Notification

Botulinum Toxin Agents


Notification Issue Date: 09/18/2019



Policy Attachment


Attachment to Policy # 08.00.26v


Attachment:A

Policy #:08.00.26v

Description:ICD-10 Diagnosis Codes

Title:Botulinum Toxin Agents


Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.



MEDICALLY NECESSARY

ONABOTULINUMTOXINA (BOTOX®), ABOBOTULINUMTOXINA (DYSPORT®), AND INCOBOTULINUMTOXINA (XEOMIN®) ARE CONSIDERED MEDICALLY NECESSARY FOR THE FOLLOWING INDICATIONS:

G04.1 Tropical spastic paraplegia

G11.4 Hereditary spastic paraplegia

G24.09 Other drug induced dystonia

G24.1 Genetic torsion dystonia

G24.2 Idiopathic nonfamilial dystonia

G24.3 Spasmodic torticollis

G24.4 Idiopathic orofacial dystonia

G24.5 Blepharospasm

G24.8 Other dystonia

G24.9 Dystonia, unspecified

G25.0 Essential tremor

G25.89 Other specified extrapyramidal and movement disorders

G43.001 Migraine without aura, not intractable, with status migrainosus

G43.009 Migraine without aura, not intractable, without status migrainosus

G43.011 Migraine without aura, intractable, with status migrainosus

G43.019 Migraine without aura, intractable, without status migrainosus

G43.101 Migraine with aura, not intractable, with status migrainosus

G43.109 Migraine with aura, not intractable, without status migrainosus

G43.111 Migraine with aura, intractable, with status migrainosus

G43.119 Migraine with aura, intractable, without status migrainosus

G43.401 Hemiplegic migraine, not intractable, with status migrainosus

G43.409 Hemiplegic migraine, not intractable, without status migrainosus

G43.411 Hemiplegic migraine, intractable, with status migrainosus

G43.419 Hemiplegic migraine, intractable, without status migrainosus

G43.501 Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus

G43.509 Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus

G43.511 Persistent migraine aura without cerebral infarction, intractable, with status migrainosus

G43.519 Persistent migraine aura without cerebral infarction, intractable, without status migrainosus

G43.601 Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus

G43.609 Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus

G43.611 Persistent migraine aura with cerebral infarction, intractable, with status migrainosus

G43.619 Persistent migraine aura with cerebral infarction, intractable, without status migrainosus

G43.701 Chronic migraine without aura, not intractable, with status migrainosus

G43.709 Chronic migraine without aura, not intractable, without status migrainosus

G43.711 Chronic migraine without aura, intractable, with status migrainosus

G43.719 Chronic migraine without aura, intractable, without status migrainosus

G43.801 Other migraine, not intractable, with status migrainosus

G43.809 Other migraine, not intractable, without status migrainosus

G43.811 Other migraine, intractable, with status migrainosus

G43.819 Other migraine, intractable, without status migrainosus

G43.901 Migraine, unspecified, not intractable, with status migrainosus

G43.909 Migraine, unspecified, not intractable, without status migrainosus

G43.911 Migraine, unspecified, intractable, with status migrainosus

G43.919 Migraine, unspecified, intractable, without status migrainosus

G43.B0 Ophthalmoplegic migraine, not intractable

G43.B1 Ophthalmoplegic migraine, intractable

G51.2 Melkersson's syndrome

G51.31 Clonic hemifacial spasm, right

G51.32 Clonic hemifacial spasm, left

G51.33 Clonic hemifacial spasm, bilateral

G51.39 Clonic hemifacial spasm, unspecified

G51.8 Other disorders of facial nerve

G61.0 Guillain-Barre syndrome

G80.0 Spastic quadriplegic cerebral palsy

G80.1 Spastic diplegic cerebral palsy

G80.2 Spastic hemiplegic cerebral palsy

G81.10 Spastic hemiplegia affecting unspecified side

G81.11 Spastic hemiplegia affecting right dominant side

G81.12 Spastic hemiplegia affecting left dominant side

G81.13 Spastic hemiplegia affecting right nondominant side

G81.14 Spastic hemiplegia affecting left nondominant side

G82.50 Quadriplegia, unspecified

G82.51 Quadriplegia, C1-C4 complete

G82.52 Quadriplegia, C1-C4 incomplete

G82.53 Quadriplegia, C5-C7 complete

G82.54 Quadriplegia, C5-C7 incomplete

G83.0 Diplegia of upper limbs

G83.10 Monoplegia of lower limb affecting unspecified side

G83.11 Monoplegia of lower limb affecting right dominant side

G83.12 Monoplegia of lower limb affecting left dominant side

G83.13 Monoplegia of lower limb affecting right nondominant side

G83.14 Monoplegia of lower limb affecting left nondominant side

G83.20 Monoplegia of upper limb affecting unspecified side

G83.21 Monoplegia of upper limb affecting right dominant side

G83.22 Monoplegia of upper limb affecting left dominant side

G83.23 Monoplegia of upper limb affecting right nondominant side

G83.24 Monoplegia of upper limb affecting left nondominant side

G83.30 Monoplegia, unspecified affecting unspecified side

G83.31 Monoplegia, unspecified affecting right dominant side

G83.32 Monoplegia, unspecified affecting left dominant side

G83.33 Monoplegia, unspecified affecting right nondominant side

G83.34 Monoplegia, unspecified affecting left nondominant side

G83.81 Brown-Sequard syndrome

G83.82 Anterior cord syndrome

G83.83 Posterior cord syndrome

G83.84 Todd's paralysis (postepileptic)

