Toradol, 15mg J1885 Injection, joint, intermediate 20605

Date of service: Waiver? l Patient name: Insurance: Subscriber name: Address: Group #: Previous balance: Copay: Today s charges: Phone: Account #: Today s payment: check# DOB: Age: Sex: Physician name: Balance due: RANK Office visit New Est RANK Office procedures RANK Laboratory Minimal 99211 Anoscopy 46600 Venipuncture 36415 Problem focused 99201 99212 Audiometry 92551 Blood glucose, monitoring device 82962 Expanded problem focused 99202 99213 Cerumen removal 69210 Blood glucose, visual dipstick 82948 Detailed 99203 99214 Colposcopy 57452 CBC, w/ auto differential 85025 Comprehensive 99204 99215 Colposcopy w/biopsy 57455 CBC, w/o auto differential 85027 Comprehensive (new patient) 99205 ECG, w/interpretation 93000 Cholesterol 82465 Significant, separate service -25-25 ECG, rhythm strip 93040 Hemoccult, guaiac 82270 Well visit New Est Endometrial biopsy 58100 Hemoccult, immunoassay 82274 < 1 y 99381 99391 Flexible sigmoidoscopy 45330 Hemoglobin A1C 85018 1-4 y 99382 99392 Flexible sigmoidoscopy w/biopsy 45331 Lipid panel 80061 5-11 y 99383 99393 Fracture care, cast/splint 29 Liver panel 80076 12-17 y 99384 99394 Site: KOH prep (skin, hair, nails) 87220 18-39 y 99385 99395 Nebulizer 94640 Metabolic panel, basic 80048 40-64 y 99386 99396 Nebulizer demo 94664 Metabolic panel, comprehensive 80053 65 y + 99387 99397 Spirometry 94010 Mononucleosis 86308 Medicare preventive services Spirometry, pre and post 94060 Pregnancy, blood 84703 Pap Q0091 Tympanometry 92567 Pregnancy, urine 81025 Pelvic & breast G0101 Vasectomy 55250 Renal panel 80069 Prostate/PSA G0103 Skin procedures Units Sedimentation rate 85651 Tobacco counseling/3-10 min 99406 Burn care, initial 16000 Strep, rapid 86403 Tobacco counseling/>10 min 99407 Foreign body, skin, simple 10120 Strep culture 87081 Welcome to Medicare exam G0344 Foreign body, skin, complex 10121 Strep A 87880 ECG w/welcome to Medicare exam G0366 I&D, abscess 10060 TB 86580 Flexible sigmoidoscopy G0104 I&D, hematoma/seroma 10140 UA, complete, non-automated 81000 Hemoccult, guaiac G0107 Laceration repair, simple 120 UA, w/o micro, non-automated 81002 Flu shot G0008 Site: Size: UA, w/ micro, non-automated 81003 Pneumonia shot G0009 Laceration repair, layered 120 Urine colony count 87086 Consultation/preop clance Site: Size: Urine culture, presumptive 87088 Expanded problem focused 99242 Lesion, biopsy, one 11100 Wet mount/koh 87210 Detailed 99243 Lesion, biopsy, each add l 11101 Vaccines Comprehensive/mod complexity 99244 Lesion, destruct., benign, 1-14 17110 DT, <7 y 90702 Comprehensive/high complexity 99245 Lesion, destruct., premal., single 17000 DTP 90701 Other services Lesion, destruct., premal., ea. add l 17003 DtaP, <7 y 90700 After posted hours 99050 Lesion, excision, benign 114 Flu, 6-35 months 90657 Evening/weekend appointment 99051 Site: Size: Flu, 3 y + 90658 Home health certification G0180 Lesion, excision, malignant 116 Hep A, adult 90632 Home health recertification G0179 Site: Size: Hep A, ped/adol, 2 dose 90633 Post-op follow-up 99024 Lesion, paring/cutting, one 11055 Hep B, adult 90746 Prolonged/30-74 min 99354 Lesion, paring/cutting, 2-4 11056 Hep B, ped/adol 3 dose 90744 Special reports/forms 99080 Lesion, shave 113 Hep B-Hib 90748 Disability/Workers comp 99455 Site: Size: Hib, 4 dose 90645 Radiology Nail removal, partial 11730 HPV 90649 Nail removal, w/matrix 11750 IPV 90713 Skin tag, 1-15 11200 MMR 90707 Diagnoses Medications Units Pneumonia, >2 y 90732 1 Ampicillin, up to 500mg J0290 Pneumonia conjugate, <5 y 90669 2 B-12, up to 1,000 mcg J3420 Td, >7 y 90718 3 Epinephrine, up to 1ml J0170 Varicella 90716 4 Kenalog, 10mg J3301 Immunizations & Injections Units Next office visit Lidocaine, 10mg J2001 Allergen, one 95115 Recheck Prev PRN D W M Y Normal saline, 1000cc J7030 Allergen, multiple 95117 Instructions: Phenergan, up to 50mg J2550 Imm admin, one 90471 Progesterone, 150mg J1055 Imm admin, each add l 90472 Rocephin, 250mg J0696 Imm admin, intranasal, one 90473 Testosterone, 200mg J1080 Imm admin, intranasal, each add l 90474 Referral Tigan, up to 200 mg J3250 Injection, joint, small 20600 To: Toradol, 15mg J1885 Injection, joint, intermediate 20605 Instructions: Miscellaneous services Injection, joint, major 20610 Injection, ther/proph/diag 90772 Injection, trigger point 20552 Physician signature Supplies X

Infectious & Parasitic Diseases B00.9 Herpesviral infection, A60.9 Anogenital herpesviral infection B02.9 Zoster without complications B27.00 Gammaherpesviral mononucleosis without complication B27.01 Gammaherpesviral mononucleosis with polyneuropathy B27.02 Gammaherpesviral mononucleosis with meningitis B27.09 Gammaherpesviral mononucleosis with other complications B27.10 Cytomegaloviral mononucleosis without complications B27.11 Cytomegaloviral mononucleosis with polyneuropathy B27.12 Cytomegaloviral mononucleosis with meningitis B27.19 Cytomegaloviral mononucleosis with other complication B27.80 Other infectious mononucleosis without complication B27.81 Other infectious mononucleosis with polyneuropathy B27.82 Other infectious mononucleosis with meningitis B27.89 Other infectious mononucleosis with other complication B27.90 Infectious mononucleosis, without complication B27.91 Infectious mononucleosis, with polyneuropathy B27.92 Infectious mononucleosis, with meningitis B27.99 Infectious mononucleosis, with other complication J02.0 Streptococcal pharyngitis J03.00 Acute streptococcal tonsillitis, J03.01 Acute recurrent streptococcal tonsillitis J02.0 Streptococcal sore throat B97.8 Other viral agents as the cause of diseases classified elsewhere B07 Viral warts Neoplasms Benign Neoplasms D49.2 Neoplasm of behavior of bone, soft tissue, and skin D23.9 Other benign neoplasm of skin, Endocrine, Nutritional & Metabolic Disorders Endocrine E10.8 Type 1 diabetes mellitus with complications E10.9 Type 1 diabetes mellitus without complications E11.8 Type 2 diabetes mellitus with complications E11.9 Type 2 diabetes mellitus without complications