U-M Premier Care Therapy Diagnosis Codes - BCBSM

U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

C00.2

Lip, unspecified vermillion border

C00.9

Malignant neoplasm of lip, unspecified

C02

Malignant neoplasm tongue

C02.1

Malignant neoplasm tip and lateral border of tongue

C02.3

Malignant neoplasm anterior two-thirds of tongue, part unspecified

C07

Malignant neoplasm of major salivary glands

C08.0

Malignant neoplasm submandibular gland

C04.9

Malignant neoplasm floor of mouth, part unspecified

C05.0

Malignant neoplasm hard palate

C05.1

Malignant neoplasm soft palate

C05.9

Malignant neoplasm plate, unspecified

C05.8

Malignant neoplasm of overlapping sites of palate

C06.2

Malignant neoplasm retromolar area

C06.9

Malignant neoplasm mouth, unspecified

C09.9

Malignant neoplasm of oropharynx

C09.8

Malignant neoplasm of overlapping sites of tonsil

C09.0

Malignant neoplasm tonsillar fossa

C11.9

Malignant neoplasm nasopharynx, unspecified

C13.0

Malignant neoplasm of hypopharynx

C12

Malignant neoplasm pyriform sinus

C13.9

Malignant neoplasm hypopharynx, unspecified

C14.0

Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx

C14.2

Malignant neoplasm of waldeyer's ring

C14.8

Malignant neuroplasm of overlapping sites of lip, oral cavity and pharynx

C15.9

Malignant neoplasm esophagus, unspecified

C30.0

Malignant neoplasm of nasal cavities, middle ear and accessory sinuses

C31.0

Malignant neoplasm maxillary sinus

C31.1

Malignant neoplasm ethmoidal sinus

C31.2

Malignant neoplasm frontal sinus

C31.3

Malignant neoplasm sphenoidal sinus

C32.0

Malignant neoplasm of Larynx

C32.1

Malignant neoplasm supraglottis

C32.2

Malignant neoplasm subglottis

C32.9

Malignant neoplasm larynx, unspecified

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

C33

Malignant neoplasm of trachea, bronchus and lung

C34.00

Malignant neoplasm of unspecified main bronchus

C34.01

Malignant neoplasm of right main bronchus

C34.02

Malignant neuroplasm of left main bronchus

C34.10

Malignant neoplasm of upper lobe, unspecified main bronchus or lung

C34.11

Malignant neoplasm of upper lobe, right bronchus or lung

C34.12

Malignant neoplasm of upper lobe, left bronchus or lung

C34.2

Malignant neoplasm of middle lobe, bronchus or lung

C34.31

Malignant neoplasm of lower lobe, right bronchus or lung

C34.32

Malignant neoplasm of lower lobe, left bronchus or lung

C34.30

Malignant neoplasm of lower lobe, unspecified bronchus or lung

C34.80

Malignant neoplasm of overlapping sites of unspecified bronchus and lung

C34.82

Malignant neoplasm of overlapping sites of left bronchus and lung

C34.90

Malignant neoplasm of unspecified part of unspecified bronchus of lung

C34.91

Malignant neoplasm of unspecified part of right bronchus or lung

C34.92

Malignant neoplasm of unspecified part of left bronchus or lung

C41.0

Malignant neoplasm of bone and articular cartilage

C41.1

Malignant neoplasm mandible

C44.20

Malignant neoplasm of skin or unspecified ear and external auricular canal

C44.201 Malignant neoplasm skin of other and unspecified parts of face

C44.21

Malignant neoplasm of skin of right ear and external auricular canal

C44.22

Malignant neoplasm of skin of left ear and external aricular canal

C69.90

Malignant neoplasm eye, part unspecified

C69.91