G83.89 Other specified paralytic syndromes

G83.9 Paralytic syndrome, unspecified

G90.3 Multi-system degeneration of the autonomic nervous system

H49.00 Third [oculomotor] nerve palsy, unspecified eye

H49.01 Third [oculomotor] nerve palsy, right eye

H49.02 Third [oculomotor] nerve palsy, left eye

H49.03 Third [oculomotor] nerve palsy, bilateral

H49.11 Fourth [trochlear] nerve palsy, right eye

H49.12 Fourth [trochlear] nerve palsy, left eye

H49.13 Fourth [trochlear] nerve palsy, bilateral

H49.20 Sixth [abducent] nerve palsy, unspecified eye

H49.21 Sixth [abducent] nerve palsy, right eye

H49.22 Sixth [abducent] nerve palsy, left eye

H49.23 Sixth [abducent] nerve palsy, bilateral

H49.30 Total (external) ophthalmoplegia, unspecified eye

H49.31 Total (external) ophthalmoplegia, right eye

H49.32 Total (external) ophthalmoplegia, left eye

H49.33 Total (external) ophthalmoplegia, bilateral

H49.40 Progressive external ophthalmoplegia, unspecified eye

H49.41 Progressive external ophthalmoplegia, right eye

H49.42 Progressive external ophthalmoplegia, left eye

H49.43 Progressive external ophthalmoplegia, bilateral

H49.881 Other paralytic strabismus, right eye

H49.882 Other paralytic strabismus, left eye

H49.883 Other paralytic strabismus, bilateral

H49.889 Other paralytic strabismus, unspecified eye

H49.9 Unspecified paralytic strabismus

H50.00 Unspecified esotropia

H50.011 Monocular esotropia, right eye

H50.012 Monocular esotropia, left eye

H50.021 Monocular esotropia with A pattern, right eye

H50.022 Monocular esotropia with A pattern, left eye

H50.031 Monocular esotropia with V pattern, right eye

H50.032 Monocular esotropia with V pattern, left eye

H50.041 Monocular esotropia with other noncomitancies, right eye

H50.042 Monocular esotropia with other noncomitancies, left eye

H50.05 Alternating esotropia

H50.06 Alternating esotropia with A pattern

H50.07 Alternating esotropia with V pattern

H50.08 Alternating esotropia with other noncomitancies

H50.10 Unspecified exotropia

H50.111 Monocular exotropia, right eye

H50.112 Monocular exotropia, left eye

H50.121 Monocular exotropia with A pattern, right eye

H50.122 Monocular exotropia with A pattern, left eye

H50.131 Monocular exotropia with V pattern, right eye

H50.132 Monocular exotropia with V pattern, left eye

H50.141 Monocular exotropia with other noncomitancies, right eye

H50.142 Monocular exotropia with other noncomitancies, left eye

H50.15 Alternating exotropia

H50.16 Alternating exotropia with A pattern

H50.17 Alternating exotropia with V pattern

H50.18 Alternating exotropia with other noncomitancies

H50.21 Vertical strabismus, right eye

H50.22 Vertical strabismus, left eye

H50.30 Unspecified intermittent heterotropia

H50.311 Intermittent monocular esotropia, right eye

H50.312 Intermittent monocular esotropia, left eye

H50.32 Intermittent alternating esotropia

H50.331 Intermittent monocular exotropia, right eye

H50.332 Intermittent monocular exotropia, left eye

H50.34 Intermittent alternating exotropia

H50.40 Unspecified heterotropia

H50.411 Cyclotropia, right eye

H50.412 Cyclotropia, left eye

H50.42 Monofixation syndrome

H50.43 Accommodative component in esotropia

H50.50 Unspecified heterophoria

H50.51 Esophoria

H50.52 Exophoria

H50.53 Vertical heterophoria

H50.54 Cyclophoria

H50.55 Alternating heterophoria

H50.60 Mechanical strabismus, unspecified

H50.611 Brown's sheath syndrome, right eye

H50.612 Brown's sheath syndrome, left eye

H50.69 Other mechanical strabismus

H50.811 Duane's syndrome, right eye

H50.812 Duane's syndrome, left eye

H50.89 Other specified strabismus

H50.9 Unspecified strabismus

H51.0 Palsy (spasm) of conjugate gaze

H51.11 Convergence insufficiency

H51.12 Convergence excess

H51.20 Internuclear ophthalmoplegia, unspecified eye

H51.21 Internuclear ophthalmoplegia, right eye

H51.22 Internuclear ophthalmoplegia, left eye

H51.23 Internuclear ophthalmoplegia, bilateral

H51.8 Other specified disorders of binocular movement

H51.9 Unspecified disorder of binocular movement

H53.031 Strabismic amblyopia, right eye

H53.032 Strabismic amblyopia, left eye

H53.033 Strabismic amblyopia, bilateral

H53.039 Strabismic amblyopia, unspecified eye

I69.031 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right dominant side

I69.032 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69.033 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

I69.034 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

I69.039 Monoplegia of upper limb following nontraumatic subarachnoid hemorrhage affecting unspecified side

I69.041 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting right dominant side

I69.042 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69.043 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

I69.044 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

I69.049 Monoplegia of lower limb following nontraumatic subarachnoid hemorrhage affecting unspecified side

I69.061 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right dominant side

I69.062 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69.063 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

I69.064 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

I69.065 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage, bilateral

I69.069 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting unspecified side

I69.131 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.132 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting left dominant side

I69.133 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.134 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.139 Monoplegia of upper limb following nontraumatic intracerebral hemorrhage affecting unspecified side

I69.141 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.142 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left dominant side

I69.143 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.144 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.149 Monoplegia of lower limb following nontraumatic intracerebral hemorrhage affecting unspecified side

I69.151 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.152 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side

I69.153 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.154 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.159 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side

I69.161 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.162 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left dominant side

I69.163 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.164 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.165 Other paralytic syndrome following nontraumatic intracerebral hemorrhage, bilateral

I69.169 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting unspecified side

I69.231 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting right dominant side

I69.232 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting left dominant side

I69.233 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting right non-dominant side

I69.234 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting left non-dominant side

I69.239 Monoplegia of upper limb following other nontraumatic intracranial hemorrhage affecting unspecified side

I69.241 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting right dominant side

I69.242 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left dominant side

I69.243 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting right non-dominant side

I69.244 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting left non-dominant side

I69.249 Monoplegia of lower limb following other nontraumatic intracranial hemorrhage affecting unspecified side

I69.261 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right dominant side

I69.262 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left dominant side

I69.263 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right non-dominant side

I69.264 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left non-dominant side

I69.265 Other paralytic syndrome following other nontraumatic intracranial hemorrhage, bilateral

I69.269 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting unspecified side

I69.331 Monoplegia of upper limb following cerebral infarction affecting right dominant side

I69.332 Monoplegia of upper limb following cerebral infarction affecting left dominant side

I69.333 Monoplegia of upper limb following cerebral infarction affecting right non-dominant side

I69.334 Monoplegia of upper limb following cerebral infarction affecting left non-dominant side

I69.339 Monoplegia of upper limb following cerebral infarction affecting unspecified side

I69.341 Monoplegia of lower limb following cerebral infarction affecting right dominant side

I69.342 Monoplegia of lower limb following cerebral infarction affecting left dominant side

I69.343 Monoplegia of lower limb following cerebral infarction affecting right non-dominant side

I69.344 Monoplegia of lower limb following cerebral infarction affecting left non-dominant side

I69.349 Monoplegia of lower limb following cerebral infarction affecting unspecified side

I69.398 Other sequelae of cerebral infarction

I69.361 Other paralytic syndrome following cerebral infarction affecting right dominant side

I69.362 Other paralytic syndrome following cerebral infarction affecting left dominant side

I69.363 Other paralytic syndrome following cerebral infarction affecting right non-dominant side

I69.364 Other paralytic syndrome following cerebral infarction affecting left non-dominant side

I69.365 Other paralytic syndrome following cerebral infarction, bilateral

I69.369 Other paralytic syndrome following cerebral infarction affecting unspecified side

I69.831 Monoplegia of upper limb following other cerebrovascular disease affecting right dominant side

I69.832 Monoplegia of upper limb following other cerebrovascular disease affecting left dominant side

I69.833 Monoplegia of upper limb following other cerebrovascular disease affecting right non-dominant side

I69.834 Monoplegia of upper limb following other cerebrovascular disease affecting left non-dominant side

I69.839 Monoplegia of upper limb following other cerebrovascular disease affecting unspecified side

