DRAFT. ICD-10 Clinical Modification Code Sets



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NOTE: The tables provided below are for reference only and should not be programmed or submitted. Table 8.1 Ischemic Stroke ICD-10 Code I6300 I63011 I63012 I63019 I6302 I63031 I63032 I63039 I6309 I6310 I63111 I63112 I63119 I6312 I63131 I63132 I63139 I6319 I6320 I63211 I63212 I63219 I6322 I63231 I63232 I63239 I6329 I6330 I63311 I63312 I63319 I63321 I63322 I63329 ICD-10 Code Description Cerebral infarction due to thrombosis of unspecified precerebral artery Cerebral infarction due to thrombosis of right vertebral artery Cerebral infarction due to thrombosis of left vertebral artery Cerebral infarction due to thrombosis of unspecified vertebral artery Cerebral infarction due to thrombosis of basilar artery Cerebral infarction due to thrombosis of right carotid artery Cerebral infarction due to thrombosis of left carotid artery Cerebral infarction due to thrombosis of unspecified carotid artery Cerebral infarction due to thrombosis of other precerebral artery Cerebral infarction due to embolism of unspecified precerebral artery Cerebral infarction due to embolism of right vertebral artery Cerebral infarction due to embolism of left vertebral artery Cerebral infarction due to embolism of unspecified vertebral artery Cerebral infarction due to embolism of basilar artery Cerebral infarction due to embolism of right carotid artery Cerebral infarction due to embolism of left carotid artery Cerebral infarction due to embolism of unspecified carotid artery Cerebral infarction due to embolism of other precerebral artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries Cerebral infarction due to unspecified occlusion or stenosis of right vertebral arteries Cerebral infarction due to unspecified occlusion or stenosis of left vertebral arteries Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries Cerebral infarction due to unspecified occlusion or stenosis of basilar arteries Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid arteries Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries Cerebral infarction due to thrombosis of unspecified cerebral artery Cerebral infarction due to thrombosis of right middle cerebral artery Cerebral infarction due to thrombosis of left middle cerebral artery Cerebral infarction due to thrombosis of unspecified middle cerebral artery Cerebral infarction due to thrombosis of right anterior cerebral artery Cerebral infarction due to thrombosis of left anterior cerebral artery Cerebral infarction due to thrombosis of unspecified anterior cerebral artery January 1, 2015 through March 31, 2015 (1Q2015) Page 1

I63331 I63332 I63339 I63341 I63342 I63349 I6339 I6340 I63411 I63412 I63419 I63421 I63422 I63429 I63431 I63432 I63439 I63441 I63442 I63449 I6350 I63511 I63512 I63519 I63521 I63522 I63529 I63531 I63532 I63539 I63541 I63542 I63549 I6359 I636 Cerebral infarction due to thrombosis of right posterior cerebral artery Cerebral infarction due to thrombosis of left posterior cerebral artery Cerebral infarction due to thrombosis of unspecified posterior cerebral artery Cerebral infarction due to thrombosis of right cerebellar artery Cerebral infarction due to thrombosis of left cerebellar artery Cerebral infarction due to thrombosis of unspecified cerebellar artery Cerebral infarction due to thrombosis of other cerebral artery Cerebral infarction due to embolism of unspecified cerebral artery Cerebral infarction due to embolism of right middle cerebral artery Cerebral infarction due to embolism of left middle cerebral artery Cerebral infarction due to embolism of unspecified middle cerebral artery Cerebral infarction due to embolism of right anterior cerebral artery Cerebral infarction due to embolism of left anterior cerebral artery Cerebral infarction due to embolism of unspecified anterior cerebral artery Cerebral infarction due to embolism of right posterior cerebral artery Cerebral infarction due to embolism of left posterior cerebral artery Cerebral infarction due to embolism of unspecified posterior cerebral artery Cerebral infarction due to embolism of right cerebellar artery Cerebral infarction due to embolism of left cerebellar artery Cerebral infarction due to embolism of unspecified cerebellar artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery Cerebral infarction due to cerebral venous thrombosis, nonpyogenic January 1, 2015 through March 31, 2015 (1Q2015) Page 2

I638 I639 I6521 I6522 I6523 I6529 I6601 I6602 I6603 I6609 I6611 I6612 I6613 I6619 I6621 I6622 I6623 I6629 I663 Other cerebral infarction Cerebral infarction, unspecified Occlusion and stenosis of right carotid artery Occlusion and stenosis of left carotid artery Occlusion and stenosis of bilateral carotid arteries Occlusion and stenosis of unspecified carotid artery Occlusion and stenosis of right middle cerebral artery Occlusion and stenosis of left middle cerebral artery Occlusion and stenosis of bilateral middle cerebral arteries Occlusion and stenosis of unspecified middle cerebral artery Occlusion and stenosis of right anterior cerebral artery Occlusion and stenosis of left anterior cerebral artery Occlusion and stenosis of bilateral anterior cerebral arteries Occlusion and stenosis of unspecified anterior cerebral artery Occlusion and stenosis of right posterior cerebral artery Occlusion and stenosis of left posterior cerebral artery Occlusion and stenosis of bilateral posterior cerebral arteries Occlusion and stenosis of unspecified posterior cerebral artery Occlusion and stenosis of cerebellar arteries Table 8.1a Thrombolytic Agent Procedures ICD-10 Code 3E03017 3E03317 3E04017 3E04317 3E05017 3E05317 3E06017 3E06317 ICD-10 Code Description Introduction of Other Thrombolytic into Peripheral Vein, Open Introduction of Other Thrombolytic into Peripheral Vein, Percutaneous Introduction of Other Thrombolytic into Central Vein, Open Introduction of Other Thrombolytic into Central Vein, Percutaneous Introduction of Other Thrombolytic into Peripheral Artery, Open Introduction of Other Thrombolytic into Peripheral Artery, Percutaneous Introduction of Other Thrombolytic into Central Artery, Open Introduction of Other Thrombolytic into Central Artery, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 3

Table 8.1b Mechanical Endovascular Reperfusion Procedures ICD-10 Code 03CG0ZZ 03CG3ZZ 03CG4ZZ 03CH0ZZ 03CH3ZZ 03CH4ZZ 03CJ0ZZ 03CJ3ZZ 03CJ4ZZ 03CK0ZZ 03CK3ZZ 03CK4ZZ 03CL0ZZ 03CL3ZZ 03CL4ZZ 03CM0ZZ 03CM3ZZ 03CM4ZZ 03CN0ZZ 03CN3ZZ 03CN4ZZ 03CP0ZZ 03CP3ZZ 03CP4ZZ 03CQ0ZZ 03CQ3ZZ 03CQ4ZZ ICD-10 Code Description Extirpation of Matter from Intracranial Artery, Open Extirpation of Matter from Intracranial Artery, Percutaneous Extirpation of Matter from Intracranial Artery, Percutaneous Endoscopic Extirpation of Matter from Common Carotid Artery, Right, Open Extirpation of Matter from Common Carotid Artery, Right, Percutaneous Extirpation of Matter from Right Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Common Carotid Artery, Open Extirpation of Matter from Left Common Carotid Artery, Percutaneous Extirpation of Matter from Left Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Internal Carotid Artery, Open Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Internal Carotid Artery, Open Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right External Carotid Artery, Open Extirpation of Matter from Right External Carotid Artery, Percutaneous Extirpation of Matter from Right External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left External Carotid Artery, Open Extirpation of Matter from Left External Carotid Artery, Percutaneous Extirpation of Matter from Left External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Artery, Open Extirpation of Matter from Right Vertebral Artery, Percutaneous Extirpation of Matter from Right Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Artery, Open Extirpation of Matter from Left Vertebral Artery, Percutaneous Extirpation of Matter from Left Vertebral Artery, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 4

Table 8.2 Hemorrhagic Stroke ICD-10 Code I6000 I6001 I6002 I6010 I6011 I6012 I6020 I6021 I6022 I6030 I6031 I6032 I604 I6050 I6051 I6052 I606 I607 I608 I609 I610 I611 I612 I613 I614 I615 I616 I618 I619 ICD-10 Code Description Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery Nontraumatic subarachnoid hemorrhage from right middle cerebral artery Nontraumatic subarachnoid hemorrhage from left middle cerebral artery Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating artery Nontraumatic subarachnoid hemorrhage from right anterior communicating artery Nontraumatic subarachnoid hemorrhage from left anterior communicating artery Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery Nontraumatic subarachnoid hemorrhage from right posterior communicating artery Nontraumatic subarachnoid hemorrhage from left posterior communicating artery Nontraumatic subarachnoid hemorrhage from basilar artery Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery Nontraumatic subarachnoid hemorrhage from right vertebral artery Nontraumatic subarachnoid hemorrhage from left vertebral artery Nontraumatic subarachnoid hemorrhage from other intracranial arteries Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery Other nontraumatic subarachnoid hemorrhage Nontraumatic subarachnoid hemorrhage, unspecified Nontraumatic intracerebral hemorrhage in hemisphere, subcortical Nontraumatic intracerebral hemorrhage in hemisphere, cortical Nontraumatic intracerebral hemorrhage in hemisphere, unspecified Nontraumatic intracerebral hemorrhage in brain stem Nontraumatic intracerebral hemorrhage in cerebellum Nontraumatic intracerebral hemorrhage, intraventricular Nontraumatic intracerebral hemorrhage, multiple localized Other nontraumatic intracerebral hemorrhage Nontraumatic intracerebral hemorrhage, unspecified January 1, 2015 through March 31, 2015 (1Q2015) Page 5

Table 8.2a Subarachnoid Hemorrhage ICD-10 Code I6000 I6001 I6002 I6010 I6011 I6012 I6020 I6021 I6022 I6030 I6031 I6032 I604 I6050 I6051 I6052 I606 I607 I608 I609 ICD-10 Code Description Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery Nontraumatic subarachnoid hemorrhage from right middle cerebral artery Nontraumatic subarachnoid hemorrhage from left middle cerebral artery Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating artery Nontraumatic subarachnoid hemorrhage from right anterior communicating artery Nontraumatic subarachnoid hemorrhage from left anterior communicating artery Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery Nontraumatic subarachnoid hemorrhage from right posterior communicating artery Nontraumatic subarachnoid hemorrhage from left posterior communicating artery Nontraumatic subarachnoid hemorrhage from basilar artery Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery Nontraumatic subarachnoid hemorrhage from right vertebral artery Nontraumatic subarachnoid hemorrhage from left vertebral artery Nontraumatic subarachnoid hemorrhage from other intracranial arteries Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery Other nontraumatic subarachnoid hemorrhage Nontraumatic subarachnoid hemorrhage, unspecified Table 8.2b Intracerebral Hemorrhage ICD-10 Code I610 I611 I612 I613 I614 I615 I616 I618 I619 ICD-10 Code Description Nontraumatic intracerebral hemorrhage in hemisphere, subcortical Nontraumatic intracerebral hemorrhage in hemisphere, cortical Nontraumatic intracerebral hemorrhage in hemisphere, unspecified Nontraumatic intracerebral hemorrhage in brain stem Nontraumatic intracerebral hemorrhage in cerebellum Nontraumatic intracerebral hemorrhage, intraventricular Nontraumatic intracerebral hemorrhage, multiple localized Other nontraumatic intracerebral hemorrhage Nontraumatic intracerebral hemorrhage, unspecified January 1, 2015 through March 31, 2015 (1Q2015) Page 6

Table 8.2c Primary Parenchymal Intracerebral Hemorrhage ICD-10 Code I610 I611 I612 I613 I614 I615 I616 I618 I619 I6200 I6201 I6202 I6203 I629 ICD-10 Code Description Nontraumatic intracerebral hemorrhage in hemisphere, subcortical Nontraumatic intracerebral hemorrhage in hemisphere, cortical Nontraumatic intracerebral hemorrhage in hemisphere, unspecified Nontraumatic intracerebral hemorrhage in brain stem Nontraumatic intracerebral hemorrhage in cerebellum Nontraumatic intracerebral hemorrhage, intraventricular Nontraumatic intracerebral hemorrhage, multiple localized Other nontraumatic intracerebral hemorrhage Nontraumatic intracerebral hemorrhage, unspecified Nontraumatic subdural hemorrhage, unspecified Nontraumatic acute subdural hemorrhage Nontraumatic subacute subdural hemorrhage Nontraumatic chronic subdural hemorrhage Nontraumatic intracranial hemorrhage, unspecified Table 8.2d Aneurysm Repair Procedures ICD-10 Code 03VH0CZ 03VH3CZ 03VH4CZ 03VJ0CZ 03VJ3CZ 03VJ4CZ 03VK0CZ 03VK3CZ 03VK4CZ 03VL0CZ 03VL3CZ 03VL4CZ 03VM0CZ ICD-10 Code Description Restriction of Right Common Carotid Artery with Extraluminal Device, Open Restriction of Right Common Carotid Artery with Extraluminal Device, Percutaneous Restriction of Right Common Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Left Common Carotid Artery with Extraluminal Device, Open Restriction of Left Common Carotid Artery with Extraluminal Device, Percutaneous Restriction of Left Common Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Right Internal Carotid Artery with Extraluminal Device, Open Restriction of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Restriction of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Left Internal Carotid Artery with Extraluminal Device, Open Restriction of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Restriction of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Right External Carotid Artery with Extraluminal Device, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 7

