Notification



Notification Issue Date:



Policy Attachment


Attachment to Policy # 10.02.02i


Attachment:A

Policy #:10.02.02i

Description:Medically necessary ICD-10 diagnosis codes

Title:Chiropractic Spinal and Extraspinal Manipulation Therapy


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.



A18.01 Tuberculosis of spine

G24.3 Spasmodic torticollis

G44.1 Vascular headache, not elsewhere classified

G44.209 Tension-type headache, unspecified, not intractable

G54.1 Lumbosacral plexus disorders

G54.2 Cervical root disorders, not elsewhere classified

G54.3 Thoracic root disorders, not elsewhere classified

G54.4 Lumbosacral root disorders, not elsewhere classified

G54.8 Other nerve root and plexus disorders

G54.9 Nerve root and plexus disorder, unspecified

G55 Nerve root and plexus compressions in diseases classified elsewhere

M15.3 Secondary multiple arthritis

M15.4 Erosive (osteo)arthritis

M15.8 Other polyosteoarthritis

M21.751 Unequal limb length (acquired), right femur

M21.752 Unequal limb length (acquired), left femur

M21.761 Unequal limb length (acquired), right tibia

M21.762 Unequal limb length (acquired), left tibia

M21.763 Unequal limb length (acquired), right fibula

M21.764 Unequal limb length (acquired), left fibula

M25.50 Pain in unspecified joint

M25.60 Stiffness of unspecified joint, not elsewhere classified

M25.78 Osteophyte, vertebrae

M40.00 Postural kyphosis, site unspecified

M40.03 Postural kyphosis, cervicothoracic region

M40.04 Postural kyphosis, thoracic region

M40.05 Postural kyphosis, thoracolumbar region

M40.10 Other secondary kyphosis, site unspecified

M40.12 Other secondary kyphosis, cervical region

M40.13 Other secondary kyphosis, cervicothoracic region

M40.14 Other secondary kyphosis, thoracic region

M40.15 Other secondary kyphosis, thoracolumbar region

M40.202 Unspecified kyphosis, cervical region

M40.203 Unspecified kyphosis, cervicothoracic region

M40.204 Unspecified kyphosis, thoracic region

M40.205 Unspecified kyphosis, thoracolumbar region

M40.209 Unspecified kyphosis, site unspecified

M40.40 Postural lordosis, site unspecified

M40.45 Postural lordosis, thoracolumbar region

M40.46 Postural lordosis, lumbar region

M40.47 Postural lordosis, lumbosacral region

M40.50 Lordosis, unspecified, site unspecified

M40.55 Lordosis, unspecified, thoracolumbar region

M40.56 Lordosis, unspecified, lumbar region

M40.57 Lordosis, unspecified, lumbosacral region

M41.00 Infantile idiopathic scoliosis, site unspecified

M41.02 Infantile idiopathic scoliosis, cervical region

M41.03 Infantile idiopathic scoliosis, cervicothoracic region

M41.04 Infantile idiopathic scoliosis, thoracic region

M41.05 Infantile idiopathic scoliosis, thoracolumbar region

M41.06 Infantile idiopathic scoliosis, lumbar region

M41.07 Infantile idiopathic scoliosis, lumbosacral region

M41.08 Infantile idiopathic scoliosis, sacral and sacrococcygeal region

M41.112 Juvenile idiopathic scoliosis, cervical region

M41.113 Juvenile idiopathic scoliosis, cervicothoracic region

M41.114 Juvenile idiopathic scoliosis, thoracic region

M41.115 Juvenile idiopathic scoliosis, thoracolumbar region

M41.116 Juvenile idiopathic scoliosis, lumbar region

M41.117 Juvenile idiopathic scoliosis, lumbosacral region

M41.119 Juvenile idiopathic scoliosis, site unspecified

M41.122 Adolescent idiopathic scoliosis, cervical region

M41.123 Adolescent idiopathic scoliosis, cervicothoracic region

M41.124 Adolescent idiopathic scoliosis, thoracic region

M41.125 Adolescent idiopathic scoliosis, thoracolumbar region

M41.126 Adolescent idiopathic scoliosis, lumbar region

M41.127 Adolescent idiopathic scoliosis, lumbosacral region

M41.129 Adolescent idiopathic scoliosis, site unspecified

M41.20 Other idiopathic scoliosis, site unspecified

M41.22 Other idiopathic scoliosis, cervical region

M41.23 Other idiopathic scoliosis, cervicothoracic region

M41.24 Other idiopathic scoliosis, thoracic region

M41.25 Other idiopathic scoliosis, thoracolumbar region

M41.26 Other idiopathic scoliosis, lumbar region

M41.27 Other idiopathic scoliosis, lumbosacral region

M41.30 Thoracogenic scoliosis, site unspecified

M41.34 Thoracogenic scoliosis, thoracic region