I69.841 Monoplegia of lower limb following other cerebrovascular disease affecting right dominant side

I69.842 Monoplegia of lower limb following other cerebrovascular disease affecting left dominant side

I69.843 Monoplegia of lower limb following other cerebrovascular disease affecting right non-dominant side

I69.844 Monoplegia of lower limb following other cerebrovascular disease affecting left non-dominant side

I69.849 Monoplegia of lower limb following other cerebrovascular disease affecting unspecified side

I69.931 Monoplegia of upper limb following unspecified cerebrovascular disease affecting right dominant side

I69.932 Monoplegia of upper limb following unspecified cerebrovascular disease affecting left dominant side

I69.933 Monoplegia of upper limb following unspecified cerebrovascular disease affecting right non-dominant side

I69.934 Monoplegia of upper limb following unspecified cerebrovascular disease affecting left non-dominant side

I69.939 Monoplegia of upper limb following unspecified cerebrovascular disease affecting unspecified side

I69.941 Monoplegia of lower limb following unspecified cerebrovascular disease affecting right dominant side

I69.942 Monoplegia of lower limb following unspecified cerebrovascular disease affecting left dominant side

I69.943 Monoplegia of lower limb following unspecified cerebrovascular disease affecting right non-dominant side

I69.944 Monoplegia of lower limb following unspecified cerebrovascular disease affecting left non-dominant side

I69.949 Monoplegia of lower limb following unspecified cerebrovascular disease affecting unspecified side

J38.3 Other diseases of vocal cords

J38.5 Laryngeal spasm

J38.7 Other diseases of larynx

K11.20 Sialoadenitis, unspecified

K11.21 Acute sialoadenitis

K11.22 Acute recurrent sialoadenitis

K11.23 Chronic sialoadenitis

K11.7 Disturbances of salivary secretion

K22.0 Achalasia of cardia

K59.4 Anal spasm

K60.1 Chronic anal fissure

L74.510 Primary focal hyperhidrosis, axilla

L74.512 Primary focal hyperhidrosis, palms

L74.513 Primary focal hyperhidrosis, soles

L74.519 Primary focal hyperhidrosis, unspecified
M43.6 Torticollis

N30.10 Interstitial cystitis (chronic) without hematuria

N30.11 Interstitial cystitis (chronic) with hematuria

N31.0 Uninhibited neuropathic bladder, not elsewhere classified

N31.1 Reflex neuropathic bladder, not elsewhere classified

N31.8 Other neuromuscular dysfunction of bladder

N31.9 Neuromuscular dysfunction of bladder, unspecified

N32.81 Overactive bladder

N39.41 Urge incontinence

N39.42 Incontinence without sensory awareness

N39.46 Mixed incontinence

N39.498 Other specified urinary incontinence

Q39.5 Congenital dilatation of esophagus

Q40.0 Congenital hypertrophic pyloric stenosis

R32 Unspecified urinary incontinence

R49.0 Dysphonia

R49.8 Other voice and resonance disorders

R68.2 Dry mouth, unspecified

ONABOTULINUMTOXINA (BOTOX®), ABOBOTULINUMTOXINA (DYSPORT®), AND INCOBOTULINUMTOXINA (XEOMIN®) ARE MEDICALLY NECESSARY WHEN REPORTED FOR THE FOLLOWING INDICATIONS:

For spasticity of limbs coverage multiple diagnoses are required:

M62.838 Other muscle spasm

AND one of the following:

G23.8 Other specified degenerative diseases of basal ganglia

G23.9 Degenerative disease of basal ganglia, unspecified

G35 Multiple sclerosis

G36.0 Neuromyelitis optica [Devic]

G36.1 Acute and subacute hemorrhagic leukoencephalitis [Hurst]

G36.8 Other specified acute disseminated demyelination

G36.9 Acute disseminated demyelination, unspecified

G37.0 Diffuse sclerosis of central nervous system

G37.1 Central demyelination of corpus callosum

G37.2 Central pontine myelinolysis

G37.3 Acute transverse myelitis in demyelinating disease of central nervous system

G37.4 Subacute necrotizing myelitis of central nervous system

G37.5 Concentric sclerosis [Balo] of central nervous system

G37.8 Other specified demyelinating diseases of central nervous system

G37.9 Demyelinating disease of central nervous system, unspecified

G51.4 Facial myokymia

G61.81 Chronic inflammatory demyelinating polyneuritis

G80.3 Athetoid cerebral palsy

G80.4 Ataxic cerebral palsy

G80.8 Other cerebral palsy

G80.9 Cerebral palsy, unspecified

G82.20 Paraplegia, unspecified

G82.21 Paraplegia, complete

G82.22 Paraplegia, incomplete

I69.051 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side

I69.052 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side

I69.053 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side

I69.054 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side

I69.059 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting unspecified side

I69.151 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side

I69.152 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side

I69.153 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side

I69.154 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side

I69.159 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting unspecified side

I69.251 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right dominant side

I69.252 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left dominant side

I69.253 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right non-dominant side

I69.254 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left non-dominant side

I69.259 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting unspecified side

I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side

I69.352 Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side

I69.353 Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side

I69.354 Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side

I69.359 Hemiplegia and hemiparesis following cerebral infarction affecting unspecified side

I69.398 Other sequelae of cerebral infarction

I69.851 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right dominant side

I69.852 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left dominant side

I69.853 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right non-dominant side

I69.854 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left non-dominant side

I69.859 Hemiplegia and hemiparesis following other cerebrovascular disease affecting unspecified side

I69.861 Other paralytic syndrome following other cerebrovascular disease affecting right dominant side

I69.862 Other paralytic syndrome following other cerebrovascular disease affecting left dominant side

I69.863 Other paralytic syndrome following other cerebrovascular disease affecting right non-dominant side

I69.864 Other paralytic syndrome following other cerebrovascular disease affecting left non-dominant side

I69.865 Other paralytic syndrome following other cerebrovascular disease, bilateral

I69.869 Other paralytic syndrome following other cerebrovascular disease affecting unspecified side

I69.951 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right dominant side

I69.952 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left dominant side

I69.953 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting right non-dominant side

I69.954 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting left non-dominant side

I69.959 Hemiplegia and hemiparesis following unspecified cerebrovascular disease affecting unspecified side

I69.961 Other paralytic syndrome following unspecified cerebrovascular disease affecting right dominant side

I69.962 Other paralytic syndrome following unspecified cerebrovascular disease affecting left dominant side

I69.963 Other paralytic syndrome following unspecified cerebrovascular disease affecting right non-dominant side

I69.964 Other paralytic syndrome following unspecified cerebrovascular disease affecting left non-dominant side

I69.965 Other paralytic syndrome following unspecified cerebrovascular disease, bilateral

I69.969 Other paralytic syndrome following unspecified cerebrovascular disease affecting unspecified side

S01.90XA Unspecified open wound of unspecified part of head, initial encounter

S01.90XD Unspecified open wound of unspecified part of head, subsequent encounter

