ER Dx by hedongchenchen

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									                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000


UK-HMO Emergency Room (ER) Autopay CPT Code List
Updated 10-19-10

The automated ER list includes all the diagnosis codes that are set to
automatically pay through the system
DX CODE                 CODE DESCRIPTION
0050                      Other bacterial food poisoning: staphylococcal, botulism, due to
0051                       Clostridium perfringens, due to other Clostridia, due to Vibrio
0052                              parahaemolyticus, due to Vibrio vulnificus, other
0053
0054
00581
00589
0059                    FOOD POISONING NOS
00800                   E. Coli: unspecified, enteropathogenic, enterotoxigenic, enteroinvasive,
00801                   enterohemorrhagic, other; Arizona group of paracolon bacilli; Aervacter
00802                         aerogenes; Proteus; Other: staphylococcus, pseudomanas,
00803                       campylobacter, yersinia enterocolitica, clostridium difficile, other
00804                     anaerobes, other gram-negative bacteria, other; Vacterial enteritis,
00809                      unspecified; Enteritis due to specified virus: rotavirus, adenovirus,
0081                    norwalk virus, other small round viruses (SRVs), calicivirus, astrovirus,
                                          enterovirus NEC, other viral enteritis
0082
0083
0084
00841
00842
00843
00844
00845
00846
00847
00849
0085
0086
00861
00862
00863
00864
00865
00866
00867
00869
088                     Intestinal infection due to other organism, not elsewhere classified
090                     Infectious colitis, enteritis, and gastroenteritis
0091                       Colitis, enteritis, and gastroenteritis of presumed infectious origin;
                               Infectious diarrhea, Diarrhea of presumed infectious origin

                                                                                                    Page 1
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000
           Colitis, enteritis, and gastroenteritis of presumed infectious origin;
0092           Infectious diarrhea, Diarrhea of presumed infectious origin
0093
0340     Streptococcal Sore Throat
0341     SCARLET FEVER
0380     Septicemia: streptococall, staphylococcal (unspecified, aureus, other),
0381         pneumococcal, due to anaerobes, due to other gram-negative
03810               organisms (unspecified, hemophilus influenzae)
03811
03819
0382
0383
0384
03840
03841
03842    E. COLI SEPTICEMIA
03843       Septicemia due to other gram-negative organisms: pseudomonas,
03844                 serratia, other. Other specified septicemias
03849
0388
0389     SEPTICEMIA NOS
0470       Meningitis due to enterovirus: coxsackie virus, ECHO virus, other
0471                           specified viral meningitis
0478
0479                             VIRAL MENINGITIS NOS
06640    West Nile Fever, Unspecified
06641    West Nile Fever with encephalitis
06642    West Nile Fever with other neurologic manifestation
06649    West Nile Fever with other complications
07070    Unspecified viral hepatitis C without hepatic coma
07071    Unspecified viral hepatitis C with hepatic coma
075      Infectious mononucleosis
07981       Other specified viral and chlamydial infections: Hantavirus, SARS-
07982                              associated coronavirus
2501                        DIABETES WITH KETOACIDOSIS
25010
25011
25012
25013
2502
25020
25021
25022
25023
2503
25030    DM2 COMA NEC, NSU
25031    DM1 COMA NEC, NSU
25032    Diabetes with other coma, type II or unspecified type, uncontrolled



                                                                                    Page 2
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

25033    Diabetes with other coma, type I, uncontrolled
25080    DM2 W MANIFEST NEC, NSU
25081    DM1 W MANIFEST NEC, NSU
25082    DM2 W MANIFEST NEC, UNC
25083    DM1 W MANIFEST NEC, UNC
2510                      DIABETES-COMA,HYPOGLYCEMIA
2511
2512
25200                       Hyperparathyroidism, unspecified
25201                         Primary hyperparathyroidism
25202                  Secondary hyperparathyroidism, non-renal
25208                          Other hyperparatyhroidism
2740      Gout: arthropathy, nephropathy, nephropathy (unspecified), uric acid
2741      nephrolithiasis, other. Gouty tophi of ear, tophi of other sites, other
27410
27411
27419
2748
27481
27482
27489
2760     HYPEROSMOLALITY
2761     HYPOSMOLALITY
2765     HYPOVOLEMIA
2766     FLUID OVERLOAD
2767     HYPERPOTASSEMIA
2768     HYPOPOTASSEMIA
2769     ELECT/FLUID DISORD NEC
28262    HB-S DISEASE WITH CRISIS
28264    Sickle-cell/Hb-C disease with crisis
28269    Other sickle-cell disease with crisis
2848     APLASTIC ANEMIAS NEC
2860     CONG FACTOR VIII DISORD
2880     AGRANULOCYTOSIS
28959    Other diseases of spleen; other
29281    DRUG-INDUCED DELIRIUM
2930     ACUTE DELIRIUM
3102     POSTCONCUSSION SYNDROME
3220                  Meningitis: nonpyogenic, eosinophillic, chronic
3221
3222
3229     MENINGITIS NOS
32351    Encephalitis and encephalomyelitis following immunization procedures

32352    Myelitis following immunization procedures
32361    Infectious acute disseminated encephalomyelitis (ADEM)
32371    Toxic encephalitis and encephalomyelitis



                                                                                    Page 3
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

32372    Toxic myelitis
3361     Other diseases of spinal cord; vascular myelopathies
3450     Generalized nonconvulsive epilepsy
3454     Partial epilepsy, with impairment of consciousness
3455     Partial epilepsy, without mention of impairment of consciousness
3456     Infantile spasms
3459     Epilepsy, unspecified
34600      Migraine: classical (w/out mention of intractable migraine), common,
34601               variants, other (with intractable migraine, so stated)
3461
34610
34611
3462
34620
34621
3468
34680
34681
3482     Benign intracranial Hypertension
3490     LUMBAR PUNCTURE REACTION
3501     TRIGEMINAL NEURALGIA
36050          EYE INJURY/FOREIGN BODY/RETINAL DETACHMENT
36051
36052
36053
36054
36055
36059
3606
36060
36061
36062
36063
36064
36065
36069
3608
36081
36089
3609
361
3610
36100
36101
36102
36103
36104



                                                                                  Page 4
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

36105
36106
36107
3611
36110
36111
36112
36113
36114
36119
3612
3613
36130
36131
36132
36133
3618
36181
36189
36419
36400    ACUTE IRIDOCYCLITIS NOS
3643     IRIDOCYCLITIS NOS
3698     VISUAL LOSS, ONE EYE NOS
3699     VISUAL LOSS NOS
37000    CORNEAL ULCER NOS
37024    PHOTOKERATITIS
37040    KERATOCONJUNCTIVITIS NOS
3709     KERATITIS NOS
37182    CORNEA PBX/CONTACT LENS
37200    Acute conjunctivitis, unspecified
37202    Acute follicular conjunctivitis
37205    Acute atopic conjunctivitis
37313    ABSCESS OF EYELID
37601    ORBITAL CELLULITIS
37923    VITREOUS HEMORRHAGE
37991    Pain in or around eye
3810     Acute nonsuppurative otitis media
38100    Acute nonsuppurative otitis media, unspecified
38101    Acute serous otitis media
38102    Acute mucoid otitis media
38103    Acute sanguinous otitis media
38104    Acute allergic serous otitis media
38105    Acute allergic mucoid otitis media
38106    Acute allergic sanguinous otitis media
3815     Eustachian salpingitis
38150    Eustachian salpingitis, unspecified
38151    Acute Eustachian salpingitis



                                                          Page 5
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

38200      Acute suppurative otitis media without spontaneous rupture of ear
38201                drum, with spntaneous rupture of ear drum
38202
3821     Chronic tubotympanic suppurative otitis media
3822     Chronic atticoantral suppurative otitis media
3823     Unspecified chronic suppurative otitis media
38600    MENIERE'S DISEASE NOS
38610    PERIPHERAL VERTIGO NOS
38611    BEN PAROXYSMAL VERTIGO
38612    VESTIBULAR NEURONITIS
38619    PERIPHERAL VERTIGO NEC
3862     CENTRAL ORIGIN VERTIGO
38630    Labyrinthitis, unspecified
38811    Acoustic trauma (explosive) to ear
3882     Sudden hearing loss, unspecified
38871    Otogenic pain
4010     MALIGNANT HYPERTENSION
4019     Unspecified essential hypertension
40201    Malignant with heart failure
40211    Benign with heart failure
40291    HTN HEART DIS NOS W CHF
41001    ANTEROLAT AMI-INITIAL
41011    ANT AMI NEC-INITIAL
41021    Of inferolateral wall, initial episode of care
41031    Of inferoposterior wall, initial episode of care
41041    INF AMI NEC-INITIAL
41051    Of other lateral wall, initial episode of care
41061    True posterior wall infarction, initial episode of care
41071    SUBEND INFARCT-INIT
41081    Of other specified sites, initial episode of care
41090    AMI NOS-EPISODE NOS
41091    AMI NOS-INITIAL EPISODE
4111     INTERMED CORONARY SYND
4139     ANGINA PECTORIS NEC/NOS
41519    PULMON EMBOL/INFARCT NEC
4260     A/V BLOCK COMPLETE
42611    First degree atrioventricular block
4264     Right bundle branch block
427              CARDIAC DYSRHYTHMIAS, ACUTE HEART FAILURE
4270
4271
4272
4273
42731
42732
4274
42741



                                                                               Page 6
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

42742
4275
4276
42760
42761
42769
4278
42781
42789
4279
428
4280
4281
42821
42822
42823
4283
42830
42831
42832
42833
4284
42840
42841
42842
42843
4289
42789    Other specified cardiac dysrhythmias
4280     Congestive heart failure
42989    Other ill-defined heart diseases, other , carditis
430      Subarachnoid hemorrhage
431                                         TIA
432
4320
4321
4329
433
4330
43300
43301
4331
43310
43311
4332
43320
43321
4333



                                                              Page 7
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

43330
43331
4338
43380
43381
4339
43390
43391
434
4340
43400
43401
4341
43410
43411
4349
43490
43491
435
4350
4351
4352
4353
4358
4359
436
431      Intracerebral hemorrhage
4321     Subdural hemorrhage
4329     Unspecified intracranial hemorrhage
436      Acute, ill-defined, cerebrovascular disease
438      LATE EFFECTS OF CEREBROVASCULAR DISEASE
4411       Thoracic aneurysm: ruptured, without mention of rupture. Abdominal
4412                                aneurysm, ruptured.
4413
4414     ABD AORTIC ANEURYSM
4415       Aortic aneurysm of unspecified site, ruptured; thoracoabdominal
4416       aneurysm, ruptured, w/out mention of rupture; aortic aneurysm of
4417                  unspecified site without mention of rupture
4419
44422    LOWER EXTREMITY EMBOLSIM
44770    Aortic ectasia, unspecified site                                       Added 10/1/10
44771    Thoracic aortic ectasia                                                Added 10/1/10
44772    Abdominal aortic ectasia                                               Added 10/1/10
44773    Thoracoabdominal aortic ectasia                                        Added 10/1/10
4510     SUPERF PHLEBITIS-LEG
4512     THROMBOPHLEBITIS LEG NOS
45182    SUPERF PHLEBITIS ARM



                                                                                     Page 8
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

45184    THROMBOPHLEBITIS ARM NOS
4519     THROMBOPHLEBITIS NOS
45340    Venous embolism and thrombosis of deep vessels of unspecified deep
         vessels of lower extremity
45341    Venous embolism and thrombosis of deep vessels of proximal lower
         extremity
45342    Venous embolism and thrombosis of deep vessels of distal lower
         extremity
4538     VENOUS THROMBOSIS NEC
4539     VENOUS THROMBOSIS NOS
4554     EXT THROMB HEMORRHOID
4555     EXT HEMRRHOID W COMP NEC
4580     ORTHOSTATIC HYPOTENSION
4589     HYPOTENSION NOS
4590     Hemorrhage, unspecified
4644     Croup
4660     Acute bronchitis
4661     Acute bronchiolitis
46619    Acute bronchiolitis due to other infection organisms
475      Peritonsillar abscess
4781     Other diseases of nasal cavity and sinuses
485      Bronchopneumonia, organism unspecified
486      Pneumonia, organism unspecified
48801    Influenza due to identified avian influenza virus with pneumonia         Added 10/01/10
48802    Influenza due to identified avian influenza virus with other respiratory
         manifestations                                                           Added 10/01/10
48809    Influenza due to identified avian influenza virus with other
         manifestations                                                           Added 10/01/10
48811    Influenza due to identified novel H1N1 influenza virus with pneumonia
                                                                                  Added 10/01/10
48812    Influenza due to identified novel H1N1 influenza virus with other
         respiratory manifestations                                               Added 10/01/10
48819    Influenza due to identified novel H1N1 influenza virus with other
         manifestations                                                           Added 10/01/10
490      Bronchitis, not specified as acute or chronic
49121    Obstructive chronic bronchitis with acute exacerbation
49122    Chronic bronchitis with acute bronchitis
49300    Asthma; Extrinsic asthma; unspecified
49301    EXTR ASTH W STATUS ASTH
49302    Extrinsic asthma, with acute exacerbation
49311    Asthma; Intrinsic asthma; with status asthmaticus
49312    Asthma; Intrinsic asthma; with (acute) exacerbation
49320    Chronic obstructive asthma, unspecified
49321    Chronic obstructive asthma, with status asthmaticus
49322    Chronic obstructive asthma, with (acute) exacerbation
49380    Asthma; Other forms of asthma; Unspecified
49381    Asthma; Other forms of asthma;Exercise induced brochospasm
49382    Asthma; Other forms of asthma;Cough variant asthma


                                                                                      Page 9
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

49390    Asthma, unspecified type, without mention of status asthmaticus
49391    Asthma, unspecified type, with status asthmaticus
49392    Unspecified asthma, with acute exacerbation
496      CHRONIC AIRWAY OBSTRUCTION
5060     FUME/VAPOR PNEUMONITIS
5061      Acute pulmonary edema due to fumes and vapors, upper respiratory
5062        inflammation due to fumes and vapors, other acute and subacute
5063                 respiratory condiations due to fumes and vapors
5069     Unspecified respiratory conditions due to fumes and vapors
5070     FOOD/VOMIT PNEUMONITIS
5110     Pleurisy without mention of effusion or current tuberculosis
5118     PLEURAL EFFUS NEC NOT TB
5119     PLEURAL EFFUSION NOS
512                                 PNEUMOTHORAX
5120
5121
5128     SPONT PNEUMOTHORAX NEC
514      PULMONARY CONGESTION
5180     PULMONARY COLLAPSE
5183     Other diseases of lung; Pulmonary eosinophilia
5184     ACUTE LUNG EDEMA NOS
5187     Tranfusion related acute lung injury(TRALI)
51881    Respiratory failure
51882    Other pulmonary insufficiency not elsewhere classified
51884    Acute and chronic respiratory failure
5190     TRACHEOSTOMY COMPS
5191     Other diseases of trachea and bronchus, not elsewhere classified
51911    Acute bronchospasm
53010    Esophagitis, unspecified
53011    Reflux esophagitis
53012    Acute esophagitis
53081    Esophageal reflux
53082    Esophageal hemorrhage
531                          GI ULCER WITH HEMORRHAGE
5310
53100
53101
5311
53110
53111
53112
53120    Acute with hemmorrhage and perforation: w/out mention of obstruction,
53121                                with obstruction
53501    Acute gastritis with hemorrhage
53550    Unspecified gastritis and gastroduodenitis (without mention of
         hemorrhage)
53551    Unspecified gastritis and gastroduodenitis with hemorrhage



