| M80.051S | ICD10CM | Covered |
| M80.052A | ICD10CM | Covered |
| M80.052G | ICD10CM | Covered |
| M80.052K | ICD10CM | Covered |
| M80.052S | ICD10CM | Covered |
| M80.0B1A | ICD10CM | Covered |
| M80.0B1G | ICD10CM | Covered |
| M80.0B1K | ICD10CM | Covered |
| M80.0B1P | ICD10CM | Covered |
| M80.0B1S | ICD10CM | Covered |
| M80.0B2A | ICD10CM | Covered |
| M80.0B2G | ICD10CM | Covered |
| M80.0B2K | ICD10CM | Covered |
| M80.0B2P | ICD10CM | Covered |
| M80.0B2S | ICD10CM | Covered |
| M80.851A | ICD10CM | Covered |
| M80.851G | ICD10CM | Covered |
| M80.851K | ICD10CM | Covered |
| M80.851S | ICD10CM | Covered |
| M80.852A | ICD10CM | Covered |
| M80.852G | ICD10CM | Covered |
| M80.852K | ICD10CM | Covered |
| M80.852S | ICD10CM | Covered |
| M80.8B1A | ICD10CM | Covered |
| M80.8B1G | ICD10CM | Covered |
| M80.8B1K | ICD10CM | Covered |
| M80.8B1P | ICD10CM | Covered |
| M80.8B1S | ICD10CM | Covered |
| M80.8B2A | ICD10CM | Covered |
| M80.8B2G | ICD10CM | Covered |
| M80.8B2K | ICD10CM | Covered |
| M80.8B2P | ICD10CM | Covered |
| M80.8B2S | ICD10CM | Covered |
| M84.351A | ICD10CM | Covered |
| M84.351G | ICD10CM | Covered |
| M84.351K | ICD10CM | Covered |
| M84.351S | ICD10CM | Covered |
| M84.352A | ICD10CM | Covered |
| M84.352G | ICD10CM | Covered |
| M84.352K | ICD10CM | Covered |
| M84.352S | ICD10CM | Covered |
| M84.451A | ICD10CM | Covered |
| M84.451G | ICD10CM | Covered |
| M84.451K | ICD10CM | Covered |
| M84.451S | ICD10CM | Covered |
| M84.452A | ICD10CM | Covered |
| M84.452G | ICD10CM | Covered |
| M84.452K | ICD10CM | Covered |
| M84.452S | ICD10CM | Covered |
| M84.461A | ICD10CM | Covered |
| M84.461G | ICD10CM | Covered |
| M84.461K | ICD10CM | Covered |
| M84.461S | ICD10CM | Covered |
| M84.462A | ICD10CM | Covered |
| M84.462G | ICD10CM | Covered |
| M84.462K | ICD10CM | Covered |
| M84.462S | ICD10CM | Covered |
| M84.551A | ICD10CM | Covered |
| M84.551G | ICD10CM | Covered |
| M84.551K | ICD10CM | Covered |
| M84.551S | ICD10CM | Covered |
| M84.552A | ICD10CM | Covered |
| M84.552G | ICD10CM | Covered |
| M84.552K | ICD10CM | Covered |
| M84.552S | ICD10CM | Covered |
| M84.561A | ICD10CM | Covered |
| M84.561G | ICD10CM | Covered |
| M84.561K | ICD10CM | Covered |
| M84.561S | ICD10CM | Covered |
| M84.562A | ICD10CM | Covered |
| M84.562G | ICD10CM | Covered |
| M84.562K | ICD10CM | Covered |
| M84.562S | ICD10CM | Covered |
| M84.651A | ICD10CM | Covered |
| M84.651G | ICD10CM | Covered |
| M84.651K | ICD10CM | Covered |
| M84.651S | ICD10CM | Covered |
| M84.652A | ICD10CM | Covered |
| M84.652G | ICD10CM | Covered |
| M84.652K | ICD10CM | Covered |
| M84.652S | ICD10CM | Covered |
| M84.661A | ICD10CM | Covered |
| M84.661G | ICD10CM | Covered |
| M84.661K | ICD10CM | Covered |
| M84.661S | ICD10CM | Covered |
| M84.662A | ICD10CM | Covered |
| M84.662G | ICD10CM | Covered |
| M84.662K | ICD10CM | Covered |
| M84.662S | ICD10CM | Covered |
| M84.751A | ICD10CM | Covered |
| M84.751D | ICD10CM | Covered |
| M84.751G | ICD10CM | Covered |
| M84.751K | ICD10CM | Covered |
| M84.751P | ICD10CM | Covered |
| M84.751S | ICD10CM | Covered |
| M84.752A | ICD10CM | Covered |
| M84.752D | ICD10CM | Covered |
| M84.752G | ICD10CM | Covered |
| M84.752K | ICD10CM | Covered |
| M84.752P | ICD10CM | Covered |
| M84.752S | ICD10CM | Covered |
| M84.754A | ICD10CM | Covered |
| M84.754D | ICD10CM | Covered |
| M84.754G | ICD10CM | Covered |
| M84.754K | ICD10CM | Covered |
| M84.754P | ICD10CM | Covered |
| M84.754S | ICD10CM | Covered |