M41.35 Thoracogenic scoliosis, thoracolumbar region

M41.40 Neuromuscular scoliosis, site unspecified

M41.41 Neuromuscular scoliosis, occipito-atlanto-axial region

M41.42 Neuromuscular scoliosis, cervical region

M41.43 Neuromuscular scoliosis, cervicothoracic region

M41.44 Neuromuscular scoliosis, thoracic region

M41.45 Neuromuscular scoliosis, thoracolumbar region

M41.46 Neuromuscular scoliosis, lumbar region

M41.47 Neuromuscular scoliosis, lumbosacral region

M41.50 Other secondary scoliosis, site unspecified

M41.52 Other secondary scoliosis, cervical region

M41.53 Other secondary scoliosis, cervicothoracic region

M41.54 Other secondary scoliosis, thoracic region

M41.55 Other secondary scoliosis, thoracolumbar region

M41.56 Other secondary scoliosis, lumbar region

M41.57 Other secondary scoliosis, lumbosacral region

M41.80 Other forms of scoliosis, site unspecified

M41.82 Other forms of scoliosis, cervical region

M41.83 Other forms of scoliosis, cervicothoracic region

M41.84 Other forms of scoliosis, thoracic region

M41.85 Other forms of scoliosis, thoracolumbar region

M41.86 Other forms of scoliosis, lumbar region

M41.87 Other forms of scoliosis, lumbosacral region

M41.9 Scoliosis, unspecified

M43.00 Spondylolysis, site unspecified

M43.01 Spondylolysis, occipito-atlanto-axial region

M43.02 Spondylolysis, cervical region

M43.03 Spondylolysis, cervicothoracic region

M43.04 Spondylolysis, thoracic region

M43.05 Spondylolysis, thoracolumbar region

M43.06 Spondylolysis, lumbar region

M43.07 Spondylolysis, lumbosacral region

M43.08 Spondylolysis, sacral and sacrococcygeal region

M43.09 Spondylolysis, multiple sites in spine

M43.10 Spondylolisthesis, site unspecified

M43.11 Spondylolisthesis, occipito-atlanto-axial region

M43.12 Spondylolisthesis, cervical region

M43.13 Spondylolisthesis, cervicothoracic region

M43.14 Spondylolisthesis, thoracic region

M43.15 Spondylolisthesis, thoracolumbar region

M43.16 Spondylolisthesis, lumbar region

M43.17 Spondylolisthesis, lumbosacral region

M43.18 Spondylolisthesis, sacral and sacrococcygeal region

M43.19 Spondylolisthesis, multiple sites in spine

M43.20 Fusion of spine, site unspecified

M43.21 Fusion of spine, occipito-atlanto-axial region

M43.22 Fusion of spine, cervical region

M43.23 Fusion of spine, cervicothoracic region

M43.24 Fusion of spine, thoracic region

M43.25 Fusion of spine, thoracolumbar region

M43.26 Fusion of spine, lumbar region

M43.27 Fusion of spine, lumbosacral region

M43.28 Fusion of spine, sacral and sacrococcygeal region

M43.6 Torticollis

M43.8x1 Other specified deforming dorsopathies, occipito-atlanto-axial region

M43.8x2 Other specified deforming dorsopathies, cervical region

M43.8x3 Other specified deforming dorsopathies, cervicothoracic region

M43.8x4 Other specified deforming dorsopathies, thoracic region

M43.8x5 Other specified deforming dorsopathies, thoracolumbar region

M43.8x6 Other specified deforming dorsopathies, lumbar region

M43.8x7 Other specified deforming dorsopathies, lumbosacral region

M43.8x8 Other specified deforming dorsopathies, sacral and sacrococcygeal region

M43.8x9 Other specified deforming dorsopathies, site unspecified

M43.9 Deforming dorsopathy, unspecified

M46.40 Discitis, unspecified, site unspecified

M46.41 Discitis, unspecified, occipito-atlanto-axial region

M46.42 Discitis, unspecified, cervical region

M46.43 Discitis, unspecified, cervicothoracic region

M46.44 Discitis, unspecified, thoracic region

M46.45 Discitis, unspecified, thoracolumbar region

M46.46 Discitis, unspecified, lumbar region

M46.47 Discitis, unspecified, lumbosacral region

M46.48 Discitis, unspecified, sacral and sacrococcygeal region

M46.49 Discitis, unspecified, multiple sites in spine

M47.20 Other spondylosis with radiculopathy, site unspecified

M47.21 Other spondylosis with radiculopathy, occipito-atlanto-axial region

M47.22 Other spondylosis with radiculopathy, cervical region

M47.23 Other spondylosis with radiculopathy, cervicothoracic region

M47.24 Other spondylosis with radiculopathy, thoracic region

M47.25 Other spondylosis with radiculopathy, thoracolumbar region

M47.26 Other spondylosis with radiculopathy, lumbar region

M47.27 Other spondylosis with radiculopathy, lumbosacral region