03VM3CZ 03VM4CZ 03VN0CZ 03VN3CZ 03VN4CZ 03VP0CZ 03VP3CZ 03VP4CZ 03VQ0CZ 03VQ3CZ 03VQ4CZ 03VG0ZZ 03VG4ZZ 03VH0ZZ 03VH4ZZ 03VJ0ZZ 03VJ4ZZ 03VK0ZZ 03VK4ZZ 03VL0ZZ 03VL4ZZ 03VM0ZZ 03VM4ZZ 03VN0ZZ 03VN4ZZ 03VP0ZZ 03VP4ZZ 03VQ0ZZ 03VQ4ZZ 03VG0DZ 03VG3DZ 03VG4DZ 03VH0DZ 03VH3DZ 03VH4DZ Restriction of Right External Carotid Artery with Extraluminal Device, Percutaneous Restriction of Right External Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Left External Carotid Artery with Extraluminal Device, Open Restriction of Left External Carotid Artery with Extraluminal Device, Percutaneous Restriction of Left External Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Right Vertebral Artery with Extraluminal Device, Open Restriction of Right Vertebral Artery with Extraluminal Device, Percutaneous Restriction of Right Vertebral Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Left Vertebral Artery with Extraluminal Device, Open Restriction of Left Vertebral Artery with Extraluminal Device, Percutaneous Restriction of Left Vertebral Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Intracranial Artery, Open Restriction of Intracranial Artery, Percutaneous Endoscopic Restriction of Right Common Carotid Artery, Open Restriction of Right Common Carotid Artery, Percutaneous Endoscopic Restriction of Left Common Carotid Artery, Open Restriction of Left Common Carotid Artery, Percutaneous Endoscopic Restriction of Right Internal Carotid Artery, Open Restriction of Right Internal Carotid Artery, Percutaneous Endoscopic Restriction of Left Internal Carotid Artery, Open Restriction of Left Internal Carotid Artery, Percutaneous Endoscopic Restriction of Right External Carotid Artery, Open Restriction of Right External Carotid Artery, Percutaneous Endoscopic Restriction of Left External Carotid Artery, Open Restriction of Left External Carotid Artery, Percutaneous Endoscopic Restriction of Right Vertebral Artery, Open Restriction of Right Vertebral Artery, Percutaneous Endoscopic Restriction of Left Vertebral Artery, Open Restriction of Left Vertebral Artery, Percutaneous Endoscopic Restriction of Intracranial Artery with Intraluminal Device, Open Restriction of Intracranial Artery with Intraluminal Device, Percutaneous Restriction of Intracranial Artery with Intraluminal Device, Percutaneous Endoscopic Restriction of Right Common Carotid Artery with Intraluminal Device, Open Restriction of Right Common Carotid Artery with Intraluminal Device, Percutaneous Restriction of Right Common Carotid Artery with Intraluminal Device, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 8

Endoscopic 03VJ0DZ Restriction of Left Common Carotid Artery with Intraluminal Device, Open 03VJ3DZ Restriction of Left Common Carotid Artery with Intraluminal Device, Percutaneous 03VJ4DZ Restriction of Left Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic 03VK0DZ Restriction of Right Internal Carotid Artery with Intraluminal Device, Open 03VK3DZ Restriction of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Restriction of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic 03VK4DZ 03VL0DZ Restriction of Left Internal Carotid Artery with Intraluminal Device, Open 03VL3DZ Restriction of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Restriction of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic 03VL4DZ 03VM0DZ Restriction of Right External Carotid Artery with Intraluminal Device, Open 03VM3DZ Restriction of Right External Carotid Artery with Intraluminal Device, Percutaneous Restriction of Right External Carotid Artery with Intraluminal Device, Percutaneous 03VM4DZ Endoscopic 03VN0DZ Restriction of Left External Carotid Artery with Intraluminal Device, Open 03VN3DZ Restriction of Left External Carotid Artery with Intraluminal Device, Percutaneous Restriction of Left External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic 03VN4DZ 03VP0DZ Restriction of Right Vertebral Artery with Intraluminal Device, Open 03VP3DZ Restriction of Right Vertebral Artery with Intraluminal Device, Percutaneous Restriction of Right Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic 03VP4DZ 03VQ0DZ Restriction of Left Vertebral Artery with Intraluminal Device, Open 03VQ3DZ Restriction of Left Vertebral Artery with Intraluminal Device, Percutaneous Restriction of Left Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic 03VQ4DZ 03VG0BZ Restriction of Intracranial Artery with Bioactive Intraluminal Device, Open 03VG3BZ Restriction of Intracranial Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Intracranial Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic 03VG4BZ Restriction of Right Common Carotid Artery with Bioactive Intraluminal Device, Open 03VH0BZ Restriction of Right Common Carotid Artery with Bioactive Intraluminal Device, Percutaneous 03VH3BZ Restriction of Right Common Carotid Artery with Bioactive Intraluminal Device, Percutaneous 03VH4BZ Endoscopic 03VJ0BZ Restriction of Left Common Carotid Artery with Bioactive Intraluminal Device, Open Restriction of Left Common Carotid Artery with Bioactive Intraluminal Device, Percutaneous 03VJ3BZ January 1, 2015 through March 31, 2015 (1Q2015) Page 9

03VJ4BZ 03VK0BZ 03VK3BZ 03VK4BZ 03VL0BZ 03VL3BZ 03VL4BZ 03VM0BZ 03VM3BZ 03VM4BZ 03VN0BZ 03VN3BZ 03VN4BZ 03VP0BZ 03VP3BZ 03VP4BZ 03VQ0BZ 03VQ3BZ 03VQ4BZ 03VG0CZ 03VG3CZ 03VG3ZZ 03VG4CZ 03VH3ZZ 03VJ3ZZ 03VK3ZZ 03VL3ZZ 03VM3ZZ 03VN3ZZ Restriction of Left Common Carotid Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Right Internal Carotid Artery with Bioactive Intraluminal Device, Open Restriction of Right Internal Carotid Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Right Internal Carotid Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Left Internal Carotid Artery with Bioactive Intraluminal Device, Open Restriction of Left Internal Carotid Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Left Internal Carotid Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Right External Carotid Artery with Bioactive Intraluminal Device, Open Restriction of Right External Carotid Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Right External Carotid Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Left External Carotid Artery with Bioactive Intraluminal Device, Open Restriction of Left External Carotid Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Left External Carotid Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Right Vertebral Artery with Bioactive Intraluminal Device, Open Restriction of Right Vertebral Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Right Vertebral Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction of Left Vertebral Artery with Bioactive Intraluminal Device, Open Restriction of Left Vertebral Artery with Bioactive Intraluminal Device, Percutaneous Restriction of Left Vertebral Artery with Bioactive Intraluminal Device, Percutaneous Endoscopic Restriction Intracranial Artery with Extraluminal Device, Open Restriction Intracranial Artery with Extraluminal Device, Percutaneous Restriction Intracranial Artery, Percutaneous Restriction Intracranial Artery with Extraluminal Device, Percutaneous Endoscopic Restriction Common Carotid Artery, Right, Percutaneous Restriction Common Carotid Artery, Left, Percutaneous Restriction Internal Carotid Artery, Right, Percutaneous Restriction Internal Carotid Artery, Left, Percutaneous Restriction External Carotid Artery, Right, Percutaneous Restriction External Carotid Artery, Left, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 10

03VP3ZZ 03VQ3ZZ Restriction Vertebral Artery, Right, Percutaneous Restriction Vertebral Artery, Left, Percutaneous Table 8.2e Surgical Intervention Procedures ICD-10 Code 037H34Z 037H3DZ 037H3ZZ 037H44Z 037H4DZ 037H4ZZ 037J34Z 037J3DZ 037J3ZZ 037J44Z 037J4DZ 037J4ZZ 037K34Z 037K3DZ 037K3ZZ 037K44Z 037K4DZ 037K4ZZ 037L34Z 037L3DZ 037L3ZZ 037L44Z 037L4DZ ICD-10 Code Description Dilation of Right Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right Common Carotid Artery, Percutaneous Dilation of Right Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Common Carotid Artery, Percutaneous Endoscopic Dilation of Left Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left Common Carotid Artery, Percutaneous Dilation of Left Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Common Carotid Artery, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right Internal Carotid Artery, Percutaneous Dilation of Right Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery, Percutaneous Endoscopic Dilation of Left Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left Internal Carotid Artery, Percutaneous Dilation of Left Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 11

037L4ZZ 037M34Z 037M3DZ 037M3ZZ 037M44Z 037M4DZ 037M4ZZ 037N34Z 037N3DZ 037N3ZZ 037N44Z 037N4DZ 037N4ZZ 037P34Z 037P3DZ 037P3ZZ 037P44Z 037P4DZ 037P4ZZ 037Q34Z 037Q3DZ 037Q3ZZ 037Q44Z 037Q4DZ 037Q4ZZ 03CH3ZZ 03CJ3ZZ 03CK3ZZ 03CL3ZZ 03CM3ZZ Dilation of Left Internal Carotid Artery, Percutaneous Endoscopic Dilation of Right External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right External Carotid Artery, Percutaneous Dilation of Right External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Carotid Artery, Percutaneous Endoscopic Dilation of Left External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left External Carotid Artery, Percutaneous Dilation of Left External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Carotid Artery, Percutaneous Endoscopic Dilation of Right Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous Dilation of Right Vertebral Artery, Percutaneous Dilation of Right Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Artery, Percutaneous Endoscopic Dilation of Left Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Dilation of Left Vertebral Artery, Percutaneous Dilation of Left Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Right Common Carotid Artery, Percutaneous Extirpation of Matter from Left Common Carotid Artery, Percutaneous Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Extirpation of Matter from Right External Carotid Artery, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 12

03CN3ZZ 03CP3ZZ 03CQ3ZZ 057M3DZ 057M4DZ 057N3DZ 057N4DZ 057P3DZ 057P4DZ 057Q3DZ 057Q4DZ 057R3DZ 057R4DZ 057S3DZ 057S4DZ 057T3DZ 057T4DZ 037G34Z 037G3DZ 037G3ZZ 037G44Z 037G4DZ 037G4ZZ 03CG3ZZ 057L3DZ 057L4DZ 05CL3ZZ 037H3DZ 037H4DZ 037J3DZ 037J4DZ 037K3DZ 037K4DZ Extirpation of Matter from Left External Carotid Artery, Percutaneous Extirpation of Matter from Right Vertebral Artery, Percutaneous Extirpation of Matter from Left Vertebral Artery, Percutaneous Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Face Vein with Intraluminal Device, Percutaneous Dilation of Right Face Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Dilation of Intracranial Artery, Percutaneous Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery, Percutaneous Endoscopic Extirpation of Matter from Intracranial Artery, Percutaneous Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic Extirpation of Matter from Intracranial Vein, Percutaneous Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 13

037L3DZ 037L4DZ 037M3DZ 037M4DZ 037N3DZ 037N4DZ 037P3DZ 037P4DZ 037Q3DZ 037Q4DZ 037S3DZ 037S4DZ 037T3DZ 037T4DZ 057M3DZ 057M4DZ 057N3DZ 057N4DZ 057P3DZ 057P4DZ 057Q3DZ 057Q4DZ 057R3DZ 057R4DZ 057S3DZ 057S4DZ 037G34Z 037G3DZ 037G44Z 037G4DZ Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Temporal Artery with Intraluminal Device, Percutaneous Dilation of Right Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Temporal Artery with Intraluminal Device, Percutaneous Dilation of Left Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 14

057L3DZ 057L4DZ 009130Z 00913ZZ 009140Z 00914ZZ 009230Z 00923ZZ 009240Z 00924ZZ 009430Z 00943ZZ 009440Z 00944ZZ 00963ZZ 00964ZZ 0W9130Z 0W913ZZ 0W9140Z 0W914ZZ 3E0Q0AZ 3E0Q0E0 3E0Q0E1 3E0Q33Z 3E0Q36Z 3E0Q37Z 3E0Q3AZ 3E0Q3BZ 3E0Q3E0 3E0Q3E1 3E0Q3GC 3E0Q3HZ 3E0Q3KZ 3E0Q3SF Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic Drainage of Cerebral Meninges with Drainage Device, Percutaneous Drainage of Cerebral Meninges, Percutaneous Drainage of Cerebral Meninges with Drainage Device, Percutaneous Endoscopic Drainage of Cerebral Meninges, Percutaneous Endoscopic Drainage of Dura Mater with Drainage Device, Percutaneous Drainage of Dura Mater, Percutaneous Drainage of Dura Mater with Drainage Device, Percutaneous Endoscopic Drainage of Dura Mater, Percutaneous Endoscopic Drainage of Subdural Space with Drainage Device, Percutaneous Drainage of Subdural Space, Percutaneous Drainage of Subdural Space with Drainage Device, Percutaneous Endoscopic Drainage of Subdural Space, Percutaneous Endoscopic Drainage of Cerebral Ventricle, Percutaneous Drainage of Cerebral Ventricle, Percutaneous Endoscopic Drainage of Cranial Cavity with Drainage Device, Percutaneous Drainage of Cranial Cavity, Percutaneous Drainage of Cranial Cavity with Drainage Device, Percutaneous Endoscopic Drainage of Cranial Cavity, Percutaneous Endoscopic Introduction of Embryonic Stem Cells into Cranial Cavity and Brain, Open Introduction of Autologous Somatic Stem Cells into Cranial Cavity and Brain, Open Introduction of Nonautologous Somatic Stem Cells into Cranial Cavity and Brain, Open Introduction of Anti-inflammatory into Cranial Cavity and Brain, Percutaneous Introduction of Nutritional Substance into Cranial Cavity and Brain, Percutaneous Introduction of Electrolytic and Water Balance Substance into Cranial Cavity and Brain, Percutaneous Introduction of Embryonic Stem Cells into Cranial Cavity and Brain, Percutaneous Introduction of Local Anesthetic into Cranial Cavity and Brain, Percutaneous Introduction of Autologous Somatic Stem Cells into Cranial Cavity and Brain, Percutaneous Introduction of Nonautologous Somatic Stem Cells into Cranial Cavity and Brain, Percutaneous Introduction of Other Therapeutic Substance into Cranial Cavity and Brain, Percutaneous Introduction of Radioactive Substance into Cranial Cavity and Brain, Percutaneous Introduction of Other Diagnostic Substance into Cranial Cavity and Brain, Percutaneous Introduction of Other Gas into Cranial Cavity and Brain, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 15

3E0Q3TZ 3E0Q7SF 0WJ10ZZ 00J00ZZ 00W00JZ 00W00KZ 0N800ZZ 0N803ZZ 0N804ZZ 0N810ZZ 0N813ZZ 0N814ZZ 0N820ZZ 0N823ZZ 0N824ZZ 0N830ZZ 0N833ZZ 0N834ZZ 0N840ZZ 0N843ZZ 0N844ZZ 0N850ZZ 0N853ZZ 0N854ZZ 0N860ZZ 0N863ZZ 0N864ZZ 0N870ZZ 0N873ZZ 0N874ZZ 0N880ZZ 0N883ZZ 0N884ZZ 0NC10ZZ 0NC13ZZ 0NC14ZZ 0NC20ZZ 0NC23ZZ Introduction of Destructive Agent into Cranial Cavity and Brain, Percutaneous Introduction of Other Gas into Cranial Cavity and Brain, Via Natural or Artificial Opening Inspection of Cranial Cavity, Open Inspection of Brain, Open Revision of Synthetic Substitute in Brain, Open Revision of Nonautologous Tissue Substitute in Brain, Open Division of Skull, Open Division of Skull, Percutaneous Division of Skull, Percutaneous Endoscopic Division of Right Frontal Bone, Open Division of Right Frontal Bone, Percutaneous Division of Right Frontal Bone, Percutaneous Endoscopic Division of Left Frontal Bone, Open Division of Left Frontal Bone, Percutaneous Division of Left Frontal Bone, Percutaneous Endoscopic Division of Right Parietal Bone, Open Division of Right Parietal Bone, Percutaneous Division of Right Parietal Bone, Percutaneous Endoscopic Division of Left Parietal Bone, Open Division of Left Parietal Bone, Percutaneous Division of Left Parietal Bone, Percutaneous Endoscopic Division of Right Temporal Bone, Open Division of Right Temporal Bone, Percutaneous Division of Right Temporal Bone, Percutaneous Endoscopic Division of Left Temporal Bone, Open Division of Left Temporal Bone, Percutaneous Division of Left Temporal Bone, Percutaneous Endoscopic Division of Right Occipital Bone, Open Division of Right Occipital Bone, Percutaneous Division of Right Occipital Bone, Percutaneous Endoscopic Division of Left Occipital Bone, Open Division of Left Occipital Bone, Percutaneous Division of Left Occipital Bone, Percutaneous Endoscopic Extirpation of Matter from Right Frontal Bone, Open Extirpation of Matter from Right Frontal Bone, Percutaneous Extirpation of Matter from Right Frontal Bone, Percutaneous Endoscopic Extirpation of Matter from Left Frontal Bone, Open Extirpation of Matter from Left Frontal Bone, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 16

