About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Magnesium L39400.
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 4,359 codes. The source has the full list.
| Code | Code system | Status in this policy |
|---|---|---|
| 83735 | HCPCS | Covered |
| C13.0 | ICD10CM | Covered |
| C13.1 | ICD10CM | Covered |
| C13.2 | ICD10CM | Covered |
| C13.8 | ICD10CM | Covered |
| C13.9 | ICD10CM | Covered |
| C15.3 | ICD10CM | Covered |
| C15.4 | ICD10CM | Covered |
| C15.5 | ICD10CM | Covered |
| C15.9 | ICD10CM | Covered |
| C76.0 | ICD10CM | Covered |
| C76.1 | ICD10CM | Covered |
| C76.2 | ICD10CM | Covered |
| C76.3 | ICD10CM | Covered |
| D59.39 | ICD10CM | Covered |
| D86.85 | ICD10CM | Covered |
| E03.5 | ICD10CM | Covered |
| E05.00 | ICD10CM | Covered |
| E05.01 | ICD10CM | Covered |
| E05.10 | ICD10CM | Covered |
| E05.11 | ICD10CM | Covered |
| E05.20 | ICD10CM | Covered |
| E05.21 | ICD10CM | Covered |
| E05.30 | ICD10CM | Covered |
| E05.31 | ICD10CM | Covered |
| E05.40 | ICD10CM | Covered |
| E05.41 | ICD10CM | Covered |
| E05.80 | ICD10CM | Covered |
| E05.81 | ICD10CM | Covered |
| E05.90 | ICD10CM | Covered |
| E05.91 | ICD10CM | Covered |
| E10.10 | ICD10CM | Covered |
| E10.11 | ICD10CM | Covered |
| E10.311 | ICD10CM | Covered |
| E10.319 | ICD10CM | Covered |
| E10.3211 | ICD10CM | Covered |
| E10.3212 | ICD10CM | Covered |
| E10.3213 | ICD10CM | Covered |
| E10.3219 | ICD10CM | Covered |
| E10.3291 | ICD10CM | Covered |
| E10.3292 | ICD10CM | Covered |
| E10.3293 | ICD10CM | Covered |
| E10.3299 | ICD10CM | Covered |
| E10.3311 | ICD10CM | Covered |
| E10.3312 | ICD10CM | Covered |
| E10.3313 | ICD10CM | Covered |
| E10.3319 | ICD10CM | Covered |
| E10.3391 | ICD10CM | Covered |
| E10.3392 | ICD10CM | Covered |
| E10.3393 | ICD10CM | Covered |
| E10.3399 | ICD10CM | Covered |
| E10.3411 | ICD10CM | Covered |
| E10.3412 | ICD10CM | Covered |
| E10.3413 | ICD10CM | Covered |
| E10.3419 | ICD10CM | Covered |
| E10.3491 | ICD10CM | Covered |
| E10.3492 | ICD10CM | Covered |
| E10.3493 | ICD10CM | Covered |
| E10.3499 | ICD10CM | Covered |
| E10.3511 | ICD10CM | Covered |
| E10.3512 | ICD10CM | Covered |
| E10.3513 | ICD10CM | Covered |
| E10.3519 | ICD10CM | Covered |
| E10.3521 | ICD10CM | Covered |
| E10.3522 | ICD10CM | Covered |
| E10.3523 | ICD10CM | Covered |
| E10.3529 | ICD10CM | Covered |
| E10.3531 | ICD10CM | Covered |
| E10.3532 | ICD10CM | Covered |
| E10.3533 | ICD10CM | Covered |
| E10.3539 | ICD10CM | Covered |
| E10.3541 | ICD10CM | Covered |
| E10.3542 | ICD10CM | Covered |
| E10.3543 | ICD10CM | Covered |
| E10.3549 | ICD10CM | Covered |
| E10.3551 | ICD10CM | Covered |
| E10.3552 | ICD10CM | Covered |
| E10.3553 | ICD10CM | Covered |
| E10.3559 | ICD10CM | Covered |
| E10.3591 | ICD10CM | Covered |
| E10.3592 | ICD10CM | Covered |
| E10.3593 | ICD10CM | Covered |
| E10.3599 | ICD10CM | Covered |
| E10.36 | ICD10CM | Covered |
| E10.37X1 | ICD10CM | Covered |
| E10.37X2 | ICD10CM | Covered |
| E10.37X3 | ICD10CM | Covered |
| E10.37X9 | ICD10CM | Covered |
| E10.39 | ICD10CM | Covered |
| E10.40 | ICD10CM | Covered |
| E10.41 | ICD10CM | Covered |
| E10.42 | ICD10CM | Covered |
| E10.43 | ICD10CM | Covered |
| E10.44 | ICD10CM | Covered |
| E10.49 | ICD10CM | Covered |
| E10.51 | ICD10CM | Covered |
| E10.52 | ICD10CM | Covered |
| E10.59 | ICD10CM | Covered |
| E10.610 | ICD10CM | Covered |
| E10.618 | ICD10CM | Covered |
| E10.620 | ICD10CM | Covered |
| E10.621 | ICD10CM | Covered |
| E10.622 | ICD10CM | Covered |
| E10.628 | ICD10CM | Covered |
| E10.630 | ICD10CM | Covered |
| E10.649 | ICD10CM | Covered |
| E10.65 | ICD10CM | Covered |
| E10.69 | ICD10CM | Covered |
| E11.01 | ICD10CM | Covered |
| E11.10 | ICD10CM | Covered |
| E11.11 | ICD10CM | Covered |
| E11.21 | ICD10CM | Covered |
| E11.22 | ICD10CM | Covered |
| E11.29 | ICD10CM | Covered |
| E11.311 | ICD10CM | Covered |
| E11.319 | ICD10CM | Covered |
| E11.3211 | ICD10CM | Covered |
| E11.3212 | ICD10CM | Covered |
