Oregon Prioritized Health Services List

The official Oregon Health Plan list includes conditions, treatments, ICD-9 codes (International Classification of Disease, Ninth Edition) and CPT codes (Common Procedural Terminology). For easy of comparison, only conditions and a few treatments are included on this format of the list. For recipients of the Oregon Health Plan, coverage is provided for conditions 1 through 549. Treatment for conditions 550 through 730 are not covered for some state recipients, but covered for others. CCHC has bolded some conditions on this list to enhance comparison of the state-determined priority position of various more common or interesting conditions on the list.

  1. Severe/Moderate Head Injury: Hematoma/Edema with loss of consciousness
  2. Type I Diabetes Mellitus
  3. Peritonitis
  4. Acute Glomerulonephritis
  5. Pneumothorax and Hemothorax
  6. Complicated Hernia with Obstruction and/or Gangrene
  7. Torsion of Ovary
  8. Torsion of Testis
  9. Addison's Disease
  10. Injury to Internal Organs
  11. Flail Chest
  12. Appendicitis
  13. Ruptured Spleen
  14. Tuberculosis
  15. Deep Open Wound of Neck, including Larynx, Fracture of Larynx or Trachea, Open
  16. Croup Syndrome, Epiglottitis, Acute Laryngotracheitis
  17. Pneumococcal Pneumonia, Other Bacterial Pneumonia, Bronchopneumonia
  18. Pertussis and Diphtheria
  19. Rupture of Papillary Muscle
  20. Coagulation Defects
  21. Dissecting or Ruptured Aortic Aneurysm
  22. Injury to Major Blood Vessels of Extremities
  23. Intussception, Volvulus, Intestinal Obstruction and Foreign Body in Stomach,/Intestines/Colon/Rectum
  24. Non-Dissecting Aneurysm without Rupture
  25. Ruptured Viscus
  26. Acute Bacterial Meningitis
  27. Hodgkin's Disease
  28. Acute Pyelonephritis, Renal & Perinephric Abscess
  29. Arterial Embolism/Thrombosis: Abdominal Aorta, Thoracic Aorta
  30. Liver Abscess
  31. Subarachnoid/Intracerebral Hemorrhage/Hematoma; Compression of Brain (burr holes, craniectomy…)
  32. Foreign Body in Pharynx, Larynx, Trachea, Bronchus & Esophagus
  33. Neoplasms of Islets of Langerhans
  34. Non-Diabetic Hypoglycemic Coma
  35. Acute Osteomyelitis
  36. Acute Mastoiditis
  37. Pyogenic Arthritis
  38. Acute Inflammation of the Heart due to Rheumatic Fever
  39. Budd-Chiari Syndrome/Venous Emboli
  40. Burn, Partial Thickness Greater Than 30% of Body Surface
  41. Choanal Atresia
  42. Burn, Partial Thickness with Vital Site; Full Thickness with Vital Site, less than 10% of body surface
  43. Thrombocytopenia
  44. Intra-Abdominal Abscess
  45. Peripheral Vascular Disease, Limb Threatening Infections, and Vascular Complication
  46. Rupture of Bladder, Nontraumatic
  47. Erysipelas
  48. Septicemia
  49. Rickettsial and Other Arthropod-Borne Diseases
  50. Acute Orbital Cellulitis
  51. Anaphylactic Shock
  52. Deformities of Head and Compound/Depressed Fractures of Skull
  53. Congenital, Primary, and Secondary Syphilis
  54. Birth Control (contraception management)
  55. Pregnancy (maternity care)
  56. Birth of Infant (newborn care)
  57. Ectopic Pregnancy
  58. Necrotizing Enterocolitis in Fetus or Newborn
  59. Neonatal Thyrotoxicosis
  60. Other Respiratory Conditions of Fetus and Newborn