M47.28 Other spondylosis with radiculopathy, sacral and sacrococcygeal region

M47.811 Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region

M47.812 Spondylosis without myelopathy or radiculopathy, cervical region

M47.813 Spondylosis without myelopathy or radiculopathy, cervicothoracic region

M47.814 Spondylosis without myelopathy or radiculopathy, thoracic region

M47.815 Spondylosis without myelopathy or radiculopathy, thoracolumbar region

M47.816 Spondylosis without myelopathy or radiculopathy, lumbar region

M47.817 Spondylosis without myelopathy or radiculopathy, lumbosacral region

M47.818 Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region

M47.819 Spondylosis without myelopathy or radiculopathy, site unspecified

M47.891 Other spondylosis, occipito-atlanto-axial region

M47.892 Other spondylosis, cervical region

M47.893 Other spondylosis, cervicothoracic region

M47.894 Other spondylosis, thoracic region

M47.895 Other spondylosis, thoracolumbar region

M47.896 Other spondylosis, lumbar region

M47.897 Other spondylosis, lumbosacral region

M47.898 Other spondylosis, sacral and sacrococcygeal region

M47.899 Other spondylosis, site unspecified

M47.9 Spondylosis, unspecified

M48.01 Spinal stenosis, occipito-atlanto-axial region

M48.02 Spinal stenosis, cervical region

M48.03 Spinal stenosis, cervicothoracic region

M48.04 Spinal stenosis, thoracic region

M48.05 Spinal stenosis, thoracolumbar region

M48.061 Spinal stenosis, lumbar region without neurogenic claudication

M48.062 Spinal stenosis, lumbar region with neurogenic claudication

M48.07 Spinal stenosis, lumbosacral region

M48.10 Ankylosing hyperostosis [Forestier], site unspecified

M48.11 Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region

M48.12 Ankylosing hyperostosis [Forestier], cervical region

M48.13 Ankylosing hyperostosis [Forestier], cervicothoracic region

M48.14 Ankylosing hyperostosis [Forestier], thoracic region

M48.15 Ankylosing hyperostosis [Forestier], thoracolumbar region

M48.16 Ankylosing hyperostosis [Forestier], lumbar region

M48.17 Ankylosing hyperostosis [Forestier], lumbosacral region

M48.18 Ankylosing hyperostosis [Forestier], sacral and sacrococcygeal region

M48.19 Ankylosing hyperostosis [Forestier], multiple sites in spine

M48.20 Kissing spine, site unspecified

M48.21 Kissing spine, occipito-atlanto-axial region

M48.22 Kissing spine, cervical region

M48.23 Kissing spine, cervicothoracic region

M48.24 Kissing spine, thoracic region

M48.25 Kissing spine, thoracolumbar region

M48.26 Kissing spine, lumbar region

M48.27 Kissing spine, lumbosacral region

M48.30 Traumatic spondylopathy, site unspecified

M48.31 Traumatic spondylopathy, occipito-atlanto-axial region

M48.32 Traumatic spondylopathy, cervical region

M48.33 Traumatic spondylopathy, cervicothoracic region

M48.34 Traumatic spondylopathy, thoracic region

M48.35 Traumatic spondylopathy, thoracolumbar region

M48.36 Traumatic spondylopathy, lumbar region

M48.37 Traumatic spondylopathy, lumbosacral region

M48.38 Traumatic spondylopathy, sacral and sacrococcygeal region

M48.9 Spondylopathy, unspecified

M50.20 Other cervical disc displacement, unspecified cervical region

M50.21 Other cervical disc displacement, high cervical region

M50.22 Other cervical disc displacement, mid-cervical region

M50.23 Other cervical disc displacement, cervicothoracic region

M50.30 Other cervical disc degeneration, unspecified cervical region

M50.31 Other cervical disc degeneration, high cervical region

M50.32 Other cervical disc degeneration, mid-cervical region

M50.33 Other cervical disc degeneration, cervicothoracic region

M50.80 Other cervical disc disorders, unspecified cervical region

M50.81 Other cervical disc disorders, high cervical region

M50.82 Other cervical disc disorders, mid-cervical region

M50.83 Other cervical disc disorders, cervicothoracic region

M50.90 Cervical disc disorder, unspecified, unspecified cervical region

M50.91 Cervical disc disorder, unspecified, high cervical region

M50.92 Cervical disc disorder, unspecified, mid-cervical region

M50.93 Cervical disc disorder, unspecified, cervicothoracic 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