                                                                                 Page 10
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

5400     Acute appendicitis, with generalized peritonitis, with peritoneal abscess
5401
5409     ACUTE APPENDICITIS NOS
541      APPENDICITIS NOS
55000     Inguinal hernia with gangrene: unilateral or unspecified (not specified
55001        as recurrent), unilateral or unspecified (recurrent), bilateral (not
55002                  specified as recurrent), bilateral (recurrent)
55003
55010    UNILAT IH W OBSTRUCTION
55012    Inguinal hernia, with obstruction, without mention of gangrene, bilateral
         (not specified as recurrent)
55092    Inquinal hernia, without mention of obstruction or gangrene, bilateral
         (not specified as recurrent)
5601     PARALYTIC ILEUS
56030               Impaction of intestine, unspecified; Gallstone ileus
56031
5609     INTESTINAL OBSTR NOS
56212    DICRTICULOS-COLON/HEMOR
56213    Diverticulitis of colon with hemorrhage
566      ANAL & RECTAL ABSCESS
5693     RECTAL & ANAL HEMORRHAGE
56969    COLO/ENTERSTMY COMP NEC
570      ACUTE NECROSIS OF LIVER
5722     HEPATIC COMA
57401    Calculus of gallbladder with acute cholecystitis, with obstruction
57411    Calculus of gallbladder with other cholecystitis
57421    Calculus of gallbladder without mention of cholecystitis, with
         obstruction
5780     Hematemesis
578                               GI HEM/HEMATEMESIS
5780
5781
5789     Hemorrhage of gastrointestinal tract, unspecified
58881    Secondary hyperparathyroidism, (of renal origin)
59010    Acute pyelonephritis without lesion of renal medullary necrosis
5849     ACUTE RENAL FAILURE UNSPECIFIED
59080    Pyelonephritis, unspecified
592                      CALCULUS OF KIDNEY AND URETER
5920
5921
5929
593                             URETER OBSTRUCTION
5930
5931
5932
5933
5934



                                                                                     Page 11
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

59381    Vascular disorders of kidney
59389    RENAL/URETER DISORD NEC
5939     RENAL/URETER DISORD NOS
5942     URETHRAL CALCULUS
5960     BLADDER NECK OBSTRUCTION
5996     URETER OBSTRUCTION
5997     HEMATURIA
59984    URETHRAL DISORDER NEC
60490    Orchitis and epididymitis, unspecified
60499    OTH ORCHITIS/EPIDIDYMIT
605      REDUN PREPUCE & PHIMOSIS
6082     TORSION OF TESTIS
6110     Inflammatory disease of breast
6163     BARTHOLIN'S GLAND ABSC
6164     ABSCESS OF VULVA NEC
6201     OVARIAN CYST RUPTURED WITH HEMATOMA
632      MISSED ABORTION
6331     TUBAL PREGNANCY
63310        Tubal pregnancy: without intrauterine pregnancy, with intrauterine
63311                                   pregnancy
6339     ECTOPIC PREGNANCY NOS
634                   MISCARRIAGE/SPONTANEOUS ABORTION
6340
63400
63401
63402
6341
63410
63411
63412
6342
63420
63421
63422
6343
63430
63431
63432
6344
63440
63441
63442
6345
63450
63451
63452
6346



                                                                                  Page 12
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

63460
63461
63462
6347
63470
63471
63472
6348
63480
63481
63482
6349
63490
63491
63492
637      MISCARRIAGE/UNSPECIFIED ABORITON
63791    AB NOS INCOMPL, NO COMP
63792    AB NOS COMPL, NO COMP
6391     Delayed or excessive hemorrhage
64003    Threatened abortion, antepartum
640                    HEMORRHAGE IN EARLY PREGNANCY
6400
64000
64001
64002
64003
64004
6408
64080
64081
64082
64083
64084
6409
64093    HEMOR EARLY PREG-AP COND
641       ANTEPARTUM HEMORRHAGE, ABRUPTION PLACENTAE AND
6410                       PLACENTA PREVIA
64100
64101
64103
6411
64110
64111
64113
6412
64120
64121



                                                           Page 13
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

64123
6413
64130
64131
64133
6418
64180
64181
64183
6419
64193    ANTEPARTUN HEMOR NOS-AP
643                    HYPEREMESIS VOMITING
6430
64300
64301
64303
64310
64311
64313
6432
64320
64321
64323
6438
64380
64381
64383
6439
64390    Unspecified vomiting of pregnancy, unspecified as to episode of care
         or not applicable
64391    Unspecified vomiting of pregnancy, delivered, with or without mention
         of antepartum condition
64393    Unspecified vomiting of pregnancy, antepartum condition or
         complication
644                        EARLY OR THREATENED LABOR
6440
64400
64403
6441
64410
64413
6442
64420
64421
64663    Antepartum infections of genitourinary tract
64930    Coagulation defects complicating pregnancy, childbirth, or the
         puerperium, unspecified as to episode of care or not applicable



                                                                                 Page 14
                             HUMANA HEALTH PLANS
                     EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                             EFFECTIVE MAY 1, 2000

64931             Coagulation defects complicating pregnancy, childbirth, or the
UK-HMO             Room (ER) Autopay CPT Code List
         Emergencydiagnosis code description puerperium,delivered with or without
                  mention of antepartum condition
64932             Coagulation defects complicating pregnancy, childbirth, or the
                  puerperium, delivered, with mention of postpartum complication
64933             Coagulation defects complicating pregnancy, childbirth, or the
                  puerperium, antepartum condition or complication
64934             Coagulation defects complicating pregnancy, childbirth, or the
                  puerperium, postpartum condition or complication
64940             Epilepsy complicating pregnancy, childbirth, or the puerperium,
                  unspecified as to episode of care or not applicable
64941             Epilepsy complicating pregnancy, childbirth, or the puerperium,
                  delivered with or without mention of antepartum condition
64942             Epilepsy complicating pregnancy, childbirth, or the puerperium,
                  delivered with mention of postpartum complication
64943             Epilepsy complicating pregnancy, childbirth, or the puerperium,
                  antepartum condition or complication
64944             Epilepsy complicating pregnancy, childbirth, or the puerperium,
                  postpartum condition or complication
64950             Spotting complicating pregnancy, unspecified as to episode of care or
                  not applicable
64951             Spotting complicating pregnancy, delivered, without mention of
                  antepartum condition
64953             Spotting complicating pregnancy, antepartum condition or complication

65573                   DECR FETAL MOVEMNT-AP
666                     POSTPARTUM HEMORRHAGE/RETAINED PLACENTA
6660                    Third-stage hemorrhage
66600                   Third-stage hemorrhage, unspecified as to episode of care or not
                        applicable
66602                   Third-stage hemorrhage, delivered, with mention of postpartum
                        complication
66604                   Third-stage hemorrhage, postpartum condition or complication
6661                    Other immediate postpartum hemorrhage
66610                   Other immediate postpartum hemorrhage, unspecified as to episode of
                        care or not applicable
66612                   Other immediate postpartum hemorrhage, with mention of postpartum
                        complication
66614                   Other immediate postpartum hemorrhage, postpartum condition or
                        complication
6663                    Postpartum coagulation defects
66630                   Postpartum coagulation defects, unspecified as to episode of care or
                        not applicable
66632                   Postpartum coagulation defects, delivered, with mention of postpartum
                        complication
66634                   Postpartum coagulation defects, postpartum condition or complication

67434                   OB SURG COMP NEC, PP



                                                                                                Page 15
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

67524    MASTITIS-POSTPARTUM
6824     Cellulitis and bascess of hand, except fingers and thumb
6951     ERYTHEMA MULTIFORME
7080     Allergic urticaria
71831    RECUR DISLOCAT-SHOULD
71884    JT DERANGEMENT NEC-HAND
71906    Effusion of lower leg joint
71907    JOINT EFFUSION-ANKLE
7220     CERV DISC DISPLACMENT
72210    LUMBAR DISC DISPLACEMENT
7234     Brachial neuritis or radiculitis nos
7235     TORTICOLLIS NOS
7243     Sciatica
72610    Disorders of bursae and tendons in shoulder region, unspecified
7331     PATHOLOGICAL FRACTURES
73310    Patologic fracture, unspecified site
73311    Pathologic fracture of humerus
73312    Pathologic fracture of distal radius and ulna
73313    Pathologic fracture of vertebrae
73314    Pathologic fracture of neck of femur
73315    Pathologic fracture of other specified part of femur
73316    Pathologic fracture of tibia or fibula
73319    Pathologic fracture of other specified site
7336     Tietze's disease
73393    Stress fracture of tibia or fibula
73394    Stress fracture of the metatarsals
73395    Stress fracture of other bone
7672     Birth trauma; Fracture of clavicle
7673     Birth trauma; Other injuries to skeleton
7674     Birth trauma; Injury to spine and spinal cord
7687     Hypoxic-ischieic encephalopathy(HIE)
769      Respiratory distress syndrome
7708     Other respiratory problems after birth
77087    Respiratory arrest of newborn
7724     Gastrointestinal hemorrhage
7746     FETAL/NN JAUNDICE NOS
77581    Other acidosis of newborn
7773     Swallowed maternal blood
7783     Other hypothermia of newborn
7784     Other disturbances of temperature regulation of newborn
7790     Convulsions in newborn
77985    Cardiac arrest of newborn
78002    TRANS ALTER AWARENESS
78009    ALTER CONSCIOUSNESS NEC
7801     ALTERATION OF CONSCIOUSNESS
         (CONVULSIONS,SYNCOPE/COLLAPSE)
7802     Syncope and collapse



                                                                           Page 16
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

7803     Convulsions
78031    FEBRILE CONVULSIONS
78032    Complex febrile convulsions
78033    Post traumatic seizures                                    Added 10-01-10
78039    OTH CONVULSIONS
7804     DIZZINESS AND GIDDINESS
7806     Pyrexia of unknown origin
78066    Febrile nonhemolytic transfusion reaction                  Added 10-01-10
7810     Abnormal involuntary movements
7820     Disturbance of skin sensation
7823     Edema
7825     Cyanosis
7827     SPONTANEOUS ECCHYMOSES
7840     Headache
7843     APHASIA
7847     Epistaxis
7848     Hemorrhage from throat
7850     Tachyardia, unspecified
7851     Palpitations
7852     CARDIAC MURMURS NEC
7854     GANGRENE
7859     CV SYSTEM SYMPTOMS NEC
78609    Respiratory abnormality, unspecified, other
7863     Hemoptysis, unspecified
78631    Acute idiopathic pulmonary hemorrhage in infants (AIPHI)   Added 10-01-10
78639    Other hemoptysis                                           Added 10-01-10
78650    Chest pain, unspecified
78651    Precordial pain
78652    Painful respiration
7865                         CHEST PAIN,PRECORDIAL PAIN
78650
78651
78659    Chest pain, other, discomfort, pressure, tightness
786                      RESPIRATORY DISTRESS/STRIDOR
7860
78600
78601
78602
78603
78604
78605
78606
78607
78609
7861
7880     Renal Colic
7881     Dysuria



                                                                        Page 17
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

7882     RETENTION OF URIN
78820    Retention of urine, unspecified
78821    INCOMPL BLADDER EMPYING
78829    RETENTION OF URINE NEC
7890     Abdominal pain
78900    Abdominal pain unspecified site
7891                  CHEST PAIN (EXCLUDES COLIC,CRAMPS)
78900
78901
78902
78903
78904
78905
78906
78907
78909
7891
7892
7893
78930
78931
78932
78933
78934
78935
78936
78937
78939
78940
78941
78942
78943
78944
78945
78946
78947
78949
7895
78960
78961
78962
78963
78964
78965
78966
78967
78969



                                                           Page 18
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

7899
7907     BACTEREMIA
7980     Sudden infant death syndrome
7990     ASPHYXIA
7991     RESPIRATORY ARREST
800      Fracture of vault of skull
8000     Closed without mention of intracranial injury
80000    Closed without mention of intracranial injury, unspecified state of
         consciousness
80001    Closed without mention of intracranial injury, with no loss of
         consciousness
80002    Closed without mention of intracranial injury, with brief loss of
         consciousness
80003    Closed without mention of intracranial injury, with moderate loss of
         consciousness
80004    Closed without mention of intracranial injury, with prolonged loss of
         consciousness and return to pre-existing conscious level
80005    Closed without mention of intracranial injury, with prolonged loss of
         consciousness, without return to pre-existing conscious level
80006    Closed without mention of intracranial injury, with loss of
         consciousness of unspecified duration
80009    Closed without mention of intracranial injury, with concussion,
         unspecified
80010    Closed with cerebral laceration and contusion, unspecified state of
         consciousness
80011    Closed with cerebral laceration and contusion, with no loss of
         consciousness
80012    Closed with cerebral laceration and contusion, with brief loss of
         consciousness
80013    Closed with cerebral laceration and contusion, with moderate loss of
         consciousness
80014    Closed with cerebral laceration and contusion, with prolonged loss of
         consciousness and return to pre-existing conscious level
80015    Closed with cerebral laceration and contusion, with prolonged loss of
         consciousness, without return to pre-exiting conscious level
80016    Closed with cerebral laceration and contusion, with loss of
         consciousness of unspecified duration
80019    Closed with cerebral laceration and contusion, with concussion,
         unspecified
80020    Closed with subarachnoid, subdural, and extradural hemorrhage,
         unspecified state of consciousness
80021    Closed with subarachnoid, subdural, and extradural hemorrhage, with
         no loss of consciousness
80022    Closed with subarachnoid, subdural, and extradural hemorrhage, with
         brief loss of consciousness
80023    Closed with subarachnoid, subdural, and extradural hemorrhage, with
         moderate loss of consciousness




                                                                                 Page 19
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

80024             Closed with subarachnoid, subdural, and extradural hemorrhage, with
UK-HMO             Room (ER) Autopay CPT Code List
         Emergencyprolonged loss of consciousness and return to pre-existing conscious
                  level
80025             Closed with subarachnoid, subdural, and extradural hemorrhage, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
80026             Closed with subarachnoid, subdural, and extradural hemorrhage, with
                  loss of consciousness of unspecified duration
80029             Closed with subarachnoid, subdural, and extradural hemorrhage, with
                  consussion, unspecified
80030             Closed with other and unspecified intracranial hemorrhage, unspecified
                  state of consciousness
80031             Closed with other and unspecified intracranial hemorrhage, with no
                  loss of consciousness
80032             Closed with other and unspecified intracranial hemorrhage, with brief
                  loss of consciousness
80033             Closed with other and unspecified intracranial hemorrhage, with
                  moderate loss of consciousness
80034             Closed with other and unspecified intracranial hemorrhage, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
80035             Closed with other and unspecified intracranial hemorrhage, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
80036             Closed with other and unspecified intracranial hemorrhage, with loss of
                  consciousness of unspecified duration
80039             Closed with other and unspecified intracranial hemorrhage, with
                  consussion, unspecified
80040             Closed with intracranial injury of other and unspecified nature,
                  unspecified state of consciousness
80041             Closed with intracranial injury of other and unspecified nature, with no
                  loss of consciousness
80042             Closed with intracranial injury of other and unspecified nature, with
                  brief loss of consciousness
80043             Closed with intracranial injury of other and unspecified nature, with
                  moderate loss of consciousness
80044             Closed with intracranial injury of other and unspecified nature, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
80045             Closed with intracranial injury of other and unspecified nature, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
80046             Closed with intracranial injury of other and unspecified nature, with loss
                  of consciousness of unspecified duration
80049             Closed with intracranial injury of other and unspecified nature, with
                  concussion, unspecified
80050             Open, without mention of intracranial injury, unspecified state of
                  consciousness