  61. Drug Reactions and Intoxications Specific to Newborn
  62. Tetanus Neonatorum
  63. Hydrops Fetalis
  64. Galactosemia
  65. Congenital Hypothyroidism
  66. Phenylketonuria (PKU)
  67. Neonatal Myasthenia Gravis
  68. Convulsions and Other Cerebral Irritability in Newborn
  69. Hematological Disorders of Fetus and Newborn
  70. Cerebral Depression, Coma, & Other Abnormal Cerebral Signs of Newborn
  71. Low Birth Weight (under 2500 grams)
  72. Conditions Involving the Temperature Regulation of Newborns
  73. Adrenal or Cutaneous Hemorrhage of Fetus or Neonate
  74. Omphalitis of the Newborn and Neonatal Infective Mastitis
  75. Birth Trauma for Baby
  76. Polycythemia Neonatorum, Symptoms
  77. Anemia of Prematurity or Transient Neonatal Neutropenia
  78. Congenital Anomalies of Digestive System and Abdominal Wall excluding Necrosis…
  79. Congenital Infectious Diseases
  80. Disorders Relating to Long Gestation and High Birthweight
  81. Feeding Problems in Newborn
  82. Hemolytic Disease due to Isoimmunization, Anemia due to Transplacental Hemorrhage…Jaundice
  83. Neonate Conjunctivitis, Dacryocystitis and Candida Infection
  84. Drug Withdrawal Syndrome in Newborn
  85. Hypocalcemia, Hypomagnesemia /Other Endocrine and Metabolic Disturbances-fetus and newborn
  86. Adrenogenital Disorders
  87. Encephalocele; Congenital Hydrocephalus
  88. Spina Bifida
  89. Congenital Dislocation of Hip; Coxa Vara & Valga
  90. Syndrome of "Infant of Diabetic Mother" and Neonatal Hypoglycemia
  91. Congenital Cystic Lung - Mild and Moderate
  92. Rumination Disorder of Infancy
  93. Sterilization - (vasectomy)
  94. Sterilization - (tubal ligation)
  95. Coarctation of the Aorta
  96. Atrial Septal Defect, Primum
  97. Ventricular Septal Defect
  98. Subvalvular Aortic Stenosis, Right Ventricular Infundibular Obstruction…Anomalies of Heart
  99. Congenital Anomalies of Upper Alimentary Tract, excluding Tongue
  100. Congenital Anomalies of Urinary System
  101. Coronary Artery Anomaly
  102. Complete, Corrected and Other Transposition of Great Vessels
  103. Tetralogy of Fallot (TOF)
  104. Patent Ductus Arteriosus; Aortic Pulmonary Fistula (ligation)
  105. Total Anomalous Pulmonary Venous Connection
  106. Other and Unspecified Type Endocardial Cushion Defects
  107. Biliary Atresia
  108. Cystic Fibrosis
  109. End Stage Renal Disease (renal transplant)
  110. Cirrhosis of Liver or Biliary Tract; Budd-Chiari Syndrome; Hepatic Vein Thrombosis …
  111. Cleft Palate with Airway Obstruction, Pierre Robin Deformity
  112. Myocarditis (nonviral), Pericarditis (nonviral), Endocarditis
  113. Cervical Vertebral Dislocations/Fractures, Open or Closed; Other…Spinal Cord Injuries…
  114. Fracture of Pelvis, Open and Closed
  115. Injury to Blood Vessels of the Thoracic Cavity
  116. Toxic Epidermal Necrolysis and Staphylococcal Scalded Skin Syndrome; Stevens-Johnson…
  117. Acquired Hemolytic Anemias
  118. Acute Leukemias, Myelodysplastic Syndrome
  119. Acute Lymphocytic Leukemia (child)
  120. Hodgkin's Disease (transplant)
  121. Constitutional Aplastic Anemia
  122. Other Specified Aplastic Anemias
  123. Non-Hodgkin's Lymphomas
  124. Non-Hodgkin's Lymphomas(transplant)