M51.24 Other intervertebral disc displacement, thoracic region

M51.25 Other intervertebral disc displacement, thoracolumbar region

M51.26 Other intervertebral disc displacement, lumbar region

M51.27 Other intervertebral disc displacement, lumbosacral region

M51.34 Other intervertebral disc degeneration, thoracic region

M51.35 Other intervertebral disc degeneration, thoracolumbar region

M51.36 Other intervertebral disc degeneration, lumbar region

M51.37 Other intervertebral disc degeneration, lumbosacral region

M51.84 Other intervertebral disc disorders, thoracic region

M51.85 Other intervertebral disc disorders, thoracolumbar region

M51.86 Other intervertebral disc disorders, lumbar region

M51.87 Other intervertebral disc disorders, lumbosacral region

M51.9 Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder

M53.0 Cervicocranial syndrome

M53.1 Cervicobrachial syndrome

M53.2x7 Spinal instabilities, lumbosacral region

M53.2x8 Spinal instabilities, sacral and sacrococcygeal region

M53.3 Sacrococcygeal disorders, not elsewhere classified

M53.80 Other specified dorsopathies, site unspecified

M53.81 Other specified dorsopathies, occipito-atlanto-axial region

M53.82 Other specified dorsopathies, cervical region

M53.83 Other specified dorsopathies, cervicothoracic region

M53.84 Other specified dorsopathies, thoracic region

M53.85 Other specified dorsopathies, thoracolumbar region

M53.86 Other specified dorsopathies, lumbar region

M53.87 Other specified dorsopathies, lumbosacral region

M53.88 Other specified dorsopathies, sacral and sacrococcygeal region

M53.9 Dorsopathy, unspecified

M54.03 Panniculitis affecting regions of neck and back, cervicothoracic region

M54.04 Panniculitis affecting regions of neck and back, thoracic region

M54.05 Panniculitis affecting regions of neck and back, thoracolumbar region

M54.06 Panniculitis affecting regions of neck and back, lumbar region

M54.07 Panniculitis affecting regions of neck and back, lumbosacral region

M54.08 Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region

M54.09 Panniculitis affecting regions, neck and back, multiple sites in spine

M54.14 Radiculopathy, thoracic region

M54.15 Radiculopathy, thoracolumbar region

M54.16 Radiculopathy, lumbar region

M54.17 Radiculopathy, lumbosacral region

M54.2 Cervicalgia

M54.31 Sciatica, right side

M54.32 Sciatica, left side

M54.41 Lumbago with sciatica, right side

M54.42 Lumbago with sciatica, left side

M54.5 Low back pain

M54.6 Pain in thoracic spine

M54.81 Occipital neuralgia

M54.89 Other dorsalgia

M54.9 Dorsalgia, unspecified

M60.10 Interstitial myositis of unspecified site

M60.111 Interstitial myositis, right shoulder

M60.112 Interstitial myositis, left shoulder

M60.121 Interstitial myositis, right upper arm

M60.122 Interstitial myositis, left upper arm

M60.131 Interstitial myositis, right forearm

M60.132 Interstitial myositis, left forearm

M60.141 Interstitial myositis, right hand

M60.142 Interstitial myositis, left hand

M60.151 Interstitial myositis, right thigh

M60.152 Interstitial myositis, left thigh

M60.161 Interstitial myositis, right lower leg

M60.162 Interstitial myositis, left lower leg

M60.171 Interstitial myositis, right ankle and foot

M60.172 Interstitial myositis, left ankle and foot

M60.18 Interstitial myositis, other site

M60.19 Interstitial myositis, multiple sites

M60.80 Other myositis, unspecified site

M60.811 Other myositis, right shoulder