| M84.755A | ICD10CM | Covered |
| M84.755D | ICD10CM | Covered |
| M84.755G | ICD10CM | Covered |
| M84.755K | ICD10CM | Covered |
| M84.755P | ICD10CM | Covered |
| M84.755S | ICD10CM | Covered |
| M84.757A | ICD10CM | Covered |
| M84.757D | ICD10CM | Covered |
| M84.757G | ICD10CM | Covered |
| M84.757K | ICD10CM | Covered |
| M84.757P | ICD10CM | Covered |
| M84.757S | ICD10CM | Covered |
| M84.758A | ICD10CM | Covered |
| M84.758D | ICD10CM | Covered |
| M84.758G | ICD10CM | Covered |
| M84.758K | ICD10CM | Covered |
| M84.758P | ICD10CM | Covered |
| M84.758S | ICD10CM | Covered |
| M87.050 | ICD10CM | Covered |
| M87.051 | ICD10CM | Covered |
| M87.052 | ICD10CM | Covered |
| M87.150 | ICD10CM | Covered |
| M87.151 | ICD10CM | Covered |
| M87.152 | ICD10CM | Covered |
| M87.251 | ICD10CM | Covered |
| M87.252 | ICD10CM | Covered |
| M87.351 | ICD10CM | Covered |
| M87.352 | ICD10CM | Covered |
| M87.851 | ICD10CM | Covered |
| M87.852 | ICD10CM | Covered |
| M88.861 | ICD10CM | Covered |
| M88.862 | ICD10CM | Covered |
| M90.551 | ICD10CM | Covered |
| M90.552 | ICD10CM | Covered |
| M96.661 | ICD10CM | Covered |
| M96.662 | ICD10CM | Covered |
| M96.671 | ICD10CM | Covered |
| M96.672 | ICD10CM | Covered |
| M97.01XA | ICD10CM | Covered |
| M97.01XD | ICD10CM | Covered |
| M97.01XS | ICD10CM | Covered |
| M97.02XA | ICD10CM | Covered |
| M97.02XD | ICD10CM | Covered |
| M97.02XS | ICD10CM | Covered |
| M97.11XA | ICD10CM | Covered |
| M97.11XD | ICD10CM | Covered |
| M97.11XS | ICD10CM | Covered |
| M97.12XA | ICD10CM | Covered |
| M97.12XD | ICD10CM | Covered |
| M97.12XS | ICD10CM | Covered |
| Q65.01 | ICD10CM | Covered |
| Q65.02 | ICD10CM | Covered |
| Q65.89 | ICD10CM | Covered |
| S32.301A | ICD10CM | Covered |
| S32.301G | ICD10CM | Covered |
| S32.301K | ICD10CM | Covered |
| S32.301S | ICD10CM | Covered |
| S32.302A | ICD10CM | Covered |
| S32.302G | ICD10CM | Covered |
| S32.302K | ICD10CM | Covered |
| S32.302S | ICD10CM | Covered |
| S32.311A | ICD10CM | Covered |
| S32.311G | ICD10CM | Covered |
| S32.311K | ICD10CM | Covered |
| S32.311S | ICD10CM | Covered |
| S32.312A | ICD10CM | Covered |
| S32.312G | ICD10CM | Covered |
| S32.312K | ICD10CM | Covered |
| S32.312S | ICD10CM | Covered |
| S32.314A | ICD10CM | Covered |
| S32.314G | ICD10CM | Covered |
| S32.314K | ICD10CM | Covered |
| S32.314S | ICD10CM | Covered |
| S32.315A | ICD10CM | Covered |
| S32.315G | ICD10CM | Covered |
| S32.315K | ICD10CM | Covered |
| S32.315S | ICD10CM | Covered |
| S32.391A | ICD10CM | Covered |
| S32.391G | ICD10CM | Covered |
| S32.391K | ICD10CM | Covered |
| S32.391S | ICD10CM | Covered |
| S32.392A | ICD10CM | Covered |
| S32.392G | ICD10CM | Covered |
| S32.392K | ICD10CM | Covered |
| S32.392S | ICD10CM | Covered |
| S32.401A | ICD10CM | Covered |
| S32.401G | ICD10CM | Covered |
| S32.401K | ICD10CM | Covered |
| S32.401S | ICD10CM | Covered |
| S32.402A | ICD10CM | Covered |
| S32.402G | ICD10CM | Covered |
| S32.402K | ICD10CM | Covered |
| S32.402S | ICD10CM | Covered |
| S32.411A | ICD10CM | Covered |
| S32.411G | ICD10CM | Covered |
| S32.411K | ICD10CM | Covered |
| S32.411S | ICD10CM | Covered |
| S32.412A | ICD10CM | Covered |
| S32.412G | ICD10CM | Covered |
| S32.412K | ICD10CM | Covered |
| S32.412S | ICD10CM | Covered |
| S32.414A | ICD10CM | Covered |
| S32.414G | ICD10CM | Covered |
| S32.414K | ICD10CM | Covered |
| S32.414S | ICD10CM | Covered |
| S32.415A | ICD10CM | Covered |
| S32.415G | ICD10CM | Covered |