S01.90XS Unspecified open wound of unspecified part of head, sequela

S06.0X0A Concussion without loss of consciousness, initial encounter

S06.0X0D Concussion without loss of consciousness, subsequent encounter

S06.0X0S Concussion without loss of consciousness, sequela

S06.1X0A Traumatic cerebral edema without loss of consciousness, initial encounter

S06.1X0D Traumatic cerebral edema without loss of consciousness, subsequent encounter

S06.1X0S Traumatic cerebral edema without loss of consciousness, sequela

S06.1X1A Traumatic cerebral edema with loss of consciousness of 30 minutes or less, initial encounter

S06.1X1D Traumatic cerebral edema with loss of consciousness of 30 minutes or less, subsequent encounter

S06.1X1S Traumatic cerebral edema with loss of consciousness of 30 minutes or less, sequela

S06.1X2A Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.1X2D Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.1X2S Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.1X3A Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.1X3D Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.1X3S Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.1X4A Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.1X4D Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.1X4S Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, sequela

S06.1X5A Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.1X5D Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.1X5S Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.1X6A Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.1X6D Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.1X6S Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.1X7A Traumatic cerebral edema with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.1X8A Traumatic cerebral edema with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.1X9A Traumatic cerebral edema with loss of consciousness of unspecified duration, initial encounter

S06.1X9D Traumatic cerebral edema with loss of consciousness of unspecified duration, subsequent encounter

S06.1X9S Traumatic cerebral edema with loss of consciousness of unspecified duration, sequela

S06.2X0A Diffuse traumatic brain injury without loss of consciousness, initial encounter

S06.2X0D Diffuse traumatic brain injury without loss of consciousness, subsequent encounter

S06.2X0S Diffuse traumatic brain injury without loss of consciousness, sequela

S06.2X1A Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter

S06.2X1D Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, subsequent encounter

S06.2X1S Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, sequela

S06.2X2A Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.2X2D Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.2X2S Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.2X3A Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.2X3D Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.2X3S Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.2X4A Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.2X4D Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.2X4S Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.2X5A Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, initial encounter

S06.2X5D Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, subsequent encounter

S06.2X5S Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, sequela

S06.2X6A Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.2X6D Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.2X6S Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.2X7A Diffuse traumatic brain injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.2X8A Diffuse traumatic brain injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.2X9A Diffuse traumatic brain injury with loss of consciousness of unspecified duration, initial encounter

S06.2X9D Diffuse traumatic brain injury with loss of consciousness of unspecified duration, subsequent encounter

S06.2X9S Diffuse traumatic brain injury with loss of consciousness of unspecified duration, sequela

S06.300A Unspecified focal traumatic brain injury without loss of consciousness, initial encounter

S06.300D Unspecified focal traumatic brain injury without loss of consciousness, subsequent encounter

S06.300S Unspecified focal traumatic brain injury without loss of consciousness, sequela

S06.301A Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, initial encounter

S06.301D Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, subsequent encounter

S06.301S Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, sequela

S06.302A Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.302D Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.302S Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.303A Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.303D Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.303S Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.304A Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.304D Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.304S Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.305A Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.305D Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.305S Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.306A Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.306D Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.306S Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.307A Unspecified focal traumatic brain injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.308A Unspecified focal traumatic brain injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.309A Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, initial encounter

S06.309D Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, subsequent encounter

S06.309S Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, sequela

S06.810A Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter

S06.810D Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, subsequent encounter

S06.810S Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela

S06.811A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter

S06.811D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, subsequent encounter

S06.811S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela

S06.812A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.812D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.812S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.813A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.813D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.813S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.814A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.814D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.814S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela

S06.815A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.815D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.815S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.816A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.816D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.816S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.817A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.818A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.819A Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter

S06.819D Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, subsequent encounter

S06.819S Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela

S06.820A Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, initial encounter

S06.820D Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, subsequent encounter

S06.820S Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela

S06.821A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, initial encounter

S06.821D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, subsequent encounter

S06.821S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela

S06.822A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.822D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.822S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.823A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.823D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.823S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.824A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.824D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.824S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela

S06.825A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.825D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.825S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.826A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.826D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.826S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.827A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.828A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.829A Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, initial encounter

S06.829D Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, subsequent encounter

S06.829S Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela

S06.890A Other specified intracranial injury without loss of consciousness, initial encounter

S06.890D Other specified intracranial injury without loss of consciousness, subsequent encounter

S06.890S Other specified intracranial injury without loss of consciousness, sequela

S06.891A Other specified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter

S06.891D Other specified intracranial injury with loss of consciousness of 30 minutes or less, subsequent encounter

S06.891S Other specified intracranial injury with loss of consciousness of 30 minutes or less, sequela

S06.892A Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.892D Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.892S Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.893A Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.893D Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.893S Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.894A Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.894D Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.894S Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.895A Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.895D Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.895S Other specified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.896A Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.896D Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.896S Other specified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.897A Other specified intracranial injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.898A Other specified intracranial injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.899A Other specified intracranial injury with loss of consciousness of unspecified duration, initial encounter

S06.899D Other specified intracranial injury with loss of consciousness of unspecified duration, subsequent encounter

S06.899S Other specified intracranial injury with loss of consciousness of unspecified duration, sequela

S06.9X0A Unspecified intracranial injury without loss of consciousness, initial encounter

S06.9X0D Unspecified intracranial injury without loss of consciousness, subsequent encounter

S06.9X0S Unspecified intracranial injury without loss of consciousness, sequela

S06.9X1A Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter

S06.9X1D Unspecified intracranial injury with loss of consciousness of 30 minutes or less, subsequent encounter

S06.9X1S Unspecified intracranial injury with loss of consciousness of 30 minutes or less, sequela

S06.9X2A Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, initial encounter

S06.9X2D Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, subsequent encounter

S06.9X2S Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.9X3A Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, initial encounter

S06.9X3D Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, subsequent encounter

S06.9X3S Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.9X4A Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, initial encounter

S06.9X4D Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, subsequent encounter

S06.9X4S Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.9X5A Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, initial encounter

S06.9X5D Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, subsequent encounter

S06.9X5S Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela

S06.9X6A Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, initial encounter

S06.9X6D Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, subsequent encounter

S06.9X6S Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela

S06.9X7A Unspecified intracranial injury with loss of consciousness of any duration with death due to brain injury prior to regaining consciousness, initial encounter

S06.9X8A Unspecified intracranial injury with loss of consciousness of any duration with death due to other cause prior to regaining consciousness, initial encounter

S06.9X9A Unspecified intracranial injury with loss of consciousness of unspecified duration, initial encounter

S06.9X9D Unspecified intracranial injury with loss of consciousness of unspecified duration, subsequent encounter

S06.9X9S Unspecified intracranial injury with loss of consciousness of unspecified duration, sequela

S14.0XXA Concussion and edema of cervical spinal cord, initial encounter

S14.0XXD Concussion and edema of cervical spinal cord, subsequent encounter

S14.0XXS Concussion and edema of cervical spinal cord, sequela

S14.101A Unspecified injury at C1 level of cervical spinal cord, initial encounter

S14.101D Unspecified injury at C1 level of cervical spinal cord, subsequent encounter

S14.101S Unspecified injury at C1 level of cervical spinal cord, sequela

S14.102A Unspecified injury at C2 level of cervical spinal cord, initial encounter