| E11.3213 | ICD10CM | Covered |
| E11.3219 | ICD10CM | Covered |
| E11.3291 | ICD10CM | Covered |
| E11.3292 | ICD10CM | Covered |
| E11.3293 | ICD10CM | Covered |
| E11.3299 | ICD10CM | Covered |
| E11.3311 | ICD10CM | Covered |
| E11.3312 | ICD10CM | Covered |
| E11.3313 | ICD10CM | Covered |
| E11.3319 | ICD10CM | Covered |
| E11.3391 | ICD10CM | Covered |
| E11.3392 | ICD10CM | Covered |
| E11.3393 | ICD10CM | Covered |
| E11.3399 | ICD10CM | Covered |
| E11.3411 | ICD10CM | Covered |
| E11.3412 | ICD10CM | Covered |
| E11.3413 | ICD10CM | Covered |
| E11.3419 | ICD10CM | Covered |
| E11.3491 | ICD10CM | Covered |
| E11.3492 | ICD10CM | Covered |
| E11.3493 | ICD10CM | Covered |
| E11.3499 | ICD10CM | Covered |
| E11.3511 | ICD10CM | Covered |
| E11.3512 | ICD10CM | Covered |
| E11.3513 | ICD10CM | Covered |
| E11.3519 | ICD10CM | Covered |
| E11.3521 | ICD10CM | Covered |
| E11.3522 | ICD10CM | Covered |
| E11.3523 | ICD10CM | Covered |
| E11.3529 | ICD10CM | Covered |
| E11.3531 | ICD10CM | Covered |
| E11.3532 | ICD10CM | Covered |
| E11.3533 | ICD10CM | Covered |
| E11.3539 | ICD10CM | Covered |
| E11.3541 | ICD10CM | Covered |
| E11.3542 | ICD10CM | Covered |
| E11.3543 | ICD10CM | Covered |
| E11.3549 | ICD10CM | Covered |
| E11.3551 | ICD10CM | Covered |
| E11.3552 | ICD10CM | Covered |
| E11.3553 | ICD10CM | Covered |
| E11.3559 | ICD10CM | Covered |
| E11.3591 | ICD10CM | Covered |
| E11.3592 | ICD10CM | Covered |
| E11.3593 | ICD10CM | Covered |
| E11.3599 | ICD10CM | Covered |
| E11.36 | ICD10CM | Covered |
| E11.37X1 | ICD10CM | Covered |
| E11.37X2 | ICD10CM | Covered |
| E11.37X3 | ICD10CM | Covered |
| E11.37X9 | ICD10CM | Covered |
| E11.39 | ICD10CM | Covered |
| E11.40 | ICD10CM | Covered |
| E11.41 | ICD10CM | Covered |
| E11.42 | ICD10CM | Covered |
| E11.43 | ICD10CM | Covered |
| E11.44 | ICD10CM | Covered |
| E11.49 | ICD10CM | Covered |
| E11.51 | ICD10CM | Covered |
| E11.52 | ICD10CM | Covered |
| E11.59 | ICD10CM | Covered |
| E11.610 | ICD10CM | Covered |
| E11.618 | ICD10CM | Covered |
| E11.620 | ICD10CM | Covered |
| E11.621 | ICD10CM | Covered |
| E11.622 | ICD10CM | Covered |
| E11.628 | ICD10CM | Covered |
| E11.630 | ICD10CM | Covered |
| E11.638 | ICD10CM | Covered |
| E11.641 | ICD10CM | Covered |
| E11.649 | ICD10CM | Covered |
| E11.65 | ICD10CM | Covered |
| E11.69 | ICD10CM | Covered |
| E13.00 | ICD10CM | Covered |
| E13.01 | ICD10CM | Covered |
| E13.10 | ICD10CM | Covered |
| E13.11 | ICD10CM | Covered |
| E13.21 | ICD10CM | Covered |
| E13.22 | ICD10CM | Covered |
| E13.29 | ICD10CM | Covered |
| E13.311 | ICD10CM | Covered |
| E13.319 | ICD10CM | Covered |
| E13.3211 | ICD10CM | Covered |
| E13.3212 | ICD10CM | Covered |
| E13.3213 | ICD10CM | Covered |
| E13.3219 | ICD10CM | Covered |
| E13.3291 | ICD10CM | Covered |
| E13.3292 | ICD10CM | Covered |
| E13.3293 | ICD10CM | Covered |
| E13.3299 | ICD10CM | Covered |
| E13.3311 | ICD10CM | Covered |
| E13.3312 | ICD10CM | Covered |
| E13.3313 | ICD10CM | Covered |
| E13.3319 | ICD10CM | Covered |
| E13.3391 | ICD10CM | Covered |
| E13.3392 | ICD10CM | Covered |
| E13.3393 | ICD10CM | Covered |
| E13.3399 | ICD10CM | Covered |
| E13.3411 | ICD10CM | Covered |
| E13.3412 | ICD10CM | Covered |
| E13.3413 | ICD10CM | Covered |
| E13.3419 | ICD10CM | Covered |
| E13.3491 | ICD10CM | Covered |
| E13.3492 | ICD10CM | Covered |
| E13.3493 | ICD10CM | Covered |
| E13.3499 | ICD10CM | Covered |
| E13.3511 | ICD10CM | Covered |
| E13.3512 | ICD10CM | Covered |
| E13.3513 | ICD10CM | Covered |
| E13.3519 | ICD10CM | Covered |
| E13.3521 | ICD10CM | Covered |
| E13.3522 | ICD10CM | Covered |
| E13.3523 | ICD10CM | Covered |
| E13.3529 | ICD10CM | Covered |
| E13.3531 | ICD10CM | Covered |
| E13.3532 | ICD10CM | Covered |
| E13.3533 | ICD10CM | Covered |
| E13.3539 | ICD10CM | Covered |
| E13.3541 | ICD10CM | Covered |
| E13.3542 | ICD10CM | Covered |
| E13.3543 | ICD10CM | Covered |
| E13.3549 | ICD10CM | Covered |
| E13.3551 | ICD10CM | Covered |