| S32.415K | ICD10CM | Covered |
| S32.415S | ICD10CM | Covered |
| S32.421A | ICD10CM | Covered |
| S32.421G | ICD10CM | Covered |
| S32.421K | ICD10CM | Covered |
| S32.421S | ICD10CM | Covered |
| S32.422A | ICD10CM | Covered |
| S32.422G | ICD10CM | Covered |
| S32.422K | ICD10CM | Covered |
| S32.422S | ICD10CM | Covered |
| S32.424A | ICD10CM | Covered |
| S32.424G | ICD10CM | Covered |
| S32.424K | ICD10CM | Covered |
| S32.424S | ICD10CM | Covered |
| S32.425A | ICD10CM | Covered |
| S32.425G | ICD10CM | Covered |
| S32.425K | ICD10CM | Covered |
| S32.425S | ICD10CM | Covered |
| S32.431A | ICD10CM | Covered |
| S32.431G | ICD10CM | Covered |
| S32.431K | ICD10CM | Covered |
| S32.431S | ICD10CM | Covered |
| S32.432A | ICD10CM | Covered |
| S32.432G | ICD10CM | Covered |
| S32.432K | ICD10CM | Covered |
| S32.432S | ICD10CM | Covered |
| S32.434A | ICD10CM | Covered |
| S32.434G | ICD10CM | Covered |
| S32.434K | ICD10CM | Covered |
| S32.434S | ICD10CM | Covered |
| S32.435A | ICD10CM | Covered |
| S32.435G | ICD10CM | Covered |
| S32.435K | ICD10CM | Covered |
| S32.435S | ICD10CM | Covered |
| S32.441A | ICD10CM | Covered |
| S32.441G | ICD10CM | Covered |
| S32.441K | ICD10CM | Covered |
| S32.441S | ICD10CM | Covered |
| S32.442A | ICD10CM | Covered |
| S32.442G | ICD10CM | Covered |
| S32.442K | ICD10CM | Covered |
| S32.442S | ICD10CM | Covered |
| S32.444A | ICD10CM | Covered |
| S32.444G | ICD10CM | Covered |
| S32.444K | ICD10CM | Covered |
| S32.444S | ICD10CM | Covered |
| S32.445A | ICD10CM | Covered |
| S32.445G | ICD10CM | Covered |
| S32.445K | ICD10CM | Covered |
| S32.445S | ICD10CM | Covered |
| S32.451A | ICD10CM | Covered |
| S32.451G | ICD10CM | Covered |
| S32.451K | ICD10CM | Covered |
| S32.451S | ICD10CM | Covered |
| S32.452A | ICD10CM | Covered |
| S32.452G | ICD10CM | Covered |
| S32.452K | ICD10CM | Covered |
| S32.452S | ICD10CM | Covered |
| S32.454A | ICD10CM | Covered |
| S32.454G | ICD10CM | Covered |
| S32.454K | ICD10CM | Covered |
| S32.454S | ICD10CM | Covered |
| S32.455A | ICD10CM | Covered |
| S32.455G | ICD10CM | Covered |
| S32.455K | ICD10CM | Covered |
| S32.455S | ICD10CM | Covered |
| S32.461A | ICD10CM | Covered |
| S32.461G | ICD10CM | Covered |
| S32.461K | ICD10CM | Covered |
| S32.461S | ICD10CM | Covered |
| S32.462A | ICD10CM | Covered |
| S32.462G | ICD10CM | Covered |
| S32.462K | ICD10CM | Covered |
| S32.462S | ICD10CM | Covered |
| S32.464A | ICD10CM | Covered |
| S32.464G | ICD10CM | Covered |
| S32.464K | ICD10CM | Covered |
| S32.464S | ICD10CM | Covered |
| S32.465A | ICD10CM | Covered |
| S32.465G | ICD10CM | Covered |
| S32.465K | ICD10CM | Covered |
| S32.465S | ICD10CM | Covered |
| S32.471A | ICD10CM | Covered |
| S32.471G | ICD10CM | Covered |
| S32.471K | ICD10CM | Covered |
| S32.471S | ICD10CM | Covered |
| S32.472A | ICD10CM | Covered |
| S32.472G | ICD10CM | Covered |
| S32.472K | ICD10CM | Covered |
| S32.472S | ICD10CM | Covered |
| S32.474A | ICD10CM | Covered |
| S32.474G | ICD10CM | Covered |
| S32.474K | ICD10CM | Covered |
| S32.474S | ICD10CM | Covered |
| S32.475A | ICD10CM | Covered |
| S32.475G | ICD10CM | Covered |
| S32.475K | ICD10CM | Covered |
| S32.475S | ICD10CM | Covered |
| S32.481A | ICD10CM | Covered |
| S32.481G | ICD10CM | Covered |
| S32.481K | ICD10CM | Covered |
| S32.481S | ICD10CM | Covered |
| S32.482A | ICD10CM | Covered |
| S32.482G | ICD10CM | Covered |
| S32.482K | ICD10CM | Covered |
| S32.482S | ICD10CM | Covered |