S14.102D Unspecified injury at C2 level of cervical spinal cord, subsequent encounter

S14.102S Unspecified injury at C2 level of cervical spinal cord, sequela

S14.103A Unspecified injury at C3 level of cervical spinal cord, initial encounter

S14.103D Unspecified injury at C3 level of cervical spinal cord, subsequent encounter

S14.103S Unspecified injury at C3 level of cervical spinal cord, sequela

S14.104A Unspecified injury at C4 level of cervical spinal cord, initial encounter

S14.104D Unspecified injury at C4 level of cervical spinal cord, subsequent encounter

S14.104S Unspecified injury at C4 level of cervical spinal cord, sequela

S14.105A Unspecified injury at C5 level of cervical spinal cord, initial encounter

S14.105D Unspecified injury at C5 level of cervical spinal cord, subsequent encounter

S14.105S Unspecified injury at C5 level of cervical spinal cord, sequela

S14.106A Unspecified injury at C6 level of cervical spinal cord, initial encounter

S14.106D Unspecified injury at C6 level of cervical spinal cord, subsequent encounter

S14.106S Unspecified injury at C6 level of cervical spinal cord, sequela

S14.107A Unspecified injury at C7 level of cervical spinal cord, initial encounter

S14.107D Unspecified injury at C7 level of cervical spinal cord, subsequent encounter

S14.107S Unspecified injury at C7 level of cervical spinal cord, sequela

S14.108A Unspecified injury at C8 level of cervical spinal cord, initial encounter

S14.108D Unspecified injury at C8 level of cervical spinal cord, subsequent encounter

S14.108S Unspecified injury at C8 level of cervical spinal cord, sequela

S14.109A Unspecified injury at unspecified level of cervical spinal cord, initial encounter

S14.109D Unspecified injury at unspecified level of cervical spinal cord, subsequent encounter

S14.109S Unspecified injury at unspecified level of cervical spinal cord, sequela

S14.111A Complete lesion at C1 level of cervical spinal cord, initial encounter

S14.111D Complete lesion at C1 level of cervical spinal cord, subsequent encounter

S14.111S Complete lesion at C1 level of cervical spinal cord, sequela

S14.112A Complete lesion at C2 level of cervical spinal cord, initial encounter

S14.112D Complete lesion at C2 level of cervical spinal cord, subsequent encounter

S14.112S Complete lesion at C2 level of cervical spinal cord, sequela

S14.113A Complete lesion at C3 level of cervical spinal cord, initial encounter

S14.113D Complete lesion at C3 level of cervical spinal cord, subsequent encounter

S14.113S Complete lesion at C3 level of cervical spinal cord, sequela

S14.114A Complete lesion at C4 level of cervical spinal cord, initial encounter

S14.114D Complete lesion at C4 level of cervical spinal cord, subsequent encounter

S14.114S Complete lesion at C4 level of cervical spinal cord, sequela

S14.115A Complete lesion at C5 level of cervical spinal cord, initial encounter

S14.115D Complete lesion at C5 level of cervical spinal cord, subsequent encounter

S14.115S Complete lesion at C5 level of cervical spinal cord, sequela

S14.116A Complete lesion at C6 level of cervical spinal cord, initial encounter

S14.116D Complete lesion at C6 level of cervical spinal cord, subsequent encounter

S14.116S Complete lesion at C6 level of cervical spinal cord, sequela

S14.117A Complete lesion at C7 level of cervical spinal cord, initial encounter

S14.117D Complete lesion at C7 level of cervical spinal cord, subsequent encounter

S14.117S Complete lesion at C7 level of cervical spinal cord, sequela

S14.118A Complete lesion at C8 level of cervical spinal cord, initial encounter

S14.118D Complete lesion at C8 level of cervical spinal cord, subsequent encounter

S14.118S Complete lesion at C8 level of cervical spinal cord, sequela

S14.119A Complete lesion at unspecified level of cervical spinal cord, initial encounter

S14.119D Complete lesion at unspecified level of cervical spinal cord, subsequent encounter

S14.119S Complete lesion at unspecified level of cervical spinal cord, sequela

S14.121A Central cord syndrome at C1 level of cervical spinal cord, initial encounter

S14.121D Central cord syndrome at C1 level of cervical spinal cord, subsequent encounter

S14.121S Central cord syndrome at C1 level of cervical spinal cord, sequela

S14.122A Central cord syndrome at C2 level of cervical spinal cord, initial encounter

S14.122D Central cord syndrome at C2 level of cervical spinal cord, subsequent encounter

S14.122S Central cord syndrome at C2 level of cervical spinal cord, sequela

S14.123A Central cord syndrome at C3 level of cervical spinal cord, initial encounter

S14.123D Central cord syndrome at C3 level of cervical spinal cord, subsequent encounter

S14.123S Central cord syndrome at C3 level of cervical spinal cord, sequela

S14.124A Central cord syndrome at C4 level of cervical spinal cord, initial encounter

S14.124D Central cord syndrome at C4 level of cervical spinal cord, subsequent encounter

S14.124S Central cord syndrome at C4 level of cervical spinal cord, sequela

S14.125A Central cord syndrome at C5 level of cervical spinal cord, initial encounter

S14.125D Central cord syndrome at C5 level of cervical spinal cord, subsequent encounter

S14.125S Central cord syndrome at C5 level of cervical spinal cord, sequela

S14.126A Central cord syndrome at C6 level of cervical spinal cord, initial encounter

S14.126D Central cord syndrome at C6 level of cervical spinal cord, subsequent encounter

S14.126S Central cord syndrome at C6 level of cervical spinal cord, sequela

S14.127A Central cord syndrome at C7 level of cervical spinal cord, initial encounter

S14.127D Central cord syndrome at C7 level of cervical spinal cord, subsequent encounter

S14.127S Central cord syndrome at C7 level of cervical spinal cord, sequela

S14.128A Central cord syndrome at C8 level of cervical spinal cord, initial encounter

S14.128D Central cord syndrome at C8 level of cervical spinal cord, subsequent encounter

S14.128S Central cord syndrome at C8 level of cervical spinal cord, sequela

S14.129A Central cord syndrome at unspecified level of cervical spinal cord, initial encounter

S14.129D Central cord syndrome at unspecified level of cervical spinal cord, subsequent encounter

S14.129S Central cord syndrome at unspecified level of cervical spinal cord, sequela

S14.131A Anterior cord syndrome at C1 level of cervical spinal cord, initial encounter

S14.131D Anterior cord syndrome at C1 level of cervical spinal cord, subsequent encounter

S14.131S Anterior cord syndrome at C1 level of cervical spinal cord, sequela

S14.132A Anterior cord syndrome at C2 level of cervical spinal cord, initial encounter

S14.132D Anterior cord syndrome at C2 level of cervical spinal cord, subsequent encounter

S14.132S Anterior cord syndrome at C2 level of cervical spinal cord, sequela

S14.133A Anterior cord syndrome at C3 level of cervical spinal cord, initial encounter

S14.133D Anterior cord syndrome at C3 level of cervical spinal cord, subsequent encounter