0NC24ZZ 0NC30ZZ 0NC33ZZ 0NC34ZZ 0NC40ZZ 0NC43ZZ 0NC44ZZ 0NC50ZZ 0NC53ZZ 0NC54ZZ 0NC60ZZ 0NC63ZZ 0NC64ZZ 0NC70ZZ 0NC73ZZ 0NC74ZZ 0NC80ZZ 0NC83ZZ 0NC84ZZ 0NH00MZ 0NH03MZ 0NH04MZ 0NP000Z 0NP004Z 0NP005Z 0NP007Z 0NP00KZ 0NP00SZ 0NP030Z 0NP034Z 0NP037Z 0NP03KZ 0NP03SZ 0NP040Z 0NP044Z 0NP047Z 0NP04KZ 0NP04SZ Extirpation of Matter from Left Frontal Bone, Percutaneous Endoscopic Extirpation of Matter from Right Parietal Bone, Open Extirpation of Matter from Right Parietal Bone, Percutaneous Extirpation of Matter from Right Parietal Bone, Percutaneous Endoscopic Extirpation of Matter from Left Parietal Bone, Open Extirpation of Matter from Left Parietal Bone, Percutaneous Extirpation of Matter from Left Parietal Bone, Percutaneous Endoscopic Extirpation of Matter from Right Temporal Bone, Open Extirpation of Matter from Right Temporal Bone, Percutaneous Extirpation of Matter from Right Temporal Bone, Percutaneous Endoscopic Extirpation of Matter from Left Temporal Bone, Open Extirpation of Matter from Left Temporal Bone, Percutaneous Extirpation of Matter from Left Temporal Bone, Percutaneous Endoscopic Extirpation of Matter from Right Occipital Bone, Open Extirpation of Matter from Right Occipital Bone, Percutaneous Extirpation of Matter from Right Occipital Bone, Percutaneous Endoscopic Extirpation of Matter from Left Occipital Bone, Open Extirpation of Matter from Left Occipital Bone, Percutaneous Extirpation of Matter from Left Occipital Bone, Percutaneous Endoscopic Insertion of Bone Growth Stimulator into Skull, Open Insertion of Bone Growth Stimulator into Skull, Percutaneous Insertion of Bone Growth Stimulator into Skull, Percutaneous Endoscopic Removal of Drainage Device from Skull, Open Removal of Internal Fixation Device from Skull, Open Removal of External Fixation Device from Skull, Open Removal of Autologous Tissue Substitute from Skull, Open Removal of Nonautologous Tissue Substitute from Skull, Open Removal of Hearing Device from Skull, Open Removal of Drainage Device from Skull, Percutaneous Removal of Internal Fixation Device from Skull, Percutaneous Removal of Autologous Tissue Substitute from Skull, Percutaneous Removal of Nonautologous Tissue Substitute from Skull, Percutaneous Removal of Hearing Device from Skull, Percutaneous Removal of Drainage Device from Skull, Percutaneous Endoscopic Removal of Internal Fixation Device from Skull, Percutaneous Endoscopic Removal of Autologous Tissue Substitute from Skull, Percutaneous Endoscopic Removal of Nonautologous Tissue Substitute from Skull, Percutaneous Endoscopic Removal of Hearing Device from Skull, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 17

0NP0X4Z 0NP0XSZ 0NW000Z 0NW004Z 0NW005Z 0NW007Z 0NW00JZ 0NW00KZ 0NW00MZ 0NW00NZ 0NW00SZ 0NW030Z 0NW034Z 0NW035Z 0NW037Z 0NW03JZ 0NW03KZ 0NW03MZ 0NW03SZ 0NW040Z 0NW044Z 0NW045Z 0NW047Z 0NW04JZ 0NW04KZ 0NW04MZ 0NW04SZ 0W9100Z 0W910ZZ 0WC10ZZ 0WC13ZZ 0WC14ZZ 0WH10YZ 0WH13YZ 0WH14YZ 0WJ10ZZ 0WP100Z 0WP101Z Removal of Internal Fixation Device from Skull, External Removal of Hearing Device from Skull, External Revision of Drainage Device in Skull, Open Revision of Internal Fixation Device in Skull, Open Revision of External Fixation Device in Skull, Open Revision of Autologous Tissue Substitute in Skull, Open Revision of Synthetic Substitute in Skull, Open Revision of Nonautologous Tissue Substitute in Skull, Open Revision of Bone Growth Stimulator in Skull, Open Revision of Neurostimulator Generator in Skull, Open Revision of Hearing Device in Skull, Open Revision of Drainage Device in Skull, Percutaneous Revision of Internal Fixation Device in Skull, Percutaneous Revision of External Fixation Device in Skull, Percutaneous Revision of Autologous Tissue Substitute in Skull, Percutaneous Revision of Synthetic Substitute in Skull, Percutaneous Revision of Nonautologous Tissue Substitute in Skull, Percutaneous Revision of Bone Growth Stimulator in Skull, Percutaneous Revision of Hearing Device in Skull, Percutaneous Revision of Drainage Device in Skull, Percutaneous Endoscopic Revision of Internal Fixation Device in Skull, Percutaneous Endoscopic Revision of External Fixation Device in Skull, Percutaneous Endoscopic Revision of Autologous Tissue Substitute in Skull, Percutaneous Endoscopic Revision of Synthetic Substitute in Skull, Percutaneous Endoscopic Revision of Nonautologous Tissue Substitute in Skull, Percutaneous Endoscopic Revision of Bone Growth Stimulator in Skull, Percutaneous Endoscopic Revision of Hearing Device in Skull, Percutaneous Endoscopic Drainage of Cranial Cavity with Drainage Device, Open Drainage of Cranial Cavity, Open Extirpation of Matter from Cranial Cavity, Open Extirpation of Matter from Cranial Cavity, Percutaneous Extirpation of Matter from Cranial Cavity, Percutaneous Endoscopic Insertion of Other Device into Cranial Cavity, Open Insertion of Other Device into Cranial Cavity, Percutaneous Insertion of Other Device into Cranial Cavity, Percutaneous Endoscopic Inspection of Cranial Cavity, Open Removal of Drainage Device from Cranial Cavity, Open Removal of Radioactive Element from Cranial Cavity, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 18

0WP10JZ 0WP10YZ 0WP130Z 0WP131Z 0WP13JZ 0WP13YZ 0WP140Z 0WP141Z 0WP14JZ 0WP14YZ 0WW100Z 0WW101Z 0WW103Z 0WW10JZ 0WW10YZ 0WW130Z 0WW131Z 0WW133Z 0WW13JZ 0WW13YZ 0WW140Z 0WW141Z 0WW143Z 0WW14JZ 0WW14YZ 009000Z 00900ZZ 009030Z 00903ZZ 009040Z 00904ZZ 009300Z 00930ZZ 009330Z 00933ZZ 009340Z 00934ZZ 00960ZZ Removal of Synthetic Substitute from Cranial Cavity, Open Removal of Other Device from Cranial Cavity, Open Removal of Drainage Device from Cranial Cavity, Percutaneous Removal of Radioactive Element from Cranial Cavity, Percutaneous Removal of Synthetic Substitute from Cranial Cavity, Percutaneous Removal of Other Device from Cranial Cavity, Percutaneous Removal of Drainage Device from Cranial Cavity, Percutaneous Endoscopic Removal of Radioactive Element from Cranial Cavity, Percutaneous Endoscopic Removal of Synthetic Substitute from Cranial Cavity, Percutaneous Endoscopic Removal of Other Device from Cranial Cavity, Percutaneous Endoscopic Revision of Drainage Device in Cranial Cavity, Open Revision of Radioactive Element in Cranial Cavity, Open Revision of Infusion Device in Cranial Cavity, Open Revision of Synthetic Substitute in Cranial Cavity, Open Revision of Other Device in Cranial Cavity, Open Revision of Drainage Device in Cranial Cavity, Percutaneous Revision of Radioactive Element in Cranial Cavity, Percutaneous Revision of Infusion Device in Cranial Cavity, Percutaneous Revision of Synthetic Substitute in Cranial Cavity, Percutaneous Revision of Other Device in Cranial Cavity, Percutaneous Revision of Drainage Device in Cranial Cavity, Percutaneous Endoscopic Revision of Radioactive Element in Cranial Cavity, Percutaneous Endoscopic Revision of Infusion Device in Cranial Cavity, Percutaneous Endoscopic Revision of Synthetic Substitute in Cranial Cavity, Percutaneous Endoscopic Revision of Other Device in Cranial Cavity, Percutaneous Endoscopic Drainage of Brain with Drainage Device, Open Drainage of Brain, Open Drainage of Brain with Drainage Device, Percutaneous Drainage of Brain, Percutaneous Drainage of Brain with Drainage Device, Percutaneous Endoscopic Drainage of Brain, Percutaneous Endoscopic Drainage of Epidural Space with Drainage Device, Open Drainage of Epidural Space, Open Drainage of Epidural Space with Drainage Device, Percutaneous Drainage of Epidural Space, Percutaneous Drainage of Epidural Space with Drainage Device, Percutaneous Endoscopic Drainage of Epidural Space, Percutaneous Endoscopic Drainage of Cerebral Ventricle, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 19

009700Z 00970ZZ 009730Z 00973ZZ 009740Z 00974ZZ 009B00Z 009B0ZZ 009B30Z 009B3ZZ 009B40Z 009B4ZZ 009C00Z 009C0ZZ 009C30Z 009C3ZZ 009C40Z 009C4ZZ 009D00Z 009D0ZZ 009D30Z 009D3ZZ 009D40Z 009D4ZZ 00C00ZZ 00C03ZZ 00C04ZZ 00C30ZZ 00C33ZZ 00C34ZZ 00C60ZZ 00C63ZZ 00C64ZZ 00C70ZZ 00C73ZZ 00C74ZZ 00CB0ZZ 00CB3ZZ Drainage of Cerebral Hemisphere with Drainage Device, Open Drainage of Cerebral Hemisphere, Open Drainage of Cerebral Hemisphere with Drainage Device, Percutaneous Drainage of Cerebral Hemisphere, Percutaneous Drainage of Cerebral Hemisphere with Drainage Device, Percutaneous Endoscopic Drainage of Cerebral Hemisphere, Percutaneous Endoscopic Drainage of Pons with Drainage Device, Open Drainage of Pons, Open Drainage of Pons with Drainage Device, Percutaneous Drainage of Pons, Percutaneous Drainage of Pons with Drainage Device, Percutaneous Endoscopic Drainage of Pons, Percutaneous Endoscopic Drainage of Cerebellum with Drainage Device, Open Drainage of Cerebellum, Open Drainage of Cerebellum with Drainage Device, Percutaneous Drainage of Cerebellum, Percutaneous Drainage of Cerebellum with Drainage Device, Percutaneous Endoscopic Drainage of Cerebellum, Percutaneous Endoscopic Drainage of Medulla Oblongata with Drainage Device, Open Drainage of Medulla Oblongata, Open Drainage of Medulla Oblongata with Drainage Device, Percutaneous Drainage of Medulla Oblongata, Percutaneous Drainage of Medulla Oblongata with Drainage Device, Percutaneous Endoscopic Drainage of Medulla Oblongata, Percutaneous Endoscopic Extirpation of Matter from Brain, Open Extirpation of Matter from Brain, Percutaneous Extirpation of Matter from Brain, Percutaneous Endoscopic Extirpation of Matter from Epidural Space, Open Extirpation of Matter from Epidural Space, Percutaneous Extirpation of Matter from Epidural Space, Percutaneous Endoscopic Extirpation of Matter from Cerebral Ventricle, Open Extirpation of Matter from Cerebral Ventricle, Percutaneous Extirpation of Matter from Cerebral Ventricle, Percutaneous Endoscopic Extirpation of Matter from Cerebral Hemisphere, Open Extirpation of Matter from Cerebral Hemisphere, Percutaneous Extirpation of Matter from Cerebral Hemisphere, Percutaneous Endoscopic Extirpation of Matter from Pons, Open Extirpation of Matter from Pons, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 20