E05.90 Thyrotoxicosis, without thyrotoxic crisis or storm E03.9 Hypothyroidism, Metabolic/Other M10.9 Gout, E78.0 Pure hypercholesterolemia E78.2 Mixed hyperlipidemia E66.1 Drug-induced obesity E66.9 Obesity, E66.3 Overweight E66.09 Other obesity due to excess calories Blood Diseases D64.9 Anemia, Mental Disorders F41.9 Anxiety disorder, F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type F90.9 Attention-deficit hyperactivity disorder, type F03 Unspecified dementia F33.9 Major depressive disorder, recurrent, Nervous System & Sense Organ Disorders Nervous System Diseases G56.00 Carpal tunnel syndrome, side G56.01 Carpal tunnel syndrome, right side G56.02 Carpal tunnel syndrome, left side G40.90 Epilepsy,, not intractable G40.901 Epilepsy,, not intractable, with status epilepticus G40.909 Epilepsy,, not intractable, without status epilepticus G43.90 Migraine,, not intractable G44.039 Episodic paroxysmal hemicrania, not intractable Episodic paroxysmal hemicrania NOS G44.049 Chronic paroxysmal hemicrania, not intractable Chronic paroxysmal hemicrania NOS Eye Diseases H10.9 Unspecified conjunctivitis H53.10 Unspecified subjective visual disturbances H53.11 Day blindness Ear Diseases H61.20 Impacted cerumen, H61.21 Impacted cerumen, right H61.22 Impacted cerumen, left H61.23 Impacted cerumen, bilateral H60.00 Abscess of external, H60.01 Abscess of right external H60.02 Abscess of left external H60.03 Abscess of external, bilateral H60.10 Cellulitis of external, H60.11 Cellulitis of right external H60.12 Cellulitis of left external H60.13 Cellulitis of external, bilateral H60.311 Diffuse otitis externa, right H60.312 Diffuse otitis externa, left H60.313 Diffuse otitis externa, bilateral H60.319 Diffuse otitis externa, H60.32 Hemorrhagic otitis externa H60.321 Hemorrhagic otitis externa, right H60.322 Hemorrhagic otitis externa, left H60.323 Hemorrhagic otitis externa, bilateral H60.329 Hemorrhagic otitis externa, H60.391 Other infective otitis externa, right H60.392 Other infective otitis externa, left H60.393 Other infective otitis externa, bilateral H60.399 Other infective otitis externa, H66.001 Acute suppurative otitis media without right H66.002 Acute suppurative otitis media without left H66.003 Acute suppurative otitis media without bilateral H66.004 Acute suppurative otitis media without recurrent, right H66.005 Acute suppurative otitis media without recurrent, left H66.006 Acute suppurative otitis media without recurrent, bilateral H66.007 Acute suppurative otitis media without recurrent, H66.009 Acute suppurative otitis media without Circulatory System Arrythmias I48.0 Atrial fibrillation Cardiac I20.8 Other forms of angina pectoris I20.9 Angina pectoris, I25.701 Atherosclerosis of coronary artery bypass graft(s),, with angina pectoris with documented spasm I25.111 Atherosclerotic ht disease of native coronary artery with angina pectoris with documented spasm I25.118 Atherosclerotic ht disease of native coronary artery with other forms of angina pectoris I25.119 Atherosclerotic ht disease of native coronary artery with angina pectoris I25.708 Atherosclerosis of coronary artery bypass graft(s),, with other forms of angina pectoris I25.709 Atherosclerosis of coronary artery bypass graft(s),, with angina pectoris I25.711 Atherosclerosis of autologous vein angina pectoris with documented spasm I25.718 Atherosclerosis of autologous vein other forms of angina pectoris I25.719 Atherosclerosis of autologous vein angina pectoris I25.721 Atherosclerosis of autologous artery angina pectoris with documented spasm I25.728 Atherosclerosis of autologous artery other forms of angina pectoris I25.729 Atherosclerosis of autologous artery angina pectoris I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris I25.751 Atherosclerosis of native coronary artery of transplanted ht with angina pectoris with documented spasm I25.758 Atherosclerosis of native coronary artery of transplanted ht with other forms of angina pectoris I25.759 Atherosclerosis of native coronary artery of transplanted ht with angina pectoris I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted ht with angina pectoris with documented spasm 2

I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted ht with other forms of angina pectoris I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted ht with angina pectoris I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris I25.799 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris I50.9 Ht failure, I35.0 Nonrheumatic aortic (valve) stenosis I35.1 Nonrheumatic aortic (valve) insufficiency I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency I35.8 Other nonrheumatic aortic valve disorders I35.9 Nonrheumatic aortic valve disorder, I39 Endocarditis and ht valve disorders in diseases classified elsewhere I25.9 Chronic ischemic ht disease, Vascular R03.0 Elevated blood-pressure reading, without diagnosis of hypertension I10 Essential (primary) hypertension I95.1 Orthostatic hypotension I73.9 Peripheral vascular disease, I80.9 Phlebitis and thrombophlebitis of site I87.2 Venous insufficiency (chronic) (peripheral) I87.9 Disorder of vein, Respiratory System Lower Respiratory Tract J45.909 Unspecified asthma, uncomplicated J45.998 Other asthma J20.0 Acute bronchitis due to Mycoplasma pneumoniae J20.1 Acute bronchitis due to Hemophilus influenzae J20.2 Acute bronchitis due to streptococcus J20.3 Acute bronchitis due to coxsackievirus J20.4 Acute bronchitis due to parainfluenza virus J20.5 Acute bronchitis due to respiratory syncytial virus J20.6 Acute bronchitis due to rhinovirus J20.7 Acute bronchitis due to echovirus J20.8 Acute bronchitis due to other specified organisms J20.9 Acute bronchitis, J44.9 Chronic obstructive pulmonary disease, J18.8 Other pneumonia, organism J18.9 Pneumonia, organism Upper Respiratory Tract J02.8 Acute pharyngitis due to other specified organisms J02.9 Acute pharyngitis, J30.0 Vasomotor rhinitis J30.9 Allergic rhinitis, J01.90 Acute sinusitis, J01.91 Acute recurrent sinusitis, J01.80 