Malignant neoplasm of unspecified site of right eye

C69.92

Malignant neoplasm of unspecified site or left eye

C71.0

Malignant neoplasm of the brain

C73

Malignant neoplasm of thyroid gland

C76.0

Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx

C76.1

Malignant neoplasm of thorax

C76.2

Malignant neoplasm of abdomen

C76.3

Malignant neoplasm of pelvis

C76.40

Malignant neoplasm of unspecified upper limb

C76.41

Malignant neoplasm of right upper limb

C76.42

Malignant neoplasm of left upper limb

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

C76.50

Malignant neoplasm of unspecified lower limb

C76.51

Malignant neoplasm of right lower limb

C76.52

Malignant neoplasm of left lower limb

C76.8

Malignant neoplasm of other specified ill-defined sites

C457

Mesothelioma of other sites

C77.0

Secondary and unspecified malignant neoplasm of lymph nodes

C77.1

Secondary and unsp malignant neoplasm of intrathorac nodes

C77.2

Secondary and unsp malignant neoplasm of intra-abd nodes

C77.3

Sec and unsp malig neoplasm of axilla and upper limb nodes

C77.4

Sec and unsp malig neoplasm of inguinal and lower limb nodes

C77.5

Secondary and unsp malignant neoplasm of intrapelv nodes

C77.8

Sec and unsp malig neoplasm of nodes of multiple regions

C77.9

Secondary and unsp malignant neoplasm of lymph node, unsp

G12.9

Spinal muscular atrophy

G20

Parkinson's disease

G21.4

Vascular parkinsonism

G81.00

Flaccid hemiplegia affecting unspecified side

G81.01

Flaccid hemiplegia affecting right dominant side

G81.02

Flaccid hemiplegia affecting left dominant side

G81.03

Flaccid hemiplegia affecting right nondominant side

G81.04

Flaccid hemiplegia affecting left nondominant side

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

G81.90

Hemiplegia unspecified affecting unspecified side

G81.91

Hemiplegia unspecified affecting right dominant side

G81.92

Hemiplegia, unspecified affecting left dominant side

G81.93

Hemiplegia, unspecified affecting right nondominant side

G81.94

Hemiplegia, unspecified affecting left nondominant side

G81.90

Hemiplegia unspecified affecting unspecified side

G81.91

Hemiplegia unspecified affecting right dominant side

G81.92

Hemiplegia unspecified affecting left dominant side

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

G81.93

Hemiplegia, unspecified affecting right nondominant side

G81.94

Hemiplegia, unspecified affecting left nondominant side

G82.20

Paraplegia

G04.1

Tropical spastic paraplegia

G82.21

Paraplegia, complete

G82.22

Paraplegia, incomplete

G93.1

Anoxic brain damage, not elsewhere classified

G93.40

Encephalopathy, unspecified

G93.41

Encephalopathy-metabolic

G93.49

Encephalopathy-other

G93.1

Encephalopathy-anoxic

G54.0

Nerve root and plexus disorders

G56.30

Mononeuritis of upper limb and monoeuritis multiplex lesion of radial nerve

G56.31

Lesion of radial nerve, right upper limb

G56.32

Lesion of radial nerve, left upper limb

G56.33

Lesion of radial nerve, bilateral upper limb

G61.0

Guillain-Bare syndrome

G61.81

Chronic inflammatory demyelinating polyneuritis

H90.3

Sensorineural hearing loss, bilateral

I60.00

Ntrm subarach hemorrhage from unsp carotid siphon and bifurc

I60.01

Ntrm subarach hemor from right carotid siphon and bifurc

I60.02

Ntrm subarach hemorrhage from left carotid siphon and bifurc