00CB4ZZ 00CC0ZZ 00CC3ZZ 00CC4ZZ 00CD0ZZ 00CD3ZZ 00CD4ZZ 00H002Z 00H003Z 00H032Z 00H042Z 00H043Z 00H602Z 00H603Z 00H632Z 00H633Z 00H642Z 00H643Z 00P000Z 00P002Z 00P003Z 00P007Z 00P00JZ 00P00KZ 00P030Z 00P032Z 00P033Z 00P037Z 00P03JZ 00P03KZ 00P040Z 00P042Z 00P043Z 00P047Z 00P04JZ 00P04KZ 00P600Z 00P602Z Extirpation of Matter from Pons, Percutaneous Endoscopic Extirpation of Matter from Cerebellum, Open Extirpation of Matter from Cerebellum, Percutaneous Extirpation of Matter from Cerebellum, Percutaneous Endoscopic Extirpation of Matter from Medulla Oblongata, Open Extirpation of Matter from Medulla Oblongata, Percutaneous Extirpation of Matter from Medulla Oblongata, Percutaneous Endoscopic Insertion of Monitoring Device into Brain, Open Insertion of Infusion Device into Brain, Open Insertion of Monitoring Device into Brain, Percutaneous Insertion of Monitoring Device into Brain, Percutaneous Endoscopic Insertion of Infusion Device into Brain, Percutaneous Endoscopic Insertion of Monitoring Device into Cerebral Ventricle, Open Insertion of Infusion Device into Cerebral Ventricle, Open Insertion of Monitoring Device into Cerebral Ventricle, Percutaneous Insertion of Infusion Device into Cerebral Ventricle, Percutaneous Insertion of Monitoring Device into Cerebral Ventricle, Percutaneous Endoscopic Insertion of Infusion Device into Cerebral Ventricle, Percutaneous Endoscopic Removal of Drainage Device from Brain, Open Removal of Monitoring Device from Brain, Open Removal of Infusion Device from Brain, Open Removal of Autologous Tissue Substitute from Brain, Open Removal of Synthetic Substitute from Brain, Open Removal of Nonautologous Tissue Substitute from Brain, Open Removal of Drainage Device from Brain, Percutaneous Removal of Monitoring Device from Brain, Percutaneous Removal of Infusion Device from Brain, Percutaneous Removal of Autologous Tissue Substitute from Brain, Percutaneous Removal of Synthetic Substitute from Brain, Percutaneous Removal of Nonautologous Tissue Substitute from Brain, Percutaneous Removal of Drainage Device from Brain, Percutaneous Endoscopic Removal of Monitoring Device from Brain, Percutaneous Endoscopic Removal of Infusion Device from Brain, Percutaneous Endoscopic Removal of Autologous Tissue Substitute from Brain, Percutaneous Endoscopic Removal of Synthetic Substitute from Brain, Percutaneous Endoscopic Removal of Nonautologous Tissue Substitute from Brain, Percutaneous Endoscopic Removal of Drainage Device from Cerebral Ventricle, Open Removal of Monitoring Device from Cerebral Ventricle, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 21

00P603Z 00P630Z 00P632Z 00P633Z 00P640Z 00P642Z 00P643Z 00P6X2Z 00W000Z 00W002Z 00W003Z 00W007Z 00W00MZ 00W030Z 00W032Z 00W033Z 00W037Z 00W03JZ 00W03KZ 00W03MZ 00W040Z 00W042Z 00W043Z 00W047Z 00W04JZ 00W04KZ 00W04MZ 00W600Z 00W602Z 00W603Z 00W60MZ 00W630Z 00W632Z 00W633Z 00W63MZ 00W640Z 00W642Z 00W643Z Removal of Infusion Device from Cerebral Ventricle, Open Removal of Drainage Device from Cerebral Ventricle, Percutaneous Removal of Monitoring Device from Cerebral Ventricle, Percutaneous Removal of Infusion Device from Cerebral Ventricle, Percutaneous Removal of Drainage Device from Cerebral Ventricle, Percutaneous Endoscopic Removal of Monitoring Device from Cerebral Ventricle, Percutaneous Endoscopic Removal of Infusion Device from Cerebral Ventricle, Percutaneous Endoscopic Removal of Monitoring Device from Cerebral Ventricle, External Revision of Drainage Device in Brain, Open Revision of Monitoring Device in Brain, Open Revision of Infusion Device in Brain, Open Revision of Autologous Tissue Substitute in Brain, Open Revision of Neurostimulator Lead in Brain, Open Revision of Drainage Device in Brain, Percutaneous Revision of Monitoring Device in Brain, Percutaneous Revision of Infusion Device in Brain, Percutaneous Revision of Autologous Tissue Substitute in Brain, Percutaneous Revision of Synthetic Substitute in Brain, Percutaneous Revision of Nonautologous Tissue Substitute in Brain, Percutaneous Revision of Neurostimulator Lead in Brain, Percutaneous Revision of Drainage Device in Brain, Percutaneous Endoscopic Revision of Monitoring Device in Brain, Percutaneous Endoscopic Revision of Infusion Device in Brain, Percutaneous Endoscopic Revision of Autologous Tissue Substitute in Brain, Percutaneous Endoscopic Revision of Synthetic Substitute in Brain, Percutaneous Endoscopic Revision of Nonautologous Tissue Substitute in Brain, Percutaneous Endoscopic Revision of Neurostimulator Lead in Brain, Percutaneous Endoscopic Revision of Drainage Device in Cerebral Ventricle, Open Revision of Monitoring Device in Cerebral Ventricle, Open Revision of Infusion Device in Cerebral Ventricle, Open Revision of Neurostimulator Lead in Cerebral Ventricle, Open Revision of Drainage Device in Cerebral Ventricle, Percutaneous Revision of Monitoring Device in Cerebral Ventricle, Percutaneous Revision of Infusion Device in Cerebral Ventricle, Percutaneous Revision of Neurostimulator Lead in Cerebral Ventricle, Percutaneous Revision of Drainage Device in Cerebral Ventricle, Percutaneous Endoscopic Revision of Monitoring Device in Cerebral Ventricle, Percutaneous Endoscopic Revision of Infusion Device in Cerebral Ventricle, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 22

00W64MZ 0NR00JZ 0NR03JZ 0NR04JZ 0NR10JZ 0NR13JZ 0NR14JZ 0NR20JZ 0NR23JZ 0NR24JZ 0NR30JZ 0NR33JZ 0NR34JZ 0NR40JZ 0NR43JZ 0NR44JZ 0NR50JZ 0NR53JZ 0NR54JZ 0NR60JZ 0NR63JZ 0NR64JZ 0NR70JZ 0NR73JZ 0NR74JZ 0NR80JZ 0NR83JZ 0NR84JZ 0NU00JZ 0NU03JZ 0NU04JZ 0NU10JZ Revision of Neurostimulator Lead in Cerebral Ventricle, Percutaneous Endoscopic Replacement of Skull with Synthetic Substitute, Open Replacement of Skull with Synthetic Substitute, Percutaneous Replacement of Skull with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Frontal Bone with Synthetic Substitute, Open Replacement of Right Frontal Bone with Synthetic Substitute, Percutaneous Replacement of Right Frontal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Frontal Bone with Synthetic Substitute, Open Replacement of Left Frontal Bone with Synthetic Substitute, Percutaneous Replacement of Left Frontal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Parietal Bone with Synthetic Substitute, Open Replacement of Right Parietal Bone with Synthetic Substitute, Percutaneous Replacement of Right Parietal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Parietal Bone with Synthetic Substitute, Open Replacement of Left Parietal Bone with Synthetic Substitute, Percutaneous Replacement of Left Parietal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Temporal Bone with Synthetic Substitute, Open Replacement of Right Temporal Bone with Synthetic Substitute, Percutaneous Replacement of Right Temporal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Temporal Bone with Synthetic Substitute, Open Replacement of Left Temporal Bone with Synthetic Substitute, Percutaneous Replacement of Left Temporal Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Occipital Bone with Synthetic Substitute, Open Replacement of Right Occipital Bone with Synthetic Substitute, Percutaneous Replacement of Right Occipital Bone with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Occipital Bone with Synthetic Substitute, Open Replacement of Left Occipital Bone with Synthetic Substitute, Percutaneous Replacement of Left Occipital Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Skull with Synthetic Substitute, Open Supplement Skull with Synthetic Substitute, Percutaneous Supplement Skull with Synthetic Substitute, Percutaneous Endoscopic Supplement Right Frontal Bone with Synthetic Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 23

0NU13JZ 0NU14JZ 0NU20JZ 0NU23JZ 0NU24JZ 0NU30JZ 0NU33JZ 0NU34JZ 0NU40JZ 0NU43JZ 0NU44JZ 0NU50JZ 0NU53JZ 0NU54JZ 0NU60JZ 0NU63JZ 0NU64JZ 0NU70JZ 0NU73JZ 0NU74JZ 0NU80JZ 0NU83JZ 0NU84JZ 0NH104Z 0NH134Z 0NH144Z 0NH204Z 0NH234Z 0NH244Z 0NH304Z 0NH334Z 0NH344Z 0NH404Z Supplement Right Frontal Bone with Synthetic Substitute, Percutaneous Supplement Right Frontal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Left Frontal Bone with Synthetic Substitute, Open Supplement Left Frontal Bone with Synthetic Substitute, Percutaneous Supplement Left Frontal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Right Parietal Bone with Synthetic Substitute, Open Supplement Right Parietal Bone with Synthetic Substitute, Percutaneous Supplement Right Parietal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Left Parietal Bone with Synthetic Substitute, Open Supplement Left Parietal Bone with Synthetic Substitute, Percutaneous Supplement Left Parietal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Right Temporal Bone with Synthetic Substitute, Open Supplement Right Temporal Bone with Synthetic Substitute, Percutaneous Supplement Right Temporal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Left Temporal Bone with Synthetic Substitute, Open Supplement Left Temporal Bone with Synthetic Substitute, Percutaneous Supplement Left Temporal Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Right Occipital Bone with Synthetic Substitute, Open Supplement Right Occipital Bone with Synthetic Substitute, Percutaneous Supplement Right Occipital Bone with Synthetic Substitute, Percutaneous Endoscopic Supplement Left Occipital Bone with Synthetic Substitute, Open Supplement Left Occipital Bone with Synthetic Substitute, Percutaneous Supplement Left Occipital Bone with Synthetic Substitute, Percutaneous Endoscopic Insertion of Internal Fixation Device into Right Frontal Bone, Open Insertion of Internal Fixation Device into Right Frontal Bone, Percutaneous Insertion of Internal Fixation Device into Right Frontal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Left Frontal Bone, Open Insertion of Internal Fixation Device into Left Frontal Bone, Percutaneous Insertion of Internal Fixation Device into Left Frontal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Right Parietal Bone, Open Insertion of Internal Fixation Device into Right Parietal Bone, Percutaneous Insertion of Internal Fixation Device into Right Parietal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Left Parietal Bone, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 24

0NH434Z 0NH444Z 0NH504Z 0NH534Z 0NH544Z 0NH604Z 0NH634Z 0NH644Z 0NH704Z 0NH734Z 0NH744Z 0NH804Z 0NH834Z 0NH844Z 0NN10ZZ 0NN13ZZ 0NN14ZZ 0NN20ZZ 0NN23ZZ 0NN24ZZ 0NN30ZZ 0NN33ZZ 0NN34ZZ 0NN40ZZ 0NN43ZZ 0NN44ZZ 0NN50ZZ 0NN53ZZ 0NN54ZZ 0NN60ZZ 0NN63ZZ 0NN64ZZ 0NN70ZZ 0NN73ZZ 0NN74ZZ Insertion of Internal Fixation Device into Left Parietal Bone, Percutaneous Insertion of Internal Fixation Device into Left Parietal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Right Temporal Bone, Open Insertion of Internal Fixation Device into Right Temporal Bone, Percutaneous Insertion of Internal Fixation Device into Right Temporal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Left Temporal Bone, Open Insertion of Internal Fixation Device into Left Temporal Bone, Percutaneous Insertion of Internal Fixation Device into Left Temporal Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Right Occipital Bone, Open Insertion of Internal Fixation Device into Right Occipital Bone, Percutaneous Insertion of Internal Fixation Device into Right Occipital Bone, Percutaneous Endoscopic Insertion of Internal Fixation Device into Left Occipital Bone, Open Insertion of Internal Fixation Device into Left Occipital Bone, Percutaneous Insertion of Internal Fixation Device into Left Occipital Bone, Percutaneous Endoscopic Release Right Frontal Bone, Open Release Right Frontal Bone, Percutaneous Release Right Frontal Bone, Percutaneous Endoscopic Release Left Frontal Bone, Open Release Left Frontal Bone, Percutaneous Release Left Frontal Bone, Percutaneous Endoscopic Release Right Parietal Bone, Open Release Right Parietal Bone, Percutaneous Release Right Parietal Bone, Percutaneous Endoscopic Release Left Parietal Bone, Open Release Left Parietal Bone, Percutaneous Release Left Parietal Bone, Percutaneous Endoscopic Release Right Temporal Bone, Open Release Right Temporal Bone, Percutaneous Release Right Temporal Bone, Percutaneous Endoscopic Release Left Temporal Bone, Open Release Left Temporal Bone, Percutaneous Release Left Temporal Bone, Percutaneous Endoscopic Release Right Occipital Bone, Open Release Right Occipital Bone, Percutaneous Release Right Occipital Bone, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 25

0NN80ZZ 0NN83ZZ 0NN84ZZ 0NQ00ZZ 0NQ03ZZ 0NQ04ZZ 0NQ10ZZ 0NQ13ZZ 0NQ14ZZ 0NQ1XZZ 0NQ20ZZ 0NQ23ZZ 0NQ24ZZ 0NQ2XZZ 0NQ30ZZ 0NQ33ZZ 0NQ34ZZ 0NQ3XZZ 0NQ40ZZ 0NQ43ZZ 0NQ44ZZ 0NQ4XZZ 0NQ50ZZ 0NQ53ZZ 0NQ54ZZ 0NQ5XZZ 0NQ60ZZ 0NQ63ZZ 0NQ64ZZ 0NQ6XZZ 0NQ70ZZ 0NQ73ZZ 0NQ74ZZ 0NQ7XZZ 0NQ80ZZ 0NQ83ZZ 0NQ84ZZ 0NQ8XZZ Release Left Occipital Bone, Open Release Left Occipital Bone, Percutaneous Release Left Occipital Bone, Percutaneous Endoscopic Repair Skull, Open Repair Skull, Percutaneous Repair Skull, Percutaneous Endoscopic Repair Right Frontal Bone, Open Repair Right Frontal Bone, Percutaneous Repair Right Frontal Bone, Percutaneous Endoscopic Repair Right Frontal Bone, External Repair Left Frontal Bone, Open Repair Left Frontal Bone, Percutaneous Repair Left Frontal Bone, Percutaneous Endoscopic Repair Left Frontal Bone, External Repair Right Parietal Bone, Open Repair Right Parietal Bone, Percutaneous Repair Right Parietal Bone, Percutaneous Endoscopic Repair Right Parietal Bone, External Repair Left Parietal Bone, Open Repair Left Parietal Bone, Percutaneous Repair Left Parietal Bone, Percutaneous Endoscopic Repair Left Parietal Bone, External Repair Right Temporal Bone, Open Repair Right Temporal Bone, Percutaneous Repair Right Temporal Bone, Percutaneous Endoscopic Repair Right Temporal Bone, External Repair Left Temporal Bone, Open Repair Left Temporal Bone, Percutaneous Repair Left Temporal Bone, Percutaneous Endoscopic Repair Left Temporal Bone, External Repair Right Occipital Bone, Open Repair Right Occipital Bone, Percutaneous Repair Right Occipital Bone, Percutaneous Endoscopic Repair Right Occipital Bone, External Repair Left Occipital Bone, Open Repair Left Occipital Bone, Percutaneous Repair Left Occipital Bone, Percutaneous Endoscopic Repair Left Occipital Bone, External January 1, 2015 through March 31, 2015 (1Q2015) Page 26