Other acute sinusitis J01.81 Other acute recurrent sinusitis J06.9 Acute upper respiratory infection, Digestive System K92.1 Melena K59.00 Constipation, K57.30 Diverticulosis of large intestine without perforation or abscess without bleeding K57.50 Diverticulosis of both small and large intestine without perforation or abscess without bleeding K57.90 Diverticulosis of intestine, part, without perforation or abscess without bleeding K57.20 Diverticulitis of large intestine with perforation and abscess without bleeding K57.40 Diverticulitis of both small and large intestine with perforation and abscess without bleeding K57.52 Diverticulitis of both small and large intestine without perforation or abscess without bleeding K57.80 Diverticulitis of intestine, part, with perforation and abscess without bleeding K57.92 Diverticulitis of intestine, part, without perforation or abscess without bleeding K29.70 Gastritis,, without bleeding K29.90 Gastroduodenitis,, without bleeding K52.8 Other specified noninfective gastroenteritis and colitis K52.9 Noninfective gastroenteritis and colitis, K21.9 Gastro-esophageal reflux disease without esophagitis I84.20 Unspecified hemorrhoids without complication K58.0 Irritable bowel syndrome with diarrhea K58.9 Irritable bowel syndrome without diarrhea Genitourinary System Urinary System Diseases N20.2 Calculus of kidney with calculus of ureter N20.9 Urinary calculus, N30.00 Acute cystitis without hematuria N30.01 Acute cystitis with hematuria R31.0 Gross hematuria R31.1 Benign essential microscopic hematuria R31.2 Other microscopic hematuria R31.9 Hematuria, N28.9 Disorder of kidney and ureter, N29 Other disorders of kidney and ureter in diseases classified elsewhere N39.0 Urinary tract infection, site not specified Male Genital Organ Diseases N52.01 Erectile dysfunction due to arterial insufficiency N52.02 Corporo-venous occlusive erectile dysfunction N52.03 Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction N52.1 Erectile dysfunction due to diseases classified elsewhere N52.2 Drug-induced erectile dysfunction N52.31 Erectile dysfunction following radical prostatectomy N52.32 Erectile dysfunction following radical cystectomy N52.33 Erectile dysfunction following urethral surgery N52.34 Erectile dysfunction following simple prostatectomy N52.39 Other post-surgical erectile dysfunction N53.8 Other male sexual dysfunction N53.9 Unspecified male sexual dysfunction F52.21 Male erectile disorder N41.9 Inflammatory disease of prostate, Breast Diseases N63 Unspecified lump in breast Female Genital Organ Diseases Z87.44 Personal history of cervical dysplasia N72 Inflammatory disease of cervix uteri N87.9 Dysplasia of cervix uteri, N76.0 Acute vaginitis N76.1 Subacute and chronic vaginitis N76.2 Acute vulvitis N76.3 Subacute and chronic vulvitis N76.4 Abscess of vulva Disorders of Menstruation N91.0 Primary amenorrhea N91.1 Secondary amenorrhea N91.2 Amenorrhea, N95.9 Unspecified menopausal and perimenopausal disorder N92.0 Excessive and frequent menstruation with regular cycle N92.1 Excessive and frequent menstruation with irregular cycle N94.4 Primary dysmenorrhea N94.5 Secondary dysmenorrhea N94.6 Dysmenorrhea, N92.1 Excessive and frequent menstruation with irregular cycle Pregnancy, Childbirth O46.90 Antepartum hemorrhage,, trimester Z39.2 Encounter for routine postpartum follow-up Z33.1 Pregnant state, incidental Z34.00 Encounter for supervision of normal first pregnancy, trimester Z34.01 Encounter for supervision of normal first pregnancy, trimester Z34.02 Encounter for supervision of normal first pregnancy, second trimester Z34.03 Encounter for supervision of normal first pregnancy, third trimester V22.1 Prenatal care, normal, other pregnancy Z34.80 Encounter for supervision of other normal pregnancy, trimester Z34.81 Encounter for supervision of other normal pregnancy, first trimester Z34.82 Encounter for supervision of other normal pregnancy, second trimester Z34.83 Encounter for supervision of other normal pregnancy, third trimester Z34.90 Encounter for supervision of normal pregnancy,, trimester Z34.91 Encounter for supervision of normal pregnancy,, first trimester Z34.92 Encounter for supervision of normal pregnancy,, second trimester Z34.93 Encounter for supervision of normal pregnancy,, third trimester Skin, Subcutaneous Tissue L70.0 Acne vulgaris L70.1 Acne conglobata L70.3 Acne tropica L70.4 Infantile acne L70.5 Acné excoriée des jeunes filles L70.8 Other acne L70.9 Acne, L73.0 Acne keloid L57.0 Actinic keratosis L03.90 Cellulitis, L03.91 Acute lymphangitis, 3

L03.129 Acute lymphangitis of part of limb L03.119 Cellulitis of part of limb L98.3 Eosinophilic cellulitis [Wells] L23.9 Allergic contact dermatitis, cause L24.9 Irritant contact dermatitis, cause L25.9 Unspecified contact dermatitis, cause L30.0 Nummular dermatitis L30.2 Cutaneous autosensitization L30.8 Other specified dermatitis L30.9 Dermatitis, L20.8 Other atopic dermatitis L20.81 Atopic neurodermatitis L20.82 Flexural eczema L20.83 Infantile (acute) (chronic) eczema L20.84 Intrinsic (allergic) eczema L20.89 Other atopic dermatitis L20.9 Atopic dermatitis, L21.8 Other seborrheic dermatitis L60.0 Ingrowing nail B35.1 Tinea unguium L44.9 Papulosquamous disorder, L45 Papulosquamous disorders in diseases classified elsewhere L98.9 Disorder of the skin and subcutaneous tissue, L40.0 Psoriasis vulgaris L40.1 Generalized pustular psoriasis L40.2 Acrodermatitis continua L40.3 Pustulosis palmaris et plantaris L40.4 Guttate psoriasis L40.8 Other psoriasis L40.9 Psoriasis, L71.0 Perioral dermatitis L71.1 Rhinophyma L71.8 Other rosacea L71.9 Rosacea, L72.0 Epidermal cyst L72.1 Trichodermal cyst L72.2 Steatocystoma multiplex L72.8 Other follicular cysts of the skin and subcutaneous tissue L72.9 Follicular cyst of the skin and subcutaneous tissue, L82.0 Inflamed seborrheic keratosis L82.1 Other seborrheic keratosis L98.491 Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin L98.492 Non-pressure chronic ulcer of skin of other sites with fat layer exposed