I60.10

Ntrm subarach hemorrhage from unsp middle cerebral artery

I60.11

Ntrm subarach hemorrhage from right middle cerebral artery

I60.12

Ntrm subarach hemorrhage from left middle cerebral artery

I60.30

Ntrm subarach hemor from unsp posterior communicating artery

I60.31

Ntrm subarach hemor from right post communicating artery

I60.32

Ntrm subarach hemor from left posterior communicating artery

I60.4

Nontraumatic subarachnoid hemorrhage from basilar artery

I60.50

Nontraumatic subarachnoid hemorrhage from unsp verteb art

I60.51

Nontraumatic subarachnoid hemorrhage from r verteb art

I60.52

Nontraumatic subarachnoid hemorrhage from l verteb art

I60.6

Nontraumatic subarachnoid hemorrhage from oth intracran art

I60.7

Nontraumatic subarachnoid hemorrhage from unsp intracran art

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

I60.8

Other nontraumatic subarachnoid hemorrhage

I60.9

Nontraumatic subarachnoid hemorrhage, unspecified

I61.0

Nontraumatic intracerebral hemorrhage in hemisphere cortical

I61.1

Nontraumatic intracerebral hemorrhage in hemisphere subcortical

I61.2

Nontraumatic intracerebral hemorrhage in hemisphere unspecified

I61.3

Nontraumatic intracerebral hemorrhage in brain stem

I61.4

Nontraumatic intracerebral hemorrhage in cerebellum

I61.5

Nontraumatic intracerebral hemorrhage inventraventricular

I61.6

Nontraumatic intracerebral hemorrhage, multiple localized

I61.8

Other nontraumatic intracerebral hemorrhage

I61.9

Nontraumatic intracerebral hemorrhage, unspecified

I63.50

Cereb infrc d/t unsp occls or stenos of unsp cereb art

I63.511

Cereb infrc d/t unsp occls or stenos of right mid cereb art

I63.512

Cereb infrc d/t unsp occls or stenos of left mid cereb art

I63.519

Cereb infrc d/t unsp occls or stenos of unsp mid cereb art

I63.521

Cereb infrc d/t unsp occls or stenos of right ant cereb art

I63.522

Cereb infrc d/t unsp occls or stenos of left ant cereb art

I63.529

Cereb infrc d/t unsp occls or stenos of unsp ant cereb art

I63.531

Cereb infrc d/t unsp occls or stenos of right post cereb art

I63.532

Cereb infrc d/t unsp occls or stenos of left post cereb art

I63.539

Cereb infrc d/t unsp occls or stenos of unsp post cereb art

I63.541

Cereb infrc due to unsp occls or stenos of right cereblr art

I63.542

Cereb infrc due to unsp occls or stenos of left cereblr art

I63.549

Cereb infrc due to unsp occls or stenos of unsp cereblr art

I63.59

Cereb infrc due to unsp occls or stenosis of cerebral artery

I63.8

Other cerebral infarction

I63.9

Cerebral infarction, unspecified

I97.2

Post mastectomy lymphedema syndrome

I89.0

Other Lymphedema

I89.1

Lymphangitis

I89.8

Other noninfectious disorders of lymphatic channels

I89.9

Unspecified noninfectious disorder of lymphatic channels

M27.8

Other specified diseases of the jaws

K13.1

Cheek and lip biting

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

K13.4

Granuloma and granuloma-like lesions of oral mucosa

K13.6

Irritative hyperplasia of oral mucosa

K13.70

Unspecified lesions of oral mucosa

K13.79

Other lesions of oral mucosa

M05.40

Rheumatoid myopathy with rheumatoid arthritis of unsp site

M05.411 Rheumatoid myopathy w rheumatoid arthritis of right shoulder

M05.412 Rheumatoid myopathy w rheumatoid arthritis of left shoulder