0NP00JZ 0NP03JZ 0NP04JZ 009600Z 009630Z 009640Z 03CG0ZZ 05CL0ZZ 05CL4ZZ 03CH0ZZ 03CJ0ZZ 03CK0ZZ 03CL0ZZ 03CM0ZZ 03CN0ZZ 03CP0ZZ 03CQ0ZZ 03CR0ZZ 03CS0ZZ 03CT0ZZ 03CU0ZZ 03CV0ZZ 05CM0ZZ 05CM3ZZ 05CM4ZZ 05CN0ZZ 05CN3ZZ 05CN4ZZ 05CP0ZZ 05CP3ZZ 05CP4ZZ 05CQ0ZZ 05CQ3ZZ 05CQ4ZZ 05CR0ZZ 05CR3ZZ 05CR4ZZ 05CS0ZZ Removal of Synthetic Substitute from Skull, Open Removal of Synthetic Substitute from Skull, Percutaneous Removal of Synthetic Substitute from Skull, Percutaneous Endoscopic Drainage of Cerebral Ventricle with Drainage Device, Open Drainage of Cerebral Ventricle with Drainage Device, Percutaneous Drainage of Cerebral Ventricle with Drainage Device, Percutaneous Endoscopic Extirpation of Matter from Intracranial Artery, Open Extirpation of Matter from Intracranial Vein, Open Extirpation of Matter from Intracranial Vein, Percutaneous Endoscopic Extirpation of Matter from Right Common Carotid Artery, Open Extirpation of Matter from Left Common Carotid Artery, Open Extirpation of Matter from Right Internal Carotid Artery, Open Extirpation of Matter from Left Internal Carotid Artery, Open Extirpation of Matter from Right External Carotid Artery, Open Extirpation of Matter from Left External Carotid Artery, Open Extirpation of Matter from Right Vertebral Artery, Open Extirpation of Matter from Left Vertebral Artery, Open Extirpation of Matter from Face Artery, Open Extirpation of Matter from Right Temporal Artery, Open Extirpation of Matter from Left Temporal Artery, Open Extirpation of Matter from Right Thyroid Artery, Open Extirpation of Matter from Left Thyroid Artery, Open Extirpation of Matter from Right Internal Jugular Vein, Open Extirpation of Matter from Right Internal Jugular Vein, Percutaneous Extirpation of Matter from Right Internal Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Left Internal Jugular Vein, Open Extirpation of Matter from Left Internal Jugular Vein, Percutaneous Extirpation of Matter from Left Internal Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Right External Jugular Vein, Open Extirpation of Matter from Right External Jugular Vein, Percutaneous Extirpation of Matter from Right External Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Left External Jugular Vein, Open Extirpation of Matter from Left External Jugular Vein, Percutaneous Extirpation of Matter from Left External Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Vein, Open Extirpation of Matter from Right Vertebral Vein, Percutaneous Extirpation of Matter from Right Vertebral Vein, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Vein, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 27

05CS3ZZ 05CS4ZZ 03CH0ZZ 03CH4ZZ 03CJ0ZZ 03CJ4ZZ 03CK0ZZ 03CK4ZZ 03CL0ZZ 03CL4ZZ 03CM0ZZ 03CM4ZZ 03CN0ZZ 03CN4ZZ 03CP0ZZ 03CP4ZZ 03CQ0ZZ 03CQ4ZZ 03CS0ZZ 03CS3ZZ 03CS4ZZ 03CT0ZZ 03CT3ZZ 03CT4ZZ 03BY0ZZ 03BY3ZZ 03BY4ZZ 04BY0ZZ 04BY3ZZ 04BY4ZZ 05BY0ZZ 05BY4ZZ 06BY0ZZ 06BY4ZZ 03BG0ZZ 03BG4ZZ 05BL0ZZ 05BL4ZZ Extirpation of Matter from Left Vertebral Vein, Percutaneous Extirpation of Matter from Left Vertebral Vein, Percutaneous Endoscopic Extirpation of Matter from Right Common Carotid Artery, Open Extirpation of Matter from Right Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Common Carotid Artery, Open Extirpation of Matter from Left Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Internal Carotid Artery, Open Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Internal Carotid Artery, Open Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right External Carotid Artery, Open Extirpation of Matter from Right External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left External Carotid Artery, Open Extirpation of Matter from Left External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Artery, Open Extirpation of Matter from Right Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Artery, Open Extirpation of Matter from Left Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Right Temporal Artery, Open Extirpation of Matter from Right Temporal Artery, Percutaneous Extirpation of Matter from Right Temporal Artery, Percutaneous Endoscopic Extirpation of Matter from Left Temporal Artery, Open Extirpation of Matter from Left Temporal Artery, Percutaneous Extirpation of Matter from Left Temporal Artery, Percutaneous Endoscopic Excision of Upper Artery, Open Excision of Upper Artery, Percutaneous Excision of Upper Artery, Percutaneous Endoscopic Excision of Lower Artery, Open Excision of Lower Artery, Percutaneous Excision of Lower Artery, Percutaneous Endoscopic Excision of Upper Vein, Open Excision of Upper Vein, Percutaneous Endoscopic Excision of Lower Vein, Open Excision of Lower Vein, Percutaneous Endoscopic Excision of Intracranial Artery, Open Excision of Intracranial Artery, Percutaneous Endoscopic Excision of Intracranial Vein, Open Excision of Intracranial Vein, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 28

03BH0ZZ 03BH4ZZ 03BJ0ZZ 03BJ4ZZ 03BK0ZZ 03BK4ZZ 03BL0ZZ 03BL4ZZ 03BM0ZZ 03BM4ZZ 03BN0ZZ 03BN4ZZ 03BP0ZZ 03BP4ZZ 03BQ0ZZ 03BQ4ZZ 03BS0ZZ 03BS4ZZ 03BT0ZZ 03BT4ZZ 05BM0ZZ 05BM4ZZ 05BN0ZZ 05BN4ZZ 05BP0ZZ 05BP4ZZ 05BQ0ZZ 05BQ4ZZ 05BR0ZZ 05BR4ZZ 05BS0ZZ 05BS4ZZ 03RG07Z 03RG0JZ 03RG0KZ 03RG47Z 03RG4JZ Excision of Right Common Carotid Artery, Open Excision of Right Common Carotid Artery, Percutaneous Endoscopic Excision of Left Common Carotid Artery, Open Excision of Left Common Carotid Artery, Percutaneous Endoscopic Excision of Right Internal Carotid Artery, Open Excision of Right Internal Carotid Artery, Percutaneous Endoscopic Excision of Left Internal Carotid Artery, Open Excision of Left Internal Carotid Artery, Percutaneous Endoscopic Excision of Right External Carotid Artery, Open Excision of Right External Carotid Artery, Percutaneous Endoscopic Excision of Left External Carotid Artery, Open Excision of Left External Carotid Artery, Percutaneous Endoscopic Excision of Right Vertebral Artery, Open Excision of Right Vertebral Artery, Percutaneous Endoscopic Excision of Left Vertebral Artery, Open Excision of Left Vertebral Artery, Percutaneous Endoscopic Excision of Right Temporal Artery, Open Excision of Right Temporal Artery, Percutaneous Endoscopic Excision of Left Temporal Artery, Open Excision of Left Temporal Artery, Percutaneous Endoscopic Excision of Right Internal Jugular Vein, Open Excision of Right Internal Jugular Vein, Percutaneous Endoscopic Excision of Left Internal Jugular Vein, Open Excision of Left Internal Jugular Vein, Percutaneous Endoscopic Excision of Right External Jugular Vein, Open Excision of Right External Jugular Vein, Percutaneous Endoscopic Excision of Left External Jugular Vein, Open Excision of Left External Jugular Vein, Percutaneous Endoscopic Excision of Right Vertebral Vein, Open Excision of Right Vertebral Vein, Percutaneous Endoscopic Excision of Left Vertebral Vein, Open Excision of Left Vertebral Vein, Percutaneous Endoscopic Replacement of Intracranial Artery with Autologous Tissue Substitute, Open Replacement of Intracranial Artery with Synthetic Substitute, Open Replacement of Intracranial Artery with Nonautologous Tissue Substitute, Open Replacement of Intracranial Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Intracranial Artery with Synthetic Substitute, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 29

03RG4KZ 05RL07Z 05RL0JZ 05RL0KZ 05RL47Z 05RL4JZ 05RL4KZ 03RH07Z 03RH0JZ 03RH0KZ 03RH47Z 03RH4JZ 03RH4KZ 03RJ07Z 03RJ0JZ 03RJ0KZ 03RJ47Z 03RJ4JZ 03RJ4KZ 03RK07Z 03RK0JZ 03RK0KZ 03RK47Z 03RK4JZ 03RK4KZ Replacement of Intracranial Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Intracranial Vein with Autologous Tissue Substitute, Open Replacement of Intracranial Vein with Synthetic Substitute, Open Replacement of Intracranial Vein with Nonautologous Tissue Substitute, Open Replacement of Intracranial Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Intracranial Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Intracranial Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Common Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right Common Carotid Artery with Synthetic Substitute, Open Replacement of Right Common Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right Common Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Common Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Common Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Autologous Tissue Substitute, Open Replacement of Left Common Carotid Artery with Synthetic Substitute, Open Replacement of Left Common Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left Common Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Internal Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right Internal Carotid Artery with Synthetic Substitute, Open Replacement of Right Internal Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right Internal Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Internal Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Internal Carotid Artery with Nonautologous Tissue Substitute, January 1, 2015 through March 31, 2015 (1Q2015) Page 30

03RL07Z 03RL0JZ 03RL0KZ 03RL47Z 03RL4JZ 03RL4KZ 03RM07Z 03RM0JZ 03RM0KZ 03RM47Z 03RM4JZ 03RM4KZ 03RN07Z 03RN0JZ 03RN0KZ 03RN47Z 03RN4JZ 03RN4KZ 03RP07Z 03RP0JZ 03RP0KZ 03RP47Z 03RP4JZ 03RP4KZ Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Autologous Tissue Substitute, Open Replacement of Left Internal Carotid Artery with Synthetic Substitute, Open Replacement of Left Internal Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left Internal Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right External Carotid Artery with Synthetic Substitute, Open Replacement of Right External Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right External Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Autologous Tissue Substitute, Open Replacement of Left External Carotid Artery with Synthetic Substitute, Open Replacement of Left External Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left External Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Autologous Tissue Substitute, Open Replacement of Right Vertebral Artery with Synthetic Substitute, Open Replacement of Right Vertebral Artery with Nonautologous Tissue Substitute, Open Replacement of Right Vertebral Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 31

03RQ07Z 03RQ0JZ 03RQ0KZ 03RQ47Z 03RQ4JZ 03RQ4KZ 05RM07Z 05RM0JZ 05RM0KZ 05RM47Z 05RM4JZ 05RM4KZ 05RN07Z 05RN0JZ 05RN0KZ 05RN47Z 05RN4JZ 05RN4KZ 05RP07Z 05RP0JZ 05RP0KZ 05RP47Z 05RP4JZ 05RP4KZ 05RQ07Z 05RQ0JZ Replacement of Left Vertebral Artery with Autologous Tissue Substitute, Open Replacement of Left Vertebral Artery with Synthetic Substitute, Open Replacement of Left Vertebral Artery with Nonautologous Tissue Substitute, Open Replacement of Left Vertebral Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Internal Jugular Vein with Autologous Tissue Substitute, Open Replacement of Right Internal Jugular Vein with Synthetic Substitute, Open Replacement of Right Internal Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Right Internal Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Internal Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Internal Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Autologous Tissue Substitute, Open Replacement of Left Internal Jugular Vein with Synthetic Substitute, Open Replacement of Left Internal Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Left Internal Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Autologous Tissue Substitute, Open Replacement of Right External Jugular Vein with Synthetic Substitute, Open Replacement of Right External Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Right External Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Autologous Tissue Substitute, Open Replacement of Left External Jugular Vein with Synthetic Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 32

05RQ0KZ 05RQ47Z 05RQ4JZ 05RQ4KZ 05RR07Z 05RR0JZ 05RR0KZ 05RR47Z 05RR4JZ 05RR4KZ 05RS07Z 05RS0JZ 05RS0KZ 05RS47Z 05RS4JZ 05RS4KZ 03LG0CZ 03LG0ZZ 03LG3CZ 03LG3ZZ 03LG4CZ 03LG4ZZ 05LL0CZ 05LL0DZ 05LL0ZZ 05LL3CZ 05LL3DZ 05LL3ZZ 05LL4CZ 05LL4DZ 05LL4ZZ Replacement of Left External Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Left External Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Autologous Tissue Substitute, Open Replacement of Right Vertebral Vein with Synthetic Substitute, Open Replacement of Right Vertebral Vein with Nonautologous Tissue Substitute, Open Replacement of Right Vertebral Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Autologous Tissue Substitute, Open Replacement of Left Vertebral Vein with Synthetic Substitute, Open Replacement of Left Vertebral Vein with Nonautologous Tissue Substitute, Open Replacement of Left Vertebral Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Occlusion of Intracranial Artery with Extraluminal Device, Open Occlusion of Intracranial Artery, Open Occlusion of Intracranial Artery with Extraluminal Device, Percutaneous Occlusion of Intracranial Artery, Percutaneous Occlusion of Intracranial Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Intracranial Artery, Percutaneous Endoscopic Occlusion of Intracranial Vein with Extraluminal Device, Open Occlusion of Intracranial Vein with Intraluminal Device, Open Occlusion of Intracranial Vein, Open Occlusion of Intracranial Vein with Extraluminal Device, Percutaneous Occlusion of Intracranial Vein with Intraluminal Device, Percutaneous Occlusion of Intracranial Vein, Percutaneous Occlusion of Intracranial Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Intracranial Vein, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 33