L98.493 Non-pressure chronic ulcer of skin of other sites with necrosis of muscle L98.494 Non-pressure chronic ulcer of skin of other sites with necrosis of bone L98.499 Non-pressure chronic ulcer of skin of other sites with severity L50.9 Urticaria, Musculoskeletal & Connective Tissue General M12.9 Arthropathy, M60.80 Other myositis, site M60.811 Other myositis, right M60.812 Other myositis, left M60.819 Other myositis, M60.821 Other myositis, right upper arm M60.822 Other myositis, left upper arm M60.829 Other myositis, upper arm M60.831 Other myositis, right form M60.832 Other myositis, left form M60.839 Other myositis, form M60.841 Other myositis, right hand M60.842 Other myositis, left hand M60.849 Other myositis, hand M60.851 Other myositis, right thigh M60.852 Other myositis, left thigh M60.859 Other myositis, thigh M60.861 Other myositis, right lower leg M60.862 Other myositis, left lower leg M60.869 Other myositis, lower leg M60.871 Other myositis, right ankle and foot M60.872 Other myositis, left ankle and foot M60.879 Other myositis, ankle and foot M60.88 Other myositis, Other site M60.89 Other myositis, multiple sites M60.9 Myositis, M79.1 Myalgia M79.7 Fibromyalgia M15.9 Polyosteoarthritis, M19.90 Unspecified osteoarthritis, site M81.8 Other osteoporosis without current pathological fracture M05.70 Rheumatoid arthritis with rheumatoid factor of site without organ or M05.71 Rheumatoid arthritis with rheumatoid factor of without organ or M05.711 Rheumatoid arthritis with rheumatoid factor of right without organ or M05.712 Rheumatoid arthritis with rheumatoid factor of left without organ or M05.719 Rheumatoid arthritis with rheumatoid factor of without organ or M05.721 Rheumatoid arthritis with rheumatoid factor of right elbow without organ or M05.722 Rheumatoid arthritis with rheumatoid factor of left elbow without organ or M05.729 Rheumatoid arthritis with rheumatoid factor of elbow without organ or M05.73 Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement M05.731 Rheumatoid arthritis with rheumatoid factor of right wrist without organ or M05.732 Rheumatoid arthritis with rheumatoid factor of left wrist without organ or M05.739 Rheumatoid arthritis with rheumatoid factor of wrist without organ or M05.74 Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement M05.741 Rheumatoid arthritis with rheumatoid factor of right hand without organ or M05.742 Rheumatoid arthritis with rheumatoid factor of left hand without organ or M05.749 Rheumatoid arthritis with rheumatoid factor of hand without organ or M05.75 Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement M05.751 Rheumatoid arthritis with rheumatoid factor of right hip without organ or M05.752 Rheumatoid arthritis with rheumatoid factor of left hip without organ or M05.759 Rheumatoid arthritis with rheumatoid factor of hip without organ or M05.76 Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement M05.761 Rheumatoid arthritis with rheumatoid factor of right knee without organ or M05.762 Rheumatoid arthritis with rheumatoid factor of left knee without organ or M05.769 Rheumatoid arthritis with rheumatoid factor of knee without organ or M05.77 Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or M05.771 Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or M05.772 Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or M05.779 Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or M05.79 Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or M05.80 Other rheumatoid arthritis with rheumatoid factor of site M05.811 Other rheumatoid arthritis with rheumatoid factor of right M05.812 Other rheumatoid arthritis with rheumatoid factor of left M05.819 Other rheumatoid arthritis with rheumatoid factor of M05.82 Other rheumatoid arthritis with rheumatoid factor of elbow M05.821 Other rheumatoid arthritis with rheumatoid factor of right elbow M05.822 Other rheumatoid arthritis with rheumatoid factor of left elbow M05.829 Other rheumatoid arthritis with rheumatoid factor of elbow M05.83 Other rheumatoid arthritis with rheumatoid factor of wrist M05.831 Other rheumatoid arthritis with rheumatoid factor of right wrist M05.832 Other rheumatoid arthritis with rheumatoid factor of left wrist M05.839 Other rheumatoid arthritis with rheumatoid factor of wrist M05.84 Other rheumatoid arthritis with rheumatoid factor of hand M05.841 Other rheumatoid arthritis with rheumatoid factor of right hand M05.842 Other rheumatoid arthritis with rheumatoid factor of left hand M05.849 Other rheumatoid arthritis with rheumatoid factor of hand M05.85 Other rheumatoid arthritis with rheumatoid factor of hip M05.851 Other rheumatoid arthritis with rheumatoid factor of right hip M05.852 Other rheumatoid arthritis with rheumatoid factor of left hip M05.859 Other rheumatoid arthritis with rheumatoid factor of hip M05.86 Other rheumatoid arthritis with rheumatoid factor of knee M05.861 Other rheumatoid arthritis with rheumatoid factor of right knee M05.862 Other rheumatoid arthritis with rheumatoid factor of left knee M05.869 Other rheumatoid arthritis with rheumatoid factor of knee M05.87 Other rheumatoid arthritis with rheumatoid factor of ankle and foot 4