| E13.3552 | ICD10CM | Covered |
| E13.3553 | ICD10CM | Covered |
| E13.3559 | ICD10CM | Covered |
| E13.3591 | ICD10CM | Covered |
| E13.3592 | ICD10CM | Covered |
| E13.3593 | ICD10CM | Covered |
| E13.3599 | ICD10CM | Covered |
| E13.36 | ICD10CM | Covered |
| E13.37X1 | ICD10CM | Covered |
| E13.37X2 | ICD10CM | Covered |
| E13.37X3 | ICD10CM | Covered |
| E13.37X9 | ICD10CM | Covered |
| E13.39 | ICD10CM | Covered |
| E13.40 | ICD10CM | Covered |
| E13.41 | ICD10CM | Covered |
| E13.42 | ICD10CM | Covered |
| E13.43 | ICD10CM | Covered |
| E13.44 | ICD10CM | Covered |
| E13.49 | ICD10CM | Covered |
| E13.51 | ICD10CM | Covered |
| E13.52 | ICD10CM | Covered |
| E13.59 | ICD10CM | Covered |
| E13.610 | ICD10CM | Covered |
| E13.618 | ICD10CM | Covered |
| E13.620 | ICD10CM | Covered |
| E13.621 | ICD10CM | Covered |
| E13.622 | ICD10CM | Covered |
| E13.628 | ICD10CM | Covered |
| E13.630 | ICD10CM | Covered |
| E13.638 | ICD10CM | Covered |
| E13.641 | ICD10CM | Covered |
| E13.649 | ICD10CM | Covered |
| E13.65 | ICD10CM | Covered |
| E13.69 | ICD10CM | Covered |
| E20.0 | ICD10CM | Covered |
| E20.1 | ICD10CM | Covered |
| E20.810 | ICD10CM | Covered |
| E20.811 | ICD10CM | Covered |
| E20.812 | ICD10CM | Covered |
| E20.818 | ICD10CM | Covered |
| E20.819 | ICD10CM | Covered |
| E20.89 | ICD10CM | Covered |
| E20.9 | ICD10CM | Covered |
| E21.0 | ICD10CM | Covered |
| E21.1 | ICD10CM | Covered |
| E21.2 | ICD10CM | Covered |
| E21.3 | ICD10CM | Covered |
| E21.4 | ICD10CM | Covered |
| E22.2 | ICD10CM | Covered |
| E26.01 | ICD10CM | Covered |
| E26.02 | ICD10CM | Covered |
| E26.09 | ICD10CM | Covered |
| E26.1 | ICD10CM | Covered |
| E26.81 | ICD10CM | Covered |
| E26.89 | ICD10CM | Covered |
| E26.9 | ICD10CM | Covered |
| E27.1 | ICD10CM | Covered |
| E27.2 | ICD10CM | Covered |
| E27.3 | ICD10CM | Covered |
| E27.40 | ICD10CM | Covered |
| E27.49 | ICD10CM | Covered |
| E34.2 | ICD10CM | Covered |
| E40 | ICD10CM | Covered |
| E41 | ICD10CM | Covered |
| E42 | ICD10CM | Covered |
| E43 | ICD10CM | Covered |
| E44.0 | ICD10CM | Covered |
| E46 | ICD10CM | Covered |
| E79.0 | ICD10CM | Covered |
| E83.40 | ICD10CM | Covered |
| E83.41 | ICD10CM | Covered |
| E83.42 | ICD10CM | Covered |
| E83.49 | ICD10CM | Covered |
| E83.50 | ICD10CM | Covered |
| E83.51 | ICD10CM | Covered |
| E83.52 | ICD10CM | Covered |
| E83.59 | ICD10CM | Covered |
| E86.0 | ICD10CM | Covered |
| E86.1 | ICD10CM | Covered |
| E86.9 | ICD10CM | Covered |
| E87.20 | ICD10CM | Covered |
| E87.22 | ICD10CM | Covered |
| E87.29 | ICD10CM | Covered |
| E87.4 | ICD10CM | Covered |
| E87.5 | ICD10CM | Covered |
| E87.6 | ICD10CM | Covered |
| E89.2 | ICD10CM | Covered |
| E89.6 | ICD10CM | Covered |
| F05 | ICD10CM | Covered |
| F10.10 | ICD10CM | Covered |
| F10.11 | ICD10CM | Covered |
| F10.120 | ICD10CM | Covered |
| F10.129 | ICD10CM | Covered |
| F10.20 | ICD10CM | Covered |
| F10.21 | ICD10CM | Covered |
| F10.90 | ICD10CM | Covered |
| F10.91 | ICD10CM | Covered |
| F11.91 | ICD10CM | Covered |
| F12.91 | ICD10CM | Covered |
| F14.91 | ICD10CM | Covered |
| F16.91 | ICD10CM | Covered |
| F50.00 | ICD10CM | Covered |
| F50.010 | ICD10CM | Covered |
| F50.011 | ICD10CM | Covered |
| F50.012 | ICD10CM | Covered |
| F50.013 | ICD10CM | Covered |
| F50.014 | ICD10CM | Covered |
| F50.021 | ICD10CM | Covered |
| F50.022 | ICD10CM | Covered |
| F50.023 | ICD10CM | Covered |
| F50.024 | ICD10CM | Covered |
| F98.3 | ICD10CM | Covered |
| G25.3 | ICD10CM | Covered |
| G25.61 | ICD10CM | Covered |
| G25.69 | ICD10CM | Covered |
| G40.001 | ICD10CM | Covered |
| G40.009 | ICD10CM | Covered |
| G40.011 | ICD10CM | Covered |
| G40.019 | ICD10CM | Covered |
| G40.101 | ICD10CM | Covered |
| G40.109 | ICD10CM | Covered |
| G40.111 | ICD10CM | Covered |
| G40.119 | ICD10CM | Covered |
| G40.201 | ICD10CM | Covered |
| G40.209 | ICD10CM | Covered |
| G40.211 | ICD10CM | Covered |
| G40.219 | ICD10CM | Covered |
| G40.301 | ICD10CM | Covered |
| G40.309 | ICD10CM | Covered |