                                                                                               Page 20
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

80051             Open, without mention of intracranial injury, with no loss of
UK-HMO             Room (ER)
         Emergencyconsciousness Autopay CPT Code List
80052             Open, without mention of intracranial injury, with brief loss of
                  consciousness
80053             Open, without mention of intracranial injury, with moderate loss of
                  consciousness
80054             Open, without mention of intracranial injury, with prolonged loss of
                  consciousness and return to pre-existing conscious level
80055             Open, without mention of intracranial injury, with prolonged loss of
                  consciousness, without return to pre-existing conscious level
80056             Open, without mention of intracranial injury, with loss of consciousness
                  of unspecified duration
80059             Open, without mention of intracranial injury, with concussion,
                  unspecified
80060             Open with cerebral laceration and contusion, unspecified state of
                  consciousness
80061             Open with cerebral laceration and contusion, with no loss of
                  consciousness
80062             Open with cerebral laceration and contusion, with brief loss of
                  consciousness
80063             Open with cerebral laceration and contusion, with moderate loss of
                  consciousness
80064             Open with cerebral laceration and contusion, with prolonged loss of
                  consciousness and return to pre-existing conscious level
80065             Open with cerebral laceration and contusion, with prolonged loss of
                  consciousness, without return to pre-existing conscious level
80066             Open with cerebral laceration and contusion, with loss of
                  consciousness of unspecified duration
80069             Open with cerebral laceration and contusion, with concussion,
                  unspecified
80070             Open with subarachnoid, subdural, and extradural hemorrhage,
                  unspecified state of consciousness
80071             Open with subarachnoid, subdural, and extradural hemorrhage, with no
                  loss of consciousness
80072             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  brief loss of consciousness
80073             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  moderate loss of consciousness
80074             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
80075             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
80076             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  loss of consciousness of unspecified duration
80079             Open with subarachnoid, subdural, and extradural hemorrhage, with
                  concussion, unspecified



                                                                                             Page 21
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

80080             Open with other and unspecified intracranial hemorrhage, unspecified
UK-HMO             Room (ER) Autopay CPT Code List
         Emergencystate of consciousness
80081             Open with other and unspecified intracranial hemorrhage, with no loss
                  of consciousness
80082             Open with other and unspecified intracranial hemorrhage, with brief
                  loss of consciousness
80083             Open with other and unspecified intracranial hemorrhage, with
                  moderate loss of consciousness
80084             Open with other and unspecified intracranial hemorrhage, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
80085             Open with other and unspecified intracranial hemorrhage, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
80086             Open with other and unspecified intracranial hemorrhage, with loss of
                  consciousness of unspecified duration
80089             Open with other and unspecified intracranial hemorrhage, with
                  concussion, unspecified
80090             Open with intracranial injury of other and unspecified nature,
                  unspecified state of consciousness
80091             Open with intracranial injury of other and unspecified nature, with no
                  loss of consciousness
80092             Open with intracranial injury of other and unspecified nature, with brief
                  loss of consciousness
80093             Open with intracranial injury of other and unspecified nature, with
                  moderate loss of consciousness
80094             Open with intracranial injury of other and unspecified nature, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
80095             Open with intracranial injury of other and unspecified nature, with
                  prolonged loss of consciousness, without return to pre-existing
                  consciouslevel
80096             Open with intracranial injury of other and unspecified nature, with loss
                  of consciousness of unspecified duration
80099             Open with intracranial injury of other and unspecified nature, with
                  concussion, unspecified
801               Fracture of base of skull
8010                            Closed without mention of intracranial injury
80100
80101
80102
80103
80104
80105
80106
80109
8011                                 Closed with cerebral laceration and contusion
80110



                                                                                              Page 22
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000
                Closed with cerebral laceration and contusion

80111
80112
80113
80114
80115
80116
80119
8012         Closed with subarachnoid, subdural, and extradural hemorrhage
80120
80121
80122
80123
80124
80125
80126
80129
8013           Closed with other and unspecified intracranial hemorrhage
80130
80131
80132
80133
80134
80135
80136
80139
8014          Closed with intracranial injury of other and unspecified nature
80140
80141
80142
80143
80144
80145
80146
80149
8015                   Open without mention of intracranial injury
80150
80151
80152
80153
80154
80155
80156
80159
8016                  Open with cerebral laceration and contusion
80160
80161
80162



                                                                                Page 23
                HUMANA HEALTH PLANS
                 Open with cerebral laceration and contusion
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80163
80164
80165
80166
80169
8017          Open with subarachnoid, subdural, and extradural hemorrhage
80170
80171
80172
80173
80174
80175
80176
80179
8018             Open with other and unspecified intracranial hemorrhage
80180
80181
80182
80183
80184
80185
80186
80189
8019           Open with intracranial injury of other and unspecified nature
80190
80191
80192
80193
80194
80195
80196
80199
802       Fracture of face bones
8020      Fracture of nasal bones, closed
8021      Fracture of nasal bones, open
8022      Fracture of mandible, closed
80220     Fracture of unspecified site
80221     Fracture of condylar process
80222     Fracture of subcondylar
80223     Fracture of coronoid process
80224     Fracture of ramus, unspecified
80225     Fracture of angle of jaw
80226     Fracture of symphysis of body
80227     Fracture of alveolar border of body
80228     Fracture of body, other and unspecified
80229     Fracture multiple sites
8023      Fracture of mandible, open



                                                                               Page 24
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80231    Condylar site
80232    Subcondylar
80233    Coronoid process
80234    Ramus, unspecified
80235    Angle of jaw
80236    Symphysis of body
80237    Alveolar border of body
80238    Body, other and unspecified
80239    Multiple sites
8024     Malar and maxillary bones, closed
8025     Malar and maxillary bones, open
8026     Orbital floor (blow out), closed
8027     Orbital floor (blow out), open
8028     Other facial bones, closed
8029     Other facial bones, open
803      Other and unqualified skull fractures
8030     Closed without mention of intracranial injury
8031                    Closed with cerebral laceration and contusion
80310
80311
80312
80313
80314
80315
80316
80319
8032        Closed with subarachnoid, subdural, and extradural hemorrhage
80320
80321
80322
80323
80324
80325
80326
80329
8033           Closed with other and unspecified intracranial hemorrhage
80330
80331
80332
80333
80334
80335
80336
80339
8034          Closed with intracranial injury of other and unspecified nature
80340
80341



                                                                                Page 25
                  HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
            Closed with intracranial injury of other and unspecified nature
                   EFFECTIVE MAY 1, 2000

80342
80343
80344
80345
80346
80349
8035                    Open without mention of intracranial injury
80350
80351
80352
80353
80354
80355
80356
80359
8036                   Open with cerebral laceration and contusion
80360
80361
80362
80363
80364
80365
80366
80369
8037          Open with subarachnoid, subdural, and extradural hemorrhage
80370
80371
80372
80373
80374
80375
80376
80379
8038             Open with other and unspecified intracranial hemorrhage
80380
80381
80382
80383
80384
80385
80386
80389
8039            Open with intracranial injury of other and unspecified nature
80390
80391
80392
80393



                                                                                Page 26
               Open with intracranial injury of other and unspecified nature
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80394
80395
80396
80399
804      Multiple fractures involving skull or face with other bones
8040                    Closed without mention of intracranial injury
80400
80401
80402
80403
80404
80405
80406
80409
8041                  Closed with cerebral laceration and contusion
80410
80411
80412
80413
80414
80415
80416
80419
8042        Closed with subarachnoid, subdural, and extradural hemorrhage
80420
80421
80422
80423
80424
80425
80426
80429
8043           Closed with other and unspecified intracranial hemorrhage
80430
80431
80432
80433
80434
80435
80436
80439
8044          Closed with intracranial injury of other and unspecified nature
80440
80441
80442
80443
80444



                                                                                Page 27
            Closed with intracranial injury of other and unspecified nature
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80445
80446
80449
8045                 Open without mention of intracranial injury
80450
80451
80452
80453
80454
80455
80456
80459
8046                Open with cerebral laceration and contusion
80460
80461
80462
80463
80464
80465
80466
80469
8047       Open with subarachnoid, subdural, and extradural hemorrhage
80471
80472
80473
80474
80475
80476
80479
8048          Open with other and unspecified intracranial hemorrhage
80480
80481
80482
80483
80484
80485
80486
80489
8049        Open with intracranial injury of other and unspecified nature
80490
80491
80492
80493
80494
80495
80496
80499



                                                                              Page 28
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

805      Fracture of vertebral column without mention of spinal cord injury
8050                                Cervical, closed
80500
80501
80502
80503
80504
80505
80506
80507
80508
8051                                  Cervical, open
80510
80511
80512
80513
80514
80515
80516
80517
80518
8052     Dorsal [thoracic], closed
8053     Dorsal [thoracic], open
8054     Lumbar, closed
8055     Lumbar, open
8056     Sacrum and coccyx, closed
8057     Sacrum and coccyx, open
8058     Unspecified, closed
8059     Unspecified, open
806      Fracture of vertebral column with spinal cord injury
8060     Cervical, closed
80600    C1-C4 level with unspecified spinal cord injury
80601    C1-C4 level with complete lesion of cord
80602    C1-C4 level with anterior cord syndrome
80603    C1-C4 level with central cord syndrome
80604    C1-C4 level with other specified spinal cord injury
80605    C5-C7 level with unspecified spinal cord injury
80606    C5-C7 level with complete lesion of cord
80607    C5-C7 level with anterior cord syndrome
80608    C5-C7 level with central cord syndrome
80609    C5-C7 level with other specified spinal cord injury
8061     Cervical, open
80610    C1-C4 level with unspecified spinal cord injury
80611    C1-C4 level with complete lesion of cord
80612    C1-C4 level with anterior cord syndrome
80613    C1-C4 level with central cord syndrome
80614    C1-C4 level with other specified spinal cord injury



                                                                              Page 29
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80615    C5-C7 level with unspecified spinal cord injury
80617    C5-C7 level with complete lesion of cord
80618    C5-C7 level with central cord syndrome
80619    C5-C7 level with other specified spinal cord injury
8062     Dorsal [thoracic], closed
80620    T1-T6 level with unspecified spinal cord injury
80621    T1-T6 level with complete lesion of cord
80622    T1-T6 level with anterior cord syndrome
80623    T1-T6 level with central cord syndrome
80624    T1-T6 level with other specified spinal cord injury
80625    T7-T12 level with unspecified spinal cord injury
80626    T7-T12 level with complete lesion of cord
80627    T7-T12 level with anterior cord syndrome
80628    T7-T12 level with central cord syndrome
80629    T7-T12 level with other specified spinal cord injury
8063     Dorsal [thoracic], open
80630    T1-T6 level with unspecified spinal cord injury
80631    T1-T6 level with complete lesion of cord
80632    T1-T6 level with anterior cord syndrome
80633    T1-T6 level with central cord syndrome
80634    T1-T6 level with other specified spinal cord injury
80635    T7-T12 level with unspecified spinal cord injury
80636    T7-T12 level with complete lesion of cord
80637    T7-T12 level with anterior cord syndrome
80638    T7-T12 level with central cord syndrome
80639    T7-T12 level with other specified spinal cord injury
8064     Lumbar, closed
8065     Lumbar, open
8066     Sacrum and coccy, closed
80660    With unspecified spinal cord injury
80661    With complete cauda equina lesion
80662    With other cauda equina injury
80669    With other spinal cord injury
8067     Sacrum and coccyx, open
80670    Sacrum and coccyx, with unspecified spinal cord injury
80671    With complete cauda equina lesion
80672    With other cauda equina injury
80679    With other spinal cord injury
807      Fracture of rib(s), sternum, larynx, and trachea
80700    Rib(s) closed, rib(s) unspecified
80701    Rib(s) closed, one rib
80702    Rib(s) closed, two ribs
80703    Rib(s) closed, three ribs
80704    Rib(s) closed, four ribs
80705    Rib(s) closed, five ribs
80706    Rib(s) closed, six ribs
80707    Rib(s) closed, seven ribs



                                                                  Page 30
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

80708    Rib(s) closed, eight or more ribs
80709    Rib(s) closed, multiple ribs, unspecified
8071     Rib(s) open
80710    Rib(s) open, rib(s) unspecifed
80711    Rib(s) open, one rib
80712    Rib(s) open, two ribs
80713    Rib(s) open, three ribs
80714    Rib(s) open, four ribs
80715    Rib(s) open, five ribs
80716    Rib(s) open, six ribs
80717    Rib(s) open, seven ribs
80718    Rib(s) open, eight or more ribs
80719    Rib(s) open, multiple ribs, unspecified
8072     Sternum, closed
8073     Sternum, open
8074     Flail chest
8075     Larynx and trachea, closed
8076     Larynx and trachea, open
808      Fracture of pelvis
8080     Acetabulum, closed
8081     Acetabulum, open
8082     Pubis, closed
8083     Pubis, open
8084     Other specified part, closed
80841    Ilium
80842    Ischium
80843    Multiple pelvic fractures with disruption of pelvic circle
80849    Other, innonimnate bone, pelvic rim
8085     Other specified part, open
80851    Ilium
80852    Ischium
80853    Multiple pelvic fractures with disruption of pelvic circle
80859    Other
8088     Fracture of pelvis, unspecified, closed
8089     Unspecified, open
809      Ill-defined fractures of bones of trunk
8090     Fracture of bones of trunk, closed
8091     Fracture of bones of trunk, open
810      Fracture of clavicle
8100     Closed
81000    Closed fracture of clavicle, unspecified part
81001    Closed fracture of clavicle, sternal end of clavicle
81002    Closed fracture of clavicle, shaft of clavicle
81003    Closed fracture of clavicle, acromial end of clavicle
8101     Open
81010    Open fracture of clavicle, unspecified part
81011    Open fracture of clavicle, sternal end of clavicle



                                                                      Page 31
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

81012    Open fracture of clavicle, shaft of clavicle
81013    Open fracture of clavicle, acromial end of clavicle
811      Fracture of scapula
8110     Closed
81100    Closed fracture of scapula, unspecified part
81101    Closed fracture of scapula, acromial process
81102    Closed fracture of scapula, coracoid process
81103    Closed fracture of scapula, glenoid cavity and neck of scapula
81109    Closed fracture of scapula, other
8111     Open
81110    Open fracture of scapula, unspecified part
81111    Open fracture of scapula, acromial process
81112    Open fracture of scapula, coracoid process
81113    Open fracture of scapula, glenoid cavity and neck of scapula
81119    Open fracture of scapula, other
812      Fracture of humerus
81200    Upper end, unspecified part
81201    Surgical neck
81202    Anatomical neck
81203    Greater turberosity
81209    Other, head, upper epiphysis
8121     Upper end, open
81210    Upper end, unspecified part
81211    Surgical neck
81212    Anatomical neck
81213    Greater turberosity
81219    Other
8122     Shaft or unspecified part, closed
81220    Unspecified part of humerus
81221    Shaft of humerus
8123     Shaft or unspecified part, open
81230    Unspecified part of humerus
81231    Shaft of humerus
8124     Lower end, closed
81240    Lower end, unspecified part
81241    Supracondylar fracture of humerus
81242    Lateral condyle
81243    Medial condyle
81244    Condyle(s), unspecified
81249    Other; multiple fractures of lower end, trochlea
8125     Lower end, open
81250    Lower end, unspecified part
81251    Supracondylar fracture of humerus
81252    Lateral condyle
81253    Medial condyle
81254    Condyle(s) , unspecified
81259    Other