  125. Thalassemia, Osteopetrosis and Hemoglobinopathies (bone marrow rescue/transplant)
  126. Hydatidiform Mole
  127. Acute Vascular Insufficiency of Intestine
  128. Short Bowel Syndrome - age 5 or under
  129. Adult Respiratory Distress Syndrome; Respiratory Conditions due to Physical and Chemical Agents
  130. Rupture of Liver
  131. Subacute Meningitis (Tuberculosis, Cryptococcosis
  132. Fracture of Joint, Open
  133. Fracture of Shaft of Bone, Open
  134. Open Fracture of Epiphysis of Lower Extremity
  135. Diseases of Pharynx including Retropharyngeal Abscess
  136. Arterial Aneurysm of Neck
  137. Chronic Leukemias; Polycythemia Rubra Vera
  138. Hypothermia
  139. Benign Neoplasm of the Brain
  140. Malignant Melanoma of Skin, Treatable
  141. Multiple Endocrine Neoplasia
  142. Diabetes Insipidus
  143. Disorders of Spine with Neurologic Impairment
  144. Preventive Services, Birth to 10 years of age
  145. Anorexia Nervosa
  146. Reactive Attachment Disorder
  147. Coarctation of the Aorta
  148. Complications of a Procedure Always Requiring Treatment
  149. Crush Injuries: Trunk, Upper Limbs, Lower Limb including Blood Vessels
  150. Congenital Mitral Valve Stenosis
  151. Common Truncus
  152. Congenital Tricuspid Atresia and Stenosis
  153. Bulbus Cordis Anomalies & Anomalies of Cardiac Septal Closure: Double Outlet Right Ventricle
  154. Common Ventricle
  155. Congenital Pulmonary Valve Atresia
  156. Interrupted Aortic Arch
  157. Congestive Heart Failure, Cardiomyopathy, Transposition of Great Vessels, Hypoplastic Left Heart…
  158. Disorders of Bile Duct
  159. Asthma
  160. Pneumonia due to Respiratory Syncytial Virus in Persons Under Age 3
  161. Respiratory Failure
  162. Schizophrenic Disorders
  163. Major Depression, Recurrent
  164. Bipolar Disorders
  165. Burn Full Thickness Greater Than 10% of Body Surface
  166. Disorders of Fluid, Electrolyte, and Acid-Base Balance
  167. Thyrotoxicosis with or w/o Goiter, Endocrine Exophthalmos; Chronic Thyroiditis
  168. Hypertensive Heart and Renal Disease
  169. Benign Cerebral Cysts
  170. HIV Disease (including AIDS) and related Opportunistic Infections
  171. Opportunistic Infections in Immunocompromised Host; Candidiasis of Stoma; Persons Receiving…
  172. Empyema and Abscess of Lung
  173. Anemias due to Disease or Treatment and Other Aplastic Anemias
  174. Malaria and Relapsing Fever
  175. Heart Failure
  176. Hereditary Anemias, Hemoglobinopathies, and Disorder of the Spleen
  177. Life-Threatening Cardiac Arrhythmias
  178. End Stage Renal Disease (medical therapy, including dialysis)
  179. Acute and Subacute Necrosis of Liver; Specified Inborn Errors of Metabolism (eg. Maple Syrup…)
  180. Fracture of Hip, Closed
  181. Hereditary Angioedema; Angioneurotic Edema
  182. Pediatric Solid Malignancies, Seminoma
  183. Chronic Non-Lymphocytic Leukemia
  184. Preventive Services with Proven Effectiveness, over Age of 10
  185. Tobacco Dependence
  186. Preventive Foot Care in High Risk Patients
  187. Abuse or Dependence of Psychoactive Substance
  188. Major Depression, Single Episode or Mild
  189. Brief Reactive Psychosis
  190. Attention Deficit Disorders with Hyperactivity or Undifferentiated
  191. Hypertension and Hypertensive Disease