M05.871 Other rheumatoid arthritis with rheumatoid factor of right ankle and foot M05.872 Other rheumatoid arthritis with rheumatoid factor of left ankle and foot M05.879 Other rheumatoid arthritis with rheumatoid factor of ankle and foot M05.89 Other rheumatoid arthritis with rheumatoid factor of multiple sites M05.9 Rheumatoid arthritis with rheumatoid factor, M06.00 Rheumatoid arthritis without rheumatoid factor, site M06.01 Rheumatoid arthritis without rheumatoid factor, M06.011 Rheumatoid arthritis without rheumatoid factor, right M06.012 Rheumatoid arthritis without rheumatoid factor, left M06.019 Rheumatoid arthritis without rheumatoid factor, M06.021 Rheumatoid arthritis without rheumatoid factor, right elbow M06.022 Rheumatoid arthritis without rheumatoid factor, left elbow M06.029 Rheumatoid arthritis without rheumatoid factor, elbow M06.03 Rheumatoid arthritis without rheumatoid factor, wrist M06.031 Rheumatoid arthritis without rheumatoid factor, right wrist M06.032 Rheumatoid arthritis without rheumatoid factor, left wrist M06.039 Rheumatoid arthritis without rheumatoid factor, wrist M06.04 Rheumatoid arthritis without rheumatoid factor, hand M06.041 Rheumatoid arthritis without rheumatoid factor, right hand M06.042 Rheumatoid arthritis without rheumatoid factor, left hand M06.049 Rheumatoid arthritis without rheumatoid factor, hand M06.05 Rheumatoid arthritis without rheumatoid factor, hip M06.051 Rheumatoid arthritis without rheumatoid factor, right hip M06.052 Rheumatoid arthritis without rheumatoid factor, left hip M06.059 Rheumatoid arthritis without rheumatoid factor, hip M06.06 Rheumatoid arthritis without rheumatoid factor, knee M06.061 Rheumatoid arthritis without rheumatoid factor, right knee M06.062 Rheumatoid arthritis without rheumatoid factor, left knee M06.069 Rheumatoid arthritis without rheumatoid factor, knee M06.07 Rheumatoid arthritis without rheumatoid factor, ankle and foot M06.071 Rheumatoid arthritis without rheumatoid factor, right ankle and foot M06.072 Rheumatoid arthritis without rheumatoid factor, left ankle and foot M06.079 Rheumatoid arthritis without rheumatoid factor, ankle and foot M06.08 Rheumatoid arthritis without rheumatoid factor, vertebrae M06.09 Rheumatoid arthritis without rheumatoid factor, multiple sites M06.1 Adult-onset Still's disease M06.2 Rheumatoid bursitis M06.20 Rheumatoid bursitis, site M06.21 Rheumatoid bursitis, M06.211 Rheumatoid bursitis, right M06.212 Rheumatoid bursitis, left M06.219 Rheumatoid bursitis, M06.22 Rheumatoid bursitis, elbow M06.221 Rheumatoid bursitis, right elbow M06.222 Rheumatoid bursitis, left elbow M06.229 Rheumatoid bursitis, elbow M06.23 Rheumatoid bursitis, wrist M06.231 Rheumatoid bursitis, right wrist M06.232 Rheumatoid bursitis, left wrist M06.239 Rheumatoid bursitis, wrist M06.24 Rheumatoid bursitis, hand M06.241 Rheumatoid bursitis, right hand M06.242 Rheumatoid bursitis, left hand M06.249 Rheumatoid bursitis, hand M06.25 Rheumatoid bursitis, hip M06.251 Rheumatoid bursitis, right hip M06.252 Rheumatoid bursitis, left hip M06.259 Rheumatoid bursitis, hip M06.26 Rheumatoid bursitis, knee M06.261 Rheumatoid bursitis, right knee M06.262 Rheumatoid bursitis, left knee M06.269 Rheumatoid bursitis, knee M06.27 Rheumatoid bursitis, ankle and foot M06.271 Rheumatoid bursitis, right ankle and foot M06.272 Rheumatoid bursitis, left ankle and foot M06.279 Rheumatoid bursitis, ankle and foot M06.28 Rheumatoid bursitis, vertebrae M06.29 Rheumatoid bursitis, multiple sites M06.30 Rheumatoid nodule, site M06.31 Rheumatoid nodule, M06.311 Rheumatoid nodule, right M06.312 Rheumatoid nodule, left M06.319 Rheumatoid nodule, M06.32 Rheumatoid nodule, elbow M06.321 Rheumatoid nodule, right elbow M06.322 Rheumatoid nodule, left elbow M06.329 Rheumatoid nodule, elbow M06.33 Rheumatoid nodule, wrist M06.331 Rheumatoid nodule, right wrist M06.332 Rheumatoid nodule, left wrist M06.339 Rheumatoid nodule, wrist M06.34 Rheumatoid nodule, hand M06.341 Rheumatoid nodule, right hand M06.342 Rheumatoid nodule, left hand M06.349 Rheumatoid nodule, hand M06.352 Rheumatoid nodule, left hip M06.359 Rheumatoid nodule, hip M06.36 Rheumatoid nodule, knee M06.361 Rheumatoid nodule, right knee M06.362 Rheumatoid nodule, left knee M06.369 Rheumatoid nodule, knee M06.37 Rheumatoid nodule, ankle and foot M06.371 Rheumatoid nodule, right ankle and foot M06.372 Rheumatoid nodule, left ankle and foot M06.379 Rheumatoid nodule, ankle and foot M06.38 Rheumatoid nodule, vertebrae M06.39 Rheumatoid nodule, multiple sites M06.80 Other specified rheumatoid arthritis, site M06.81 Other specified rheumatoid arthritis, M06.811 Other specified rheumatoid arthritis, right M06.812 Other specified rheumatoid arthritis, left M06.819 Other specified rheumatoid arthritis, M06.82 Other specified rheumatoid arthritis, elbow M06.821 Other specified rheumatoid arthritis, right elbow M06.822 Other specified rheumatoid arthritis, left elbow M06.829 Other specified rheumatoid arthritis, elbow M06.83 Other specified rheumatoid arthritis, wrist M06.831 Other specified rheumatoid arthritis, right wrist M06.832 Other specified rheumatoid arthritis, left wrist M06.839 Other specified rheumatoid arthritis, wrist M06.84 Other specified rheumatoid arthritis, hand M06.841 Other specified rheumatoid arthritis, right hand M06.842 Other specified rheumatoid arthritis, left hand M06.849 Other specified rheumatoid arthritis, hand M06.85 Other specified rheumatoid arthritis, hip M06.851 Other specified rheumatoid arthritis, right hip M06.852 Other specified rheumatoid arthritis, left hip M06.859 Other specified rheumatoid arthritis, hip M06.86 Other specified rheumatoid arthritis, knee M06.861 Other specified rheumatoid arthritis, right knee M06.862 Other specified rheumatoid arthritis, left knee M06.869 Other specified rheumatoid arthritis, knee M06.87 Other specified rheumatoid arthritis, ankle and foot M06.871 Other specified rheumatoid arthritis, right ankle and foot M06.872 Other specified rheumatoid arthritis, left ankle and foot M06.879 Other specified rheumatoid arthritis, ankle and foot M06.88 Other specified rheumatoid arthritis, M06.89 Other specified rheumatoid arthritis, multiple sites M06.9 Rheumatoid arthritis, M65.9 Synovitis and tenosynovitis, Lower Extremity M79.601 Pain in right arm M79.602 Pain in left arm M79.603 Pain in arm, M79.604 Pain in right leg M79.605 Pain in left leg M79.606 Pain in leg, M79.609 Pain in limb M79.621 Pain in right upper arm M79.622 Pain in left upper arm M79.629 Pain in upper arm M79.631 Pain in right form M79.632 Pain in left form M79.639 Pain in form M79.641 Pain in right hand M79.642 Pain in left hand M79.643 Pain in hand M79.644 Pain in right finger(s) M79.645 Pain in left finger(s) M79.646 Pain in (s) M79.651 Pain in right thigh M79.652 Pain in left thigh M79.659 Pain in thigh M79.661 Pain in right lower leg M79.662 Pain in left lower leg M79.669 Pain in lower leg M79.671 Pain in right foot M79.672 Pain in left foot M79.673 Pain in foot M79.674 Pain in right toe(s) M79.675 Pain in left toe(s) M79.676 Pain in toe(s) 5