                                                                          Page 32
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

813      Fracture of radius and ulna
81300    Upper end of forearm, unspecified
81301    Olecranon process of ulna
81302    Coronoid process of ulna
81303    Monteggia's fracture
81304    Other and unspecified fractures of proximal end of ulna (alone)
81305    Fracture head of radius
81306    Neck of radius
81307    Other and unspecified fractures of proximal end of radius (alone)
81308    Radius with ulna, upper end [any part]
8131     Upper end, open
81310    Upper end of forearm, unspecified
81311    Olecranon process of ulna
81312    Coronoid process of ulna
81313    Monteggia's fracture
81314    Other and unspecified fractures proximal end of ulna (alone)
81315    Head of radius
81316    Neck of radius
81317    Other and unspecified fractures of proximal end of radius (alone)
81318    Radius with ulna, upper end [any part]
8132     Shaft, closed
81320    Shaft, unspecified
81321    Radius ( alone)
81322    Ulna (alone)
81323    Radius with ulna
8133     Shaft, open
81330    Shaft, unspecified
81331    Radius ( alone)
81332    Ulna (alone)
81333    Radius with ulna
8134     Lower end, closed
81340    Lower end of forearm, unspecified
81341    Colles' fracture
81342    Other closed fractures of distal end of radius (alone)
81343    Distal end of ulna (alone)
81344    Radius with ulna, lower end
81345    Torus fracture of radius
8135     Lower end , open
81350    Lower end of forearm, unspecified
81351    Colles' fracture
81352    Other fractures of distal end of radius (alone)
81353    Distal end of ulna (alone)
81354    Radius with ulna,lower end
8138     Unspecified part, closed
81380    Forearm, unspecified
81381    Radius (alone)
81382    Ulna (alone)



                                                                             Page 33
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

81383    Radius with ulna
8139     Unspecified part, open
81390    Forearm, unspecified
81391    Radius ( alone)
81392    Ulna (alone)
81393    Radius with ulna
814      Fracture of carpal bone(s)
8140     Carpal bone, unspecified
81400    Closed fracture of carpal bone, carpal bone, unspecified
81401    Closed fracture of carpal bone, navicular (scaphoid) of wrist
81402    Closed fracture of carpal bone, lunate (semilunar) bone of wrist
81403    Closed fracture of carpal bone, triquetral (cuneiform) bone of wrist
81404    Closed fracture of carpal bone, pisiform
81405    Closed fracture of carpal bone, trapezium bone
81406    Closed fracture of carpal bone, trapezoid bone
81407    Closed fracture of carpal bone, capitate bone
81408    Closed fracture of carpal bone, hamate bone
81409    Closed fracture of carpal bone, other
8141     Open
81410    Open fracture of carpal bone, carpal bone, unspecified
81411    Open fracture of carpal bone, navicular (scaphoid) of wrist
81412    Open fracture of carpal bone, lunate (semilunar) bone of wrist
81413    Open fracture of carpal bone, triquetral (cuneiform) bone of wrist
81414    Open fracture of carpal bone, pisiform
81415    Open fracture of carpal bone, trapezium bone
81416    Open fracture of carpal bone, Trapezoid bone
81417    Open fracture of carpal bone, capitate bone
81418    Open fracture of carpal bone, hamate bone
81419    Open fracture of carpal bone, other
815      Fracture of metacarpal bone(s)
8150     Metacarpal bones(s), site unspecified
81500    Closed fracture of metacarpal bone(s), site unspecified
81501    Closed fracture of metacarpal bone, base of thumb
81502    Closed fracture of metacarpal bone, base of other metacarpal bone
81503    Closed fracture of shaft of metacarpal bone(s)
81504    Closed fracture of metacarpal bone, neck of metacarpal bone
81509    Closed fracture of metacarpal bone, multiple sites of metacarpus
8151     Base of thumb [first] metacarpal
81510    Open fracture of metacarpal bone, metacarpal bone site unspecified

81511    Open fracture of metacarpal bone, base of thumb
81512    Open fracture of metacarpal bone, base of othe rmetacarpal bone
81513    Open fracture of metacarpal bone, shaft of metacarpal bone
81514    Open fracture of metacarpal bone, neck of metacarpal bone
81519    Open fracture of metacarpal bone, multiple site of metacarpus
816      Fracture of one or more phalanges of hand
8160     Phalanx or phalanges, unspecified



                                                                                Page 34
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

81600    Closed fracture of phalanx or phalanges of hand, unspecified
81601    Closed fracture of middle or proximal phalanx or phalanges of hand
81602    Closed fracture of distal phalanx or phalanges
81603    Closed fracture of multiple sites
8161     Open
81610    Open fracture of phalanx or phalanges, unspecified
81611    Open fracture of middle or proximal phalanx or phalanges
81612    Open fracture of distal phalanx or phalanges
81613    Open fracture of multiple sites
817      Multiple fractures of hand bones
8170     Closed
8171     Open
818      Ill-defined fractures of upper limb
8180     Closed
8181     Open
819      Multiple fractures involving both upper limbs and upper limb with rib(s)
         and sternum
8190     Multiple fractures involving both upper limbs and upper limb with rib(s)
         and sternum, closed
8191     Open
820      Fracture of neck of femur
8200     Transcervical fracture, closed
82000    Intracapsular section, unspecified
82001    Epiphysis (separation) (upper)
82002    Midcervical section
82003    Base of neck
82009    Other, head of femur, Subcapital
8201     Transcervical fracture, open
82010    Intracapsular section, unspecified
82011    Epiphysis (separation) (upper)
82012    Midcervical section
82013    Base of neck
82019    Other
8202     Pertrochanteric fracture, closed
82020    Trochanteric section, unspecified
82021    Intertrochanteric section
82022    Subtrochanteric section
8203     Pertrochanteric fracture, open
82030    Trochanteric section, unspecified
82031    Intertrochanteric section
82032    Subtrochanteric section
8208     Unspecified part of neck of femur, closed
8209     Unspecified part of neck of femur, open
821      Fracture of other and unspecified parts of femur
8210     Shaft or unspecified part, closed
82100    Unspecified part of femur
82101    Shaft



                                                                                    Page 35
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

8211     Fracture femur, shaft or unspecified part, open
82110    Fracture femur, unspecified part of femur
82111    Fracture femur, shaft
8212     Lower end, closed
82120    Lower end, unspecified part
82121    Condyle, femoral
82122    Epiphysis, lower(separation)
82123    Supracondylar fracture of femur
82129    Other, multiple fractures of lower end
8213     Lower end,open
82130    Lower end, unspecified part
82131    Condyle, femoral
82132    Epiphysis, lower(separation)
82133    Supracondylar fracture of femur
82139    Other
822      Fracture of patella
8220     Closed
8221     Open
823      Fracture of tibia and fibula
8230     Upper end, closed
82300    Closed fracture upper end, tibia alone
82301    Closed fracture upper end, fibula alone
82302    Closed fracture upper end, fibula with tibia
8231     Upper end, open
82310    Open fracture upper end, tibia alone
82311    Open fracture upper end, fibula alone
82312    Open fracture upper end, fibula with tibia
8232     Shaft, closed
82320    Closed fracture shaft, tibia alone
82321    Closed fracture shaft, fibula alone
82322    Closed fracture shaft, fibula with tibia
8233     Shaft, open
82330    Open fracture shaft, tibia alone
82331    Open fracture shaft, fibula alone
82332    Open fracture shaft, fibula with tibia
8234     Torus fracture
82340    Torus fracture, tibia alone
82341    Torus fracture, fibula alone
82342    Torus fracture, fibula with tibia
82380    Unspecified part, closed, tibia alone
82381    Unspecified part, closed, fibula alone
82382    Unspecified part, closed, fibula with tibia
8239     Unspecified part, open
82390    Unspecified part, open, tibia alone
82391    Unspecified part, open, fibula alone
82392    Unspecified part, open, fibula with tibia
824      Fracture of ankle



                                                           Page 36
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

8240     Medial malleolus, closed
8241     Medial malleolus, open
8242     Lateral malleolus, open
8243     Lateral malleolus, closed
8244     Bimallelolar, closed
8245     Bimallelolar, open
8246     Trimallelolar, closed
8247     Trimallelolar, open
825      Fracture of one or more tarsal and metatarsal bones
8250     Fracture of calcaneus, closed
8251     Fracrure of calcaneus, open
8252     Fracture of other tarsal and metatarsal bones, closed
82521    Astragalus
82522    Navicular [scaphoid], foot
82523    Cuboid
82524    Cuneiform, foot
82525    Fracture of metatarsal bone(s), closed
82529    Other, tarsal with metatarsal bone(s) only
8253     Fracture of other tarsal and metatarsal bones, open
82530    Unspecified bone(s) of foot [except toes]
82531    Astragalus
82532    Navicular [scaphoid], foot
82533    Cuboid
82534    Cuneiform, foot
82535    Metatarsal bones(s)
82539    Other
826      Fracture of one or more phalanges of foot
8260     Closed
8261     Open
827      Other, multiple, and ill-defined fractures of lower limb
8270     Closed
8271     Open
828      Multiple fractures involving both upper limbs and upper limb with rib(s)
         and sternum
8280     Closed
8281     Open
829      Fracture of unspecified bones
8290     Unspecified bone, closed
8291     Unspecified bone, open
830      Dislocation of jaw
8300     Closed dislocation
8301     Open dislocation
831      Dislocation of shoulder
8310     Closed dislocation
83100    Closed dislocation, shoulder, unspecified
83101    Closed dislocation, anterior dislocation of humerus
83102    Closed dislocation, posterior dislocation of humerus



                                                                                    Page 37
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

83103    Closed dislocation, inferior dislocation of humerus
83104    Closed dislocation, acromioclavicular
83109    Closed dislocation, other
8311     Open dislocation
83110    Open dislocation, shoulder, unspecified
83111    Open dislocation, anterior dislocation of humerus
83112    Open dislocation, posterior dislocation of humerus
83113    Open dislocation, inferior dislocation of humerus
83114    Open dislocation, acromioclavicular
83119    Open dislocation, other
832      Dislocation of elbow
8320     Closed dislocation
83200    Closed dislocation of elbow, unspecified site
83201    Closed dislocation anterior dislocation of elbow
83202    Closed dislocation posterior dislocation of elbow
83203    Closed dislocation medial dislocation of elbow
83204    Closed dislocation lateral dislocation of elbow
83209    Closed dislocation other
8321     Open dislocation
83210    Open dislocation elbow unspecified
83211    Open dislocation anterior dislocation of elbow
83212    Open dislocation posterior dislocation of elbow
83213    Open dislocation medial dislocation of elbow
83214    Open dislocation lateral dislocation of elbow
83219    Open dislocation other
833      Dislocation of wrist
8330     Closed dislocation
83300    Closed dislocation wrist, unspecified part
83301    Closed dislocation radioulnar (joint), distal
83302    Closed dislocation radiocarpal
83303    Closed dislocation midcarpal
83304    Closed dislocation carpometacarpal
83305    Closed dislocation metacarpal, proximal end
83309    Closed dislocation other
8331     Open dislocation
83310    Open dislocation wrist, unspecified part
83311    Open dislocation radioulnar (joint), distal
83312    Open dislocation radiocarpal
83313    Open dislocation midcarpal
83314    Open dislocation carpometacarpal
83315    Open dislocation metacarpal (bone) proximal end
83319    Open dislocation other
834      Dislocation of finger
8340     Closed dislocation
83400    Closed dislocation finger, unspecified part
83401    Closed dislocation metacarpophalangeal
83402    Closed dislocation interphalangeal (joint), hand



                                                               Page 38
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

8341     Open dislocation
83410    Open dislocation finger, unspecified part
83411    Open dislocation mataarpophalangeal
83412    Open dislocation interphalangeal (joint), hand
835      Dislocation of hip
8350     Closed dislocation
83500    Closed dislocation of hip, unspecified
83501    Closed dislocation posterior hip
83502    Closed dislocation obturator hip
83503    Closed dislocation other anterior dislocation
8351     Open dislocation
83510    Open dislocation of hip, unspecified
83511    Open dislocation posterior hip
83512    Open dislocation obturator hip
83513    Open dislocation other anterior dislocation
836      Dislocation of knee
8360     Tera of medial cartilage or meniscus of knee, current
8361     Tear of lateral cartilage or meniscus of knee, current
8362     Other tear of cartilage or meniscus of knee, current
8363     Dislocation of patella, closed
8364     Dislocation of patella, open
8365     Other dislocation knee, closed
83650    Dislocation of knee, unspecified
83651    Anterior dislocation of tibia, proximal end
83652    Posterior dislocation of tibia, proximal end
83653    Medial dislocation of tibia, proximal end
83654    Lateral dislocation of tibia, proximal end
83659    Other
8366     Other dislocation knee, open
83660    Dislocation of knee, unspecified
83661    Anterior dislocation of tibia, proximal end
83662    Posterior dislocation of tibia, proximal end
83663    Medial dislocation of tibia, proximal end
83664    Lateral dislocation of tibia, proximal end
83669    Other
837      Dislocation of ankle
8370     Closed dislocation
8371     Open dislocation
838      Dislocation of foot
8380     Closed dislocation
83800    Closed dislocation foot, unspecified
83801    Closed dislocation tarsal, joint unspecified
83802    Closed dislocation midtarsal
83803    Closed dislocation tarsometatarsal
83804    Closed dislocation metatarsal joint unspecified
83805    Closed dislocation metatarsophalangeal
83806    Closed dislocation interphalangeal (joint), foot



                                                                  Page 39
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

83809    Closed dislocation other
8381     Open dislocation
83810    Open dislocation foot, unspecified
83811    Open dislocation tarsal joint unspecified
83812    Open dislocation midtarsal
83813    Open dislocation tarsometatarsal
83814    Open dislocation metatarsal joint unspecified
83815    Open dislocation metatarsophalangeal
83816    Open dislocation interphalangeal, foot
83819    Open dislocation other
839      Other, multiple, and ill-defined dislocations
8390     Cervical vertebra, closed
83900    Cervical vertebra, unspecified
83901    First cervical vertebra
83902    Second cervical vertebra
83903    third cervical vertebra
83904    Fourth cervical vertebra
83905    Fifth cervical vertebra
83906    Sixth cervical vertebra
83907    Seventh cervical vertebra
83908    Multiple cervical vertebra
8391     Cervical vertebra, open
83910    Cervical vertebra, unspecified
83911    First cervical vertebra
83912    Second cervical vertebra
83913    third cervical vertebra
83914    Fourth cervical vertebra
83915    Fifth cervical vertebra
83916    Sixth cervical vertebra
83917    Seventh cervical vertebra
83918    Multiple cervical vertebra
8392     Thoracic and lumbar vertebra, closed
83920    Lumbar vertebra
83921    Thoracic vertebra
8393     Thoracic and lumbar vertebra, open
83930    Lumbar vertebra
83931    Thoracic vertebra
8394     Other vertebra, closed
83940    Vertebra, unspecified site
83941    Coccyx
83942    Sacrum
83949    Other
8395     Other vertebra, open
83950    Vertebra, unspecified site
83951    Coccyx
83952    Sacrum
83959    Other



                                                         Page 40
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

8396     Other location, closed
83961    Sternum
83969    Other, pelvis
8397     Other location, open
83971    Sternum
83979    Other
8398     Multiple and ill-defined, closed
8399     Multiple and ill-defined, open
850      Concussion
8500     With no loss of consciousness
8501     With brief loss of consciousness
85011    With loss of consciousness of 30 mins or less
85012    With loss of consciousness from 31 to 59 mins
8502     With moderate loss of consciousness
8503     With prolonged loss of consciousness and return to pre-existing
         conscious level
8504     With prolonged loss of consciousness, without return to pre-existing
         conscious level
8505     With loss of consciousness of unspecified duration
8509     Concussion, unspecified
851      Cerebral laceration and contusion
8510     Cortex (cerebral) contusion without mention of open intracranial wound