  192. Ulcers, Gastritis and Duodenitis
  193. Cancer of Thyroid, Treatable
  194. Cancer of Testis, Treatable
  195. Cancer of Uterus, Treatable
  196. Cancer of Eye and Orbit, Treatable
  197. Ulcers, GI Hemorrhage
  198. Congenital Stenosis and Insufficiency of Aortic Valve
  199. Burn, Partial Thickness without vital site-10-30% of body surface
  200. Agranulocytosis (bone marrow transplant)
  201. Chronic Granulomatous Disease
  202. Botulism
  203. Disorders of Amino-Acid Transport and Metabolism (non PKU)
  204. Chronic Respiratory Disease arising in the Neonatal Period
  205. Gonococcal Infections and Other Sexually Transmitted Diseases
  206. Herpes Simplex and Herpes Zoster with Neurological & Ophthalmological Complications
  207. Pneumocysitis Carinii Pneumonia
  208. Hypoplasia and Dysplasia of Lung
  209. Cardiomyopathy, Hypertrophic Muscle
  210. Glycogenosis
  211. Chronic Osteomyelitis
  212. Acute Lymphocytic Leukemias (Adult) and Multiple Myeloma
  213. Multiple Myeloma (bone transplant)
  214. Phlebitis & Thrombophlebitis, Deep
  215. Diseases of Endocardium
  216. Idiopathic or Viral Myocarditis and Pericarditis
  217. Intraspinal and Intracranial Abscess
  218. Fracture of Ribs and Sternum, Open
  219. Neurological Dysfunction in Breathing, Eating, Swallowing, Bowel, or Bladder Control…
  220. Esophageal Stricture
  221. Spontaneous Abortion Complicated by Infection and/or Hemorrhage, Missed Abortion
  222. Transient Nephrotic Syndrome with Lesion of Minimal Change Glomerulonephritis
  223. Disorders of Pancreatic Endocrine Secretions
  224. Erythroplakia, Leukoedema of Mouth or Tongue
  225. Leukoplakia of Oral Mucosa, including Tongue
  226. Dystrophy of Vulva
  227. Cancer of Soft Tissue, Treatable
  228. Cancer of Breast, Treatable
  229. Cancer of the Ovary, Treatable
  230. Undescended Testicle
  231. Cancer of Penis and Other Male Genital Organs, Treatable
  232. Cancer of Vagina, Vulva, and Other Female Genital Organs, Treatable
  233. Choriocarcinoma, Treatable
  234. Cancer of Bone, Treatable
  235. Cancer of Bladder and Ureter, Treatable
  236. Cancer of Retroperitoneum, Peritoneum, Omentum & Mesentery, Treatable
  237. Cancer of Oral Cavity, Pharynx, Nose and Larynx, Treatable
  238. Portal Vein Thrombosis
  239. Paralytic Ileus
  240. Traumatic Amputation or Leg(s) (complete) (Partial) with and without Complication
  241. Traumatic Amputation of Arm(s), Hand(s), Thumb(s) and Finger(s) (complete)(Partial) w/ or w/o…
  242. Iron Deficiency Anemia and Other Nutritional Deficiencies
  243. Physical and Sexual Abuse including Rape
  244. Acute Stress Disorder
  245. Separation Anxiety Disorder
  246. Peritonsillar Abscess
  247. Cancrum Oris
  248. Occlusion and Stenosis of Precerebral Arteries
  249. Acute Glomerulonephritis and Other Acute Renal Failure
  250. Nephrotic Syndrome and Other Renal Disorders
  251. Cysticercosis, Other Cestode Infection, Trichinosis
  252. Poisoning by Ingestion/Injection, and Non0Medicinal Agents
  253. Metabolic Disorders including Hyperlipidemia
  254. Hereditary Fructose Intolerance, Intestinal Disaccharidase and Other Deficiencies
  255. Intestinal Malabsorption
  256. Delirium Due to Medical Causes