Spine/Torso M54.14 Radiculopathy, thoracic region M54.15 Radiculopathy, thoracolumbar region M54.16 Radiculopathy, lumbar region M54.17 Radiculopathy, lumbosacral region M51.14 Intervertebral disc disorders with radiculopathy, thoracic region M51.15 Intervertebral disc disorders with radiculopathy, thoracolumbar region M51.16 Intervertebral disc disorders with radiculopathy, lumbar region M51.17 Intervertebral disc disorders with radiculopathy, lumbosacral region M53.9 Dorsopathy, Upper Extremity M75.10 Rotator cuff syndrome, M75.11 Rotator cuff syndrome, right M75.12 Rotator cuff syndrome, left Perinatal (Infant) P92.0 Vomiting of newborn P92.1 Regurgitation and rumination of newborn P92.2 Slow feeding of newborn P92.3 Underfeeding of newborn P92.4 Overfeeding of newborn P92.5 Neonatal difficulty in feeding at breast P92.8 Other feeding problems of newborn P92.9 Feeding problem of newborn, Signs & Symptoms R10.0 Acute abdomen R10.83 Colic R10.9 Unspecified abdominal pain R87.619 Unspecified abnormal cytological findings in specimens from cervix uteri M25.50 Pain in joint K62.5 Hemorrhage of anus and rectum R07.81 Pleurodynia R07.82 Intercostal pain R07.89 Other chest pain R07.9 Chest pain, R05 Cough R19.7 Diarrhea, R42 Dizziness and giddiness R13.10 Dysphagia, R13.11 Dysphagia, oral phase R13.12 Dysphagia, oropharyngeal phase R13.13 Dysphagia, pharyngeal phase R13.14 Dysphagia, pharyngoesophageal phase R13.19 Other dysphagia R30.0 Dysuria R30.9 Painful micturition, R60.0 Localized edema R60.1 Generalized edema R60.9 Edema, R63.3 Feeding difficulties R50.2 Drug induced fever R50.8 Other specified fever R50.9 Fever, E74.9 Disorder of carbohydrate metabolism, G44.10 Vascular headache, not elsewhere classified, not intractable G44.11 Vascular headache, not elsewhere classified, intractable G44.301 Post-traumatic headache,, intractable G44.309 Post-traumatic headache,, not intractable G44.311 Acute post-traumatic headache, intractable G44.319 Acute post-traumatic headache, not Intractable G44.321 Chronic post-traumatic headache, intractable G44.329 Chronic post-traumatic headache, not intractable G44.40 Drug-induced headache, not elsewhere classified, not intractable G44.41 Drug-induced headache, not elsewhere classified, intractable G44.51 Hemicrania continua G44.52 New daily persistent headache (NDPH) G44.53 Primary thunderclap headache G44.59 Other complicated headache syndrome G44.81 Hypnic headache G44.82 Headache associated with sexual activity G44.83 Primary cough headache G44.84 Primary exertional headache G44.85 Primary stabbing headache G44.89 Other headache syndrome R32 Unspecified urinary incontinence R22.0 Localized swelling, mass and lump, head R22.1 Localized swelling, mass and lump, neck R22.2 Localized swelling, mass and lump, trunk R22.30 Localized swelling, mass and lump, upper limb, side R22.31 Localized swelling, mass and lump, right upper limb R22.32 Localized swelling, mass and lump, left upper limb R22.33 Localized swelling, mass and lump, upper limb, bilateral R22.40 Localized swelling, mass and lump, lower limb, side R22.41 Localized swelling, mass and lump, right lower limb R22.42 Localized swelling, mass and lump, left lower limb R22.43 Localized swelling, mass and lump, lower limb, bilateral R22.9 Localized swelling, mass and lump, R59.0 Localized enlarged lymph nodes R59.1 Generalized enlarged lymph nodes R59.9 Enlarged lymph nodes, R53.0 Neoplastic (malignant) related fatigue R53.1 Weakness R53.2 Functional quadriplegia R53.81 Other malaise R53.83 Other fatigue G93.3 Postviral fatigue syndrome R11.1 Nausea alone R11.0 Nausea with vomiting M25.561 Pain in right knee M25.562 Pain in left knee M25.569 Pain in knee M54.5 Low back pain R00.2 Palpitations R35.8 Other polyuria R21 Rash and other nonspecific skin eruption R20.1 Hypoesthesia of skin R20.2 Paresthesia of skin R20.3 Hyperesthesia R20.8 Other disturbances of skin sensation R20.9 Unspecified disturbances of skin sensation R06.02 Shortness of breath R55 Syncope and collapse R35.0 Frequency of micturition R11.2 Projectile vomiting R11.3 Other vomiting without nausea R63.4 Abnormal weight loss Injuries & Adverse Effects Dislocations, Sprains & Strains S93.409A Sprain of ligament of ankle; initial S93.409D Sprain of ligament of ankle; subsequent S96.919A Strain of muscle and tendon at ankle and foot level, side; initial S96.919D Strain of muscle and tendon at ankle and foot level, side; subsequent S93.609A Unspecified sprain of foot; initial S93.609D Unspecified sprain of foot; subsequent S63.90A Initial ; Sprain of part of wrist and hand S63.90D Subsequent ; Sprain of part of wrist and hand S63.509A Initial ; Unspecified sprain of wrist S63.509D Subsequent ; Unspecified sprain of wrist S66.919A Strain of muscle, fascia and tendon at wrist and hand level of side; Initial S66.919D Strain of muscle, fascia and tendon at wrist and hand level of side; Subsequent S83.90A Initial ; Sprain of site of knee, side S83.90D Subsequent ; Sprain of site of knee, S86.919A Initial ; Strain of muscle(s) and tendon(s) at lower leg level, leg S86.919D Subsequent ; Strain of muscle(s) and tendon(s) at lower leg level, leg S16.1A Initial ; Strain of muscle, fascia and tendon at neck level S16.1D Subsequent ; Strain of muscle, fascia and tendon at neck level S13.4A Initial ; Sprain of ligaments of cervical spine S13.4D Subsequent ; Sprain of ligaments of cervical spine S13.8A Initial ; Sprain of joints and S13.8D ligaments of other parts of neck Subsequent ; Sprain of joints and ligaments of other parts of neck S43.409A Initial ; Unspecified sprain of joint S43.409D Subsequent ; Unspecified sprain of joint S43.90A Initial ; Sprain of parts of girdle, side S43.90D Subsequent ; Sprain of parts of girdle, side S46.919A Strain of muscle, fascia and tendon at and upper arm level, arm; Initial S46.919D Strain of muscle, fascia and tendon at and upper arm level, arm; Subsequent Other Trauma, Adverse Effects S00.01A Abrasion of scalp; Initial 6