| S32.484A | ICD10CM | Covered |
| S32.484G | ICD10CM | Covered |
| S32.484K | ICD10CM | Covered |
| S32.484S | ICD10CM | Covered |
| S32.485A | ICD10CM | Covered |
| S32.485G | ICD10CM | Covered |
| S32.485K | ICD10CM | Covered |
| S32.485S | ICD10CM | Covered |
| S32.491A | ICD10CM | Covered |
| S32.491G | ICD10CM | Covered |
| S32.491K | ICD10CM | Covered |
| S32.491S | ICD10CM | Covered |
| S32.492A | ICD10CM | Covered |
| S32.492G | ICD10CM | Covered |
| S32.492K | ICD10CM | Covered |
| S32.492S | ICD10CM | Covered |
| S32.591A | ICD10CM | Covered |
| S32.591G | ICD10CM | Covered |
| S32.591K | ICD10CM | Covered |
| S32.591S | ICD10CM | Covered |
| S32.592A | ICD10CM | Covered |
| S32.592G | ICD10CM | Covered |
| S32.592K | ICD10CM | Covered |
| S32.592S | ICD10CM | Covered |
| S32.601A | ICD10CM | Covered |
| S32.601G | ICD10CM | Covered |
| S32.601K | ICD10CM | Covered |
| S32.601S | ICD10CM | Covered |
| S32.602A | ICD10CM | Covered |
| S32.602G | ICD10CM | Covered |
| S32.602K | ICD10CM | Covered |
| S32.602S | ICD10CM | Covered |
| S32.611A | ICD10CM | Covered |
| S32.611G | ICD10CM | Covered |
| S32.611K | ICD10CM | Covered |
| S32.611S | ICD10CM | Covered |
| S32.612A | ICD10CM | Covered |
| S32.612G | ICD10CM | Covered |
| S32.612K | ICD10CM | Covered |
| S32.612S | ICD10CM | Covered |
| S32.614A | ICD10CM | Covered |
| S32.614G | ICD10CM | Covered |
| S32.614K | ICD10CM | Covered |
| S32.614S | ICD10CM | Covered |
| S32.615A | ICD10CM | Covered |
| S32.615G | ICD10CM | Covered |
| S32.615K | ICD10CM | Covered |
| S32.615S | ICD10CM | Covered |
| S32.691A | ICD10CM | Covered |
| S32.691G | ICD10CM | Covered |
| S32.691K | ICD10CM | Covered |
| S32.691S | ICD10CM | Covered |
| S32.692A | ICD10CM | Covered |
| S32.692G | ICD10CM | Covered |
| S32.692K | ICD10CM | Covered |
| S32.692S | ICD10CM | Covered |
| S32.89XA | ICD10CM | Covered |
| S32.89XG | ICD10CM | Covered |
| S32.89XK | ICD10CM | Covered |
| S32.89XS | ICD10CM | Covered |
| S72.011A | ICD10CM | Covered |
| S72.011G | ICD10CM | Covered |
| S72.011K | ICD10CM | Covered |
| S72.011S | ICD10CM | Covered |
| S72.012A | ICD10CM | Covered |
| S72.012G | ICD10CM | Covered |
| S72.012K | ICD10CM | Covered |
| S72.012S | ICD10CM | Covered |
| S72.021A | ICD10CM | Covered |
| S72.021G | ICD10CM | Covered |
| S72.021K | ICD10CM | Covered |
| S72.021S | ICD10CM | Covered |
| S72.022A | ICD10CM | Covered |
| S72.022G | ICD10CM | Covered |
| S72.022K | ICD10CM | Covered |
| S72.022S | ICD10CM | Covered |
| S72.024A | ICD10CM | Covered |
| S72.024G | ICD10CM | Covered |
| S72.024K | ICD10CM | Covered |
| S72.024S | ICD10CM | Covered |
| S72.025A | ICD10CM | Covered |
| S72.025G | ICD10CM | Covered |
| S72.025K | ICD10CM | Covered |
| S72.025S | ICD10CM | Covered |
| S72.031A | ICD10CM | Covered |
| S72.031G | ICD10CM | Covered |
| S72.031K | ICD10CM | Covered |
| S72.031S | ICD10CM | Covered |
| S72.032A | ICD10CM | Covered |
| S72.032G | ICD10CM | Covered |
| S72.032K | ICD10CM | Covered |
| S72.032S | ICD10CM | Covered |
| S72.034A | ICD10CM | Covered |
| S72.034G | ICD10CM | Covered |
| S72.034K | ICD10CM | Covered |
| S72.034S | ICD10CM | Covered |
| S72.035A | ICD10CM | Covered |
| S72.035G | ICD10CM | Covered |
| S72.035K | ICD10CM | Covered |
| S72.035S | ICD10CM | Covered |
| S72.041A | ICD10CM | Covered |
| S72.041G | ICD10CM | Covered |
| S72.041K | ICD10CM | Covered |
| S72.041S | ICD10CM | Covered |
| S72.042A | ICD10CM | Covered |
| S72.042G | ICD10CM | Covered |
| S72.042K | ICD10CM | Covered |