03LH0CZ 03LH0ZZ 03LH3CZ 03LH3ZZ 03LH4CZ 03LH4ZZ 03LJ0CZ 03LJ0ZZ 03LJ3CZ 03LJ3ZZ 03LJ4CZ 03LJ4ZZ 03LK0CZ 03LK0ZZ 03LK3CZ 03LK3ZZ 03LK4CZ 03LK4ZZ 03LL0CZ 03LL0ZZ 03LL3CZ 03LL3ZZ 03LL4CZ 03LL4ZZ 03LM0CZ 03LM0ZZ 03LM3CZ 03LM3ZZ 03LM4CZ 03LM4ZZ 03LN0CZ 03LN0ZZ 03LN3CZ 03LN3ZZ 03LN4CZ Occlusion of Right Common Carotid Artery with Extraluminal Device, Open Occlusion of Right Common Carotid Artery, Open Occlusion of Right Common Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Right Common Carotid Artery, Percutaneous Occlusion of Right Common Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Common Carotid Artery, Percutaneous Endoscopic Occlusion of Left Common Carotid Artery with Extraluminal Device, Open Occlusion of Left Common Carotid Artery, Open Occlusion of Left Common Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Left Common Carotid Artery, Percutaneous Occlusion of Left Common Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Common Carotid Artery, Percutaneous Endoscopic Occlusion of Right Internal Carotid Artery with Extraluminal Device, Open Occlusion of Right Internal Carotid Artery, Open Occlusion of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Right Internal Carotid Artery, Percutaneous Occlusion of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Internal Carotid Artery, Percutaneous Endoscopic Occlusion of Left Internal Carotid Artery with Extraluminal Device, Open Occlusion of Left Internal Carotid Artery, Open Occlusion of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Left Internal Carotid Artery, Percutaneous Occlusion of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Internal Carotid Artery, Percutaneous Endoscopic Occlusion of Right External Carotid Artery with Extraluminal Device, Open Occlusion of Right External Carotid Artery, Open Occlusion of Right External Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Right External Carotid Artery, Percutaneous Occlusion of Right External Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right External Carotid Artery, Percutaneous Endoscopic Occlusion of Left External Carotid Artery with Extraluminal Device, Open Occlusion of Left External Carotid Artery, Open Occlusion of Left External Carotid Artery with Extraluminal Device, Percutaneous Occlusion of Left External Carotid Artery, Percutaneous Occlusion of Left External Carotid Artery with Extraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 34

03LN4ZZ 03LP0CZ 03LP0ZZ 03LP3CZ 03LP3ZZ 03LP4CZ 03LP4ZZ 03LQ0CZ 03LQ0ZZ 03LQ3CZ 03LQ3ZZ 03LQ4CZ 03LQ4ZZ 03LR0CZ 03LS0CZ 03LS0ZZ 03LS3CZ 03LS3ZZ 03LS4CZ 03LS4ZZ 03LT0CZ 03LT0ZZ 03LT3CZ 03LT3ZZ 03LT4CZ 03LT4ZZ 05LM0CZ 05LM0DZ 05LM0ZZ 05LM3CZ 05LM3DZ 05LM3ZZ 05LM4CZ 05LM4DZ Occlusion of Left External Carotid Artery, Percutaneous Endoscopic Occlusion of Right Vertebral Artery with Extraluminal Device, Open Occlusion of Right Vertebral Artery, Open Occlusion of Right Vertebral Artery with Extraluminal Device, Percutaneous Occlusion of Right Vertebral Artery, Percutaneous Occlusion of Right Vertebral Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Vertebral Artery, Percutaneous Endoscopic Occlusion of Left Vertebral Artery with Extraluminal Device, Open Occlusion of Left Vertebral Artery, Open Occlusion of Left Vertebral Artery with Extraluminal Device, Percutaneous Occlusion of Left Vertebral Artery, Percutaneous Occlusion of Left Vertebral Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Vertebral Artery, Percutaneous Endoscopic Occlusion of Face Artery with Extraluminal Device, Open Occlusion of Right Temporal Artery with Extraluminal Device, Open Occlusion of Right Temporal Artery, Open Occlusion of Right Temporal Artery with Extraluminal Device, Percutaneous Occlusion of Right Temporal Artery, Percutaneous Occlusion of Right Temporal Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Temporal Artery, Percutaneous Endoscopic Occlusion of Left Temporal Artery with Extraluminal Device, Open Occlusion of Left Temporal Artery, Open Occlusion of Left Temporal Artery with Extraluminal Device, Percutaneous Occlusion of Left Temporal Artery, Percutaneous Occlusion of Left Temporal Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Temporal Artery, Percutaneous Endoscopic Occlusion of Right Internal Jugular Vein with Extraluminal Device, Open Occlusion of Right Internal Jugular Vein with Intraluminal Device, Open Occlusion of Right Internal Jugular Vein, Open Occlusion of Right Internal Jugular Vein with Extraluminal Device, Percutaneous Occlusion of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Occlusion of Right Internal Jugular Vein, Percutaneous Occlusion of Right Internal Jugular Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 35

05LM4ZZ 05LN0CZ 05LN0DZ 05LN0ZZ 05LN3CZ 05LN3DZ 05LN3ZZ 05LN4CZ 05LN4DZ 05LN4ZZ 05LP0CZ 05LP0DZ 05LP0ZZ 05LP3CZ 05LP3DZ 05LP3ZZ 05LP4CZ 05LP4DZ 05LP4ZZ 05LQ0CZ 05LQ0DZ 05LQ0ZZ 05LQ3CZ 05LQ3DZ 05LQ3ZZ 05LQ4CZ 05LQ4DZ 05LQ4ZZ 05LR0CZ 05LR0DZ 05LR0ZZ 05LR3CZ 05LR3DZ Occlusion of Right Internal Jugular Vein, Percutaneous Endoscopic Occlusion of Left Internal Jugular Vein with Extraluminal Device, Open Occlusion of Left Internal Jugular Vein with Intraluminal Device, Open Occlusion of Left Internal Jugular Vein, Open Occlusion of Left Internal Jugular Vein with Extraluminal Device, Percutaneous Occlusion of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Occlusion of Left Internal Jugular Vein, Percutaneous Occlusion of Left Internal Jugular Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Left Internal Jugular Vein, Percutaneous Endoscopic Occlusion of Right External Jugular Vein with Extraluminal Device, Open Occlusion of Right External Jugular Vein with Intraluminal Device, Open Occlusion of Right External Jugular Vein, Open Occlusion of Right External Jugular Vein with Extraluminal Device, Percutaneous Occlusion of Right External Jugular Vein with Intraluminal Device, Percutaneous Occlusion of Right External Jugular Vein, Percutaneous Occlusion of Right External Jugular Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Right External Jugular Vein, Percutaneous Endoscopic Occlusion of Left External Jugular Vein with Extraluminal Device, Open Occlusion of Left External Jugular Vein with Intraluminal Device, Open Occlusion of Left External Jugular Vein, Open Occlusion of Left External Jugular Vein with Extraluminal Device, Percutaneous Occlusion of Left External Jugular Vein with Intraluminal Device, Percutaneous Occlusion of Left External Jugular Vein, Percutaneous Occlusion of Left External Jugular Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Left External Jugular Vein, Percutaneous Endoscopic Occlusion of Right Vertebral Vein with Extraluminal Device, Open Occlusion of Right Vertebral Vein with Intraluminal Device, Open Occlusion of Right Vertebral Vein, Open Occlusion of Right Vertebral Vein with Extraluminal Device, Percutaneous Occlusion of Right Vertebral Vein with Intraluminal Device, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 36

05LR3ZZ 05LR4CZ 05LR4DZ 05LR4ZZ 05LS0CZ 05LS0DZ 05LS0ZZ 05LS3CZ 05LS3DZ 05LS3ZZ 05LS4CZ 05LS4DZ 05LS4ZZ 031H09J 031H0AJ 031H0JJ 031H0KJ 031H0ZJ 031J09K 031J0AK 031J0JK 031J0KK 031J0ZK 031K09J 031K0AJ 031K0JJ 031K0KJ 031K0ZJ Occlusion of Right Vertebral Vein, Percutaneous Occlusion of Right Vertebral Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Right Vertebral Vein, Percutaneous Endoscopic Occlusion of Left Vertebral Vein with Extraluminal Device, Open Occlusion of Left Vertebral Vein with Intraluminal Device, Open Occlusion of Left Vertebral Vein, Open Occlusion of Left Vertebral Vein with Extraluminal Device, Percutaneous Occlusion of Left Vertebral Vein with Intraluminal Device, Percutaneous Occlusion of Left Vertebral Vein, Percutaneous Occlusion of Left Vertebral Vein with Extraluminal Device, Percutaneous Endoscopic Occlusion of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Occlusion of Left Vertebral Vein, Percutaneous Endoscopic Bypass Right Common Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right Common Carotid Artery to Right Extracranial Artery, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Common Carotid Artery to Left Extracranial Artery, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 37

031L09K 031L0AK 031L0JK 031L0KK 031L0ZK 031M09J 031M0AJ 031M0JJ 031M0KJ 031M0ZJ 031N09K 031N0AK 031N0JK 031N0KK 031N0ZK 031S09G 031S0AG 031S0JG 031S0KG 031S0ZG 031T09G 031T0AG 031T0JG 031T0KG 031T0ZG Bypass Left Internal Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right External Carotid Artery to Right Extracranial Artery, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left External Carotid Artery to Left Extracranial Artery, Open Bypass Right Temporal Artery to Intracranial Artery with Autologous Venous Tissue, Open Bypass Right Temporal Artery to Intracranial Artery with Autologous Arterial Tissue, Open Bypass Right Temporal Artery to Intracranial Artery with Synthetic Substitute, Open Bypass Right Temporal Artery to Intracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right Temporal Artery to Intracranial Artery, Open Bypass Left Temporal Artery to Intracranial Artery with Autologous Venous Tissue, Open Bypass Left Temporal Artery to Intracranial Artery with Autologous Arterial Tissue, Open Bypass Left Temporal Artery to Intracranial Artery with Synthetic Substitute, Open Bypass Left Temporal Artery to Intracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Temporal Artery to Intracranial Artery, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 38

03VK0CZ 03VK3CZ 03VK4CZ 03VL0CZ 03VL3CZ 03VL4CZ 03LS0DZ 03LS3DZ 03LS4DZ 03LT0DZ 03LT3DZ 03LT4DZ 03CG3ZZ 03CG4ZZ 03CH3ZZ 03CH4ZZ 03CJ3ZZ 03CJ4ZZ 03CK3ZZ 03CK4ZZ 03CL3ZZ 03CL4ZZ 03CM3ZZ 03CM4ZZ 03CN3ZZ 03CN4ZZ 03CP3ZZ 03CP4ZZ 03CQ3ZZ 03CQ4ZZ 03CS3ZZ 03CS4ZZ 03CT3ZZ 03CT4ZZ Restriction of Right Internal Carotid Artery with Extraluminal Device, Open Restriction of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Restriction of Right Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Restriction of Left Internal Carotid Artery with Extraluminal Device, Open Restriction of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Restriction of Left Internal Carotid Artery with Extraluminal Device, Percutaneous Endoscopic Occlusion of Right Temporal Artery with Intraluminal Device, Open Occlusion of Right Temporal Artery with Intraluminal Device, Percutaneous Occlusion of Right Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Occlusion of Left Temporal Artery with Intraluminal Device, Open Occlusion of Left Temporal Artery with Intraluminal Device, Percutaneous Occlusion of Left Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Extirpation of Matter from Intracranial Artery, Percutaneous Extirpation of Matter from Intracranial Artery, Percutaneous Endoscopic Extirpation of Matter from Right Common Carotid Artery, Percutaneous Extirpation of Matter from Right Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Common Carotid Artery, Percutaneous Extirpation of Matter from Left Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right External Carotid Artery, Percutaneous Extirpation of Matter from Right External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left External Carotid Artery, Percutaneous Extirpation of Matter from Left External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Artery, Percutaneous Extirpation of Matter from Right Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Artery, Percutaneous Extirpation of Matter from Left Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Right Temporal Artery, Percutaneous Extirpation of Matter from Right Temporal Artery, Percutaneous Endoscopic Extirpation of Matter from Left Temporal Artery, Percutaneous Extirpation of Matter from Left Temporal Artery, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 39

Table 8.2f Traumatic Brain Injury ICD-10 Code S0190XA S020XXA S020XXB S0210XA S0210XB S0291XA S0291XB S060X0A S06330A S06331A S06332A S06333A S06.334A S06335A S06336A S06337A ICD-10 Code Description Unspecified open wound of unspecified part of head, initial encounter Fracture of vault of skull, initial encounter for closed fracture Fracture of vault of skull, initial encounter for open fracture Unspecified fracture of base of skull, initial encounter for closed fracture Unspecified fracture of base of skull, initial encounter for open fracture Unspecified fracture of skull, initial encounter for closed fracture Unspecified fracture of skull, initial encounter for open fracture Concussion without loss of consciousness, initial encounter Contusion and laceration of cerebrum, unspecified, without loss of consciousness, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Contusion and laceration of cerebrum, unspecified, with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter S06338A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of any duration January 1, 2015 through March 31, 2015 (1Q2015) Page 40

with death due to other cause prior to regaining consciousness, initial encounter S06339A S06360A S06361A S06362A S06363A S06364A S06365A S06366A S06367A S06368A S06369A S06370A S06371A S06372A Contusion and laceration of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter Traumatic hemorrhage of cerebrum, unspecified, without loss of consciousness, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, initial encounter Contusion, laceration, and hemorrhage of cerebellum without loss of consciousness, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 30 minutes or less, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 31 minutes to 59 minutes, initial encounter January 1, 2015 through March 31, 2015 (1Q2015) Page 41

S06373A S06374A S06375A S06376A S06377A S06378A S06379A S06380A S06381A S06382A S06383A S06384A S06385A S06386A Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 6 hours to 24 hours, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of unspecified duration, initial encounter Contusion, laceration, and hemorrhage of brainstem without loss of consciousness, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 30 minutes or less, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 31 minutes to 59 minutes, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 6 hours to 24 hours, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial January 1, 2015 through March 31, 2015 (1Q2015) Page 42

encounter S06387A S06388A S06389A S064X0A S064X1A S064X2A S064X3A S064X4A S064X5A S064X6A S064X7A S064X8A S064X9A S065X0A S065X1A S065X2A Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of unspecified duration, initial encounter Epidural hemorrhage without loss of consciousness, initial encounter Epidural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Epidural hemorrhage with loss of consciousness greater than 24 hours with return to preexisting conscious level, initial encounter Epidural hemorrhage with loss of consciousness greater than 24 hours without return to preexisting conscious level with patient surviving, initial encounter Epidural hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Epidural hemorrhage with loss of consciousness of any duration with death due to other causes prior to regaining consciousness, initial encounter Epidural hemorrhage with loss of consciousness of unspecified duration, initial encounter Traumatic subdural hemorrhage without loss of consciousness, initial encounter Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, January 1, 2015 through March 31, 2015 (1Q2015) Page 43

initial encounter S065X3A S065X4A S065X5A S065X6A S065X7A S065X8A S065X9A S066X0A S066X1A S066X2A S066X3A S066X4A S066X5A S066X6A Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to brain injury before regaining consciousness, initial encounter Traumatic subdural hemorrhage with loss of consciousness of any duration with death due to other cause before regaining consciousness, initial encounter Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, initial encounter Traumatic subarachnoid hemorrhage without loss of consciousness, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter January 1, 2015 through March 31, 2015 (1Q2015) Page 44