  257. Pernicious and Sideroblastic Anemia
  258. Disseminated Intravascular Coagulation
  259. Diverticulitis of Colon
  260. Cyst and Pseudocyst of Pancreas
  261. Acute Poliomyelitis
  262. Systemic Sclerosis
  263. Substance - Induced Delirium
  264. Acute and Subacute Ischemic Heart Disease, Myocardial Infarction (Heart Attack)
  265. Terminal Illness Regardless of Diagnosis (Comfort Care)
  266. Adjustment Disorders
  267. Oppositional Defiant Disorder
  268. Tourette's Disorder and Tic Disorders
  269. Anal, Rectal and Colonic Polyps
  270. Transient Cerebral Ischemia
  271. Dysplasia of Cervix and Cervical Carcinoma in Situ, Cervical Condyloma
  272. Anogenital Viral Warts
  273. Cancer of Colon, Rectum, Small Intestine and Anus, Treatable
  274. Cancer of Cervix, Treatable
  275. Cancer of Lung, Bronchus, Pleura, Trachea, Mediastinum & Other Respiratory Organs, Treatable
  276. Cancer - Prostate Gland, Treatable
  277. Cancer of Endocrine System excluding Thyroid, Treatable; Carcinoid Syndrome
  278. Cancer of Kidney and Other Urinary Organs, Treatable
  279. Cancer of Stomach, Treatable
  280. Cancer of Brain and Nervous System, Treatable
  281. Anaerobic Infection Requiring Hyperbaric Oxygen
  282. Benign Neoplasm of Pituitary Gland
  283. Cushing's Syndrome; Hyperaldosteronism, Other Corticoadrenal Overactivity, Medulloadrenal…
  284. Chronic Obstructive Pulmonary Disease
  285. Disorders of Mineral Metabolism
  286. Intracerebral Hemorrhage
  287. Stroke
  288. Acute Pulmonary Heart Disease and Pulmonary Emboli
  289. Dislocation Knee & Hip, Open
  290. Dislocation of Elbow, Hand, Ankle, Foot, Clavicle and Shoulder, Open
  291. Acute Bronchitis and Bronchiolitis
  292. Acute Pelvic Inflammatory Disease
  293. Urinary Fistula
  294. Aneurysm of Pulmonary Artery
  295. Epilepsy and Febrile Convulsions
  296. Regional Enteritis, Idiopathic Proctocolitis, Ulceration of Intestine
  297. Enteric Infections and Other Bacterial Food Poisoning
  298. Giant Cell Arteritis, Kawaski Disease, Hypersensitivity Angiitis; Thromboangiitis Obliterans
  299. Complications of Procedures Usually Requiring Treatment
  300. Termination of Pregnancy (Induced Abortion)
  301. Preventive Dental Services (cleaning and fluoride)
  302. Hearing Loss - Age 5 or Under (hearing aids)
  303. Sensorineural Hearing Loss - age 5 or under
  304. Posttraumatic Stress Disorder
  305. Obsessive-Compulsive Disorder
  306. Bilateral Anomalies of External Ear with Impairment of Hearing
  307. Generalized Convulsive Epilepsy/Partial Epilepsy without Mention of Impairment of Consciousness
  308. Candidiasis of Lung, Disseminated Candidiasis, Candidal Endocarditis and Meningitis
  309. Coccidioidomycosis, Histoplasmosis, Blastomycotic Infection, Opportunistic and Other Mycoses
  310. Tetanus
  311. Ebstein's Anomaly
  312. Disseminated Infections with Localized Sites
  313. Diseases and Disorders of Aortic Valve
  314. Type II Diabetes Mellitus
  315. Polyarteritis Nodosa and Allied Conditions
  316. Sarcoidosis
  317. Dermatomyositis, Polymyositis

    ------------ ($244.71)-----------------

  318. Atrial Septal Defect, Secundum
  319. Diseases of Mitral Valve
  320. Atelectasis (collapse of lung)