85100    Cortex contusion without mention of open intracranial wound
         unspecified state of consciousness
85101    Cortex contusion without mention of open intracranial wound, with no
         loss of consciousness
85102    Cortex contusion without mention of open intracranial wound, with brief
         loss of consciousness
85103    Cortex contusion without mention of open intracranial wound with
         moderate loss of consciousness
85104    Cortex contusion without mention of open intracranial wound, with
         prolonged loss of consciousness and return to pre-existing conscious
         state
85105    Cortex contusion without mention of open intracranial wound, with
         prolonged loss of consciousness, without return to pre-existing
         conscious state
85106    Cortex contusion without mention of open intracranial wound, with loss
         of consciousness of unspecified duration
85109    Cortex contusion with concussion, unspecified
8511     Cortex (cerebral) contusion with open intracranial wound
85110    Cortex contusion with open intracranial wound, unspecified state of
         consciousness
85111    Cortex contusion with open intracranial wound, with no loss of
         consciousness
85112    Cortex contusion with open intracranial wound, with brief loss of
         consciousness




                                                                                   Page 41
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

85113             Cortex contusion with open intracranial wound, with moderate loss of
UK-HMO             Room (ER)
         Emergencyconsciousness Autopay CPT Code List
85114             Cortex contusion with open intracranial wound, with prolonged loss of
                  consciousness and return to pre-existing conscious level
85115             Cortex contusion with open intracranial wound, with prolonged loss of
                  consciousness, without return to pre-existing conscious level
85116             Cortex contusion with open intracranial wound, with loss of
                  consciousness of unspecified duration
85119             Cortex contusion with open intracranial wound, with concussion,
                  unspecified
85120             Cortex laceration without mention of open intracranial wound,
                  unspecified state of consciousness
85121             Cortex laceration without mention of open intracranial wound, with no
                  loss of consciousness
85122             Cortex laceration without mention of open intracranial wound, with brief
                  loss of consciousness
85123             Cortex laceration without mention of open intracranial wound, with
                  moderate loss of consciousness
85124             Cortex laceration without mention of open intracranial wound, with
                  prolonged loss of consciousness and return to pre-existing conscious
                  level
85125             Cortex laceration without mention of open intracranial wound, with
                  prolonged loss of consciousness, without return to pre-existing
                  conscious level
85126             Cortex laceration without mention of open intracranial wound, with loss
                  of consciousness of unspecified duration
85129             Cortex laceration without mention of open intracranial wound, with
                  consussion, unspecifed
8513              Cortex (cerebral) laceration with open intracranial wound
85130             Cortex laceration with open intracranial wound, unspecifed state of
                  consciousness
85131             Cortex laceration with open intracranial wound, with no loss of
                  consciousness
85132             Cortex laceration with open intracranial wound, with brief loss of
                  consciousness
85133             Cortex laceration with open intracranial wound, with moderate loss of
                  consciousness
85134             Cortex laceration with open intracranial wound, with prolonged loss of
                  consciousness and return to pre-existing conscious level
85135             Cortex laceration with open intracranial wound, with prolonged loss of
                  consciousness, without return to pre-existing conscious level
85136             Cortex laceration with open intracranial wound, with loss of
                  consciousness of unspecified duration
85139             Cortex laceration with open intracranial wound, with consussion,
                  unspecfied
8514              Cerebellar of brain stem contusion without mention of open intracranial
                  wound




                                                                                             Page 42
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

85140              Cerebellar or brain stem contusion without mention of open intracranial
UK-HMO              Room (ER) Autopay CPT Code List
          Emergencywound, unspecified state of consciousness
85141              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with no loss of consciousness
85142              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with brief loss of consciousness
85143              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with moderate loss of consciousness
85144              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with prolonged loss of consciousness and return to pre-existing
                   conscious level
85145              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with prolonged loss of consciousness, without return to pre-
                   existing conscious level
85146              Cerebellar or brain stem contusion without mention of open intracranial
                   wound, with loss of consciousness of unspecified duration

85149                    Cerebellar or brain stem contusion without mention of open intracranial
                         wound, with consussion, unspecified
8515                     Cerebellar or brain stem contusion with open intracranial wound
851.50'                  Cerebellar or brain stem contusion with open intracranial wound,
                         unspecified state of consciousness
851.51                   Cerebellar or brain stem contusion with open intracranial wound, with
                         not loss of consciousness
851.52                   Cerebellar or brain stem contusion with open intracranial wound, with
                         brief loss of consciousness
851.53                   Cerebellar or brain stem contusion with open intracranial wound, with
                         moderate loss of consciousness
851.54                   Cerebellar or brain stem contusion with open intracranial wound, with
                         prolonged loss of consciousness and return to pre-existing conscious
                         level
851.55                   Cerebellar or brain stem contusion with open intracranial wound, with
                         prolonged loss of consciousness, without return to pre-existing
                         conscious level
851.56                   Cerebellar or brain stem contusion with open intracranial wound, with
                         loss of consciousness of unspecified duration
851.59                   Cerebellar or brain stem contusion with open intracranial wound, with
                         consussion, unspecified
8516                     Cerebellar or brain stem laceration without mention of open intracranial
                         wound
851.60'                  Cerebellar or brain stem laceration without mention of open intracranial
                         wound, unspecified state of consciousness
851.61                   Cerebellar or brain stem laceration without mention of open intracranial
                         wound, with no loss of consciousness
851.62                   Cerebellar or brain stem laceration without mention of open intracranial
                         wound, with brief loss of consciousness
851.63                   Cerebellar or brain stem laceration without mention of open intracranial
                         wound, with moderate [1-24hours] loss of consciousness



                                                                                                    Page 43
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

851.64             Cerebellar or brain stem laceration without mention of open intracranial
UK-HMO              Room (ER) Autopay CPT Code List
          Emergencywound, with prolonged [more than 24 hours] loss of consciousness and
                   return to pre-existing conscious level
851.65             Cerebellar or brain stem laceration without mention of open intracranial
                   wound, with prolonged [more than 24 hours] loss of consciousness,
                   without return to pre-existing conscious level
851.66             Cerebellar or brain stem laceration without mention of open intracranial
                   wound, with loss of consciousness of unspecified duration

851.69                   Cerebellar or brain stem laceration without mention of open intracranial
                         wound, with concussion, unspecified
8517                     Cerebellar or brain stem laceration with open intracranial wound
851.70'                  Cerebellar or brain stem laceration with open intracranial wound,
                         unspecified state of consciousness
851.71                   Cerebellar or brain stem laceration with open intracranial wound, with
                         no loss of consciousness
851.72                   Cerebellar or brain stem laceration with open intracranial wound, with
                         brief [less than one hour] loss of consciousness
851.73                   Cerebellar or brain stem laceration with open intracranial wound, with
                         moderate [1-24 hours] loss of consciousness
851.74                   Cerebellar or brain stem laceration with open intracranial wound, with
                         prolonged [more than 24 hours] loss of consciousness and return to
                         pre-existing conscious level
851.75                   Cerebellar or brain stem laceration with open intracranial wound, with
                         prolonged [more than 24 hours] loss of consciousness, without return
                         to pre-existing conscious level
851.76                   Cerebellar or brain stem laceration with open intracranial wound, with
                         loss of consciousness of unspecified duration
851.79                   Cerebellar or brain stem laceration with open intracranial wound, with
                         concussion, unspecified
8518                     Other and unspecified cerebral laceration and contusion, without
                         mention of open intracranial wound
851.80'                  Other and unspecified cerebral laceration with contusion, without
                         mention of open intracranial wound, unspecified state of
                         consciousness
851.81                   Other and unspecified cerebral laceration with contusion, without
                         mention of open intracranial wound, with no loss of consciousness
851.82                   Other and unspecified cerebral laceration with contusion, without
                         mention of open intracranial wound, with brief [less than one hour] loss
                         of consciousness
851.83                   Other and unspecified cerebral laceration with contusion, without
                         mention of open intracranial wound, with moderate [1-24 hours] loss of
                         consciousness
851.84                   Other and unspecified cerebral laceration with contusion, without
                         mention of open intracranial wound, with prolonged [more than 24
                         hours] loss of consciousness and return to pre-existing conscious level




                                                                                                    Page 44
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

851.85             Other and unspecified cerebral laceration with contusion, without
UK-HMO              Room open Autopay CPT Code List
          Emergencymention of (ER)intracranial wound, with prolonged [more than 24
                   hours] loss of consciousness, without return to pre-existing conscious
                   level
851.86             Other and unspecified cerebral laceration with contusion, without
                   mention of open intracranial wound, with loss of consciousness of
                   unspecified duration
851.89             Other and unspecified cerebral laceration with contusion, without
                   mention of open intracranial wound, with concussion, unspecified
8519               Other and unspecified cerebral laceration and contusion, with open
                   intracranial wound
851.90'            Other and unspecified cerebral laceration and contusion, with open
                   intracranial wound, unspecified state of consciousness
851.91             Other and unspecified cerebral laceration and contusion, with open
                   intracranial wound, with no loss of consciousness
851.92             Other and unspecified cerebral laceration and contusion, with open
                   intracranial wound, with brief [less than one hour] loss of
                   consciousness
851.93             Other and unspecified cerebral laceration and contusion, with open
                   intracranial wound, with moderate [1-24 hours] loss of consciousness

851.94                   Other and unspecified cerebral laceration and contusion, with open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness and return to pre-existing conscious level
851.95                   Other and unspecified cerebral laceration and contusion, with open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness, without return to pre-existing conscious level
851.96                   Other and unspecified cerebral laceration and contusion, with open
                         intracranial wound, with loss of consciousness of unspecified duration

851.99                   Other and unspecified cerebral laceration and contusion, with open
                         intracranial wound, with concussion, unspecified
852                      Subarachnoid, subdural, and extradural hemorrhage following injury

8520                     Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound
852.00'                  Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, unspecified state of consciousness
852.01                   Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, with no loss of consciousness
852.02                   Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, with brief [less than one hour] loss of
                         consciousness
852.03                   Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, with moderate [1-24 hours] loss of consciousness

852.04                   Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness and return to pre-existing conscious level


                                                                                                  Page 45
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

852.05             Subarachnoind hemorrhage following injury without mention of open
UK-HMO              Room wound, with prolonged [more than List
          Emergencyintracranial(ER) Autopay CPT Code24 hours] loss of
                   consciousness, without return to pre-existing conscious level
852.06             Subarachnoind hemorrhage following injury without mention of open
                   intracranial wound, with loss of consciousness of unspecified duration

852.09                   Subarachnoind hemorrhage following injury without mention of open
                         intracranial wound, with concussion, unspecified
8521                     Subarachnoid hemorrhage following injury with open intracranial
                         wound
852.10'                  Subarachnoid hemorrhage following injury with open intracranial
                         wound, unspecified state of consciousness
852.11                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with no loss of consciousness
852.12                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with brief [less than one hour] loss of consciousness
852.13                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with moderate [1-24 hours] loss of consciousness
852.14                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with prolonged [more than 24 hours] loss of consciousness and
                         return to pre-existing conscious level
852.15                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with prolonged [more than 24 hours] loss of consciousness,
                         without return to pre-existing conscious level
852.16                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with loss of consciousness of unspecified duration
852.19                   Subarachnoid hemorrhage following injury with open intracranial
                         wound, with concussion, unspecified
8522                     Subdural hemorrhage following injury without mention of open
                         intracranial wound
852.20'                  Subdural hemorrhage following injury without mention of open
                         intracranial wound, unspecified state of consciousness
852.21                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with no loss of consciousness
852.22                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with brief [less than one hour] loss of
                         consciousness
852.23                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with moderate [1-24 hours] loss of consciousness

852.24                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness and return to pre-existing conscious level
852.25                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness, without return to pre-existing conscious level
852.26                   Subdural hemorrhage following injury without mention of open
                         intracranial wound, with loss of consciousness of unspecified duration




                                                                                                  Page 46
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

852.29             Subdural hemorrhage following injury without mention of open
UK-HMO              Room wound, with conscussion, Code List
          Emergencyintracranial(ER) Autopay CPTunspecified
8523               Subdural hemorrhage following injury with open intracranial wound
852.30'            Subdural hemorrhage following injury with open intracranial wound,
                   unspecified state of consciousness
852.31             Subdural hemorrhage following injury with open intracranial wound,
                   with no loss of consciousness
852.32             Subdural hemorrhage following injury with open intracranial wound,
                   with brief [less than one hour] loss of consciousness
852.33             Subdural hemorrhage following injury with open intracranial wound,
                   with moderate [1-24 hours] loss of consciousness
852.34             Subdural hemorrhage following injury with open intracranial wound,
                   with prolonged [more than 24 hours] loss of consciousness and return
                   to pre-existing conscious level
852.35             Subdural hemorrhage following injury with open intracranial wound,
                   with prolonged [more than 24 hours] loss of consciousness, without
                   return to pre-existing conscious level
852.36             Subdural hemorrhage following injury with open intracranial wound,
                   with loss of consciousness of unspecified duration
852.39             Subdural hemorrhage following injury with open intracranial wound,
                   with concussion, unspecified
8524               Extradural hemorrhage following injury without mention of open
                   intracranial wound
852.40'            Extradural hemorrhage following injury without mention of open
                   intracranial wound, unspecified state of consciousness
852.41             Extradural hemorrhage following injury without mention of open
                   intracranial wound, with no loss of consciousness
852.42             Extradural hemorrhage following injury without mention of open
                   intracranial wound, with brief [less than one hour] loss of
                   consciousness
852.43             Extradural hemorrhage following injury without mention of open
                   intracranial wound, with moderate [1-24 hours] loss of consciousness

852.44                   Extradural hemorrhage following injury without mention of open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness and return to pre-existing conscious level
852.45                   Extradural hemorrhage following injury without mention of open
                         intracranial wound, with prolonged [more than 24 hours] loss of
                         consciousness, without return to pre-existing conscious level
852.46                   Extradural hemorrhage following injury without mention of open
                         intracranial wound, with loss of consciousness of unspecified duration

852.49                   Extradural hemorrhage following injury without mention of open
                         intracranial wound, with concussion, unspecified
8525                     Extradural hemorrhage following injury with open intracranial wound

852.50'                  Extradural hemorrhage following injury with open intracranial wound,
                         unspecified state of consciousness




                                                                                                  Page 47
                              HUMANA HEALTH PLANS
                      EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                              EFFECTIVE MAY 1, 2000

852.51             Extradural hemorrhage following injury with open intracranial wound,
UK-HMO              Room (ER) Autopay
          Emergencywith no loss of consciousness CPT Code List
852.52             Extradural hemorrhage following injury with open intracranial wound,
                   with brief [less than one hour] loss of consciousness
852.53             Extradural hemorrhage following injury with open intracranial wound,
                   with moderate [1-24 hours] loss of consciousness
852.54             Extradural hemorrhage following injury with open intracranial wound,
                   with prolonged [more than 24 hours] loss of consciousness and return
                   to pre-existing conscious level
852.55             Extradural hemorrhage following injury with open intracranial wound,
                   with prolonged [more than 24 hours] loss of consciousness, without
                   return to pre-existing conscious level
852.56             Extradural hemorrhage following injury with open intracranial wound,
                   with loss of consciousness of unspecfied duration
852.59             Extradural hemorrhage following injury with open intracranial wound,
                   with concussion, unspecified
853                Other and unspecified intracranial hemorrhage following injury
8530               Without mention of open intracranial wound
853.00'            Without mention of open intracranial wound, unspecified state of
                   consciousness
853.01             Without mention of open intracranial wound, with no loss of
                   consciousness
853.02             Without mention of open intracranial wound, with brief [less than one
                   hour] loss of consciousness
853.03             Without mention of open intracranial wound, with moderate [1-24
                   hours] loss of consciousness
853.04             Without mention of open intracranial wound, with prolonged [more than
                   24 hours] loss of consciousness and return to pre-existing conscious
                   level
853.05             Without mention of open intracranial wound, with prolonged [more than
                   24 hours] loss of consciousness, without return to pre-existing
                   conscious level
853.06             Without mention of open intracranial wound, with loss of
                   consciousness of unspecified duration
853.09             Without mention of open intracranial wound, with concussion,
                   unspecified
8531               With open intracranial wound
853.10'            With open intracranial wound, unspecified state of consciousness
853.11             With open intracranial wound, with no loss of consciousness
853.12             With open intracranial wound, with brief [less than one hour] loss of
                   consciousness
853.13             With open intracranial wound, with moderate [1-24 hours] loss of
                   consciousness
853.14             With open intracranial wound, with prolonged [more than 24 hours]
                   loss of consciousness and return to pre-existing conscious level
853.15             With open intracranial wound, with prolonged [more than 24 hours]
                   loss of consciousness, without return to pre-existing conscious level