| G40.311 | ICD10CM | Covered |
| G40.319 | ICD10CM | Covered |
| G40.401 | ICD10CM | Covered |
| G40.409 | ICD10CM | Covered |
| G40.411 | ICD10CM | Covered |
| G40.419 | ICD10CM | Covered |
| G40.501 | ICD10CM | Covered |
| G40.509 | ICD10CM | Covered |
| G40.801 | ICD10CM | Covered |
| G40.802 | ICD10CM | Covered |
| G40.803 | ICD10CM | Covered |
| G40.804 | ICD10CM | Covered |
| G40.811 | ICD10CM | Covered |
| G40.812 | ICD10CM | Covered |
| G40.813 | ICD10CM | Covered |
| G40.814 | ICD10CM | Covered |
| G40.821 | ICD10CM | Covered |
| G40.822 | ICD10CM | Covered |
| G40.823 | ICD10CM | Covered |
| G40.824 | ICD10CM | Covered |
| G40.841 | ICD10CM | Covered |
| G40.842 | ICD10CM | Covered |
| G40.843 | ICD10CM | Covered |
| G40.844 | ICD10CM | Covered |
| G40.89 | ICD10CM | Covered |
| G40.901 | ICD10CM | Covered |
| G40.909 | ICD10CM | Covered |
| G40.911 | ICD10CM | Covered |
| G40.919 | ICD10CM | Covered |
| G40.A01 | ICD10CM | Covered |
| G40.A09 | ICD10CM | Covered |
| G40.A11 | ICD10CM | Covered |
| G40.A19 | ICD10CM | Covered |
| G40.B01 | ICD10CM | Covered |
| G40.B09 | ICD10CM | Covered |
| G40.B11 | ICD10CM | Covered |
| G40.B19 | ICD10CM | Covered |
| G90.A | ICD10CM | Covered |
| I10 | ICD10CM | Covered |
| I11.0 | ICD10CM | Covered |
| I13.0 | ICD10CM | Covered |
| I13.2 | ICD10CM | Covered |
| I16.0 | ICD10CM | Covered |
| I16.1 | ICD10CM | Covered |
| I16.9 | ICD10CM | Covered |
| I21.01 | ICD10CM | Covered |
| I21.02 | ICD10CM | Covered |
| I21.09 | ICD10CM | Covered |
| I21.11 | ICD10CM | Covered |
| I21.19 | ICD10CM | Covered |
| I21.21 | ICD10CM | Covered |
| I21.29 | ICD10CM | Covered |
| I21.3 | ICD10CM | Covered |
| I21.4 | ICD10CM | Covered |
| I21.9 | ICD10CM | Covered |
| I21.A1 | ICD10CM | Covered |
| I21.A9 | ICD10CM | Covered |
| I44.0 | ICD10CM | Covered |
| I44.1 | ICD10CM | Covered |
| I44.2 | ICD10CM | Covered |
| I44.30 | ICD10CM | Covered |
| I44.39 | ICD10CM | Covered |
| I44.4 | ICD10CM | Covered |
| I44.5 | ICD10CM | Covered |
| I44.60 | ICD10CM | Covered |
| I44.69 | ICD10CM | Covered |
| I44.7 | ICD10CM | Covered |
| I45.0 | ICD10CM | Covered |
| I45.10 | ICD10CM | Covered |
| I45.19 | ICD10CM | Covered |
| I45.2 | ICD10CM | Covered |
| I45.3 | ICD10CM | Covered |
| I45.4 | ICD10CM | Covered |
| I45.5 | ICD10CM | Covered |
| I45.6 | ICD10CM | Covered |
| I45.81 | ICD10CM | Covered |
| I45.89 | ICD10CM | Covered |
| I45.9 | ICD10CM | Covered |
| I46.2 | ICD10CM | Covered |
| I46.8 | ICD10CM | Covered |
| I46.9 | ICD10CM | Covered |
| I47.0 | ICD10CM | Covered |
| I47.10 | ICD10CM | Covered |
| I47.11 | ICD10CM | Covered |
| I47.19 | ICD10CM | Covered |
| I47.20 | ICD10CM | Covered |
| I47.21 | ICD10CM | Covered |
| I47.29 | ICD10CM | Covered |
| I47.9 | ICD10CM | Covered |
| I48.0 | ICD10CM | Covered |
| I48.11 | ICD10CM | Covered |
| I48.19 | ICD10CM | Covered |
| I48.20 | ICD10CM | Covered |
| I48.21 | ICD10CM | Covered |
| I48.3 | ICD10CM | Covered |
| I48.4 | ICD10CM | Covered |
| I48.91 | ICD10CM | Covered |
| I48.92 | ICD10CM | Covered |
| I49.01 | ICD10CM | Covered |
| I49.02 | ICD10CM | Covered |
| I49.1 | ICD10CM | Covered |
| I49.2 | ICD10CM | Covered |
| I49.3 | ICD10CM | Covered |
| I49.40 | ICD10CM | Covered |
| I49.49 | ICD10CM | Covered |
| I49.5 | ICD10CM | Covered |
| I49.8 | ICD10CM | Covered |
| I49.9 | ICD10CM | Covered |
| K52.21 | ICD10CM | Covered |
| K52.22 | ICD10CM | Covered |
| K52.29 | ICD10CM | Covered |
| K52.831 | ICD10CM | Covered |
| K52.832 | ICD10CM | Covered |
| K52.839 | ICD10CM | Covered |
| K52.89 | ICD10CM | Covered |
| K85.00 | ICD10CM | Covered |
| K85.01 | ICD10CM | Covered |
| K85.02 | ICD10CM | Covered |
| K85.10 | ICD10CM | Covered |
| K85.11 | ICD10CM | Covered |
| K85.12 | ICD10CM | Covered |
| K85.20 | ICD10CM | Covered |
| K85.21 | ICD10CM | Covered |
| K85.22 | ICD10CM | Covered |
| K85.30 | ICD10CM | Covered |
| K85.31 | ICD10CM | Covered |
| K85.32 | ICD10CM | Covered |
| K85.80 | ICD10CM | Covered |
| K85.81 | ICD10CM | Covered |