  321. Toxic Effect of Gases, Fumes, and Vapors Requiring Hyperbaric Oxygen
  322. Acquired Hypothyroidism, Dyshormonogenic Goiter
  323. Cardiac Arrhythmias
  324. Multiple Vascular Disease
  325. Traumatic Amputation of Foot/Feet (complete)(partial) w/ & w/o Complication
  326. Brachial Plexus Lesions
  327. Spinal Deformity, Clinically Significant
  328. Disorders of Plasma Protein Metabolism
  329. Acute Non-Lymphocytic Leukemias
  330. Chronic Rheumatic Pericarditis, Rheumatic Myocarditis
  331. Acute Necrosis of Liver
  332. Chronic Hepatitis, including Viral Hepatitis B and C
  333. Acute Pancreatitis
  334. Dermatological Premalignant Lesions and Carcinoma in Situ
  335. Esophagitis
  336. Neurological Dysfunction in Posture and Movement Caused by Chronic Conditions
  337. Acute Thyroiditis
  338. Systemic Lupus Erythematosus, Other Diffuse Disease of Connective Tissue
  339. Wegener's Granulomatosis
  340. Panic Disorders, Agoraphobia
  341. Disorders of Arteries, Visceral
  342. Leptospirosis
  343. Amebiasis
  344. Zoonotic Bacterial Diseases
  345. Fracture of Face Bones; Injury to Optic and Other Cranial Nerves
  346. Benign Neoplasm of Respiratory & Intrathoracic Organs
  347. Dystonia (Uncontrollable)

    --------($ 251.12) -----------

  348. Atherosclerosis, Aortic and Renal
  349. Cancer of Skin, Excluding Malignant Melanoma, Treatable
  350. Sleep Apnea
  351. Deficiencies of Circulating Enzymes including Alpha 1-Antitrypsin Deficiency
  352. Life-Threatening Epistaxis
  353. Sialoadenitis, Abscess, Fistula of Salivary Glands
  354. Chronic Ulcer of Skin
  355. Abscess and Cellulitis, Non-Orbital
  356. Breast Cysts and Other Disorders of the Breast
  357. Pilonidal Cyst with Abscess
  358. Dental Caries (Periapical Infection)
  359. Dental Conditions (eg. Infections)
  360. Abscess of Bursa or Tendon
  361. Abscess of Prostate
  362. Other Aneurysm of Peripheral Artery (surgery)
  363. Pyoderma: Dermatophytosis: Scalp, Hand, Body, Deep-Seated
  364. Urinary Tract Calculus; Hematuria
  365. Conditions Involving Exposure to Natural Elements (eg. Lightning Strike, Heatstroke)
  366. Vesicoureteral Reflux
  367. Calculus of Bladder or Kidney
  368. Cholelithiasis, Cholecystitus, Common Biliary Duct Stone
  369. Ureteral Stricture or Obstruction; Hydronephrosis; Hydroureter
  370. Congenital Hydronephrosis
  371. Atherosclerosis, Peripheral
  372. Hypoplastic Left Heart Syndrom
  373. Congenital Pulmonary Valve Stenosis
  374. Rheumatoid Arthritis and Other Inflammatory Polyarthropathies
  375. Rheumatoid Arthritis, Osteoarthritis, Osteochrondritis Dissecans, and Aseptic Necrosis of Bone
  376. Conduct Disorder, Age 18 or Under
  377. Overanxious Disorder; Generalized Anxiety Disorder, Unspecified

    ---------($263.95) --------------

  378. Bulimia Nervosa
  379. Esophagitis
  380. Deep Open Wounds
  381. Epidermolysis Bullosa
  382. Cleft Palate with Cleft Lip (excision and repair vestibule of mouth)
  383. Cleft Palate (repair and palatoplasty, orthodontics)
  384. Cleft Lip, Congenital Fistula of Lip
  385. Trachoma
  386. Histiocytosis
  387. Leprosy, Yaws, Pinta
  388. Rheumatic Fever
  389. Unspecified Diseases due to Mycobacteria, Actinomycotic Infection, and Toxoplasmosis