                                                                                           Page 48
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

853.16             With open intracranial wound, with loss of consciousness of
UK-HMO              Room duration
          Emergencyunspecified(ER) Autopay CPT Code List
853.19             With open intracranial wound, with concussion, unspecified
854                Intracranial injury of other and unspecified nature
8540               Without mention of open intracranial wound
85400              OTH BRAIN INJ-LOC NOS
85401              BRAIN INJURY NEC-NO COMA
85402              BRAIN INJ NEC-BRIEF COMA
854.03             Without mention of open intracranial wound, with moderate [1-24
                   hours] loss of consciousness
854.04             Without mention of open intracranial wound, with prolonged [more than
                   24 hours] loss of consciousness and return to pre-existing conscious
                   level
854.06             Without mention of open intracranial wound, with loss of
                   consciousness of unspecified duration
85406              BRAIN INJ NEC-COMA NOS
85409              BRAIN INJ NEC-CONCUSSION
8541               With open intracranial wound
854.10'            With open intracranial wound, unspecified state of consciousness
854.11             With open intracranial wound, with no loss of consciousness
854.12             With open intracranial wound, with brief [less than one hour] loss of consciousness
854.13             With open intracranial wound, with moderate [1-24 hours] loss of
                   consciousness
854.14             With open intracranial wound, with prolonged [more than 24 hours]
                   loss of consciousness and return to pre-existing conscious level
854.15             With open intracranial wound, with prolonged [more than 24 hours]
                   loss of consciousness, without return to pre-existing conscious level

854.16                   With open intracranial wound, with loss of consciousness of
                         unspecified duration
854.19                   With open intracranial wound, with concussion, unspecified
860                      Traumatic pneumothorax and hemothorax
8600                     Pneumothorax without mention of open wound into thorax
8601                     Pneumothorax with open wound into thorax
8602                     Hemothorax without mention of open wound into thorax
8603                     Hemothorax with open wound into thorax
8604                     Pneumohemothorax without mention of open wound into thorax
8605                     Pneumohemothorax with open wound into thorax
861                      Injury to heart and lung
8610                     Heart, without mention of open wound into thorax
86100                    Unspecified injury
86101                    Contusion
86102                    Laceration without penetration of heart chambers
86103                    Laceration with penetration of heart chambers
8611                     heart, with open wound into thorax
86110                    Unspecified injury
86111                    Contusion
86112                    Laceration without penetration of heart chambers


                                                                                                 Page 49
                HUMANA HEALTH PLANS
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                EFFECTIVE MAY 1, 2000

86113    Laceration with penetration of heart chambers
8612     Lung, without mentin of open wound into thorax
86120    Unspecified injury
86121    Contusion
86122    Laceration
8613     Lung, with open wound into thorax
86130    Unspecified injury
86131    Contusion
86132    Laceration
862      Injury to other and unspecified intrathoracic organs
8620     Diaphragm, without mention of open wound into cavity
8621     Diaphragm, with open wound into cavity
8622     Other specified intrathoracic organs, without mention of open wound
         into cavity
86221    Bronchus
86222    Esophagus
86229    Other, pleura, thymus gland
8623     Other specified intrathoracic organs, with open wound into cavity
86231    Bronchus
86232    Esophagus
86239    Other
8628     Multiple and unspecified intrathoracic organs, without mention of open
         wound into cavity
8629     Multiple and unspecified intrathoracic organs, with open wound into
         cavity
863      Injury to gastrointestinal tract
8630     Stomach, without mention of open wound into cavity
8631     Stomach, with open wound into cavity
8632     Small intestine, without mention of open wound into cavity
86320    Small intestine, unspecified site
86321    Duodenum
86329    Other
8633     Small intestine, with open wound into cavity
86330    Small intestine, unspecified site
86331    Duodenum
86339    Other
8634     Colon or rectum, without mention of open wound into cavity
86340    Colon, unspecified site
86341    Ascending [right] colon
86342    Transverse colon
86343    Descending [left] colon
86344    Sigmoid colon
86345    Rectum
86346    Multiple sites in colon and rectum
86349    Other
8635     Colon or rectum, with open wound into cavity
86350    Colon, unspecified site



                                                                                  Page 50
                  HUMANA HEALTH PLANS
          EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                  EFFECTIVE MAY 1, 2000

86351      Ascending [right] colon
86352      Transverse colon
86353      Descending [left] colon
86354      Sigmoid colon
86355      Rectum
86356      Multiple sites in colon and rectum
86359      Other
8638       Other and unspecified gastrointestinal sites, without mention of open
           wound into cavity
86380      Gastrointestinal tract, unspecified site
86381      Pancreas, head
86382      Pancreas, body
86383      Pancreas, tail
86384      Pancreas, multiple and unspecified sites
86385      Appendix
86389      Other, intestine NOS
8639       Other and unspecified gastrointestinal sites, with open wound into
           cavity
86390      Gastrointestinal tract, unspecified site
86391      Pancreas, head
86392      Pancreas, body
86393      Pancreas, tail
86394      Pancreas, multiple and unspecified sites
86395      Appendix
86399      Other
864.0'     Injury to liver without mention of open wound into cavity
864.00'    Injury to liver without mention of open wound into cavity, unspecified
           injury
864.01     Hematoma and contusion
864.02     Laceration, minor
864.03     Laceration, moderate
864.04     Laceration, major
864.05     Laceration, unspecified
864.09     Other
86410      With open wound into cavity, unspecified injury to liver
86411      With open wound into cavity, Hematoma and contusion to liver
86412      With open wound into cavity, laceration, minor to liver
86413      With open wound into cavity, laceration, moderate to liver
86414      With open wound into cavity, laceration, major toliver
864.15     With open wound into cavity, laceration, unspecified
86419      With open wound into cavity, other, to liver
865.00'    Injury to spleen, without mention of open wound into cavity, unspecified
           injury
86501      Without mention of open wound into cavity of spleen, unspecified injury

865.02     Without mention of open wound into cavity, capsular tears, without
           major disruption of parenchyma



                                                                                      Page 51
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

865.03             Without mention of open wound into cavity, laceration extending into
UK-HMO              Room (ER) Autopay CPT Code List
          Emergencyparenchyma
865.04             Without mention of open wound into cavity, massive parenchymal
                   disruption
865.09             Without mention of open wound into cavity, other
86510              With open wound into cavity of spleen, unspecified injury
86511              With open wound into cavity of spleen, hematoma without rupture of
                   capsule
86512              With open wound into cavity of spleen, capsular tears, without major
                   disruption of parenchyma
86513              With open wound into cavity of spleen, laceration extending into
                   parenchyma
86514              With open wound into cavity of spleen, massive parenchymal
                   disruption
865.19             With open wound into cavity, other
866.00'            Injury to kidney, without mention of open wound into cavity, unspecified
                   injury
86601              Kidney hematoma without ruptue of capsule or mention of open wound
                   into cavity
866.02             Without mention of open wound into cavity, laceration
866.03             Without mention of open wound into cavity, complete disruption of
                   kidney parenchyma
866.10'            With open wound into cavity, unspecified injury
86611              With open wound into cavity of kidney, hematoma withour rupture of
                   capsule
86612              With open wound into cavity of kidney, laceration
86613              With open wound into cavity of kidney, complete disruption of kidney
                   paenchyma
867.0'             Bladder and urethra, without mention of open wound into cavity
8671               Bladder and urethra, without mention of open wound into cavity
867.2              Ureter, without mention of open wound into cavity
8673               Ureter, with open wound into cavity
867.4              Uterus, without mention of open wound intocavity
8675               Uterus, with open wound into cavity
867.6              Other specified pelvic organs, without mention of open wound into
                   cavity
8677               Other specified pelvic organs, with open wound into cavity
867.8              Unspecified pelvic organ, without mention of open wound into cavity

8679                     Unspecified pelvic organ, with open wound into cavity
868.00'                  Injury to other intra-abdominal organs, without mention of open wound
                         into cavity, unspecified intra-abdominal organ
86801                    Without mention of open wound into cavity, adrenal gland
868.02                   Without mention of open wound into cavity, bile duct and gallbladder
868.03                   Without mention of open wound into cavity, peritoneum
868.04                   Without mention of open wound into cavity, retroperitoneum
868.09                   Without mention of open wound into cavity, other and multiple intra-
                         abdominal organs



                                                                                                 Page 52
                               HUMANA HEALTH PLANS
                       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                               EFFECTIVE MAY 1, 2000

86810               With open wound into cavity of intra-abdominal organs, unspecified
UK-HMO               Room (ER) Autopay CPT Code List
           Emergencyintra-abdominal organ
86811               With open wound into cavity of intra-abdominal organs, adrenal gland

86812                     With open wound into cavity of intra-abdominal organs, bile duct and
                          gallbladder
86813                     With open wound into cavity of intra-abdominal organs, peritoneum
86814                     With open wound into cavity of intra-abdominal organs,
                          retroperitoneum
86819                     With open wound into cavity of intra-abdominal organs, other and
                          multiple intra-abdominal organs
8690                      Without mention of open wound into cavity of unspecified or ill-defined
                          organs
8691                      With open wound into cavity of unspecified or ill-defined organs
870                       Open wound of ocular adnexa
8700                      Laceration of skin of eyelid and periocular area
8701                      Laceration of eyelid, full-thickness, not involving lacrimal passages
8702                      Laceration of eyelid involving lacrimal passages
8703                      Penetrating wound of orbit, without mention of foreign body
8704                      Penetrating wound of orbit with foreign body
8708                      Other specified open wunds of ocular adnexa
8709
870-8977                  OPEN WOUNDS OF ALL BODY PARTS
871                       Open wound of eyeball
8710                      Ocular laceration without prolapse of intraocular tissue
8711                      Ocular laceration with prolapse or exposure of intraocular tissue
8712                      Rupture of eye with partial loss of intraocular tissue
8713                      Avulsion of eye
8714                      Unspecified laceration of eye
8715                      Penetrations of eyeball with magnetic foreign body
8716                      Penetration of eyeball with (nonmagnetic) foreign body
8717                      Unspecified ocular penetration
8719                      Unspecified open wound of eyeball
872                       External ear, unspecified site
87201                     Auricle, ear
87202                     Auditory canal
8721                      External ear, complicated
87210                     External ear, unspecified site
87211                     Auricle, ear
87212                     Auditory canal
87261                      Other specified parts of ear, w/out mention of complication: ear drum,
8726                            ossicles, eustachian tube, cochlea, other and multiple sites
87262
87263
87264
87269
8727                      Other specified parts of ear, complicated



                                                                                                    Page 53
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

87271    Ear drum
87272    Ossicles
87273    Eustachian tube
87274    Cochlea
87279    Other and multiple sites
8728         Ear, part unspecified, without mention of complication; ear, part
8729                             unspecified, complicated
8730     Open wound of scalp, without mention of complication
8731     Scalp, complicated wound
87320    Nose, without mention of complication: unspecified site, nasal septum,
87321                    nasal cavity, nasal sinus, multiple sites
87322
87323
87329
8733     Nose , complicated wound
87330    Nose, unspecified site
87331    Nasal septum
87332    Nose, complicated: nasal cavity
87333    Nasal sinus
87339    Other open wound of head; Nose, complicated; Multiple sites
8734     Other open wound of head; Face, without mention of complication
87340    Open wound of face, unspecified site, uncomplicated
87341    Cheek
87342    Open wound of forehead, uncomplicated
87343    Open would of lip, uncomplicated
87344    Open would of jaw, uncomplicated
87349    Other and multiple sites
8735     Face , complicated
87350    Face, unspecified site
87351    cheek
87352    Forehead
87353    Lip
87354    Jaw
87359    Other and multiple sites
8737     Internal structures of mouth, complicated
87370    Mouth, unspecified site
87371    Buccal mucosa
87372    Gum (alveolar process)
87374    Tooth (broken)
87375    Palate
87379    Other and multiple sites
8739     Other and unspecified open wound of head , complicated
8741     Larynx and trachea , complicated
87410    Larynx with trachea
87411    Larynx
87412    Trachea
8743     Thyroid gland, complicated



                                                                                  Page 54
                  HUMANA HEALTH PLANS
          EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                  EFFECTIVE MAY 1, 2000

8745       Pharynx, complicated
8749       Other and unspecified parts, complicated
8751       Open wound of chest ( wall) , complicated
8761       Open wound of back, complicated
8771       Open wound of buttock, complicated
8781       Penis, complicated
8783       Scrotum and testes, complicated
8785       Vulva, complicated
8787       Vagina, complicated
8789       Other and unspecified parts, complicated
8791       Breast, complicated
8793       Abdominal wall, anterior, complicated
8795       Abdominal, wall, lateral, complicated
8797       Other and unspecified parts of trunk, complicated
8799       Open wound(s) (multiple) of unspecified site(s), complicated
8801       Open wound of shoulder and upper arm, complicated
8800       Open wound of shoulder and upper arm, without mention of
           complication, shoulder region
88001      Without mention of complication, scapular region
88002      Without mention of complication, axillary region
88003      Without mention of complication, upper arm
88009      Without mention of complication, multiple sites
8802       Open wound of shoulder and upper arm, with tendon involvement
88020      With tendon involvement, shoulder region
88021      With tendon involvement, scapular region
88022      With tendon involvement, axillary region
88023      With tendon involvement, upper arm
88029      With tendon involvement, multiple sites
88100      Open wound of forearm, without mention of complication
88102      Open wound of wrist, without mention of complication
8811       Open wound of elbow, forearm, and wrist, complicated
881.10'    Complicated, forearm
881.11     Complicated, elbow
881.12     Complicated, wrist
8812       Open wound of elbow, forearm, and wrist, with tendon involvement
881.20'    With tendon involvement, forearm
881.21     With tendon involvement, elbow
881.22     With tendon involvement, wrist
8820       Open wound of hand except fingers alone, without mentionof
           complication
882.1      Open wound of hand except finger(s) alone, complicated
8822       Open wound of hand except finger(s) alone, with tendon involvement

8830       Open wound of fingers, without mention of complication
8831       Open wound of finger(s), complicated
8832       Open wound of finger(s), with tendon involvement
8841       Multiple and unspecified open wound of upper limb, complicated



                                                                                Page 55
               HUMANA HEALTH PLANS
       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
               EFFECTIVE MAY 1, 2000