| S72.042S | ICD10CM | Covered |
| S72.044A | ICD10CM | Covered |
| S72.044G | ICD10CM | Covered |
| S72.044K | ICD10CM | Covered |
| S72.044S | ICD10CM | Covered |
| S72.045A | ICD10CM | Covered |
| S72.045G | ICD10CM | Covered |
| S72.045K | ICD10CM | Covered |
| S72.045S | ICD10CM | Covered |
| S72.051A | ICD10CM | Covered |
| S72.051G | ICD10CM | Covered |
| S72.051K | ICD10CM | Covered |
| S72.051S | ICD10CM | Covered |
| S72.052A | ICD10CM | Covered |
| S72.052G | ICD10CM | Covered |
| S72.052K | ICD10CM | Covered |
| S72.052S | ICD10CM | Covered |
| S72.061A | ICD10CM | Covered |
| S72.061G | ICD10CM | Covered |
| S72.061K | ICD10CM | Covered |
| S72.061S | ICD10CM | Covered |
| S72.062A | ICD10CM | Covered |
| S72.062G | ICD10CM | Covered |
| S72.062K | ICD10CM | Covered |
| S72.062S | ICD10CM | Covered |
| S72.064A | ICD10CM | Covered |
| S72.064G | ICD10CM | Covered |
| S72.064K | ICD10CM | Covered |
| S72.064S | ICD10CM | Covered |
| S72.065A | ICD10CM | Covered |
| S72.065G | ICD10CM | Covered |
| S72.065K | ICD10CM | Covered |
| S72.065S | ICD10CM | Covered |
| S72.091A | ICD10CM | Covered |
| S72.091G | ICD10CM | Covered |
| S72.091K | ICD10CM | Covered |
| S72.091S | ICD10CM | Covered |
| S72.092A | ICD10CM | Covered |
| S72.092G | ICD10CM | Covered |
| S72.092K | ICD10CM | Covered |
| S72.092S | ICD10CM | Covered |
| S72.101A | ICD10CM | Covered |
| S72.101G | ICD10CM | Covered |
| S72.101K | ICD10CM | Covered |
| S72.101S | ICD10CM | Covered |
| S72.102A | ICD10CM | Covered |
| S72.102G | ICD10CM | Covered |
| S72.102K | ICD10CM | Covered |
| S72.102S | ICD10CM | Covered |
| S72.111A | ICD10CM | Covered |
| S72.111G | ICD10CM | Covered |
| S72.111K | ICD10CM | Covered |
| S72.111S | ICD10CM | Covered |
| S72.112A | ICD10CM | Covered |
| S72.112G | ICD10CM | Covered |
| S72.112K | ICD10CM | Covered |
| S72.112S | ICD10CM | Covered |
| S72.114A | ICD10CM | Covered |
| S72.114G | ICD10CM | Covered |
| S72.114K | ICD10CM | Covered |
| S72.114S | ICD10CM | Covered |
| S72.115A | ICD10CM | Covered |
| S72.115G | ICD10CM | Covered |
| S72.115K | ICD10CM | Covered |
| S72.115S | ICD10CM | Covered |
| S72.121A | ICD10CM | Covered |
| S72.121G | ICD10CM | Covered |
| S72.121K | ICD10CM | Covered |
| S72.121S | ICD10CM | Covered |
| S72.122A | ICD10CM | Covered |
| S72.122G | ICD10CM | Covered |
| S72.122K | ICD10CM | Covered |
| S72.122S | ICD10CM | Covered |
| S72.124A | ICD10CM | Covered |
| S72.124G | ICD10CM | Covered |
| S72.124K | ICD10CM | Covered |
| S72.124S | ICD10CM | Covered |
| S72.125A | ICD10CM | Covered |
| S72.125G | ICD10CM | Covered |
| S72.125K | ICD10CM | Covered |
| S72.125S | ICD10CM | Covered |
| S72.131A | ICD10CM | Covered |
| S72.131G | ICD10CM | Covered |
| S72.131K | ICD10CM | Covered |
| S72.131S | ICD10CM | Covered |
| S72.132A | ICD10CM | Covered |
| S72.132G | ICD10CM | Covered |
| S72.132K | ICD10CM | Covered |
| S72.132S | ICD10CM | Covered |
| S72.134A | ICD10CM | Covered |
| S72.134G | ICD10CM | Covered |
| S72.134K | ICD10CM | Covered |
| S72.134S | ICD10CM | Covered |
| S72.135A | ICD10CM | Covered |
| S72.135G | ICD10CM | Covered |
| S72.135K | ICD10CM | Covered |
| S72.135S | ICD10CM | Covered |
| S72.141A | ICD10CM | Covered |
| S72.141G | ICD10CM | Covered |
| S72.141K | ICD10CM | Covered |
| S72.141S | ICD10CM | Covered |
| S72.142A | ICD10CM | Covered |
| S72.142G | ICD10CM | Covered |
| S72.142K | ICD10CM | Covered |
| S72.142S | ICD10CM | Covered |
| S72.144A | ICD10CM | Covered |