  390. Acute, Subacute, Chronic and other types of Iridocyclitis
  391. Body Infestations (eg. Lice, Scabies)
  392. Paranoid (Delusional) Disorder
  393. Recurrent Erosion of the Cornea
  394. Giardiasis, Intestinal Helminthiasis
  395. Hyphema
  396. Wound of Eye Globe
  397. Diabetic and Other Retinopathy
  398. Glaucoma
  399. Primary and Other Angle-Closure Glaucoma
  400. Retinal Tear
  401. Retrolental Fibroplasia
  402. Venous Tributary (Branch) Occlusion; Central Retinal Vein Occlusion
  403. Sicca Syndrome; Polymyalgia Rheumatica
  404. Purulent Endophthalmitis
  405. Keratoconjunctivitis, Corneal Abscess and Neovascularization
  406. Scleritis
  407. Aphakia and Other Disorders of Lens


  408. Corneal Ulcer; Superficial Injury of Eye and Adnexa
  409. Glaucoma Associated With Disorders of the Lens
  410. Exophthalmos and Cysts of the Eye and Orbit
  411. Primary and Open Angle Glaucoma
  412. Rubeosis Iridis (laser surgery)
  413. Sympathetic Uveitis and Degenerative Disorders and Conditions of Globe
  414. Cataract (extraction)
  415. After Cataract (discission, lens capsule)
  416. Corneal Opacity and Other Disorders of Cornea
  417. Degeneration of Macula and Posterior Pole (Vitrectomy, Laser Surgery)
  418. Gonococcal Infection of Eye
  419. Chronic Inflammatory Disorder of Orbit
  420. Penetrating Wound of Orbit
  421. Retained Intraocular Foreign Body, magnetic and nonmagnetic
  422. Retinal Detachment and Other Retinal Disorders
  423. Vitreous Disorders (vitrectomy)
  424. Entropion
  425. Chronic Depression
  426. Substance-Induced Delusional and Mood Disorders; Intoxication
  427. Borderline Personality Disorder
  428. Identity Disorder
  429. Schizotypal Personality Disorders
  430. Acute Otitis Media
  431. Superficial Injuries with Infection
  432. Acromegaly & Gigantism, Other * Unspecified Anterior Pituitary Hyperfunction…
  433. Conversion Disorder, Child
  434. Functional Encopresis
  435. Avoidant Disorder of Childhood or Adolescence; Elective Mutism
  436. Psychological Factors Aggravating Physical Condition (Asthma, Chronic GI..Hypertension)
  437. Noninflammatory Disorders and Benign Neoplasms of Ovary, Fallopian Tubes and Uterus…


  438. Streak Ovaries
  439. Urologic Infections
  440. Functional and Mechanical Disorders of the Genitourinary System Including Bladder…
  441. Guillain-Barre Syndrome
  442. Deficiencies of Circulating Enzymes…Cystic Fibrosis; Emphysema (heart…and lung transplant)
  443. Respiratory Failure Due to Primary Pulmonary Hypertension, Primary Pulmonary Fibrosis…
  444. Diabetes Mellitus with End Stage Renal Disease (transplant)
  445. Heritary Immune Deficiencies
  446. Constitutional Aplastic Anemias
  447. Alcoholic Fatty Liver Or Alcoholic Hepatitis, Cirrhosis of Liver
  448. Vesicular Fistula
  449. Disorders of Parathyroid Gland; Benign Neoplasm of Parathyroid Gland
  450. Pituitary Disorders: Panhypopituitarism, Iatrogenic and Other
  451. Multiple Sclerosis and Other Demyelinating Diseases of Central Nervous System
  452. Hereditary Hemorrhagic Telangiectasia (excision)
  453. Arthropod-Borne Viral Disease
  454. Lyme Disease and Other Arthropod Borne Diseases
  455. Dysfunction Resulting in Loss of Ability to Maximize Level of Independence in Self-Directed Care…