8842    Multiple and unspecified open wound of upper limb, with tendon
        involvement
885     Traumatic amputation of thumb (complete)(partial)
8850    Without mention of complication
8851    Complicated
886     Traumatic amputation of other finger(s) (complete)(partial)
8860    Without mention of complication
8861    Complicated
887     Traumatic amputation of arm and hand (complete) (partial)
8870    Unilateral, below elbow, without mention of complication
8871    Unilateral, below elbow, complicated
8872    Unilateral, at or above elbow, without mention of complication
8873    Unilateral, at or above elbow, complicated
8874    Unilateral,level not specified, without mention of complication
8875    Unilateral, level not specified, complicated
8876    Bilateral [any level] without mention of complication
8877    Bilateral [any level] complicated
8901    Open wound of hip and thigh, complicated
8902    Open wound of hip and thigh with tendon involvement
8910    Open wound of knee, leg (except thigh) and ankle, without mention of
        complication
8911    Open wound of knee, leg [except thigh], and ankle, complicated
8912    Open wound of knee, leg [except thigh] and ankle, with tendon
        involvement
8920    Open wound of foot except toe(s) alone, without mention of
        complication
8921    Open wound of foot except toe(s) alone, complicated
8922    Open wound of foot except toe(s) alone, with tendon involvement
8930    Open wound of toe(s), without mention of complication
8931    Open wound of toe(s), complicated
8932    Open wond of toes(s), with tendon involvement
8940    Multiple and unspecified open wound of lower limb, without mention of
        complication
8941    Multiple and unspecified open wound of lower limb, complicated
8942    Multiple and unspecified open wound of lower limb, with tendon
        involvement
8950    Traumatic amputation of toe(s) (complete)(partial), without menton of
        complication
8951    Traumatic amputation of toe(s) (complete) (partial), complicated
8960    Unilateral, without mention of complication
8961    Unilateral, complicated
8962    Bilateral, without mention of complication
8963    Bilateral, complicated
897     Traumatic amputation of leg(s) (complete) (partial)
8970    Unilateral, below knee, without mention of complication
8971    Unilateral, below knee, complicated
8972    Unilateral, at or above knee, without mention of complication
8973    Unilateral, at or above knee, complicated


                                                                                Page 56
                HUMANA HEALTH PLANS
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                EFFECTIVE MAY 1, 2000

8974     Unilateral, level not spcified, without mention of complication
8975     Unilateral, level not specified, complicated
8976     Bilateral [any level] without mention of complication
8977     Bilateral [any level], complicated
90000    Injury to carotid artery, unspecifed
90001    Injury to common carotid artery
90002    Injury to external carotid artery
90003    Injury to internal carotid artery
9001     Internal jugular vein
90081    External jugular vein
90082    Multiple blood vessels of head and neck
90089    Other
9009     Unspecified blood vessel of head and neck
9010     Thoracic aorta
9020     Abdominal aorta
9064     Late effects of injuries to skin and subcutaneous tissues; Late effect of
         crushing
9065     Late effects of injuries to skin and subcutaneous tissues; Late effect of
         burn of eye, face, head, and neck
9066     Late effects of injuries to skin and subcutaneous tissues; Late effect of
         burn of wrist and hand
9067     Late effects of injuries to skin and subcutaneous tissues; Late effect of
         burn of other extremities
9068     Late effects of injuries to skin and subcutaneous tissues;Late effect of
         burns of other specified sites
9069     Late effects of injuries to skin and subcutaneous tissues;Late effect of
         burn of unspecified site
9100     Abrasion or friction burn of face, neck and scalp except eye, without
         mention of infection
9101     Abrasion or friction burn, infected
9164     Insect bite, nonvenomous of hip, thigh, leg, and ankle, without mention
         of infection
9180     SUPERF INJ PERIOCULAR
9181     Superficial injury of cornea
9182     SUPERFIC INJ CONJUNCTIVA
9189     SUPERFICIAL INJ EYE NEC
920      Contusion of face, scalp and neck except eye(s)
921                        CONTUSION OF EYES AND ADNEXA
9210
9211
9212
9213
9219
9221     Contusion of chest wall
9222     Contusion of abdominal wall
9223     Contusion of back
9224     CONTUSION GENITAL ORGANS
92300    Contusion of shoulder region


                                                                                     Page 57
                HUMANA HEALTH PLANS
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                EFFECTIVE MAY 1, 2000

92301                      Contusion shoulder and upper arm
92302
92303
92309
92310    Contusion of forearm
92311    Contusion of elbow
92320    Contusion of hand (s)
92321    Contusion wrist
9233     Contusion of finger
9238     Contusion multiple sites of upper limb
9239     Contusion unspecified part of upper limb
92400    Contusion thigh
92401    Contusion hip
92410    Contusion of lower leg
92411    Contusion of knee
92420    Contusion of foot
92421    Contusion ankle
9243     Contusion toe
9244     Contusion multiple sites of lower limb
9245     Contusion unspecified part of lower limb
9248     Contusion of multiple sites, not elsewhere classified
925      Crushing injury of face, scalp, and neck
9251     Crushing injury of face and scalp
9252     Crushing injury of neck
926      Crushing injury to trunk
9260     External genitalia
9261     Other specified sites
92611    Back
92612    Buttock
92619    Other, breast
9268     Multiple sites of trunk
9269     Unspecified site
927      Crushing injury of upper limb
9270     Shoulder and upper arm
92700    Crushing injury shoulder region
92701    Scapular region
92702    Crushing injury axillary region
92703    Axillary region
92709    Multiple sites
9271     Elbow and forearm
92710    Forearm
92711    Elbow
9272     Wrist and hand(s), except finger(s) alone
92720    Hand(s)
92721    Wrist
9273     Finger(s)
9278     Multiple sites of upper limb



                                                                 Page 58
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9279     Unspecified site
928      Crushing injury of lower limb
9280     Hip and thigh
92800    Crushing injury thigh
92801    Crushing injury hip
9281     Crushing injury Knee and lower leg
92810    Crushing injury lower leg
92811    Crushing injury knee
9282     Ankle and foot, excluding toe(s) alone
92820    Foot, heel
92821    Ankle
9283     Toes(s)
9288     Multiple sites of lower limb
9289     Unspecified site, leg nos
929      Crushing injury of multiple and unspecified sites
9290     Multiple sites, not elsewhere classifed
9299     Unspecified site
9300     Corneal foreign body
930                        FOREIGN BODY ON EXTERNAL EYE
9301
9302
9308
9309
931      FOREIGN BODY IN EAR
932      FOREIGN BODY IN NOSE
933               FOREIGN BODY IN PHARYNX AND LARYNX
9330
9331
934
9340
9341
9348
9349
935
9350     FOREIGN BODY IN MOUTH
9351     FOREIGN BODY ESOPHAGUS
9352     FOREIGN BODY IN STOMACH
936      FB IN INTESTINE & COLON
937      Foreign body in anus and rectum
938      FOREIGN BODY GI NOS
9392     FOREIGN BDY VULVA/VAGINA
9400     Chemical burn of eyelids and periocular area
9401     Other burns of eyelids and periocular area
9402     Alkaline chemical burn of cornea and conjunctival sac
9403     Acid chemical burn of cornea and conjunctival sac
9404     BURN CORNEA/CONJUNCT NEC
9405     Burn with resulting rupture and destruction of eyeball



                                                                  Page 59
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9409     BURN EYE & ADNEXA NOS
9410     Burn of face, head, and neck; Unspecified degree
94100    BURN NOS HEAD-UNSPEC
94101               Burn of face, head, and neck, unspecified degree
94102
94103
94104
94105
94106
94107
94108
94109
9411
94110    1ST DEG BURN HEAD NOS
94111               Burn of face, head, and neck, 1st degree
94112
94113
94114
94115
94116
94117
94118
94119
94120    2ND DEG BURN HEAD NOS
94121               Burn of face, head, and neck, 2nd degree
94122
94123
94124
94125
94126
94127    2ND DEG BURN FACE NEC
94128               Burn of face, head and neck, 2nd degree
94129
9413
94130                   Burn of face, head, and neck, 3 degree
94131
94132
94133
94134
94135
94136
94137
94138
94139
94200                      Burn of trunk, unspecified degree
94201
94202



                                                                       Page 60
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                    Burn of trunk, unspecified degree
                EFFECTIVE MAY 1, 2000

94203
94204
94205
94209
94210                          Burn of trunk, 1st degree
94211
94212
94213
94214
94215
94219
94220                          Burn of trunk, 2nd degree
94221
94222    2ND DEG BURN CHEST WALL
94223    2ND DEG BURN ABD WALL
94224                     Burn of trunk, 2nd degree
94225
94229
94230                          Burn of trunk, 3rd degree
94231
94232
94233
94234
94235
94239
94300        Burn of upper limb, except wrist and hand, unspecified degree
94301
94302
94303
94304
94305
94306
94309
94310    Burn offorearm, 1st degree
94311    1ST DEG BURN FOREARM
94312             Burn of upper limb, except wrist and hand, 1st degree
94313
94314
94315
94316
94319
94320    2ND DEG BURN ARM NOS
94321    2ND DEG BURN FOREARM
94322          Burn of upper limb, except wrist and hand, 2nd degree
94323
94324
94325



                                                                             Page 61
                HUMANA HEALTH PLANS
                 Burn of upper limb, except wrist and hand, 2nd degree
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

94326
94329
94330            Burn of upper limb, except wrist and hand, 3rd degree
94331
94332
94333
94334
94335
94336
94339
94400    BURN NOS HAND-UNSPEC
94401              Burn of wrist and hand, unspecified degree
94402
94403
94404
94405
94406
94407
94408
94410    1ST DEG BURN HAND NOS
94411                  Burn of wrist and hand, 1st degree
94412
94413
94414
94415
94416
94417
94418
94420    2ND DEG BURN HAND NOS
94421    2ND DEG BURN FINGER
94422    2nd degree burn thumb
94423    2ND DEG BURN MULT FINGER
94424    2nd degree burn two or more digits
94425    2ND DEG BURN PALM
94426    2 DEG BURN BACK OF HAND
94427    2nd degree burn wrist
94428    2ND DEG BURN HAND-MULT
94430                          Burn of wrist, 3rd degree
94431
94432
94433
94434
94435
94436
94437
94438
94440



                                                                         Page 62
                 HUMANA HEALTH PLANS
         EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                 EFFECTIVE MAY 1, 2000

94441
94442
94443
94444
94445
94446
94447
94448
94450                             Burn of Lower Limb(s)
94451
94452
94453
94454
94455
94456
94457
94458
94500     Burn of lower limb, (leg) Unspecified degree
94501     Burn of toe, Unspecified degree
94502     BURN NOS FOOT
94503                      Burn of lower limb, Unspecified degree
94504
94505
94506
94509
94510                   Burn of lower limb, Erythema (first degree)
94511
94512
94513
94514
94515
94516
94519
94520     2ND DEG BURN LEG NOS
945.21    2nd degree burn toe(s)
94522     2ND DEG BURN FOOT
94523     2ND DEG BURN ANKLE
94524     2ND DEG BURN LOWER LEG
945.25    2nd degree burn knee
94526     2ND DEG BURN THIGH
945.29    2nd degree burn multiple sites of lower limb
94530                          3rd degree burn lower limb
94531
94532
94533
94534
94535



                                                                      Page 63
                            3rd degree burn lower limb
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

94536
94539
9460                      Burns of multiple specified sites
9461
9462
9463
9464
9465
94800       Burns classified according to extent of body surface involved
94801




                                                                            Page 64
                  HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                    EFFECTIVE MAY 1, 2000
            Burns classified according to extent of body surface involved

94802
94803
94804
94805
94806
94807
94808
94809
9481
94810
94811
94812
94813
94814
94815
94816
94817
94818
94819
9482
94820
94821
94822
94823
94824
94825
94826
94827
94828
94829
9483
94830
94831
94832
94833
94834
94835
94836
94837
94838
94839
9484
94840
94841
94842
94843
94844



                                                                            Page 65
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

94845
94846
94847
94848
94849
9485
94850
94851
94852
94853
94854
94855
94856
94857
94858
94859
9486
94860
94861
94862
94863
94864
94865
94866
94867
94868
94869
9487
94870
94871
94872
94873
94874
94875
94876
94877
94878
94879
9488
94880
94881
94882
94883
94884
94885
94886
94887



                                               Page 66
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

94888
94889
9489
94890
94891
94892
94893
94894
94895
94896
94897
94898
94899
9490              Burn unspecified, 1st, 2nd, 3rd degree
9491
9492
9493
9494
9495
950              INJURY TO NERVES OR SPINAL CORD
9500
9501
9502
9503
9509
951
9510
9511
9512
9513
9514
9515
9516
9517
9518
9519
952
9520
95200
95201
95202
95203
95204
95205
95206
95207
95208



                                                           Page 67
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

95209
9521
95210
95211
95212
95213
95214
95215
95216
95217
95218
95219
9522
9523
9524
9528
9529
953
9530
9531
9532
9533
9534
9535
9538
9539
954
9540
9541
9548
9549
955
9550
9551
9552
9553
9554
9555
9556
9557
9558
9559
956
9560
9561
9562
9563



                                               Page 68
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9564
9565
9568
9569
957
9570
9571
9578
9579
9584     Traumatic shock
9585     Traumatic anuria
958      Certain early complications of trauma
9580     Air embolism
9581     Fat embolism
9582     Secondary and recurrent hemorrhage
9583     Posttraumatic wound infeciton, not elsewhere classified
9584     Traumatic shock
9585     Traumatic anuria
9586     Volkmanns' ischemic contracture
9587     Traumatic subcutaneous emphysema
9588     Other early complications of trauma
95891    Traumatic compartment syndrome of the upper extremity
95892    Traumatic compartment syndrome of the lower extremity
95893    Traumatic compartment syndrome of the abdomen
95899    Traumatic compartment syndrome of other sites
959      Injury, other and unspecified
9590     Other and unspecified injury to face and neck
95901    Head injury, unspecified
95909    Injury of face and neck
9591     Trunk
95911    Other injury of chest wall
95912    Other injury of abdomen
95913    Fracture of corpus cavernosum penis
95914    Other injury of external genitals
95919    Other injury of other sites of trunk
9592     Other and unspecified injury to shoulder and upper arm
9593     Other and unspecified injury to elbow, forearm and wrist
9594     Other and unspecified injury to hand, except finger
9595     Other and unspecified injury to finger
9596     Other and unspecified injury hip and thigh
9597     Other and unspecified injury to knee, leg, ankle and foot
9598     Other and unspecified injury , other specified sites, including multiple

9599     Other and unspecified injury, unspecified site
960                    DRUG OD,POISONINGS,CHEMICALS
9600
9601



                                                                                    Page 69
               HUMANA HEALTH PLANS
       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                 DRUG OD,POISONINGS,CHEMICALS
               EFFECTIVE MAY 1, 2000

9602
9603
9604
9605
9606
9607
9608
9609
961
9610
9611
9612
9613
9614
9615
9616
9617
9618
9619
962
9620
9621
9622
9623
9624
9625
9626
9627
9628
9629
963
9630
9631
9632
9633
9634
9635
9638
9639
964
9640
9641
9642
9643
9644
9645
9646



                                                Page 70
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9647
9648
9649
965
9650
96500
96501
96502
96509
9651
9654
9655
9656
96561
96569
9657
9658
9659
966
9660
9661
9662
9663
9664
967
9670
9671
9672
9673
9674
9675
9676
9678
9679
968
9680
9681
9682
9683
9684
9685
9686
9687
9689
969
9690
9691



                                               Page 71
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9692
9693
9694
9695
9696
9697
9698
9699
970
9700
9701
9708
97081                                          Added 10-01-10
97089                                          Added 10-01-10
9709
971
9710
9711
9712
9713
9719
972
9720
9721
9722
9723
9724
9725
9726
9727
9728
9729
973
9730
9731
9732
9733
9734
9735
9736
9738
9739
974
9740
9741
9742
9743



                                                   Page 72
               HUMANA HEALTH PLANS
       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
               EFFECTIVE MAY 1, 2000

9744
9745
9746
9747
975
9750
9751
9752
9753
9754
9755
9756
9757
9758
976
9760
9761
9762
9763
9764
9765
9766
9767
9768
9769
977
9770
9771
9772
9773
9774
9778
9779
978
9780
9781
9782
9783
9784
9785
9786
9788
9789
979
9790
9791
9792