| K85.82 | ICD10CM | Covered |
| K85.90 | ICD10CM | Covered |
| K85.91 | ICD10CM | Covered |
| K85.92 | ICD10CM | Covered |
| K86.0 | ICD10CM | Covered |
| K86.1 | ICD10CM | Covered |
| K86.2 | ICD10CM | Covered |
| K86.3 | ICD10CM | Covered |
| K86.81 | ICD10CM | Covered |
| K86.89 | ICD10CM | Covered |
| K86.9 | ICD10CM | Covered |
| K87 | ICD10CM | Covered |
| K91.2 | ICD10CM | Covered |
| M35.4 | ICD10CM | Covered |
| M62.20 | ICD10CM | Covered |
| M62.211 | ICD10CM | Covered |
| M62.212 | ICD10CM | Covered |
| M62.219 | ICD10CM | Covered |
| M62.221 | ICD10CM | Covered |
| M62.222 | ICD10CM | Covered |
| M62.231 | ICD10CM | Covered |
| M62.232 | ICD10CM | Covered |
| M62.239 | ICD10CM | Covered |
| M62.241 | ICD10CM | Covered |
| M62.242 | ICD10CM | Covered |
| M62.249 | ICD10CM | Covered |
| M62.251 | ICD10CM | Covered |
| M62.252 | ICD10CM | Covered |
| M62.259 | ICD10CM | Covered |
| M62.261 | ICD10CM | Covered |
| M62.262 | ICD10CM | Covered |
| M62.269 | ICD10CM | Covered |
| M62.271 | ICD10CM | Covered |
| M62.272 | ICD10CM | Covered |
| M62.279 | ICD10CM | Covered |
| M62.28 | ICD10CM | Covered |
| M62.81 | ICD10CM | Covered |
| M62.82 | ICD10CM | Covered |
| M62.84 | ICD10CM | Covered |
| M62.85 | ICD10CM | Covered |
| M62.89 | ICD10CM | Covered |
| M72.8 | ICD10CM | Covered |
| N02.B1 | ICD10CM | Covered |
| N02.B2 | ICD10CM | Covered |
| N02.B3 | ICD10CM | Covered |
| N02.B4 | ICD10CM | Covered |
| N02.B5 | ICD10CM | Covered |
| N02.B6 | ICD10CM | Covered |
| N02.B9 | ICD10CM | Covered |
| N04.20 | ICD10CM | Covered |
| N04.21 | ICD10CM | Covered |
| N04.22 | ICD10CM | Covered |
| N04.29 | ICD10CM | Covered |
| N04.B1 | ICD10CM | Covered |
| N04.B2 | ICD10CM | Covered |
| N06.20 | ICD10CM | Covered |
| N06.21 | ICD10CM | Covered |
| N06.22 | ICD10CM | Covered |
| N06.29 | 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 |
| N18.31 | ICD10CM | Covered |
| N18.32 | ICD10CM | Covered |
| N18.4 | ICD10CM | Covered |
| N18.5 | ICD10CM | Covered |
| N18.6 | ICD10CM | Covered |
| N18.9 | ICD10CM | Covered |
| N20.0 | ICD10CM | Covered |
| N20.1 | ICD10CM | Covered |
| N20.2 | ICD10CM | Covered |
| N25.81 | ICD10CM | Covered |
| N25.89 | ICD10CM | Covered |
| N28.0 | ICD10CM | Covered |
| P03.810 | ICD10CM | Covered |
| P03.811 | ICD10CM | Covered |
| P03.819 | ICD10CM | Covered |
| R00.0 | ICD10CM | Covered |
| R00.1 | ICD10CM | Covered |
| R00.2 | ICD10CM | Covered |
| R00.8 | ICD10CM | Covered |
| R11.0 | ICD10CM | Covered |
| R11.10 | ICD10CM | Covered |
| R11.11 | ICD10CM | Covered |
| R11.12 | ICD10CM | Covered |
| R11.13 | ICD10CM | Covered |
| R11.14 | ICD10CM | Covered |
| R11.15 | ICD10CM | Covered |
| R11.16 | ICD10CM | Covered |
| R11.2 | ICD10CM | Covered |
| R19.7 | ICD10CM | Covered |
| R25.0 | ICD10CM | Covered |
| R25.1 | ICD10CM | Covered |
| R25.2 | ICD10CM | Covered |
| R25.3 | ICD10CM | Covered |
| R25.8 | ICD10CM | Covered |
| R25.9 | ICD10CM | Covered |
| R29.0 | ICD10CM | Covered |
| R29.2 | ICD10CM | Covered |
| R40.0 | ICD10CM | Covered |
| R40.1 | ICD10CM | Covered |
| R40.20 | ICD10CM | Covered |
| R40.2110 | ICD10CM | Covered |
| R40.2111 | ICD10CM | Covered |
| R40.2112 | ICD10CM | Covered |
| R40.2113 | ICD10CM | Covered |
| R40.2114 | ICD10CM | Covered |
| R40.2120 | ICD10CM | Covered |
| R40.2121 | ICD10CM | Covered |
| R40.2122 | ICD10CM | Covered |
| R40.2123 | ICD10CM | Covered |
| R40.2124 | ICD10CM | Covered |
| R40.2210 | ICD10CM | Covered |
| R40.2211 | ICD10CM | Covered |
| R40.2212 | ICD10CM | Covered |
| R40.2213 | ICD10CM | Covered |
| R40.2214 | ICD10CM | Covered |
| R40.2220 | ICD10CM | Covered |
| R40.2221 | ICD10CM | Covered |
| R40.2222 | ICD10CM | Covered |
| R40.2223 | ICD10CM | Covered |
| R40.2224 | ICD10CM | Covered |
| R40.2310 | ICD10CM | Covered |
| R40.2311 | ICD10CM | Covered |
| R40.2312 | ICD10CM | Covered |
| R40.2313 | ICD10CM | Covered |
| R40.2314 | ICD10CM | Covered |
| R40.2320 | ICD10CM | Covered |
| R40.2321 | ICD10CM | Covered |
| R40.2322 | ICD10CM | Covered |