S00.01D Abrasion of scalp; Subsequent S00.219A Abrasion of eyelid and periocular area; Initial S00.219D Abrasion of eyelid and periocular area; Subsequent S00.31A Abrasion of nose; Initial S00.31D Abrasion of nose; Subsequent S00.419A Abrasion of ; Initial S00.419D Abrasion of ; Subsequent S00.511A Abrasion of lip; Initial S00.511D Abrasion of lip; Subsequent S00.512A Abrasion of oral cavity; Initial S00.512D Abrasion of oral cavity; Subsequent S10.11A Abrasion of throat; Initial S10.11D Abrasion of throat; Subsequent S10.81A Abrasion of other part of neck; Initial S10.81S Abrasion of other part of necks subsequent S10.91A Abrasion of part of neck; Initial S10.91D Abrasion of part of neck; Subsequent S20.119A Abrasion of breast, breast; Initial S20.119D Abrasion of breast, breast; Subsequent S20.319A Abrasion of front wall of thorax; Initial S20.319D Abrasion of front wall of thorax; Subsequent S20.419A Abrasion of back wall of thorax; Initial S20.419D Abrasion of back wall of thorax; Subsequent S20.91A Abrasion of parts of thorax; Initial S20.91D Abrasion of parts of thorax; Subsequent S30.810A Abrasion of lower back and pelvis; Initial S30.810D Abrasion of lower back and pelvis; Subsequent S30.811A Abrasion of abdominal wall; Initial S30.811D Abrasion of abdominal wall; Subsequent S30.812A Abrasion of penis; Initial S30.812D Abrasion of penis; Subsequent S30.813A Abrasion of scrotum and testes; Initial S30.813D Abrasion of scrotum and testes; Subsequent S30.814A Abrasion of vagina and vulva; Initial S30.814D Abrasion of vagina and vulva; Subsequent S30.815A Abrasion of external genital organs, male; Initial S30.815D Abrasion of external genital organs, male; Subsequent S30.816A Abrasion of external genital organs, female; Initial S30.816D Abrasion of external genital organs, female; Subsequent S30.817A Abrasion of anus; Initial S30.817D Abrasion of anus; Subsequent S40.219A Abrasion of ; Initial S40.219D Abrasion of ; Subsequent S40.819A Abrasion of upper arm; Initial S40.819D Abrasion of upper arm; Subsequent S50.319A Abrasion of elbow; Initial S50.319D Abrasion of elbow; Subsequent S50.819A Abrasion of form; Initial S50.819D Abrasion of form; Subsequent S60.319A Abrasion of thumb; Initial S60.319D Abrasion of thumb; Subsequent S60.419A Abrasion of finger; Initial S60.419D Abrasion of finger; Subsequent S60.519A Abrasion of hand; Initial S60.519D Abrasion of hand; Subsequent S60.819A Abrasion of wrist; Initial S60.819D Abrasion of wrist; Subsequent S70.219A Abrasion, hip; Initial S70.219D Abrasion, hip; Subsequent S70.319A Abrasion, thigh; Initial S70.319D Abrasion, thigh; Subsequent S80.219A Abrasion, knee; Initial S80.219D Abrasion, knee; Subsequent S90.413A Abrasion, great toe; Initial S90.413D Abrasion, great toe; Subsequent S90.416A Abrasion, lesser toe(s); Initial S90.416D Abrasion, lesser toe(s); Subsequent S90.519A Abrasion, ankle; Initial S90.519D Abrasion, ankle; Subsequent S90.819A Abrasion, foot; Initial S90.819D Abrasion, foot; Subsequent S00.03A Contusion of scalp; Initial S00.03D Contusion of scalp; Subsequent S00.19A Contusion of eyelid and periocular area; Initial S00.19D Contusion of eyelid and periocular area; Subsequent S00.33A Contusion of nose; Initial S00.33D Contusion of nose; Subsequent S00.439A Contusion of ; Initial S00.439D Contusion of ; Subsequent S00.531A Contusion of lip; Initial S00.531D Contusion of lip; Subsequent S00.532A Contusion of oral cavity; Initial S00.532D Contusion of oral cavity; Subsequent S10.0A S10.0D Contusion of throat; Initial Contusion of throat; Subsequent S10.83A Contusion of other part of neck; Initial S10.83D Contusion of other part of necks; Subsequent S10.93A Contusion of part of neck; Initial S10.93D Contusion of part of neck; Subsequent S20.00A Contusion of breast, breast; Initial S20.00D Contusion of breast, breast; Subsequent S20.219A Contusion of front wall of thorax; Initial S20.219D Contusion of front wall of thorax; Subsequent S20.229A Contusion of back wall of thorax; Initial S20.229D Contusion of back wall of thorax; Subsequent S30.00A Contusion of lower back and pelvis; Initial S30.00D Contusion of lower back and pelvis; Subsequent S30.1A S30.1D Contusion of abdominal wall; Initial Contusion of abdominal wall; Subsequent S30.21A Contusion of penis; Initial S30.21D Contusion of penis; Subsequent S30.22A Contusion of scrotum and testes; Initial S30.22D Contusion of scrotum and testes; Subsequent S30.23A Contusion of vagina and vulva; Initial S30.23D Contusion of vagina and vulva; Subsequent S30.201A Contusion of external genital organs, male; Initial S30.201D Contusion of external genital organs, male; Subsequent S30.202A Contusion of external genital organs, female; Initial S30.202D Contusion of external genital organs, female; Subsequent S30.3A S30.3D Contusion of anus; Initial Contusion of anus; Subsequent S40.019A Contusion of ; Initial S40.019D Contusion of ; Subsequent S40.029A Contusion of upper arm; Initial S40.029D Contusion of upper arm; Subsequent S50.00A Contusion of elbow; Initial S50.00D Contusion of elbow; Subsequent S50.10A Contusion of form; Initial S50.10D Contusion of form; Subsequent S60.019 Contusion of thumb; Initial 7