| S72.144G | ICD10CM | Covered |
| S72.144K | ICD10CM | Covered |
| S72.144S | ICD10CM | Covered |
| S72.145A | ICD10CM | Covered |
| S72.145G | ICD10CM | Covered |
| S72.145K | ICD10CM | Covered |
| S72.145S | ICD10CM | Covered |
| S72.21XA | ICD10CM | Covered |
| S72.21XG | ICD10CM | Covered |
| S72.21XK | ICD10CM | Covered |
| S72.21XS | ICD10CM | Covered |
| S72.22XA | ICD10CM | Covered |
| S72.22XG | ICD10CM | Covered |
| S72.22XK | ICD10CM | Covered |
| S72.22XS | ICD10CM | Covered |
| S72.24XA | ICD10CM | Covered |
| S72.24XG | ICD10CM | Covered |
| S72.24XK | ICD10CM | Covered |
| S72.24XS | ICD10CM | Covered |
| S72.25XA | ICD10CM | Covered |
| S72.25XG | ICD10CM | Covered |
| S72.25XK | ICD10CM | Covered |
| S72.25XS | ICD10CM | Covered |
| S72.391A | ICD10CM | Covered |
| S72.391G | ICD10CM | Covered |
| S72.391K | ICD10CM | Covered |
| S72.391S | ICD10CM | Covered |
| S72.392A | ICD10CM | Covered |
| S72.392G | ICD10CM | Covered |
| S72.392K | ICD10CM | Covered |
| S72.392S | ICD10CM | Covered |
| S72.401A | ICD10CM | Covered |
| S72.401G | ICD10CM | Covered |
| S72.401K | ICD10CM | Covered |
| S72.401S | ICD10CM | Covered |
| S72.402A | ICD10CM | Covered |
| S72.402G | ICD10CM | Covered |
| S72.402K | ICD10CM | Covered |
| S72.402S | ICD10CM | Covered |
| S72.411A | ICD10CM | Covered |
| S72.411G | ICD10CM | Covered |
| S72.411K | ICD10CM | Covered |
| S72.411S | ICD10CM | Covered |
| S72.412A | ICD10CM | Covered |
| S72.412G | ICD10CM | Covered |
| S72.412K | ICD10CM | Covered |
| S72.412S | ICD10CM | Covered |
| S72.414A | ICD10CM | Covered |
| S72.414G | ICD10CM | Covered |
| S72.414K | ICD10CM | Covered |
| S72.414S | ICD10CM | Covered |
| S72.415A | ICD10CM | Covered |
| S72.415G | ICD10CM | Covered |
| S72.415K | ICD10CM | Covered |
| S72.415S | ICD10CM | Covered |
| S72.421A | ICD10CM | Covered |
| S72.421G | ICD10CM | Covered |
| S72.421K | ICD10CM | Covered |
| S72.421S | ICD10CM | Covered |
| S72.422A | ICD10CM | Covered |
| S72.422G | ICD10CM | Covered |
| S72.422K | ICD10CM | Covered |
| S72.422S | ICD10CM | Covered |
| S72.424A | ICD10CM | Covered |
| S72.424G | ICD10CM | Covered |
| S72.424K | ICD10CM | Covered |
| S72.424S | ICD10CM | Covered |
| S72.425A | ICD10CM | Covered |
| S72.425G | ICD10CM | Covered |
| S72.425K | ICD10CM | Covered |
| S72.425S | ICD10CM | Covered |
| S72.431A | ICD10CM | Covered |
| S72.431G | ICD10CM | Covered |
| S72.431K | ICD10CM | Covered |
| S72.431S | ICD10CM | Covered |
| S72.432A | ICD10CM | Covered |
| S72.432G | ICD10CM | Covered |
| S72.432K | ICD10CM | Covered |
| S72.432S | ICD10CM | Covered |
| S72.434A | ICD10CM | Covered |
| S72.434G | ICD10CM | Covered |
| S72.434K | ICD10CM | Covered |
| S72.434S | ICD10CM | Covered |
| S72.435A | ICD10CM | Covered |
| S72.435G | ICD10CM | Covered |
| S72.435K | ICD10CM | Covered |
| S72.435S | ICD10CM | Covered |
| S72.441A | ICD10CM | Covered |
| S72.441G | ICD10CM | Covered |
| S72.441K | ICD10CM | Covered |
| S72.441S | ICD10CM | Covered |
| S72.442A | ICD10CM | Covered |
| S72.442G | ICD10CM | Covered |
| S72.442K | ICD10CM | Covered |
| S72.442S | ICD10CM | Covered |
| S72.444A | ICD10CM | Covered |
| S72.444G | ICD10CM | Covered |
| S72.444K | ICD10CM | Covered |
| S72.444S | ICD10CM | Covered |
| S72.445A | ICD10CM | Covered |
| S72.445G | ICD10CM | Covered |
| S72.445K | ICD10CM | Covered |
| S72.445S | ICD10CM | Covered |
| S72.451A | ICD10CM | Covered |
| S72.451G | ICD10CM | Covered |
| S72.451K | ICD10CM | Covered |
| S72.451S | ICD10CM | Covered |