S066X7A S066X8A S066X9A S06890A S06891A S06892A S06893A S06894A S06895A S06896A S06897A S06898A S06899A S069X0A S069X1A Traumatic subarachnoid hemorrhage with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, initial encounter Other specified intracranial injury without loss of consciousness, initial encounter Other specified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Other specified intracranial injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Other specified intracranial injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Other specified intracranial injury with loss of consciousness of unspecified duration, initial encounter Unspecified intracranial injury without loss of consciousness, initial encounter Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter January 1, 2015 through March 31, 2015 (1Q2015) Page 45

S069X2A S069X4A S069X5A S069X6A S069X7A S069X8A S069X9A Q280 Q282 I6200 I6201 I6202 I6203 I621 I629 Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter Unspecified intracranial injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter Unspecified intracranial injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter Unspecified intracranial injury with loss of consciousness of unspecified duration, initial encounter Arteriovenous malformation of precerebral vessels Arteriovenous malformation of cerebral vessels Nontraumatic subdural hemorrhage, unspecified Nontraumatic acute subdural hemorrhage Nontraumatic subacute subdural hemorrhage Nontraumatic chronic subdural hemorrhage Nontraumatic extradural hemorrhage Nontraumatic intracranial hemorrhage, unspecified January 1, 2015 through March 31, 2015 (1Q2015) Page 46

Table 8.3 Carotid Intervention Procedures ICD-10 Code 031H09J 031H0AJ 031H0JJ 031H0KJ 031H0ZJ 031J09K 031J0AK 031J0JK 031J0KK 031J0ZK 031K09J 031K0AJ 031K0JJ 031K0KJ ICD-10 Code Description Bypass Right Common Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right Common Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right Common Carotid Artery to Right Extracranial Artery, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left Common Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Common Carotid Artery to Left Extracranial Artery, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right Internal Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 47

031K0ZJ 031L09K 031L0AK 031L0JK 031L0KK 031L0ZK 031M09J 031M0AJ 031M0JJ 031M0KJ 031M0ZJ 031N09K 031N0AK 031N0JK 031N0KK 031N0ZK Bypass Right Internal Carotid Artery to Right Extracranial Artery, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Internal Carotid Artery to Left Extracranial Artery, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Autologous Venous Tissue, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Autologous Arterial Tissue, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Synthetic Substitute, Open Bypass Right External Carotid Artery to Right Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right External Carotid Artery to Right Extracranial Artery, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Autologous Venous Tissue, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Autologous Arterial Tissue, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Synthetic Substitute, Open Bypass Left External Carotid Artery to Left Extracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left External Carotid Artery to Left Extracranial Artery, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 48

031S09G 031S0AG 031S0JG 031S0KG 031S0ZG 031T09G 031T0AG 031T0JG 031T0KG 031T0ZG 037G34Z 037G3DZ 037G3ZZ 037G44Z 037G4DZ 037G4ZZ 037H34Z 037H3DZ Bypass Right Temporal Artery to Intracranial Artery with Autologous Venous Tissue, Open Bypass Right Temporal Artery to Intracranial Artery with Autologous Arterial Tissue, Open Bypass Right Temporal Artery to Intracranial Artery with Synthetic Substitute, Open Bypass Right Temporal Artery to Intracranial Artery with Nonautologous Tissue Substitute, Open Bypass Right Temporal Artery to Intracranial Artery, Open Bypass Left Temporal Artery to Intracranial Artery with Autologous Venous Tissue, Open Bypass Left Temporal Artery to Intracranial Artery with Autologous Arterial Tissue, Open Bypass Left Temporal Artery to Intracranial Artery with Synthetic Substitute, Open Bypass Left Temporal Artery to Intracranial Artery with Nonautologous Tissue Substitute, Open Bypass Left Temporal Artery to Intracranial Artery, Open Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Dilation of Intracranial Artery, Percutaneous Dilation of Intracranial Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Intracranial Artery, Percutaneous Endoscopic Dilation of Right Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 49

037H3ZZ 037H44Z 037H4DZ 037H4ZZ 037J34Z 037J3DZ 037J3ZZ 037J44Z 037J4DZ 037J4ZZ 037K34Z 037K3DZ 037K3ZZ 037K44Z 037K4DZ 037K4ZZ 037L34Z 037L3DZ Dilation of Right Common Carotid Artery, Percutaneous Dilation of Right Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Common Carotid Artery, Percutaneous Endoscopic Dilation of Left Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left Common Carotid Artery, Percutaneous Dilation of Left Common Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Common Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Common Carotid Artery, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right Internal Carotid Artery, Percutaneous Dilation of Right Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Internal Carotid Artery, Percutaneous Endoscopic Dilation of Left Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 50

037L3ZZ 037L44Z 037L4DZ 037L4ZZ 037M34Z 037M3DZ 037M3ZZ 037M44Z 037M4DZ 037M4ZZ 037N34Z 037N3DZ 037N3ZZ 037N44Z 037N4DZ 037N4ZZ 037P34Z 037P3DZ Dilation of Left Internal Carotid Artery, Percutaneous Dilation of Left Internal Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Carotid Artery, Percutaneous Endoscopic Dilation of Right External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Right External Carotid Artery, Percutaneous Dilation of Right External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Carotid Artery, Percutaneous Endoscopic Dilation of Left External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Dilation of Left External Carotid Artery, Percutaneous Dilation of Left External Carotid Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Carotid Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Carotid Artery, Percutaneous Endoscopic Dilation of Right Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 51

037P3ZZ 037P44Z 037P4DZ 037P4ZZ 037Q34Z 037Q3DZ 037Q3ZZ 037Q44Z 037Q4DZ 037Q4ZZ 037R3DZ 037R4DZ 037S3DZ 037S4DZ 037T3DZ 037T4DZ 03BG0ZZ 03BG4ZZ 03BH0ZZ 03BH4ZZ Dilation of Right Vertebral Artery, Percutaneous Dilation of Right Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Artery, Percutaneous Endoscopic Dilation of Left Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Dilation of Left Vertebral Artery, Percutaneous Dilation of Left Vertebral Artery with Drug-eluting Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Artery, Percutaneous Endoscopic Dilation of Face Artery with Intraluminal Device, Percutaneous Dilation of Face Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Temporal Artery with Intraluminal Device, Percutaneous Dilation of Right Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Temporal Artery with Intraluminal Device, Percutaneous Dilation of Left Temporal Artery with Intraluminal Device, Percutaneous Endoscopic Excision of Intracranial Artery, Open Excision of Intracranial Artery, Percutaneous Endoscopic Excision of Right Common Carotid Artery, Open Excision of Right Common Carotid Artery, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 52

03BJ0ZZ 03BJ4ZZ 03BK0ZZ 03BK4ZZ 03BL0ZZ 03BL4ZZ 03BM0ZZ 03BM4ZZ 03BN0ZZ 03BN4ZZ 03BP0ZZ 03BP4ZZ 03BQ0ZZ 03BQ4ZZ 03BR0ZZ 03BR4ZZ 03BS0ZZ 03BS4ZZ 03BT0ZZ 03BT4ZZ 03BU0ZZ 03BU4ZZ 03BV0ZZ Excision of Left Common Carotid Artery, Open Excision of Left Common Carotid Artery, Percutaneous Endoscopic Excision of Right Internal Carotid Artery, Open Excision of Right Internal Carotid Artery, Percutaneous Endoscopic Excision of Left Internal Carotid Artery, Open Excision of Left Internal Carotid Artery, Percutaneous Endoscopic Excision of Right External Carotid Artery, Open Excision of Right External Carotid Artery, Percutaneous Endoscopic Excision of Left External Carotid Artery, Open Excision of Left External Carotid Artery, Percutaneous Endoscopic Excision of Right Vertebral Artery, Open Excision of Right Vertebral Artery, Percutaneous Endoscopic Excision of Left Vertebral Artery, Open Excision of Left Vertebral Artery, Percutaneous Endoscopic Excision of Face Artery, Open Excision of Face Artery, Percutaneous Endoscopic Excision of Right Temporal Artery, Open Excision of Right Temporal Artery, Percutaneous Endoscopic Excision of Left Temporal Artery, Open Excision of Left Temporal Artery, Percutaneous Endoscopic Excision of Right Thyroid Artery, Open Excision of Right Thyroid Artery, Percutaneous Endoscopic Excision of Left Thyroid Artery, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 53

03BV4ZZ 03BY0ZZ 03BY3ZZ 03BY4ZZ 03BY4ZZ 03CG3ZZ 03CH0ZZ 03CH3ZZ 03CH4ZZ 03CJ0ZZ 03CJ3ZZ 03CJ4ZZ 03CK0ZZ 03CK3ZZ 03CK4ZZ 03CL0ZZ 03CL3ZZ 03CL4ZZ 03CM0ZZ 03CM3ZZ 03CM4ZZ 03CN0ZZ 03CN3ZZ Excision of Left Thyroid Artery, Percutaneous Endoscopic Excision of Upper Artery, Open Excision of Upper Artery, Percutaneous Excision of Upper Artery, Percutaneous Endoscopic Excision of Upper Artery, Percutaneous Endoscopic Extirpation of Matter from Intracranial Artery, Percutaneous Extirpation of Matter from Right Common Carotid Artery, Open Extirpation of Matter from Right Common Carotid Artery, Percutaneous Extirpation of Matter from Right Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Common Carotid Artery, Open Extirpation of Matter from Left Common Carotid Artery, Percutaneous Extirpation of Matter from Left Common Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Internal Carotid Artery, Open Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Internal Carotid Artery, Open Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right External Carotid Artery, Open Extirpation of Matter from Right External Carotid Artery, Percutaneous Extirpation of Matter from Right External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Left External Carotid Artery, Open Extirpation of Matter from Left External Carotid Artery, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 54

03CN4ZZ 03CP0ZZ 03CP3ZZ 03CP4ZZ 03CQ0ZZ 03CQ3ZZ 03CQ4ZZ 03CR0ZZ 03CR3ZZ 03CR4ZZ 03CS0ZZ 03CS3ZZ 03CS4ZZ 03CT0ZZ 03CT3ZZ 03CT4ZZ 03CU0ZZ 03CU3ZZ 03CU4ZZ 03CV0ZZ 03CV3ZZ 03CV4ZZ 03JY4ZZ Extirpation of Matter from Left External Carotid Artery, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Artery, Open Extirpation of Matter from Right Vertebral Artery, Percutaneous Extirpation of Matter from Right Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Artery, Open Extirpation of Matter from Left Vertebral Artery, Percutaneous Extirpation of Matter from Left Vertebral Artery, Percutaneous Endoscopic Extirpation of Matter from Face Artery, Open Extirpation of Matter from Face Artery, Percutaneous Extirpation of Matter from Face Artery, Percutaneous Endoscopic Extirpation of Matter from Right Temporal Artery, Open Extirpation of Matter from Right Temporal Artery, Percutaneous Extirpation of Matter from Right Temporal Artery, Percutaneous Endoscopic Extirpation of Matter from Left Temporal Artery, Open Extirpation of Matter from Left Temporal Artery, Percutaneous Extirpation of Matter from Left Temporal Artery, Percutaneous Endoscopic Extirpation of Matter from Right Thyroid Artery, Open Extirpation of Matter from Right Thyroid Artery, Percutaneous Extirpation of Matter from Right Thyroid Artery, Percutaneous Endoscopic Extirpation of Matter from Left Thyroid Artery, Open Extirpation of Matter from Left Thyroid Artery, Percutaneous Extirpation of Matter from Left Thyroid Artery, Percutaneous Endoscopic Inspection of Upper Artery, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 55

03RH07Z 03RH0JZ 03RH0KZ 03RH47Z 03RH4JZ 03RH4KZ 03RJ07Z 03RJ0JZ 03RJ0KZ 03RJ47Z 03RJ4JZ 03RJ4KZ 03RK07Z 03RK0JZ 03RK0KZ 03RK47Z Replacement of Right Common Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right Common Carotid Artery with Synthetic Substitute, Open Replacement of Right Common Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right Common Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Common Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Common Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Autologous Tissue Substitute, Open Replacement of Left Common Carotid Artery with Synthetic Substitute, Open Replacement of Left Common Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left Common Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Common Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Internal Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right Internal Carotid Artery with Synthetic Substitute, Open Replacement of Right Internal Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right Internal Carotid Artery with Autologous Tissue Substitute, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 56

Endoscopic 03RK4JZ 03RK4KZ 03RL07Z 03RL0JZ 03RL0KZ 03RL47Z 03RL4JZ 03RL4KZ 03RM07Z 03RM0JZ 03RM0KZ 03RM47Z 03RM4JZ 03RM4KZ 03RN07Z Replacement of Right Internal Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Internal Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Autologous Tissue Substitute, Open Replacement of Left Internal Carotid Artery with Synthetic Substitute, Open Replacement of Left Internal Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left Internal Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Internal Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Autologous Tissue Substitute, Open Replacement of Right External Carotid Artery with Synthetic Substitute, Open Replacement of Right External Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Right External Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right External Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Autologous Tissue Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 57

03RN0JZ 03RN0KZ 03RN47Z 03RN4JZ 03RN4KZ 03RP07Z 03RP0JZ 03RP0KZ 03RP47Z 03RP4JZ 03RP4KZ 03RQ07Z 03RQ0JZ 03RQ0KZ 03RQ47Z 03RQ4JZ Replacement of Left External Carotid Artery with Synthetic Substitute, Open Replacement of Left External Carotid Artery with Nonautologous Tissue Substitute, Open Replacement of Left External Carotid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left External Carotid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Autologous Tissue Substitute, Open Replacement of Right Vertebral Artery with Synthetic Substitute, Open Replacement of Right Vertebral Artery with Nonautologous Tissue Substitute, Open Replacement of Right Vertebral Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Artery with Autologous Tissue Substitute, Open Replacement of Left Vertebral Artery with Synthetic Substitute, Open Replacement of Left Vertebral Artery with Nonautologous Tissue Substitute, Open Replacement of Left Vertebral Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Artery with Synthetic Substitute, Percutaneous Endoscopic 03RQ4KZ Replacement of Left Vertebral Artery with Nonautologous Tissue Substitute, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 58