S14.133S Anterior cord syndrome at C3 level of cervical spinal cord, sequela

S14.134A Anterior cord syndrome at C4 level of cervical spinal cord, initial encounter

S14.134D Anterior cord syndrome at C4 level of cervical spinal cord, subsequent encounter

S14.134S Anterior cord syndrome at C4 level of cervical spinal cord, sequela

S14.135A Anterior cord syndrome at C5 level of cervical spinal cord, initial encounter

S14.135D Anterior cord syndrome at C5 level of cervical spinal cord, subsequent encounter

S14.135S Anterior cord syndrome at C5 level of cervical spinal cord, sequela

S14.136A Anterior cord syndrome at C6 level of cervical spinal cord, initial encounter

S14.136D Anterior cord syndrome at C6 level of cervical spinal cord, subsequent encounter

S14.136S Anterior cord syndrome at C6 level of cervical spinal cord, sequela

S14.137A Anterior cord syndrome at C7 level of cervical spinal cord, initial encounter

S14.137D Anterior cord syndrome at C7 level of cervical spinal cord, subsequent encounter

S14.137S Anterior cord syndrome at C7 level of cervical spinal cord, sequela

S14.138A Anterior cord syndrome at C8 level of cervical spinal cord, initial encounter

S14.138D Anterior cord syndrome at C8 level of cervical spinal cord, subsequent encounter

S14.138S Anterior cord syndrome at C8 level of cervical spinal cord, sequela

S14.139A Anterior cord syndrome at unspecified level of cervical spinal cord, initial encounter

S14.139D Anterior cord syndrome at unspecified level of cervical spinal cord, subsequent encounter

S14.139S Anterior cord syndrome at unspecified level of cervical spinal cord, sequela

S14.141A Brown-Sequard syndrome at C1 level of cervical spinal cord, initial encounter

S14.141D Brown-Sequard syndrome at C1 level of cervical spinal cord, subsequent encounter

S14.141S Brown-Sequard syndrome at C1 level of cervical spinal cord, sequela

S14.142A Brown-Sequard syndrome at C2 level of cervical spinal cord, initial encounter

S14.142D Brown-Sequard syndrome at C2 level of cervical spinal cord, subsequent encounter

S14.142S Brown-Sequard syndrome at C2 level of cervical spinal cord, sequela

S14.143A Brown-Sequard syndrome at C3 level of cervical spinal cord, initial encounter

S14.143D Brown-Sequard syndrome at C3 level of cervical spinal cord, subsequent encounter

S14.143S Brown-Sequard syndrome at C3 level of cervical spinal cord, sequela

S14.144A Brown-Sequard syndrome at C4 level of cervical spinal cord, initial encounter

S14.144D Brown-Sequard syndrome at C4 level of cervical spinal cord, subsequent encounter

S14.144S Brown-Sequard syndrome at C4 level of cervical spinal cord, sequela

S14.145A Brown-Sequard syndrome at C5 level of cervical spinal cord, initial encounter

S14.145D Brown-Sequard syndrome at C5 level of cervical spinal cord, subsequent encounter

S14.145S Brown-Sequard syndrome at C5 level of cervical spinal cord, sequela

S14.146A Brown-Sequard syndrome at C6 level of cervical spinal cord, initial encounter

S14.146D Brown-Sequard syndrome at C6 level of cervical spinal cord, subsequent encounter

S14.146S Brown-Sequard syndrome at C6 level of cervical spinal cord, sequela

S14.147A Brown-Sequard syndrome at C7 level of cervical spinal cord, initial encounter

S14.147D Brown-Sequard syndrome at C7 level of cervical spinal cord, subsequent encounter

S14.147S Brown-Sequard syndrome at C7 level of cervical spinal cord, sequela

S14.148A Brown-Sequard syndrome at C8 level of cervical spinal cord, initial encounter

S14.148D Brown-Sequard syndrome at C8 level of cervical spinal cord, subsequent encounter

S14.148S Brown-Sequard syndrome at C8 level of cervical spinal cord, sequela

S14.149A Brown-Sequard syndrome at unspecified level of cervical spinal cord, initial encounter

S14.149D Brown-Sequard syndrome at unspecified level of cervical spinal cord, subsequent encounter

S14.149S Brown-Sequard syndrome at unspecified level of cervical spinal cord, sequela

S14.151A Other incomplete lesion at C1 level of cervical spinal cord, initial encounter

S14.151D Other incomplete lesion at C1 level of cervical spinal cord, subsequent encounter

S14.151S Other incomplete lesion at C1 level of cervical spinal cord, sequela

S14.152A Other incomplete lesion at C2 level of cervical spinal cord, initial encounter

S14.152D Other incomplete lesion at C2 level of cervical spinal cord, subsequent encounter

S14.152S Other incomplete lesion at C2 level of cervical spinal cord, sequela

S14.153A Other incomplete lesion at C3 level of cervical spinal cord, initial encounter

S14.153D Other incomplete lesion at C3 level of cervical spinal cord, subsequent encounter

S14.153S Other incomplete lesion at C3 level of cervical spinal cord, sequela

S14.154A Other incomplete lesion at C4 level of cervical spinal cord, initial encounter

S14.154D Other incomplete lesion at C4 level of cervical spinal cord, subsequent encounter

S14.154S Other incomplete lesion at C4 level of cervical spinal cord, sequela

S14.155A Other incomplete lesion at C5 level of cervical spinal cord, initial encounter

S14.155D Other incomplete lesion at C5 level of cervical spinal cord, subsequent encounter

S14.155S Other incomplete lesion at C5 level of cervical spinal cord, sequela

S14.156A Other incomplete lesion at C6 level of cervical spinal cord, initial encounter

S14.156D Other incomplete lesion at C6 level of cervical spinal cord, subsequent encounter

S14.156S Other incomplete lesion at C6 level of cervical spinal cord, sequela

S14.157A Other incomplete lesion at C7 level of cervical spinal cord, initial encounter

S14.157D Other incomplete lesion at C7 level of cervical spinal cord, subsequent encounter

S14.157S Other incomplete lesion at C7 level of cervical spinal cord, sequela

S14.158A Other incomplete lesion at C8 level of cervical spinal cord, initial encounter

S14.158D Other incomplete lesion at C8 level of cervical spinal cord, subsequent encounter

S14.158S Other incomplete lesion at C8 level of cervical spinal cord, sequela

S14.159A Other incomplete lesion at unspecified level of cervical spinal cord, initial encounter

S14.159D Other incomplete lesion at unspecified level of cervical spinal cord, subsequent encounter

S14.159S Other incomplete lesion at unspecified level of cervical spinal cord, sequela

S24.0XXA Concussion and edema of thoracic spinal cord, initial encounter

S24.0XXD Concussion and edema of thoracic spinal cord, subsequent encounter

S24.0XXS Concussion and edema of thoracic spinal cord, sequela

S24.101A Unspecified injury at T1 level of thoracic spinal cord, initial encounter

S24.101D Unspecified injury at T1 level of thoracic spinal cord, subsequent encounter