M60.812 Other myositis, left shoulder

M60.821 Other myositis, right upper arm

M60.822 Other myositis, left upper arm

M60.831 Other myositis, right forearm

M60.832 Other myositis, left forearm

M60.841 Other myositis, right hand

M60.842 Other myositis, left hand

M60.851 Other myositis, right thigh

M60.852 Other myositis, left thigh

M60.861 Other myositis, right lower leg

M60.862 Other myositis, left lower leg

M60.871 Other myositis, right ankle and foot

M60.872 Other myositis, left ankle and foot

M60.88 Other myositis, other site

M60.89 Other myositis, multiple sites

M60.9 Myositis, unspecified

M62.40 Contracture of muscle, unspecified site

M62.411 Contracture of muscle, right shoulder

M62.412 Contracture of muscle, left shoulder

M62.421 Contracture of muscle, right upper arm

M62.422 Contracture of muscle, left upper arm

M62.431 Contracture of muscle, right forearm

M62.432 Contracture of muscle, left forearm

M62.441 Contracture of muscle, right hand

M62.442 Contracture of muscle, left hand

M62.451 Contracture of muscle, right thigh

M62.452 Contracture of muscle, left thigh

M62.461 Contracture of muscle, right lower leg

M62.462 Contracture of muscle, left lower leg

M62.471 Contracture of muscle, right ankle and foot

M62.472 Contracture of muscle, left ankle and foot

M62.48 Contracture of muscle, other site

M62.49 Contracture of muscle, multiple sites

M62.830 Muscle spasm of back

M62.831 Muscle spasm of calf

M62.838 Other muscle spasm

M79.10 Myalgia, specified site

M79.11 Myalgia of mastication muscle

M79.12 Myalgia of auxiliary muscles, head and neck

M79.18 Myalgia, other site

M79.7 Fibromyalgia

M95.3 Acquired deformity of neck

M95.5 Acquired deformity of pelvis

M96.1 Postlaminectomy syndrome, not elsewhere classified

M96.4 Postsurgical lordosis

M96.5 Postradiation scoliosis

M99.00 Segmental and somatic dysfunction of head region

M99.01 Segmental and somatic dysfunction of cervical region

M99.02 Segmental and somatic dysfunction of thoracic region

M99.03 Segmental and somatic dysfunction of lumbar region

M99.04 Segmental and somatic dysfunction of sacral region

M99.05 Segmental and somatic dysfunction of pelvic region

M99.08 Segmental and somatic dysfunction of rib cage

M99.20 Subluxation stenosis of neural canal of head region

M99.21 Subluxation stenosis of neural canal of cervical region

M99.22 Subluxation stenosis of neural canal of thoracic region

M99.23 Subluxation stenosis of neural canal of lumbar region

M99.30 Osseous stenosis of neural canal of head region

M99.31 Osseous stenosis of neural canal of cervical region

M99.32 Osseous stenosis of neural canal of thoracic region

M99.33 Osseous stenosis of neural canal of lumbar region

M99.40 Connective tissue stenosis of neural canal of head region

M99.41 Connective tissue stenosis of neural canal of cervical region

M99.42 Connective tissue stenosis of neural canal of thoracic region

M99.43 Connective tissue stenosis of neural canal of lumbar region

M99.50 Intervertebral disc stenosis of neural canal of head region

M99.51 Intervertebral disc stenosis of neural canal of cervical region

M99.52 Intervertebral disc stenosis of neural canal of thoracic region

M99.53 Intervertebral disc stenosis of neural canal of lumbar region

M99.60 Osseous and subluxation stenosis of intervertebral foramina of head region

M99.61 Osseous and subluxation stenosis of intervertebral foramina of cervical region