| S72.452A | ICD10CM | Covered |
| S72.452G | ICD10CM | Covered |
| S72.452K | ICD10CM | Covered |
| S72.452S | ICD10CM | Covered |
| S72.454A | ICD10CM | Covered |
| S72.454G | ICD10CM | Covered |
| S72.454K | ICD10CM | Covered |
| S72.454S | ICD10CM | Covered |
| S72.455A | ICD10CM | Covered |
| S72.455G | ICD10CM | Covered |
| S72.455K | ICD10CM | Covered |
| S72.455S | ICD10CM | Covered |
| S72.461A | ICD10CM | Covered |
| S72.461G | ICD10CM | Covered |
| S72.461K | ICD10CM | Covered |
| S72.461S | ICD10CM | Covered |
| S72.462A | ICD10CM | Covered |
| S72.462G | ICD10CM | Covered |
| S72.462K | ICD10CM | Covered |
| S72.462S | ICD10CM | Covered |
| S72.464A | ICD10CM | Covered |
| S72.464G | ICD10CM | Covered |
| S72.464K | ICD10CM | Covered |
| S72.464S | ICD10CM | Covered |
| S72.465A | ICD10CM | Covered |
| S72.465G | ICD10CM | Covered |
| S72.465K | ICD10CM | Covered |
| S72.465S | ICD10CM | Covered |
| S72.471A | ICD10CM | Covered |
| S72.471G | ICD10CM | Covered |
| S72.471K | ICD10CM | Covered |
| S72.471S | ICD10CM | Covered |
| S72.472A | ICD10CM | Covered |
| S72.472G | ICD10CM | Covered |
| S72.472K | ICD10CM | Covered |
| S72.472S | ICD10CM | Covered |
| S72.491A | ICD10CM | Covered |
| S72.491G | ICD10CM | Covered |
| S72.491K | ICD10CM | Covered |
| S72.491S | ICD10CM | Covered |
| S72.492A | ICD10CM | Covered |
| S72.492G | ICD10CM | Covered |
| S72.492K | ICD10CM | Covered |
| S72.492S | ICD10CM | Covered |
| S72.8X1A | ICD10CM | Covered |
| S72.8X1G | ICD10CM | Covered |
| S72.8X1K | ICD10CM | Covered |
| S72.8X1S | ICD10CM | Covered |
| S72.8X2A | ICD10CM | Covered |
| S72.8X2G | ICD10CM | Covered |
| S72.8X2K | ICD10CM | Covered |
| S72.8X2S | ICD10CM | Covered |
| S79.001A | ICD10CM | Covered |
| S79.001G | ICD10CM | Covered |
| S79.001K | ICD10CM | Covered |
| S79.001S | ICD10CM | Covered |
| S79.002A | ICD10CM | Covered |
| S79.002G | ICD10CM | Covered |
| S79.002K | ICD10CM | Covered |
| S79.002S | ICD10CM | Covered |
| S79.011A | ICD10CM | Covered |
| S79.011G | ICD10CM | Covered |
| S79.011K | ICD10CM | Covered |
| S79.011S | ICD10CM | Covered |
| S79.012A | ICD10CM | Covered |
| S79.012G | ICD10CM | Covered |
| S79.012K | ICD10CM | Covered |
| S79.012S | ICD10CM | Covered |
| S79.091A | ICD10CM | Covered |
| S79.091G | ICD10CM | Covered |
| S79.091K | ICD10CM | Covered |
| S79.091S | ICD10CM | Covered |
| S79.092A | ICD10CM | Covered |
| S79.092G | ICD10CM | Covered |
| S79.092K | ICD10CM | Covered |
| S79.092S | ICD10CM | Covered |
| S79.101A | ICD10CM | Covered |
| S79.101G | ICD10CM | Covered |
| S79.101K | ICD10CM | Covered |
| S79.101S | ICD10CM | Covered |
| S79.102A | ICD10CM | Covered |
| S79.102G | ICD10CM | Covered |
| S79.102K | ICD10CM | Covered |
| S79.102S | ICD10CM | Covered |
| S79.111A | ICD10CM | Covered |
| S79.111G | ICD10CM | Covered |
| S79.111K | ICD10CM | Covered |
| S79.111S | ICD10CM | Covered |
| S79.112A | ICD10CM | Covered |
| S79.112G | ICD10CM | Covered |
| S79.112K | ICD10CM | Covered |
| S79.112S | ICD10CM | Covered |
| S79.121A | ICD10CM | Covered |
| S79.121G | ICD10CM | Covered |
| S79.121K | ICD10CM | Covered |
| S79.121S | ICD10CM | Covered |
| S79.122A | ICD10CM | Covered |
| S79.122G | ICD10CM | Covered |
| S79.122K | ICD10CM | Covered |
| S79.122S | ICD10CM | Covered |
| S79.131A | ICD10CM | Covered |
| S79.131G | ICD10CM | Covered |
| S79.131K | ICD10CM | Covered |
| S79.131S | ICD10CM | Covered |
| S79.132A | ICD10CM | Covered |
| S79.132G | ICD10CM | Covered |