M05.419 Rheumatoid myopathy w rheumatoid arthritis of unsp shoulder

M05.421 Rheumatoid myopathy with rheumatoid arthritis of right elbow

M05.422 Rheumatoid myopathy with rheumatoid arthritis of left elbow

M05.429 Rheumatoid myopathy with rheumatoid arthritis of unsp elbow

M05.431 Rheumatoid myopathy with rheumatoid arthritis of right wrist

M05.432 Rheumatoid myopathy with rheumatoid arthritis of left wrist

M05.439 Rheumatoid myopathy with rheumatoid arthritis of unsp wrist

M05.441 Rheumatoid myopathy with rheumatoid arthritis of right hand

M05.442 Rheumatoid myopathy with rheumatoid arthritis of left hand

M05.449 Rheumatoid myopathy with rheumatoid arthritis of unsp hand

M05.451 Rheumatoid myopathy with rheumatoid arthritis of right hip

M05.452 Rheumatoid myopathy with rheumatoid arthritis of left hip

M05.459 Rheumatoid myopathy with rheumatoid arthritis of unsp hip

M05.461 Rheumatoid myopathy with rheumatoid arthritis of right knee

M05.462 Rheumatoid myopathy with rheumatoid arthritis of left knee

M05.469 Rheumatoid myopathy with rheumatoid arthritis of unsp knee

M05.471 Rheumatoid myopathy w rheumatoid arthritis of right ank/ft

M05.472 Rheumatoid myopathy w rheumatoid arthritis of left ank/ft

M05.479 Rheumatoid myopathy w rheumatoid arthritis of unsp ank/ft

M05.49

Rheumatoid myopathy w rheumatoid arthritis of multiple sites

M05.50

Rheumatoid polyneurop w rheumatoid arthritis of unsp site

M05.511 Rheumatoid polyneurop w rheumatoid arthritis of r shoulder

M05.512 Rheumatoid polyneurop w rheumatoid arthritis of l shoulder

M05.519 Rheu polyneurop w rheumatoid arthritis of unsp shoulder

M05.521 Rheumatoid polyneurop w rheumatoid arthritis of right elbow

M05.522 Rheumatoid polyneurop w rheumatoid arthritis of left elbow

M05.529 Rheumatoid polyneurop w rheumatoid arthritis of unsp elbow

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

M05.531 Rheumatoid polyneurop w rheumatoid arthritis of right wrist

M05.532 Rheumatoid polyneurop w rheumatoid arthritis of left wrist

M05.539 Rheumatoid polyneurop w rheumatoid arthritis of unsp wrist

M05.541 Rheumatoid polyneurop w rheumatoid arthritis of right hand

M05.542 Rheumatoid polyneurop w rheumatoid arthritis of left hand

M05.549 Rheumatoid polyneurop w rheumatoid arthritis of unsp hand

M05.551 Rheumatoid polyneurop w rheumatoid arthritis of right hip

M05.552 Rheumatoid polyneuropathy w rheumatoid arthritis of left hip

M05.559 Rheumatoid polyneuropathy w rheumatoid arthritis of unsp hip

M05.561 Rheumatoid polyneurop w rheumatoid arthritis of right knee

M05.562 Rheumatoid polyneurop w rheumatoid arthritis of left knee

M05.569 Rheumatoid polyneurop w rheumatoid arthritis of unsp knee

M05.571 Rheumatoid polyneurop w rheumatoid arthritis of right ank/ft

M05.572 Rheumatoid polyneurop w rheumatoid arthritis of left ank/ft

M05.579 Rheumatoid polyneurop w rheumatoid arthritis of unsp ank/ft

M05.59

Rheumatoid polyneuropathy w rheumatoid arthritis mult site

M05.70

Rheu arthritis w rheu factor of unsp site w/o org/sys involv

M05.711 Rheu arthritis w rheu factor of r shoulder w/o org/sys involv

M05.712 Rheu arthritis w rheu factor of l shoulder w/o org/sys involv

M05.719 Rheu arthritis w rheu factor of unsp shldr w/o org/sys involv

M05.721 Rheu arthritis w rheu factor of r elbow w/o org/sys involv

M05.722 Rheu arthritis w rheu factor of l elbow w/o org/sys involv