| R40.2323 | ICD10CM | Covered |
| R40.2324 | ICD10CM | Covered |
| R40.2340 | ICD10CM | Covered |
| R40.2341 | ICD10CM | Covered |
| R40.2342 | ICD10CM | Covered |
| R40.2343 | ICD10CM | Covered |
| R40.2344 | ICD10CM | Covered |
| R40.2A | ICD10CM | Covered |
| R40.4 | ICD10CM | Covered |
| R41.0 | ICD10CM | Covered |
| R41.1 | ICD10CM | Covered |
| R41.2 | ICD10CM | Covered |
| R41.3 | ICD10CM | Covered |
| R41.4 | ICD10CM | Covered |
| R41.81 | ICD10CM | Covered |
| R41.82 | ICD10CM | Covered |
| R41.83 | ICD10CM | Covered |
| R41.840 | ICD10CM | Covered |
| R41.841 | ICD10CM | Covered |
| R41.842 | ICD10CM | Covered |
| R41.843 | ICD10CM | Covered |
| R41.844 | ICD10CM | Covered |
| R41.89 | ICD10CM | Covered |
| R41.9 | ICD10CM | Covered |
| R53.1 | ICD10CM | Covered |
| R53.82 | ICD10CM | Covered |
| R55 | ICD10CM | Covered |
| R56.00 | ICD10CM | Covered |
| R56.01 | ICD10CM | Covered |
| R56.1 | ICD10CM | Covered |
| R56.9 | ICD10CM | Covered |
| R57.0 | ICD10CM | Covered |
| R57.1 | ICD10CM | Covered |
| R57.8 | ICD10CM | Covered |
| R57.9 | ICD10CM | Covered |
| R63.0 | ICD10CM | Covered |
| R64 | ICD10CM | Covered |
| R65.21 | ICD10CM | Covered |
| R78.71 | ICD10CM | Covered |
| R78.79 | ICD10CM | Covered |
| R78.89 | ICD10CM | Covered |
| R79.0 | ICD10CM | Covered |
| R79.89 | ICD10CM | Covered |
| R79.9 | ICD10CM | Covered |
| R94.31 | ICD10CM | Covered |
| R94.4 | ICD10CM | Covered |
| S06.0X0A | ICD10CM | Covered |
| S06.0XAA | ICD10CM | Covered |
| S06.0XAD | ICD10CM | Covered |
| S06.0XAS | ICD10CM | Covered |
| S06.1XAA | ICD10CM | Covered |
| S06.1XAD | ICD10CM | Covered |
| S06.1XAS | ICD10CM | Covered |
| S06.2XAA | ICD10CM | Covered |
| S06.2XAD | ICD10CM | Covered |
| S06.2XAS | ICD10CM | Covered |
| S06.30AA | ICD10CM | Covered |
| S06.30AD | ICD10CM | Covered |
| S06.30AS | ICD10CM | Covered |
| S06.31AA | ICD10CM | Covered |
| S06.31AD | ICD10CM | Covered |
| S06.31AS | ICD10CM | Covered |
| S06.32AA | ICD10CM | Covered |
| S06.32AD | ICD10CM | Covered |
| S06.32AS | ICD10CM | Covered |
| S06.33AA | ICD10CM | Covered |
| S06.33AD | ICD10CM | Covered |
| S06.33AS | ICD10CM | Covered |
| S06.34AA | ICD10CM | Covered |
| S06.34AD | ICD10CM | Covered |
| S06.34AS | ICD10CM | Covered |
| S06.35AA | ICD10CM | Covered |
| S06.35AD | ICD10CM | Covered |
| S06.35AS | ICD10CM | Covered |
| S06.36AA | ICD10CM | Covered |
| S06.36AD | ICD10CM | Covered |
| S06.36AS | ICD10CM | Covered |
| S06.37AA | ICD10CM | Covered |
| S06.37AD | ICD10CM | Covered |
| S06.37AS | ICD10CM | Covered |
| S06.38AA | ICD10CM | Covered |
| S06.38AD | ICD10CM | Covered |
| S06.38AS | ICD10CM | Covered |
| S06.4XAA | ICD10CM | Covered |
| S06.4XAD | ICD10CM | Covered |
| S06.4XAS | ICD10CM | Covered |
| S06.5XAA | ICD10CM | Covered |
| S06.5XAD | ICD10CM | Covered |
| S06.5XAS | ICD10CM | Covered |
| S06.6XAA | ICD10CM | Covered |
| S06.6XAD | ICD10CM | Covered |
| S06.6XAS | ICD10CM | Covered |
| S06.890D | ICD10CM | Covered |
| S06.89AA | ICD10CM | Covered |
| S06.89AD | ICD10CM | Covered |
| S06.89AS | ICD10CM | Covered |
| S06.8A0A | ICD10CM | Covered |
| S06.8A0D | ICD10CM | Covered |
| S06.8A0S | ICD10CM | Covered |
| S06.8A1A | ICD10CM | Covered |
| S06.8A1D | ICD10CM | Covered |
| S06.8A1S | ICD10CM | Covered |
| S06.8A2A | ICD10CM | Covered |
| S06.8A2D | ICD10CM | Covered |
| S06.8A2S | ICD10CM | Covered |
| S06.8A3A | ICD10CM | Covered |
| S06.8A3D | ICD10CM | Covered |
| S06.8A3S | ICD10CM | Covered |
| S06.8A4A | ICD10CM | Covered |
| S06.8A4D | ICD10CM | Covered |
| S06.8A4S | ICD10CM | Covered |
| S06.8A5A | ICD10CM | Covered |
| S06.8A5D | ICD10CM | Covered |
| S06.8A5S | ICD10CM | Covered |
| S06.8A6A | ICD10CM | Covered |
| S06.8A6D | ICD10CM | Covered |
| S06.8A6S | ICD10CM | Covered |
| S06.8A7A | ICD10CM | Covered |
| S06.8A8A | ICD10CM | Covered |
| S06.8A9A | ICD10CM | Covered |
| S06.8A9D | ICD10CM | Covered |
| S06.8A9S | ICD10CM | Covered |
| S06.8AAA | ICD10CM | Covered |
| S06.8AAD | ICD10CM | Covered |