| S79.132K | ICD10CM | Covered |
| S79.132S | ICD10CM | Covered |
| S79.141A | ICD10CM | Covered |
| S79.141G | ICD10CM | Covered |
| S79.141K | ICD10CM | Covered |
| S79.141S | ICD10CM | Covered |
| S79.142A | ICD10CM | Covered |
| S79.142G | ICD10CM | Covered |
| S79.142K | ICD10CM | Covered |
| S79.142S | ICD10CM | Covered |
| S79.191A | ICD10CM | Covered |
| S79.191G | ICD10CM | Covered |
| S79.191K | ICD10CM | Covered |
| S79.191S | ICD10CM | Covered |
| S79.192A | ICD10CM | Covered |
| S79.192G | ICD10CM | Covered |
| S79.192K | ICD10CM | Covered |
| S79.192S | ICD10CM | Covered |
| S82.001A | ICD10CM | Covered |
| S82.001G | ICD10CM | Covered |
| S82.001K | ICD10CM | Covered |
| S82.001S | ICD10CM | Covered |
| S82.002A | ICD10CM | Covered |
| S82.002G | ICD10CM | Covered |
| S82.002K | ICD10CM | Covered |
| S82.002S | ICD10CM | Covered |
| S82.011A | ICD10CM | Covered |
| S82.011G | ICD10CM | Covered |
| S82.011K | ICD10CM | Covered |
| S82.011S | ICD10CM | Covered |
| S82.012A | ICD10CM | Covered |
| S82.012G | ICD10CM | Covered |
| S82.012K | ICD10CM | Covered |
| S82.012S | ICD10CM | Covered |
| S82.014A | ICD10CM | Covered |
| S82.014G | ICD10CM | Covered |
| S82.014K | ICD10CM | Covered |
| S82.014S | ICD10CM | Covered |
| S82.015A | ICD10CM | Covered |
| S82.015G | ICD10CM | Covered |
| S82.015K | ICD10CM | Covered |
| S82.015S | ICD10CM | Covered |
| S82.021A | ICD10CM | Covered |
| S82.021G | ICD10CM | Covered |
| S82.021K | ICD10CM | Covered |
| S82.021S | ICD10CM | Covered |
| S82.022A | ICD10CM | Covered |
| S82.022G | ICD10CM | Covered |
| S82.022K | ICD10CM | Covered |
| S82.022S | ICD10CM | Covered |
| S82.024A | ICD10CM | Covered |
| S82.024G | ICD10CM | Covered |
| S82.024K | ICD10CM | Covered |
| S82.024S | ICD10CM | Covered |
| S82.025A | ICD10CM | Covered |
| S82.025G | ICD10CM | Covered |
| S82.025K | ICD10CM | Covered |
| S82.025S | ICD10CM | Covered |
| S82.031A | ICD10CM | Covered |
| S82.031G | ICD10CM | Covered |
| S82.031K | ICD10CM | Covered |
| S82.031S | ICD10CM | Covered |
| S82.032A | ICD10CM | Covered |
| S82.032G | ICD10CM | Covered |
| S82.032K | ICD10CM | Covered |
| S82.032S | ICD10CM | Covered |
| S82.034A | ICD10CM | Covered |
| S82.034G | ICD10CM | Covered |
| S82.034K | ICD10CM | Covered |
| S82.034S | ICD10CM | Covered |
| S82.035A | ICD10CM | Covered |
| S82.035G | ICD10CM | Covered |
| S82.035K | ICD10CM | Covered |
| S82.035S | ICD10CM | Covered |
| S82.041A | ICD10CM | Covered |
| S82.041G | ICD10CM | Covered |
| S82.041K | ICD10CM | Covered |
| S82.041S | ICD10CM | Covered |
| S82.042A | ICD10CM | Covered |
| S82.042G | ICD10CM | Covered |
| S82.042K | ICD10CM | Covered |
| S82.042S | ICD10CM | Covered |
| S82.044A | ICD10CM | Covered |
| S82.044G | ICD10CM | Covered |
| S82.044K | ICD10CM | Covered |
| S82.044S | ICD10CM | Covered |
| S82.045A | ICD10CM | Covered |
| S82.045G | ICD10CM | Covered |
| S82.045K | ICD10CM | Covered |
| S82.045S | ICD10CM | Covered |
| S82.091A | ICD10CM | Covered |
| S82.091G | ICD10CM | Covered |
| S82.091K | ICD10CM | Covered |
| S82.091S | ICD10CM | Covered |
| S82.092A | ICD10CM | Covered |
| S82.092G | ICD10CM | Covered |
| S82.092K | ICD10CM | Covered |
| S82.092S | ICD10CM | Covered |
| S82.101A | ICD10CM | Covered |
| S82.101G | ICD10CM | Covered |
| S82.101K | ICD10CM | Covered |
| S82.101S | ICD10CM | Covered |
| S82.102A | ICD10CM | Covered |
| S82.102G | ICD10CM | Covered |
| S82.102K | ICD10CM | Covered |
| S82.102S | ICD10CM | Covered |
| S82.121A | ICD10CM | Covered |