S60.019 Contusion of thumb; Subsequent S60.00A Contusion of finger without damage to nail; Initial S60.00D Contusion of finger without damage to nail; Subsequent S60.229A Contusion of hand; Initial S60.229D Contusion of hand; Subsequent S60.211A Contusion of right wrist; Initial S60.211D Contusion of right wrist; Subsequent S60.212A Contusion of left wrist; Initial S60.212D Contusion of left wrist; Subsequent S60.219A Contusion of wrist; Initial S60.219D Contusion of wrist; Subsequent S70.00A Contusion, hip; Initial S70.00D Contusion, hip; Subsequent S70.10A Contusion, thigh; Initial S70.10D Contusion, thigh; Subsequent S80.00A Contusion, knee; Initial S80.00D Contusion, knee; Subsequent S90.11A Contusion, great toe; Initial S90.11D Contusion, great toe; Subsequent S90.129A Contusion, lesser toe(s); Initial S90.129D Contusion, lesser toe(s); Subsequent S90.00A Contusion, ankle; Initial S90.00D Contusion, ankle; Subsequent S00.06A Insect bite of scalp; Initial S00.06D Insect bite of scalp; Subsequent S00.269A Insect bite of eyelid and periocular area; Initial S00.269D Insect bite of eyelid and periocular area; Subsequent S00.36A Insect bite of nose; Initial S00.36D Insect bite of nose; Subsequent S00.469A Insect bite of ; Initial S00.469D Insect bite of ; Subsequent S00.561A Insect bite of lip; Initial S00.561D Insect bite of lip; Subsequent S00.562A Insect bite of oral cavity; Initial S00.562D Insect bite of oral cavity; Subsequent S10.16A Insect bite of throat; Initial S10.16D Insect bite of throat; Subsequent S10.86A Insect bite of other part of neck; Initial S10.86S Insect bite of other part of necks; subsequent S10.96A Insect bite of part of neck; Initial S10.96D Insect bite of part of neck; Subsequent S20.161A Insect bite of breast, right breast; Initial S20.161D Insect bite of breast, right breast; Subsequent S20.162A Insect bite of breast, left breast; Initial S20.162D Insect bite of breast, left breast; Subsequent S20.169A Insect bite of breast, breast; Initial S20.169D Insect bite of breast, breast; Subsequent S20.361A Insect bite of right front wall of thorax; Initial S20.361D Insect bite of right front wall of thorax; Subsequent S20.361S Insect bite of right front wall of thorax; Subsequent S20.362A Insect bite of left front wall of thorax; Initial S20.362D Insect bite of left front wall of thorax; Subsequent S20.369A Insect bite of front wall of thorax; Initial S20.369D Insect bite of front wall of thorax; Subsequent S20.461A Insect bite of right back wall of thorax; Initial S20.461D Insect bite of right back wall of thorax; Subsequent S20.462A Insect bite of left back wall of thorax; Initial S20.462D Insect bite of left back wall of thorax; Subsequent S20.469A Insect bite of back wall of thorax; Initial S20.469D Insect bite of back wall of thorax; Subsequent S20.96A Insect bite of parts of thorax; Initial S20.96D Insect bite of parts of thorax; Subsequent S30.860A Insect bite of lower back and pelvis; Initial S30.860D Insect bite of lower back and pelvis; Subsequent S30.861A Insect bite of abdominal wall; Initial S30.861D Insect bite of abdominal wall; Subsequent S30.862A Insect bite of penis; Initial S30.862D Insect bite of penis; Subsequent S30.863A Insect bite of scrotum and testes; Initial S30.863D Insect bite of scrotum and testes; Subsequent S30.864A Insect bite of vagina and vulva; Initial S30.864D Insect bite of vagina and vulva; Subsequent S30.865A Insect bite of external genital organs, male; Initial S30.865D Insect bite of external genital organs, male; Subsequent S30.866A Insect bite of external genital organs, female; Initial S30.866D Insect bite of external genital organs, female; Subsequent S30.867A Insect bite of anus; Initial S30.867D Insect bite of anus; Subsequent S40.269A Insect bite of ; Initial S40.269D Insect bite of ; Subsequent S40.869A Insect bite of upper arm; Initial S40.869D Insect bite of upper arm; Subsequent S50.369A Insect bite of elbow; Initial S50.369D Insect bite of elbow; Subsequent S50.869A Insect bite of form; Initial S50.869D Insect bite of form; Subsequent S60.369A Insect bite of thumb; Initial S60.369D Insect bite of thumb; Subsequent S60.468A Insect bite of other finger; Initial S60.468D Insect bite of other finger; Subsequent S60.469A Insect bite of finger; Initial S60.469D Insect bite of finger; Subsequent S60.569A Insect bite of hand; Initial S60.569D Insect bite of hand; Subsequent S60.869A Insect bite of wrist; Initial S60.869D Insect bite of wrist; Subsequent S70.269A Insect bite, hip; Initial S70.269D Insect bite, hip; Subsequent S70.369A Insect bite, thigh; Initial S70.369D Insect bite, thigh; Subsequent S80.269A Insect bite, knee; Initial S80.269D Insect bite, knee; Subsequent S90.463A Insect bite, great toe; Initial S90.463D Insect bite, great toe; Subsequent S90.466A Insect bite, lesser toe(s); Initial S90.466D Insect bite, lesser toe(s); Subsequent S90.569A Insect bite, ankle; Initial S90.569D Insect bite, ankle; Subsequent S90.869A Insect bite, foot; Initial S90.869D Insect bite, foot; Subsequent S71.009A Unspecified open wound, hip; Initial S71.009D Unspecified open wound, hip; Subsequent S71.109A Unspecified open wound, thigh; Initial S71.109D Unspecified open wound, thigh; Subsequent S41.009A Unspecified open wound of ; Initial S41.009D Unspecified open wound of ; Subsequent S41.109A Unspecified open wound of upper arm; Initial 8

S41.109D Unspecified open wound of upper arm; Subsequent S51.009A Unspecified open wound of elbow; Initial S51.009D Unspecified open wound of elbow; Subsequent S51.809A Unspecified open wound of form; Initial S51.809D Unspecified open wound of form; Subsequent Supplemental Classification Z30.011 Encounter for initial prescription of contraceptive pills Z30.013 Encounter for initial prescription of injectable contraceptive Z30.018 Encounter for initial prescription of other contraceptives Z30.019 Encounter for initial prescription of contraceptives, Z48.01 Encounter for change or removal of surgical wound dressing Z20.9 Contact with and exposure to communicable disease Z01.411 Encounter for gynecological examination (general) (routine) with abnormal findings Z01.419 Encounter for gynecological examination (general) (routine) without abnormal findings Z01.42 Encounter for cervical sm to confirm findings of recent normal sm following initial abnormal sm Z23 Encounter for immunization Z30.2 Encounter for sterilization Z00.00 Encounter for general adult medical examination without abnormal findings Z00.01 Encounter for general adult medical examination with abnormal findings Z00.10 Encounter for routine child health examination without abnormal findings Z00.11 Encounter for routine child health examination with abnormal findings 9