| S06.8AAS | ICD10CM | Covered |
| S06.9XAA | ICD10CM | Covered |
| S06.9XAD | ICD10CM | Covered |
| S06.9XAS | ICD10CM | Covered |
| T20.00XA | ICD10CM | Covered |
| T20.00XD | ICD10CM | Covered |
| T20.00XS | ICD10CM | Covered |
| T20.011A | ICD10CM | Covered |
| T20.011D | ICD10CM | Covered |
| T20.011S | ICD10CM | Covered |
| T20.012A | ICD10CM | Covered |
| T20.012D | ICD10CM | Covered |
| T20.012S | ICD10CM | Covered |
| T20.019A | ICD10CM | Covered |
| T20.019D | ICD10CM | Covered |
| T20.019S | ICD10CM | Covered |
| T20.02XA | ICD10CM | Covered |
| T20.02XD | ICD10CM | Covered |
| T20.02XS | ICD10CM | Covered |
| T20.03XA | ICD10CM | Covered |
| T20.03XD | ICD10CM | Covered |
| T20.03XS | ICD10CM | Covered |
| T20.04XA | ICD10CM | Covered |
| T20.04XD | ICD10CM | Covered |
| T20.04XS | ICD10CM | Covered |
| T20.05XA | ICD10CM | Covered |
| T20.05XD | ICD10CM | Covered |
| T20.05XS | ICD10CM | Covered |
| T20.06XA | ICD10CM | Covered |
| T20.06XD | ICD10CM | Covered |
| T20.06XS | ICD10CM | Covered |
| T20.07XA | ICD10CM | Covered |
| T20.07XD | ICD10CM | Covered |
| T20.07XS | ICD10CM | Covered |
| T20.09XA | ICD10CM | Covered |
| T20.09XD | ICD10CM | Covered |
| T20.09XS | ICD10CM | Covered |
| T20.10XA | ICD10CM | Covered |
| T20.10XD | ICD10CM | Covered |
| T20.10XS | ICD10CM | Covered |
| T20.111A | ICD10CM | Covered |
| T20.111D | ICD10CM | Covered |
| T20.111S | ICD10CM | Covered |
| T20.112A | ICD10CM | Covered |
| T20.112D | ICD10CM | Covered |
| T20.112S | ICD10CM | Covered |
| T20.119A | ICD10CM | Covered |
| T20.119D | ICD10CM | Covered |
| T20.119S | ICD10CM | Covered |
| T20.12XA | ICD10CM | Covered |
| T20.12XD | ICD10CM | Covered |
| T20.12XS | ICD10CM | Covered |
| T20.13XA | ICD10CM | Covered |
| T20.13XD | ICD10CM | Covered |
| T20.13XS | ICD10CM | Covered |
| T20.14XA | ICD10CM | Covered |
| T20.14XD | ICD10CM | Covered |
| T20.14XS | ICD10CM | Covered |
| T20.15XA | ICD10CM | Covered |
| T20.15XD | ICD10CM | Covered |
| T20.15XS | ICD10CM | Covered |
| T20.16XA | ICD10CM | Covered |
| T20.16XD | ICD10CM | Covered |
| T20.16XS | ICD10CM | Covered |
| T20.17XA | ICD10CM | Covered |
| T20.17XD | ICD10CM | Covered |
| T20.17XS | ICD10CM | Covered |
| T20.19XA | ICD10CM | Covered |
| T20.19XD | ICD10CM | Covered |
| T20.19XS | ICD10CM | Covered |
| T20.20XA | ICD10CM | Covered |
| T20.20XD | ICD10CM | Covered |
| T20.20XS | ICD10CM | Covered |
| T20.211A | ICD10CM | Covered |
| T20.211D | ICD10CM | Covered |
| T20.211S | ICD10CM | Covered |
| T20.212A | ICD10CM | Covered |
| T20.212D | ICD10CM | Covered |
| T20.212S | ICD10CM | Covered |
| T20.219A | ICD10CM | Covered |
| T20.219D | ICD10CM | Covered |
| T20.219S | ICD10CM | Covered |
| T20.22XA | ICD10CM | Covered |
| T20.22XD | ICD10CM | Covered |
| T20.22XS | ICD10CM | Covered |
| T20.23XA | ICD10CM | Covered |
| T20.23XD | ICD10CM | Covered |
| T20.23XS | ICD10CM | Covered |
| T20.24XA | ICD10CM | Covered |
| T20.24XD | ICD10CM | Covered |
| T20.24XS | ICD10CM | Covered |
| T20.25XA | ICD10CM | Covered |
| T20.25XD | ICD10CM | Covered |
| T20.25XS | ICD10CM | Covered |
| T20.26XA | ICD10CM | Covered |
| T20.26XD | ICD10CM | Covered |
| T20.26XS | ICD10CM | Covered |
| T20.27XA | ICD10CM | Covered |
| T20.27XD | ICD10CM | Covered |
| T20.27XS | ICD10CM | Covered |
| T20.29XA | ICD10CM | Covered |
| T20.29XD | ICD10CM | Covered |
| T20.29XS | ICD10CM | Covered |
| T20.30XA | ICD10CM | Covered |
| T20.30XD | ICD10CM | Covered |
| T20.30XS | ICD10CM | Covered |
| T20.311A | ICD10CM | Covered |
| T20.311D | ICD10CM | Covered |
| T20.311S | ICD10CM | Covered |
| T20.312A | ICD10CM | Covered |
| T20.312D | ICD10CM | Covered |
| T20.312S | ICD10CM | Covered |
| T20.319A | ICD10CM | Covered |
| T20.319D | ICD10CM | Covered |
| T20.319S | ICD10CM | Covered |
| T20.32XA | ICD10CM | Covered |
| T20.32XD | ICD10CM | Covered |
| T20.32XS | ICD10CM | Covered |
| T20.33XA | ICD10CM | Covered |
| T20.33XD | ICD10CM | Covered |
| T20.33XS | ICD10CM | Covered |
| T20.34XA | ICD10CM | Covered |