S24.101S Unspecified injury at T1 level of thoracic spinal cord, sequela

S24.102A Unspecified injury at T2-T6 level of thoracic spinal cord, initial encounter

S24.102D Unspecified injury at T2-T6 level of thoracic spinal cord, subsequent encounter

S24.102S Unspecified injury at T2-T6 level of thoracic spinal cord, sequela

S24.103A Unspecified injury at T7-T10 level of thoracic spinal cord, initial encounter

S24.103D Unspecified injury at T7-T10 level of thoracic spinal cord, subsequent encounter

S24.103S Unspecified injury at T7-T10 level of thoracic spinal cord, sequela

S24.104A Unspecified injury at T11-T12 level of thoracic spinal cord, initial encounter

S24.104D Unspecified injury at T11-T12 level of thoracic spinal cord, subsequent encounter

S24.104S Unspecified injury at T11-T12 level of thoracic spinal cord, sequela

S24.109A Unspecified injury at unspecified level of thoracic spinal cord, initial encounter

S24.109D Unspecified injury at unspecified level of thoracic spinal cord, subsequent encounter

S24.109S Unspecified injury at unspecified level of thoracic spinal cord, sequela

S24.111A Complete lesion at T1 level of thoracic spinal cord, initial encounter

S24.111D Complete lesion at T1 level of thoracic spinal cord, subsequent encounter

S24.111S Complete lesion at T1 level of thoracic spinal cord, sequela

S24.112A Complete lesion at T2-T6 level of thoracic spinal cord, initial encounter

S24.112D Complete lesion at T2-T6 level of thoracic spinal cord, subsequent encounter

S24.112S Complete lesion at T2-T6 level of thoracic spinal cord, sequela

S24.113A Complete lesion at T7-T10 level of thoracic spinal cord, initial encounter

S24.113D Complete lesion at T7-T10 level of thoracic spinal cord, subsequent encounter

S24.113S Complete lesion at T7-T10 level of thoracic spinal cord, sequela

S24.114A Complete lesion at T11-T12 level of thoracic spinal cord, initial encounter

S24.114D Complete lesion at T11-T12 level of thoracic spinal cord, subsequent encounter

S24.114S Complete lesion at T11-T12 level of thoracic spinal cord, sequela

S24.119A Complete lesion at unspecified level of thoracic spinal cord, initial encounter

S24.119D Complete lesion at unspecified level of thoracic spinal cord, subsequent encounter

S24.119S Complete lesion at unspecified level of thoracic spinal cord, sequela

S24.131A Anterior cord syndrome at T1 level of thoracic spinal cord, initial encounter

S24.131D Anterior cord syndrome at T1 level of thoracic spinal cord, subsequent encounter

S24.131S Anterior cord syndrome at T1 level of thoracic spinal cord, sequela

S24.132A Anterior cord syndrome at T2-T6 level of thoracic spinal cord, initial encounter

S24.132D Anterior cord syndrome at T2-T6 level of thoracic spinal cord, subsequent encounter

S24.132S Anterior cord syndrome at T2-T6 level of thoracic spinal cord, sequela

S24.133A Anterior cord syndrome at T7-T10 level of thoracic spinal cord, initial encounter

S24.133D Anterior cord syndrome at T7-T10 level of thoracic spinal cord, subsequent encounter

S24.133S Anterior cord syndrome at T7-T10 level of thoracic spinal cord, sequela

S24.134A Anterior cord syndrome at T11-T12 level of thoracic spinal cord, initial encounter

S24.134D Anterior cord syndrome at T11-T12 level of thoracic spinal cord, subsequent encounter

S24.134S Anterior cord syndrome at T11-T12 level of thoracic spinal cord, sequela

S24.139A Anterior cord syndrome at unspecified level of thoracic spinal cord, initial encounter

S24.139D Anterior cord syndrome at unspecified level of thoracic spinal cord, subsequent encounter

S24.139S Anterior cord syndrome at unspecified level of thoracic spinal cord, sequela

S24.141A Brown-Sequard syndrome at T1 level of thoracic spinal cord, initial encounter

S24.141D Brown-Sequard syndrome at T1 level of thoracic spinal cord, subsequent encounter

S24.141S Brown-Sequard syndrome at T1 level of thoracic spinal cord, sequela

S24.142A Brown-Sequard syndrome at T2-T6 level of thoracic spinal cord, initial encounter

S24.142D Brown-Sequard syndrome at T2-T6 level of thoracic spinal cord, subsequent encounter

S24.142S Brown-Sequard syndrome at T2-T6 level of thoracic spinal cord, sequela

S24.143A Brown-Sequard syndrome at T7-T10 level of thoracic spinal cord, initial encounter

S24.143D Brown-Sequard syndrome at T7-T10 level of thoracic spinal cord, subsequent encounter

S24.143S Brown-Sequard syndrome at T7-T10 level of thoracic spinal cord, sequela

S24.144A Brown-Sequard syndrome at T11-T12 level of thoracic spinal cord, initial encounter

S24.144D Brown-Sequard syndrome at T11-T12 level of thoracic spinal cord, subsequent encounter

S24.144S Brown-Sequard syndrome at T11-T12 level of thoracic spinal cord, sequela

S24.149A Brown-Sequard syndrome at unspecified level of thoracic spinal cord, initial encounter

S24.149D Brown-Sequard syndrome at unspecified level of thoracic spinal cord, subsequent encounter

S24.149S Brown-Sequard syndrome at unspecified level of thoracic spinal cord, sequela

S24.151A Other incomplete lesion at T1 level of thoracic spinal cord, initial encounter

S24.151D Other incomplete lesion at T1 level of thoracic spinal cord, subsequent encounter

S24.151S Other incomplete lesion at T1 level of thoracic spinal cord, sequela

S24.152A Other incomplete lesion at T2-T6 level of thoracic spinal cord, initial encounter

S24.152D Other incomplete lesion at T2-T6 level of thoracic spinal cord, subsequent encounter

S24.152S Other incomplete lesion at T2-T6 level of thoracic spinal cord, sequela

S24.153A Other incomplete lesion at T7-T10 level of thoracic spinal cord, initial encounter

S24.153D Other incomplete lesion at T7-T10 level of thoracic spinal cord, subsequent encounter

S24.153S Other incomplete lesion at T7-T10 level of thoracic spinal cord, sequela

S24.154A Other incomplete lesion at T11-T12 level of thoracic spinal cord, initial encounter

S24.154D Other incomplete lesion at T11-T12 level of thoracic spinal cord, subsequent encounter

S24.154S Other incomplete lesion at T11-T12 level of thoracic spinal cord, sequela

S24.159A Other incomplete lesion at unspecified level of thoracic spinal cord, initial encounter

S24.159D Other incomplete lesion at unspecified level of thoracic spinal cord, subsequent encounter

S24.159S Other incomplete lesion at unspecified level of thoracic spinal cord, sequela