Endoscopic 03RR07Z 03RR0JZ 03RR0KZ 03RR47Z 03RR4JZ 03RR4KZ 03RS07Z 03RS0JZ 03RS0KZ 03RS47Z 03RS4JZ 03RS4KZ 03RT07Z 03RT0JZ 03RT0KZ 03RT47Z 03RT4JZ 03RT4KZ Replacement of Face Artery with Autologous Tissue Substitute, Open Replacement of Face Artery with Synthetic Substitute, Open Replacement of Face Artery with Nonautologous Tissue Substitute, Open Replacement of Face Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Face Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Face Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Temporal Artery with Autologous Tissue Substitute, Open Replacement of Right Temporal Artery with Synthetic Substitute, Open Replacement of Right Temporal Artery with Nonautologous Tissue Substitute, Open Replacement of Right Temporal Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Temporal Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Temporal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Temporal Artery with Autologous Tissue Substitute, Open Replacement of Left Temporal Artery with Synthetic Substitute, Open Replacement of Left Temporal Artery with Nonautologous Tissue Substitute, Open Replacement of Left Temporal Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Temporal Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Temporal Artery with Nonautologous Tissue Substitute, Percutaneous January 1, 2015 through March 31, 2015 (1Q2015) Page 59

Endoscopic 03RU07Z 03RU0JZ 03RU0KZ 03RU47Z 03RU4JZ 03RU4KZ 03RV07Z 03RV0JZ 03RV0KZ 03RV47Z 03RV4JZ 03RV4KZ 04BY0ZZ 04BY3ZZ 04BY4ZZ 04JY4ZZ 057L3DZ 057L4DZ Replacement of Right Thyroid Artery with Autologous Tissue Substitute, Open Replacement of Right Thyroid Artery with Synthetic Substitute, Open Replacement of Right Thyroid Artery with Nonautologous Tissue Substitute, Open Replacement of Right Thyroid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Thyroid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Thyroid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Thyroid Artery with Autologous Tissue Substitute, Open Replacement of Left Thyroid Artery with Synthetic Substitute, Open Replacement of Left Thyroid Artery with Nonautologous Tissue Substitute, Open Replacement of Left Thyroid Artery with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Thyroid Artery with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Thyroid Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Excision of Lower Artery, Open Excision of Lower Artery, Percutaneous Excision of Lower Artery, Percutaneous Endoscopic Inspection of Lower Artery, Percutaneous Endoscopic Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Dilation of Intracranial Vein with Intraluminal Device, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 60

057M3DZ 057M4DZ 057N3DZ 057N4DZ 057P3DZ 057P4DZ 057Q3DZ 057Q4DZ 057R3DZ 057R4DZ 057S3DZ 057S4DZ 057T3DZ 057T4DZ 05BL0ZZ 05BL4ZZ 05BM0ZZ 05BM4ZZ 05BN0ZZ 05BN4ZZ 05BP0ZZ Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left Internal Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Right External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Dilation of Left External Jugular Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Right Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Dilation of Left Vertebral Vein with Intraluminal Device, Percutaneous Endoscopic Dilation of Right Face Vein with Intraluminal Device, Percutaneous Dilation of Right Face Vein with Intraluminal Device, Percutaneous Endoscopic Excision of Intracranial Vein, Open Excision of Intracranial Vein, Percutaneous Endoscopic Excision of Right Internal Jugular Vein, Open Excision of Right Internal Jugular Vein, Percutaneous Endoscopic Excision of Left Internal Jugular Vein, Open Excision of Left Internal Jugular Vein, Percutaneous Endoscopic Excision of Right External Jugular Vein, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 61

05BP4ZZ 05BQ0ZZ 05BQ4ZZ 05BR0ZZ 05BR4ZZ 05BS0ZZ 05BS4ZZ 05BT0ZZ 05BT4ZZ 05BV0ZZ 05BV4ZZ 05BY0ZZ 05BY4ZZ 05CL3ZZ 05CM0ZZ 05CM3ZZ 05CM4ZZ 05CN0ZZ 05CN3ZZ 05CN4ZZ 05CP0ZZ 05CP3ZZ 05CP4ZZ Excision of Right External Jugular Vein, Percutaneous Endoscopic Excision of Left External Jugular Vein, Open Excision of Left External Jugular Vein, Percutaneous Endoscopic Excision of Right Vertebral Vein, Open Excision of Right Vertebral Vein, Percutaneous Endoscopic Excision of Left Vertebral Vein, Open Excision of Left Vertebral Vein, Percutaneous Endoscopic Excision of Right Face Vein, Open Excision of Right Face Vein, Percutaneous Endoscopic Excision of Left Face Vein, Open Excision of Left Face Vein, Percutaneous Endoscopic Excision of Upper Vein, Open Excision of Upper Vein, Percutaneous Endoscopic Extirpation of Matter from Intracranial Vein, Percutaneous Extirpation of Matter from Right Internal Jugular Vein, Open Extirpation of Matter from Right Internal Jugular Vein, Percutaneous Extirpation of Matter from Right Internal Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Left Internal Jugular Vein, Open Extirpation of Matter from Left Internal Jugular Vein, Percutaneous Extirpation of Matter from Left Internal Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Right External Jugular Vein, Open Extirpation of Matter from Right External Jugular Vein, Percutaneous Extirpation of Matter from Right External Jugular Vein, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 62

05CQ0ZZ 05CQ3ZZ 05CQ4ZZ 05CR0ZZ 05CR3ZZ 05CR4ZZ 05CS0ZZ 05CS3ZZ 05CS4ZZ 05CT0ZZ 05CT3ZZ 05CT4ZZ 05CV0ZZ 05CV3ZZ 05CV4ZZ 05HY02Z 05HY32Z 05HY42Z 05RM07Z 05RM0JZ 05RM0KZ 05RM47Z Extirpation of Matter from Left External Jugular Vein, Open Extirpation of Matter from Left External Jugular Vein, Percutaneous Extirpation of Matter from Left External Jugular Vein, Percutaneous Endoscopic Extirpation of Matter from Right Vertebral Vein, Open Extirpation of Matter from Right Vertebral Vein, Percutaneous Extirpation of Matter from Right Vertebral Vein, Percutaneous Endoscopic Extirpation of Matter from Left Vertebral Vein, Open Extirpation of Matter from Left Vertebral Vein, Percutaneous Extirpation of Matter from Left Vertebral Vein, Percutaneous Endoscopic Extirpation of Matter from Right Face Vein, Open Extirpation of Matter from Right Face Vein, Percutaneous Extirpation of Matter from Right Face Vein, Percutaneous Endoscopic Extirpation of Matter from Left Face Vein, Open Extirpation of Matter from Left Face Vein, Percutaneous Extirpation of Matter from Left Face Vein, Percutaneous Endoscopic Insertion of Monitoring Device into Upper Vein, Open Insertion of Monitoring Device into Upper Vein, Percutaneous Insertion of Monitoring Device into Upper Vein, Percutaneous Endoscopic Replacement of Right Internal Jugular Vein with Autologous Tissue Substitute, Open Replacement of Right Internal Jugular Vein with Synthetic Substitute, Open Replacement of Right Internal Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Right Internal Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic January 1, 2015 through March 31, 2015 (1Q2015) Page 63

05RM4JZ 05RM4KZ 05RN07Z 05RN0JZ 05RN0KZ 05RN47Z 05RN4JZ 05RN4KZ 05RP07Z 05RP0JZ 05RP0KZ 05RP47Z 05RP4JZ 05RP4KZ 05RQ07Z 05RQ0JZ Replacement of Right Internal Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Internal Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Autologous Tissue Substitute, Open Replacement of Left Internal Jugular Vein with Synthetic Substitute, Open Replacement of Left Internal Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Left Internal Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Internal Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Autologous Tissue Substitute, Open Replacement of Right External Jugular Vein with Synthetic Substitute, Open Replacement of Right External Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Right External Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right External Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Autologous Tissue Substitute, Open Replacement of Left External Jugular Vein with Synthetic Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 64

05RQ0KZ 05RQ47Z 05RQ4JZ 05RQ4KZ 05RR07Z 05RR0JZ 05RR0KZ 05RR47Z 05RR4JZ 05RR4KZ 05RS07Z 05RS0JZ 05RS0KZ 05RS47Z 05RS4JZ 05RS4KZ 05RT07Z Replacement of Left External Jugular Vein with Nonautologous Tissue Substitute, Open Replacement of Left External Jugular Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left External Jugular Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Autologous Tissue Substitute, Open Replacement of Right Vertebral Vein with Synthetic Substitute, Open Replacement of Right Vertebral Vein with Nonautologous Tissue Substitute, Open Replacement of Right Vertebral Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Vertebral Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Autologous Tissue Substitute, Open Replacement of Left Vertebral Vein with Synthetic Substitute, Open Replacement of Left Vertebral Vein with Nonautologous Tissue Substitute, Open Replacement of Left Vertebral Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Vertebral Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Face Vein with Autologous Tissue Substitute, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 65

05RT0JZ 05RT0KZ 05RT47Z 05RT4JZ 05RT4KZ 05RV07Z 05RV0JZ 05RV0KZ 05RV47Z 05RV4JZ 05RV4KZ 069300Z 06930ZZ 069330Z 06933ZZ 069340Z 06934ZZ 06BY0ZZ 06BY4ZZ 06C30ZZ Replacement of Right Face Vein with Synthetic Substitute, Open Replacement of Right Face Vein with Nonautologous Tissue Substitute, Open Replacement of Right Face Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Right Face Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Right Face Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Face Vein with Autologous Tissue Substitute, Open Replacement of Left Face Vein with Synthetic Substitute, Open Replacement of Left Face Vein with Nonautologous Tissue Substitute, Open Replacement of Left Face Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Left Face Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Left Face Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Drainage of Esophageal Vein with Drainage Device, Open Drainage of Esophageal Vein, Open Drainage of Esophageal Vein with Drainage Device, Percutaneous Drainage of Esophageal Vein, Percutaneous Drainage of Esophageal Vein with Drainage Device, Percutaneous Endoscopic Drainage of Esophageal Vein, Percutaneous Endoscopic Excision of Lower Vein, Open Excision of Lower Vein, Percutaneous Endoscopic Extirpation of Matter from Esophageal Vein, Open January 1, 2015 through March 31, 2015 (1Q2015) Page 66

06C33ZZ 06C34ZZ 06R307Z 06R30JZ 06R30KZ 06R347Z 06R34JZ 06R34KZ B3060ZZ B3061ZZ B306YZZ B3070ZZ B3071ZZ B307YZZ B3080ZZ B3081ZZ B308YZZ B30D0ZZ B30D1ZZ B30DYZZ B30F0ZZ Extirpation of Matter from Esophageal Vein, Percutaneous Extirpation of Matter from Esophageal Vein, Percutaneous Endoscopic Replacement of Esophageal Vein with Autologous Tissue Substitute, Open Replacement of Esophageal Vein with Synthetic Substitute, Open Replacement of Esophageal Vein with Nonautologous Tissue Substitute, Open Replacement of Esophageal Vein with Autologous Tissue Substitute, Percutaneous Endoscopic Replacement of Esophageal Vein with Synthetic Substitute, Percutaneous Endoscopic Replacement of Esophageal Vein with Nonautologous Tissue Substitute, Percutaneous Endoscopic Plain Radiography of Right Internal Carotid Artery using High Osmolar Contrast Plain Radiography of Right Internal Carotid Artery using Low Osmolar Contrast Plain Radiography of Right Internal Carotid Artery using Other Contrast Plain Radiography of Left Internal Carotid Artery using High Osmolar Contrast Plain Radiography of Left Internal Carotid Artery using Low Osmolar Contrast Plain Radiography of Left Internal Carotid Artery using Other Contrast Plain Radiography of Bilateral Internal Carotid Arteries using High Osmolar Contrast Plain Radiography of Bilateral Internal Carotid Arteries using Low Osmolar Contrast Plain Radiography of Bilateral Internal Carotid Arteries using Other Contrast Plain Radiography of Right Vertebral Artery using High Osmolar Contrast Plain Radiography of Right Vertebral Artery using Low Osmolar Contrast Plain Radiography of Right Vertebral Artery using Other Contrast Plain Radiography of Left Vertebral Artery using High Osmolar Contrast January 1, 2015 through March 31, 2015 (1Q2015) Page 67

B30F1ZZ B30FYZZ B30G0ZZ B30G1ZZ B30GYZZ B30R0ZZ B30R1ZZ B30RYZZ B30RZZZ B3160ZZ B3161ZZ B316YZZ B3170ZZ B3171ZZ B317YZZ B3180ZZ B3181ZZ B318YZZ B31D0ZZ B31D1ZZ B31DYZZ B31F0ZZ B31F1ZZ Plain Radiography of Left Vertebral Artery using Low Osmolar Contrast Plain Radiography of Left Vertebral Artery using Other Contrast Plain Radiography of Bilateral Vertebral Arteries using High Osmolar Contrast Plain Radiography of Bilateral Vertebral Arteries using Low Osmolar Contrast Plain Radiography of Bilateral Vertebral Arteries using Other Contrast Plain Radiography of Intracranial Arteries using High Osmolar Contrast Plain Radiography of Intracranial Arteries using Low Osmolar Contrast Plain Radiography of Intracranial Arteries using Other Contrast Plain Radiography of Intracranial Arteries Fluoroscopy of Right Internal Carotid Artery using High Osmolar Contrast Fluoroscopy of Right Internal Carotid Artery using Low Osmolar Contrast Fluoroscopy of Right Internal Carotid Artery using Other Contrast Fluoroscopy of Left Internal Carotid Artery using High Osmolar Contrast Fluoroscopy of Left Internal Carotid Artery using Low Osmolar Contrast Fluoroscopy of Left Internal Carotid Artery using Other Contrast Fluoroscopy of Bilateral Internal Carotid Arteries using High Osmolar Contrast Fluoroscopy of Bilateral Internal Carotid Arteries using Low Osmolar Contrast Fluoroscopy of Bilateral Internal Carotid Arteries using Other Contrast Fluoroscopy of Right Vertebral Artery using High Osmolar Contrast Fluoroscopy of Right Vertebral Artery using Low Osmolar Contrast Fluoroscopy of Right Vertebral Artery using Other Contrast Fluoroscopy of Left Vertebral Artery using High Osmolar Contrast Fluoroscopy of Left Vertebral Artery using Low Osmolar Contrast January 1, 2015 through March 31, 2015 (1Q2015) Page 68

B31FYZZ B31G0ZZ B31G1ZZ B31GYZZ B31R0ZZ B31R1ZZ B31RYZZ B31RZZZ Fluoroscopy of Left Vertebral Artery using Other Contrast Fluoroscopy of Bilateral Vertebral Arteries using High Osmolar Contrast Fluoroscopy of Bilateral Vertebral Arteries using Low Osmolar Contrast Fluoroscopy of Bilateral Vertebral Arteries using Other Contrast Fluoroscopy of Intracranial Arteries using High Osmolar Contrast Fluoroscopy of Intracranial Arteries using Low Osmolar Contrast Fluoroscopy of Intracranial Arteries using Other Contrast Fluoroscopy of Intracranial Arteries January 1, 2015 through March 31, 2015 (1Q2015) Page 69

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