M05.729 Rheu arthritis w rheu factor of unsp elbow w/o org/sys involv

M05.731 Rheu arthritis w rheu factor of r wrist w/o org/sys involv

M05.732 Rheu arthritis w rheu factor of l wrist w/o org/sys involv

M05.739 Rheu arthritis w rheu factor of unsp wrist w/o org/sys involv

M05.741 Rheu arthritis w rheu factor of r hand w/o org/sys involv

M05.742 Rheu arthritis w rheu factor of left hand w/o org/sys involv

M05.749 Rheu arthritis w rheu factor of unsp hand w/o org/sys involv

M05.751 Rheu arthritis w rheu factor of right hip w/o org/sys involv

M05.752 Rheu arthritis w rheu factor of left hip w/o org/sys involv

M05.759 Rheu arthritis w rheu factor of unsp hip w/o org/sys involv

M05.761 Rheu arthritis w rheu factor of r knee w/o org/sys involv

M05.762 Rheu arthritis w rheu factor of left knee w/o org/sys involv

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U-M Premier Care Primary (Major) Diagnosis Codes for Therapies

ICD-10 code Description

M05.769 Rheu arthritis w rheu factor of unsp knee w/o org/sys involv

M05.771 Rheu arthritis w rheu fctr of right ank/ft w/o org/sys involv

M05.772 Rheu arthritis w rheu factor of left ank/ft w/o org/sys involv

M05.779 Rheu arthritis w rheu factor of unsp ank/ft w/o org/sys involv

M05.79

Rheu arthritis w rheu factor mult site w/o org/sys involv

M05.80

Oth rheumatoid arthritis with rheumatoid factor of unsp site

M05.811 Oth rheumatoid arthritis w rheumatoid factor of r shoulder

M05.812 Oth rheumatoid arthritis w rheumatoid factor of l shoulder

M05.819 Oth rheu arthritis w rheumatoid factor of unsp shoulder

M05.821 Oth rheumatoid arthritis w rheumatoid factor of right elbow

M05.822 Oth rheumatoid arthritis w rheumatoid factor of left elbow

M05.829 Oth rheumatoid arthritis w rheumatoid factor of unsp elbow

M05.831 Oth rheumatoid arthritis w rheumatoid factor of right wrist

M05.832 Oth rheumatoid arthritis w rheumatoid factor of left wrist

M05.839 Oth rheumatoid arthritis w rheumatoid factor of unsp wrist

M05.841 Oth rheumatoid arthritis w rheumatoid factor of right hand

M05.842 Oth rheumatoid arthritis with rheumatoid factor of left hand

M05.849 Oth rheumatoid arthritis with rheumatoid factor of unsp hand

M05.851 Oth rheumatoid arthritis with rheumatoid factor of right hip

M05.852 Oth rheumatoid arthritis with rheumatoid factor of left hip

M05.859 Oth rheumatoid arthritis with rheumatoid factor of unsp hip

M05.861 Oth rheumatoid arthritis w rheumatoid factor of right knee

M05.862 Oth rheumatoid arthritis with rheumatoid factor of left knee

M05.869 Oth rheumatoid arthritis with rheumatoid factor of unsp knee

M05.871 Oth rheumatoid arthritis w rheumatoid factor of right ank/ft

M05.872 Oth rheumatoid arthritis w rheumatoid factor of left ank/ft

M05.879 Oth rheumatoid arthritis w rheumatoid factor of unsp ank/ft

M05.89

Oth rheumatoid arthritis w rheumatoid factor mult site

M05.9

Rheumatoid arthritis with rheumatoid factor, unspecified

M06.00

Rheumatoid arthritis without rheumatoid factor, unsp site

M06.011 Rheumatoid arthritis w/o rheumatoid factor, right shoulder

M06.012 Rheumatoid arthritis w/o rheumatoid factor, left shoulder

M06.019 Rheumatoid arthritis w/o rheumatoid factor, unsp shoulder

M06.021 Rheumatoid arthritis without rheumatoid factor, right elbow

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