M99.62 Osseous and subluxation stenosis of intervertebral foramina of thoracic region

M99.63 Osseous and subluxation stenosis of intervertebral foramina of lumbar region

M99.70 Connective tissue and disc stenosis of intervertebral foramina of head region

M99.71 Connective tissue and disc stenosis of intervertebral foramina of cervical region

M99.72 Connective tissue and disc stenosis of intervertebral foramina of thoracic region

M99.73 Connective tissue and disc stenosis of intervertebral foramina of lumbar region

M99.81 Other biomechanical lesions of cervical region

M99.83 Other biomechanical lesions of lumbar region

M99.84 Other biomechanical lesions of sacral region

M99.85 Other biomechanical lesions of pelvic region

M99.89 Other biomechanical lesions of abdomen and other regions

Q67.5 Congenital deformity of spine

Q76.2 Congenital spondylolisthesis

Q76.3 Congenital scoliosis due to congenital bony malformation

Q76.425 Congenital lordosis, thoracolumbar region

Q76.426 Congenital lordosis, lumbar region

Q76.427 Congenital lordosis, lumbosacral region

Q76.428 Congenital lordosis, sacral and sacrococcygeal region

Q76.429 Congenital lordosis, unspecified region

Q76.49 Other congenital malformations of spine, not associated with scoliosis

R25.2 Cramp and spasm

R26.0 Ataxic gait

R26.1 Paralytic gait

R26.81 Unsteadiness on feet

R26.89 Other abnormalities of gait and mobility

R26.9 Unspecified abnormalities of gait and mobility

R29.3 Abnormal posture

R51 Headache

S13.4xxA Sprain of ligaments of cervical spine, initial encounter

S13.4xxD Sprain of ligaments of cervical spine, subsequent encounter

S13.4xxS Sprain of ligaments of cervical spine, sequela

S13.8xxA Sprain of joints and ligaments of other parts of neck, initial encounter

S13.8xxD Sprain of joints and ligaments of other parts of neck, subsequent encounter

S13.8xxS Sprain of joints and ligaments of other parts of neck, sequela

S13.9xxA Sprain of joints and ligaments of unspecified parts of neck, initial encounter

S13.9xxD Sprain of joints and ligaments of unspecified parts of neck, subsequent encounter

S13.9xxS Sprain of joints and ligaments of unspecified parts of neck, sequela

S16.1xxA Strain of muscle, fascia and tendon at neck level, initial encounter

S16.1xxD Strain of muscle, fascia and tendon at neck level, subsequent encounter

S16.1xxS Strain of muscle, fascia and tendon at neck level, sequela

S23.3xxA Sprain of ligaments of thoracic spine, initial encounter

S23.3xxD Sprain of ligaments of thoracic spine, subsequent encounter

S23.3xxS Sprain of ligaments of thoracic spine, sequela

S23.8xxA Sprain of other specified parts of thorax, initial encounter

S23.8xxD Sprain of other specified parts of thorax, subsequent encounter

S23.8xxS Sprain of other specified parts of thorax, sequela

S23.9xxA Sprain of unspecified parts of thorax, initial encounter

S23.9xxD Sprain of unspecified parts of thorax, subsequent encounter

S23.9xxS Sprain of unspecified parts of thorax, sequela

S33.5xxA Sprain of ligaments of lumbar spine, initial encounter

S33.5xxD Sprain of ligaments of lumbar spine, subsequent encounter

S33.5xxS Sprain of ligaments of lumbar spine, sequela

S33.6xxA Sprain of sacroiliac joint, initial encounter

S33.6xxD Sprain of sacroiliac joint, subsequent encounter

S33.6xxS Sprain of sacroiliac joint, sequela

S33.8xxA Sprain of other parts of lumbar spine and pelvis, initial encounter

S33.8xxD Sprain of other parts of lumbar spine and pelvis, subsequent encounter

S33.8xxS Sprain of other parts of lumbar spine and pelvis, sequela

S33.9xxA Sprain of unspecified parts of lumbar spine and pelvis, initial encounter

S33.9xxD Sprain of unspecified parts of lumbar spine and pelvis, subsequent encounter

S33.9xxS Sprain of unspecified parts of lumbar spine and pelvis, sequela

Version Effective Date: 10/01/2018
Version Issued Date: 10/01/2018
Version Reissued Date: N/A

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