                                              Page 73
               HUMANA HEALTH PLANS
       EMERGENCY DIAGNOSES FOR AUTO PAYMENT
               EFFECTIVE MAY 1, 2000

9793
9794
9795
9796
9797
9799
980
9800
9801
9802
9803
9808
9809
981
982
9820
9821
9822
9823
9824
9828
983
9830
9831
9832
9839
984
9840
9841
9848
9849
985
9850
9851
9852
9853
9854
9855
9856
9858
9859
986
987
9870
9871
9872
9873



                                              Page 74
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9874
9875
9876
9877
9878
9879
988
9880
9881
9882
9888
9889
989
9890
9891
9892
9893
9894
9895
9896
9897
9898
98981
98982
98983
98984
98989
9899     Toxic effect of unspedified substance, chiefly nonmedicinal as to
         source
991                           FROSTBITE/HYPOTHERMIA
9910
9911
9912
9913
9914
9915
9916
9918
9919
992              HEAT STROKE/SUN STROKE/HEAT EXHAUSTION
9920
9921
9922
9923
9924
9925
9926



                                                                             Page 75
                 HEAT STROKE/SUN STROKE/HEAT EXHAUSTION



                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000

9927
9928
9929
9932     EFF HIGH ALTITUD NEC/NOS
9941     DROWNING/NONFATAL SUBMER
9947     ASPHYXIATION AND STRANGULATION
9948     EFFECTS ELECTRIC CURRENT
9950     OTHER ANAPHYLACTIC SHOCK
9951     ANGIONEUROTIC EDEMA
9952     ADE MED/BIOL SUBST NOS
9955     Child maltreatment syndrome
99550    Child abuse
99553    CHILD SEXUAL ABUSE
99554    Child physical abuse
99555    Shaken infant syndrome
99581    ADULT MALTREATMENT SYNDROME
99583    Adult sexual abuse
99601    MECH COMP CARD PACEMAKER
99604    Mechanical complication due to automatic implantable cardiac
         defibrillator
9961     MECH COMP OTH VASC DEV
99631    MECH COMP URETHRAL CATH
99639    MALFUNCT GU DEV/GRFT NEC
9964     MECH COMP INT ORTH DEV
99659    MECH COMP DEV/GRAFT NEC
99662    INFECT D/T VASC DEVICE
99664    INFECT D/T URETHRAL CATH
99672    COMP NEC D/T HRT DEV NEC
99673    COMP D/T RENAL DIALY DEV
99674    COMP NEC D/T VASC DEVNEC
99676    COMP NEC D/T GU DEVICE
99679    COMP NEC D/T DEVICE NEC
9981     Hemorrhage or hematoma complicating a procedure, not elsewhere
         classified
99811    HEMORRHAGE COMP PX
99812    HEMATOMA COMPLICATING PX
99813    SEROMA COMPLICATING PX
9983     POSTOP WOUND DISRUPTION
99831    Disruption of internal operation wound
99832    Disruption of external operation wound
9984     FOREIGN BODY ACCIDENTALLY LEFT DURING A PROCEDURE

9985     Postoperative infection, not elsewhere classified
99859    POSTOP INFECTION NEC
99883    NON-HEALING SURG WND
99889    OTH SPEC POSTOP COMP NEC
998                  POSTOPERATIVE SHOCK/HEMORRHAGE



                                                                          Page 76
                HUMANA HEALTH PLANS
        EMERGENCY DIAGNOSES FOR AUTO PAYMENT
                EFFECTIVE MAY 1, 2000
                      POSTOPERATIVE SHOCK/HEMORRHAGE
9980
9981
9994     Anaphylacitc shock due to serum
9995     SERUM REACTION NEC
99960    ABO incompatibility reaction, unspecified                                  Added 10-01-10
99961    ABO incompatibility with hemolytic transfusion reaction not specified as
         acute or delayed                                                           Added 10-01-10
99962    ABO incompatibility with acute hemolytic transfusion reaction              Added 10-01-10
99963    ABO incompatibility with delayed hemolytic transfusion reaction            Added 10-01-10
99969    Other ABO incompatibility reaction                                         Added 10-01-10
99970    Rh incompatibility reaction, unspecified                                   Added 10-01-10
99971    Rh incompatibility with hemolytic transfusion reaction not specified as
         acute or delayed                                                           Added 10-01-10
99972    Rh incompatibility with acute hemolytic transfusion reaction               Added 10-01-10
99973    Rh incompatibility with delayed hemolytic transfusion reaction             Added 10-01-10
99974    Other Rh incompatibility reaction                                          Added 10-01-10
99975    Non-ABO incompatibility reaction, unspecified                              Added 10-01-10
99976    Non-ABO incompatibility with hemolytic transfusion reaction not
         specified as acute or delayed                                              Added 10-01-10
99977    Non-ABO incompatibility with acute hemolytic transfusion reaction          Added 10-01-10
99978    Non-ABO incompatibility with delayed hemolytic transfusion reaction
                                                                                    Added 10-01-10
99979    Other non-ABO incompatibility reaction                                     Added 10-01-10
99980    Transfusion reaction, unspecified                                          Added 10-01-10
99983    Hemolytic transfusion reaction, incompatibility unspecified                Added 10-01-10
99984    Acute hemolytic transfusion reaction, incompatibility unspecified          Added 10-01-10
99985    Delayed hemolytic transfusion reaction, incompatibility unspecified        Added 10-01-10
9999     COMP MED CARE NEC&NOS
V4611    Dependence on respirator, status
V4612    Encounter for respirator dependence during power failure
V5881    Fitting and adjustment of vascular catheter
V6285    Homicidal ideation                                                         Added 10-01-10
V714     OBS-ACCIDENT NEC
V715     OBS-ALLEGED RAPE
V716     Observation following other inflicted injury




                                                                                        Page 77
ICD-9 CodeX   Description
       91 X   Colitis, enteritis, and gastroenteritis of presumed infectious origin;
       92 X   Infectious diarrhea, Diarrhea of presumed infectious origin
       93 X
    24900     Secondary diabetes mellitus without mention of complication, not
          X   stated as uncontrolled, or unspecified
    24901     Secondary diabetes mellitus without mention of complication,
          X   uncontrolled
    24920     Secondary diabetes mellitus with hyerosmolarity, not stated as
          X   uncontrolled, or unspecified
    24921 X   Secondary diabetes mellitus with hyperosmolarity, uncontrolled
    25200 X   Hyperparathyroidism, unspecified
    25201 X   Primary hyperparathyroidism
    25202 X   Secondary hyperparathyroidism, non-renal
    25208 X   Other hyperparatyhroidism
    27481 X   Gouty tophi of ear, tophi of other sites, other
    27482 X
    27489 X
     2749 X   Gout, unspecified
    27731 X   Familial Mediterranean fever
     2981 X   EXCITATIVE TYPE PSYCH
     3061 X   Respiratory malfunction arising from mental factors
     3062 X   Cardiovascular malfunction arising from mental factors
    30781 X   Tension headache
      311 X   Depressive disorder, not elsewhere classified
    33900 X   Cluster headache syndrome, unspecified
    33901 X   Episodic cluster headache
    33902 X   Chronic cluster headache
    33903 X   Episodic paroxysmal hemicrania
    33904 X   Chronic paroxysmal hemicrania
    33910 X   Tension type headache, unspecified
    33911 X   Episodic tension type headache
    33912 X   Chronic tension type headache
    33922 X   Chronic post-traumatic headache
    33941 X   Hemicrania continua
    33942 X   New daily persistent headache
    33943 X   Primary thunderclap headache
    33944 X   Other complicated headache syndrome
    33981 X   Hypnic headache
    33982 X   Headache associated with sexual activity
    33983 X   Primary cough headache
    33984 X   Primary exertional headache
    33985 X   Primary stabbing headache
    33989 X   Other headache syndromes
    34600     Migraine: classical (w/out mention of intractable migraine), common,
          X   variants, other (with intractable migraine, so stated)
    34601     Migraine: classical (w/out mention of intractable migraine), common,
          X   variants, other (with intractable migraine, so stated)
3461        Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34610       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34611       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34612       Migraine without aura, without mention of intractable migraine with
        X   status migrainosus
34613       Migraine without aura, with intractable migraine, so stated, with status
        X   migrainosus
3462        Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34602       Migraine with aura, without mention of intractable migraine with status
        X   migrainosus
34603       Migraine with aura, with intractable migraine, so stated, with status
        X   migrainosus
34620       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34621       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34622       Variants of migraine, not elsewhere classified, without mention of
        X   intractable migraine with status migrainosus
34623       Variants of migraine, not elsewhere classified, with intractable
        X   migraine so stated, with status migrainosus
34630       Hemiplegic migraine, without mention of intractable migraine without
        X   mention of status migrainosus
34631       Hemiplegic migraine, with intractable migraine, so stated, without
        X   mention of status migrainosus
34632       Hemiplegic migraine, without mention of intractable migraine with
        X   status migrainosus
34633       Hemiplegic migraine, with intractable migraine, so stated, with status
        X   migrainosus
34640       Menstrual migraine, without mention of intractable migraine without
        X   mention of status migrainosus
34641       Menstrual migraine, with intractable migraine, so stated, without
        X   mention of status migrainosus
34642       Menstrual migraine, without mention of intractable migraine with
        X   status migrainosus
34643       Menstrual migraine, with intractable migraine, so stated, with status
        X   migrainosus
34650       Persistent migraine aura without cerebral infarction, without mention
            of intractable migraine without mention of status migrainosus
        X
34651       Persistent migraine aura without cerebral infarction, with intractable
            migraine, so stated, without mention of status migrainosus
        X
34652       Persistent migraine aura without cerebral infarction, without mention
        X   of intractable migraine with status migrainosus
34653       Persistent migraine aura without cerebral infarction, with intractable
        X   migraine, so stated, with status migrainosus
34660       Persistent migraine aura with cerebral infarction, without mention of
        X   intractable migraine without mention of status migrainosus
34661       Persistent migraine aura with cerebral infarction, with intractable
        X   migraine, so stated, without mention of status migrainosus
34662       Persistent migraine aura with cerebral infarction, without mention of
        X   intractable migraine with status migrainosus
34663       Persistent migraine aura with cerebral infarction, with intractable
        X   migraine, so stated, with status migrainosus
34670       Chronic migraine without aura, without mention of intractable migraine
        X   without mention of status migrainosus
34671       Chronic migraine without aura, with intractable migraine, so stated,
        X   without mention of status migrainosus
34672       Chronic migraine without aura, without mention of intractable
        X   migraine with status migrainosus
34673       Chronic migraine without aura, with intractable migraine, so stated,
        X   with status migrainosus
 3468       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34680       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34681       Migraine: classical (w/out mention of intractable migraine), common,
        X   variants, other (with intractable migraine, so stated)
34682       Other forms of migraine, without mention of intractable migraine with
        X   status migrainosus
34683       Other forms of migraine, with intractable migraine, so stated with
      X     status migrainosus
34690 X     Migraine, unspecified
34691 X     MIGRAINE NOS/INTRACTABLE
34692       Migraine, unspecified, without mention of intractable migraine with
      X     status migrainosus
34693       Migraine, unspecified, with intractable migraine, so stated, with status
      X     migrainosus
 3810 X     Acute nonsuppurative otitis media
38100 X     Acute nonsuppurative otitis media, unspecified
38101 X     Acute serous otitis media
38102 X     Acute mucoid otitis media
38103 X     Acute sanguinous otitis media
38104 X     Acute allergic serous otitis media
38105 X     Acute allergic mucoid otitis media
38106 X     Acute allergic sanguinous otitis media
 3815 X     Eustachian salpingitis
38150 X     Eustachian salpingitis, unspecified
38151 X     Acute Eustachian salpingitis
38200 X     Acute suppurative otitis media without spontaneous rupture of ear
38201 X     drum, with spntaneous rupture of ear drum
38202 X
 3821 X     Chronic tubotympanic suppurative otitis media
 3822 X     Chronic atticoantral suppurative otitis media
 3823 X     Unspecified chronic suppurative otitis media
 3824 X     Unspecified suppurative otitis media
 3829 X     Unspecified otitis media
38870 X     Otalgia, unspecified
38871 X     Otogenic pain
53500 X     Acute gastritis (without mention of hemorrhage)
53501 X   Acute gastritis with hemorrhage
 5362 X   Persistent vomiting
 5368 X   Dyspepsia and other specified disorders of function of stomach
55090     Unilateral or unspecified inguinal hernia, without mention of
      X   obstruction or gangrene
55092     Inquinal hernia, without mention of obstruction or gangrene, bilateral
      X   (not specified as recurrent)
 5589 X   Other and unspecified noninfectious gastroenteritis and colitis
56030 X   Impaction of intestine, unspecified
56039 X   Other impaction of intestine
57400 X   GB CAL W ACUTE CHOL
57401 X   Calculus of gallbladder with acute cholecystitis, with obstruction
57410 X   GB CALCULUS W CHOL NEC
57411 X   Calculus of gallbladder with other cholecystitis
57420     Calculus of gallbladder without mention of cholecystitis, without
      X   mention of obstruction
57421     Calculus of gallbladder without mention of cholecystitis, with
      X   obstruction
 5750 X   ACUTE CHOLECYSTITIS
57510 X   CHOLECYSTITIS NOS
 5759 X   GB DISORDER NOS
 5770 X   ACUTE PANCREATITIS
 5771 X   CHRONIC PANCREATITIS
  595 X   Cystitus
 5950 X   Acute cystitus
 5959 X   Cystitis, unspecified
 5990 X   Urinary tract infection, site not specified
 6010 X   ACUTE PROSTATITIS
 6202 X   Other and unspecified ovarian cyst
 6253 X   Dysmenorrhea
 6259 X   Unspecified symptom associated with female genital organs
 6268     Other disorders of menstruation and other abnormal bleeding from
      X   female genital tract
  627 X   Menopausal and postmenopausal disorders
64390     Unspecified vomiting of pregnancy, unspecified as to episode of care
      X   or not applicable
64391     Unspecified vomiting of pregnancy, delivered, with or without mention
      X   of antepartum condition
64393     Unspecified vomiting of pregnancy, antepartum condition or
      X   complication
68100 X   Unspecified cellulitis and abscess of finger
 6822 X   Cellulitis and abscess of trunk
 6850 X   PILONIDAL CYST W ABSCESS
71941 X   Pain in joint involving shoulder region
71943 X   Pain in joint involving forearm
71947 X   Pain in joint involving ankle and foot
72871 X   Plantar fascial fibromatosis
 7291 X   Myalgia and myositis, unspecified
 7292 X   Neuralgia, neuritis, and radiculitis unspecified
 7793 X   NB FEEDING PROBLEMS
78901 X   Abdominal pain right upper quadrant
78902 X   Abdominal pain left upper quadrant
   78903   X   Abdominal pain right lower quadrant
   78904   X   Abdominal pain left lower quadrant
   78905   X   Abdominal pain periumbilic
   78906   X   Abdominal pain epigastric
   78907   X   Abdominal pain, generalized
   78909   X   Abdominal pain other specified site
   80230   X   Fracture, unspecfied site
    8068   X   Fracture, unspecified, closed
    8069   X   Fracture, unspecified, open
    8238   X   Torus fracture, unspecified part, closed, fibula and tibia
    8248   X   Trimallelolarm unspecified fracture of ankle, closed
    8249   X   Trimallelolar, unspecified, open
   82520   X   Unspecified bones(s) of foot [except toes]
    9164       Insect bite, nonvenomous of hip, thigh, leg, and ankle, without
          X    mention of infection
      917 X    Superficial injury of foot and toe(s)
     9170 X    Abrasion or friction burn without mention of infection
     9199 X    Other and unspecified superficial injury, infected
V045      X    VACC FOR RABIES
V1585     X    HX-EXPOSURE TO BDY FLUID

								
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