| T20.34XD | ICD10CM | Covered |
| T20.34XS | ICD10CM | Covered |
| T20.35XA | ICD10CM | Covered |
| T20.35XD | ICD10CM | Covered |
| T20.35XS | ICD10CM | Covered |
| T20.36XA | ICD10CM | Covered |
| T20.36XD | ICD10CM | Covered |
| T20.36XS | ICD10CM | Covered |
| T20.37XA | ICD10CM | Covered |
| T20.37XD | ICD10CM | Covered |
| T20.37XS | ICD10CM | Covered |
| T20.39XA | ICD10CM | Covered |
| T20.39XD | ICD10CM | Covered |
| T20.39XS | ICD10CM | Covered |
| T20.40XA | ICD10CM | Covered |
| T20.40XD | ICD10CM | Covered |
| T20.40XS | ICD10CM | Covered |
| T20.411A | ICD10CM | Covered |
| T20.411D | ICD10CM | Covered |
| T20.411S | ICD10CM | Covered |
| T20.412A | ICD10CM | Covered |
| T20.412D | ICD10CM | Covered |
| T20.412S | ICD10CM | Covered |
| T20.419A | ICD10CM | Covered |
| T20.419D | ICD10CM | Covered |
| T20.419S | ICD10CM | Covered |
| T20.42XA | ICD10CM | Covered |
| T20.42XD | ICD10CM | Covered |
| T20.42XS | ICD10CM | Covered |
| T20.43XA | ICD10CM | Covered |
| T20.43XD | ICD10CM | Covered |
| T20.43XS | ICD10CM | Covered |
| T20.44XA | ICD10CM | Covered |
| T20.44XD | ICD10CM | Covered |
| T20.44XS | ICD10CM | Covered |
| T20.45XA | ICD10CM | Covered |
| T20.45XD | ICD10CM | Covered |
| T20.45XS | ICD10CM | Covered |
| T20.46XA | ICD10CM | Covered |
| T20.46XD | ICD10CM | Covered |
| T20.46XS | ICD10CM | Covered |
| T20.47XA | ICD10CM | Covered |
| T20.47XD | ICD10CM | Covered |
| T20.47XS | ICD10CM | Covered |
| T20.49XA | ICD10CM | Covered |
| T20.49XD | ICD10CM | Covered |
| T20.49XS | ICD10CM | Covered |
| T20.50XA | ICD10CM | Covered |
| T20.50XD | ICD10CM | Covered |
| T20.50XS | ICD10CM | Covered |
| T20.511A | ICD10CM | Covered |
| T20.511D | ICD10CM | Covered |
| T20.511S | ICD10CM | Covered |
| T20.512A | ICD10CM | Covered |
| T20.512D | ICD10CM | Covered |
| T20.512S | ICD10CM | Covered |
| T20.519A | ICD10CM | Covered |
| T20.519D | ICD10CM | Covered |
| T20.519S | ICD10CM | Covered |
| T20.52XA | ICD10CM | Covered |
| T20.52XD | ICD10CM | Covered |
| T20.52XS | ICD10CM | Covered |
| T20.53XA | ICD10CM | Covered |
| T20.53XD | ICD10CM | Covered |
| T20.53XS | ICD10CM | Covered |
| T20.54XA | ICD10CM | Covered |
| T20.54XD | ICD10CM | Covered |
| T20.54XS | ICD10CM | Covered |
| T20.55XA | ICD10CM | Covered |
| T20.55XD | ICD10CM | Covered |
| T20.55XS | ICD10CM | Covered |
| T20.56XA | ICD10CM | Covered |
| T20.56XD | ICD10CM | Covered |
| T20.56XS | ICD10CM | Covered |
| T20.57XA | ICD10CM | Covered |
| T20.57XD | ICD10CM | Covered |
| T20.57XS | ICD10CM | Covered |
| T20.59XA | ICD10CM | Covered |
| T20.59XD | ICD10CM | Covered |
| T20.59XS | ICD10CM | Covered |
| T20.60XA | ICD10CM | Covered |
| T20.60XD | ICD10CM | Covered |
| T20.60XS | ICD10CM | Covered |
| T20.611A | ICD10CM | Covered |
| T20.611D | ICD10CM | Covered |
| T20.611S | ICD10CM | Covered |
| T20.612A | ICD10CM | Covered |
| T20.612D | ICD10CM | Covered |
| T20.612S | ICD10CM | Covered |
| T20.619A | ICD10CM | Covered |
| T20.619D | ICD10CM | Covered |
| T20.619S | ICD10CM | Covered |
| T20.62XA | ICD10CM | Covered |
| T20.62XD | ICD10CM | Covered |
| T20.62XS | ICD10CM | Covered |
| T20.63XA | ICD10CM | Covered |
| T20.63XD | ICD10CM | Covered |
| T20.63XS | ICD10CM | Covered |
| T20.64XA | ICD10CM | Covered |
| T20.64XD | ICD10CM | Covered |
| T20.64XS | ICD10CM | Covered |
| T20.65XA | ICD10CM | Covered |
| T20.65XD | ICD10CM | Covered |
| T20.65XS | ICD10CM | Covered |
| T20.66XA | ICD10CM | Covered |
| T20.66XD | ICD10CM | Covered |
| T20.66XS | ICD10CM | Covered |
| T20.67XA | ICD10CM | Covered |
| T20.67XD | ICD10CM | Covered |
| T20.67XS | ICD10CM | Covered |
| T20.69XA | ICD10CM | Covered |
| T20.69XD | ICD10CM | Covered |
| T20.69XS | ICD10CM | Covered |
| T20.70XA | ICD10CM | Covered |
| T20.70XD | ICD10CM | Covered |
| T20.70XS | ICD10CM | Covered |
| T20.711A | ICD10CM | Covered |
| T20.711D | ICD10CM | Covered |
| T20.711S | ICD10CM | Covered |
| T20.712A | ICD10CM | Covered |
| T20.712D | ICD10CM | Covered |