S34.01XA Concussion and edema of lumbar spinal cord, initial encounter

S34.01XD Concussion and edema of lumbar spinal cord, subsequent encounter

S34.01XS Concussion and edema of lumbar spinal cord, sequela

S34.02XA Concussion and edema of sacral spinal cord, initial encounter

S34.02XD Concussion and edema of sacral spinal cord, subsequent encounter

S34.02XS Concussion and edema of sacral spinal cord, sequela

S34.101A Unspecified injury to L1 level of lumbar spinal cord, initial encounter

S34.101D Unspecified injury to L1 level of lumbar spinal cord, subsequent encounter

S34.101S Unspecified injury to L1 level of lumbar spinal cord, sequela

S34.102A Unspecified injury to L2 level of lumbar spinal cord, initial encounter

S34.102D Unspecified injury to L2 level of lumbar spinal cord, subsequent encounter

S34.102S Unspecified injury to L2 level of lumbar spinal cord, sequela

S34.103A Unspecified injury to L3 level of lumbar spinal cord, initial encounter

S34.103D Unspecified injury to L3 level of lumbar spinal cord, subsequent encounter

S34.103S Unspecified injury to L3 level of lumbar spinal cord, sequela

S34.104A Unspecified injury to L4 level of lumbar spinal cord, initial encounter

S34.104D Unspecified injury to L4 level of lumbar spinal cord, subsequent encounter

S34.104S Unspecified injury to L4 level of lumbar spinal cord, sequela

S34.105A Unspecified injury to L5 level of lumbar spinal cord, initial encounter

S34.105D Unspecified injury to L5 level of lumbar spinal cord, subsequent encounter

S34.105S Unspecified injury to L5 level of lumbar spinal cord, sequela

S34.109A Unspecified injury to unspecified level of lumbar spinal cord, initial encounter

S34.109D Unspecified injury to unspecified level of lumbar spinal cord, subsequent encounter

S34.109S Unspecified injury to unspecified level of lumbar spinal cord, sequela

S34.111A Complete lesion of L1 level of lumbar spinal cord, initial encounter

S34.111D Complete lesion of L1 level of lumbar spinal cord, subsequent encounter

S34.111S Complete lesion of L1 level of lumbar spinal cord, sequela

S34.112A Complete lesion of L2 level of lumbar spinal cord, initial encounter

S34.112D Complete lesion of L2 level of lumbar spinal cord, subsequent encounter

S34.112S Complete lesion of L2 level of lumbar spinal cord, sequela

S34.113A Complete lesion of L3 level of lumbar spinal cord, initial encounter

S34.113D Complete lesion of L3 level of lumbar spinal cord, subsequent encounter

S34.113S Complete lesion of L3 level of lumbar spinal cord, sequela

S34.114A Complete lesion of L4 level of lumbar spinal cord, initial encounter

S34.114D Complete lesion of L4 level of lumbar spinal cord, subsequent encounter

S34.114S Complete lesion of L4 level of lumbar spinal cord, sequela

S34.115A Complete lesion of L5 level of lumbar spinal cord, initial encounter

S34.115D Complete lesion of L5 level of lumbar spinal cord, subsequent encounter

S34.115S Complete lesion of L5 level of lumbar spinal cord, sequela

S34.119A Complete lesion of unspecified level of lumbar spinal cord, initial encounter

S34.119D Complete lesion of unspecified level of lumbar spinal cord, subsequent encounter

S34.119S Complete lesion of unspecified level of lumbar spinal cord, sequela

S34.121A Incomplete lesion of L1 level of lumbar spinal cord, initial encounter

S34.121D Incomplete lesion of L1 level of lumbar spinal cord, subsequent encounter

S34.121S Incomplete lesion of L1 level of lumbar spinal cord, sequela

S34.122A Incomplete lesion of L2 level of lumbar spinal cord, initial encounter

S34.122D Incomplete lesion of L2 level of lumbar spinal cord, subsequent encounter

S34.122S Incomplete lesion of L2 level of lumbar spinal cord, sequela

S34.123A Incomplete lesion of L3 level of lumbar spinal cord, initial encounter

S34.123D Incomplete lesion of L3 level of lumbar spinal cord, subsequent encounter

S34.123S Incomplete lesion of L3 level of lumbar spinal cord, sequela

S34.124A Incomplete lesion of L4 level of lumbar spinal cord, initial encounter

S34.124D Incomplete lesion of L4 level of lumbar spinal cord, subsequent encounter

S34.124S Incomplete lesion of L4 level of lumbar spinal cord, sequela

S34.125A Incomplete lesion of L5 level of lumbar spinal cord, initial encounter

S34.125D Incomplete lesion of L5 level of lumbar spinal cord, subsequent encounter

S34.125S Incomplete lesion of L5 level of lumbar spinal cord, sequela

S34.129A Incomplete lesion of unspecified level of lumbar spinal cord, initial encounter

S34.129D Incomplete lesion of unspecified level of lumbar spinal cord, subsequent encounter

S34.129S Incomplete lesion of unspecified level of lumbar spinal cord, sequela

S34.131A Complete lesion of sacral spinal cord, initial encounter

S34.131D Complete lesion of sacral spinal cord, subsequent encounter

S34.131S Complete lesion of sacral spinal cord, sequela

S34.132A Incomplete lesion of sacral spinal cord, initial encounter

S34.132D Incomplete lesion of sacral spinal cord, subsequent encounter

S34.132S Incomplete lesion of sacral spinal cord, sequela

S34.139A Unspecified injury to sacral spinal cord, initial encounter

S34.139D Unspecified injury to sacral spinal cord, subsequent encounter

S34.139S Unspecified injury to sacral spinal cord, sequela

S34.3XXA Injury of cauda equina, initial encounter

S34.3XXD Injury of cauda equina, subsequent encounter

S34.3XXS Injury of cauda equina, sequela

RIMABOTULINUMTOXINB (MYOBLOC®) IS CONSIDERED MEDICALLY NECESSARY FOR THE FOLLOWING INDICATIONS:

G24.3 Spasmodic torticollis
K11.20 Sialoadenitis, unspecified

K11.21 Acute sialoadenitis

K11.22 Acute recurrent sialoadenitis

K11.23 Chronic sialoadenitis

K11.7 Disturbances of salivary secretion

BENEFIT CONTRACT EXCLUSION

ONABOTULINUMTOXINA (BOTOX® and BOTOX® COSMETIC), RIMABOTULINUMTOXINB (MYOBLOC®), ABOBOTULINUMTOXINA (DYSPORT®), OR INCOBOTULINUMTOXINA (XEOMIN®) ARE COSMETIC WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODES:

L57.2 Cutis rhomboidalis nuchae

L57.4 Cutis laxa senilis

L57.8 Other skin changes due to chronic exposure to nonionizing radiation

L90.8 Other atrophic disorders of skin

L90.9 Atrophic disorder of skin, unspecified

L91.8 Other hypertrophic disorders of the skin

L91.9 Hypertrophic disorder of the skin, unspecified

L98.8 Other specified disorders of the skin and subcutaneous tissue

R23.8 Other skin changes

R23.9 Unspecified skin changes

Version Effective Date: 12/16/2019
Version Issued Date: 12/16/2019
Version Reissued Date: N/A

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