  456. Neurological Dysfunction in Communication Caused by Chronic Conditions
  457. Paralysis of Vocal Cords or Larynx, other Diseases of Larynx, Abscess, Cellulitis, and Leukoplakia…
  458. Otosclerosis
  459. Migraine Headaches
  460. Fistula Involving Female Genital Tract (closure)
  461. Streptococcal Sore Throat and Scarlet Fever; Hypertrophy of Tonsils and Adenoids; Ulcer of Tonsil
  462. Eating Disorder Nos
  463. Dissociative Disorders: Depersonalization Disorder; Multiple Personality Disorder, Dissociative…
  464. Chronic Organic Mental Disorders Including Dementias
  465. Lymphadenitis
  466. Spontaneous Abortion
  467. Menstrual Bleeding Disorders


  468. Disorders Involving the Immune System
  469. Fracture of Shaft of Bone, Closed
  470. Closed Fracture of Physis of Lower Extremities
  471. Closed Fracture of Physis of Upper Extremities
  472. Chronic Pancreatitis
  473. Strabismus and Other Disorders of Binocular Eye Movements; Congenital Anomalies of Eye
  474. Imperforate Hymen: Abnormalities of Vaginal Septum
  475. Congenital Absence of Vagina (artificial vagina)
  476. Parkinson's Disease
  477. Meniere's Disease
  478. Stereotypy/Habit Disorder & Self-Abusive Behavior due to Neurological Dysfunction
  479. Bullous Dermatosews of the Skin
  480. Cholesteatoma; Infections of the Pinna
  481. Acute Sinusitis
  482. Uterine Leiomyoma (total hysterectomy or myomectomy)
  483. Dislocation/Deformity Knee & Hip
  484. Dislocation/Deformity of Elbow, Hand, Ankle, Foot, Jaw, Clavicle and Shoulder
  485. Close Dislocations'Fractures of Non-Cervical Vertebral Column Without Spinal Cord Injury
  486. Fracture of Joint, Closed (except Hip)
  487. Achalasia, Non-Neonatal
  488. Bronchiectasis
  489. Occupational Lung Disease
  490. Pulmonary Fibrosis
  491. Anomalies of Gallbladder, Bile Ducts, and Liver
  492. Chronic Sinusitis
  493. Pituitary Dwarfism
  494. Foreign Body in Cornea and Conjunctival Sac
  495. Gout and Crystal Arthropathies
  496. Endometriosis
  497. Ovarian Dysfunction, Gonadal Dysgenisis, Menopausal Management


  498. Peripheral Nerve Injury with Open Wound
  499. Myasthenia Gravis
  500. Cancer of Esophagus, Treatable
  501. Cancer of Liver, Treatable
  502. Cancer of Pancreas, Treatable
  503. Cancer of Gallbladder and Other Biliary, Treatable
  504. Non-Malignant Otitis Externa
  505. Esophageal Varices (shunt, sclerotherapy)
  506. Episcleritis
  507. Dental Conditions (eg. Dental caries, fractured tooth)
  508. Dental Conditionals (eg severe Tooth Decay)
  509. Disorders of Refraction and Accommodation
  510. Central Pterygium
  511. Hearing Loss - Over Age of Five
  512. Open Wound of Ear Drum
  513. Sensorineural hearing Loss - Over age of Five
  514. Somatization Disorder; Somatoform Pain Disorder; Premenstrual Tension Syndromes
  515. Trigeminal and Other Nerve Disorders
  516. Disruptions of the Ligaments and Tendons of the Arms and Legs, excluding the Knee, Grade 11 & III
  517. Disorders of Shoulder
  518. Internal Derangement of Knee and Ligamentous Disruptions of the Knee, Grade II and III
  519. Malunion & Nonunion of Fracture (surgery)
  520. Foreign Body in Uterus, Vulva and Vagina
  521. Uterine Prolapse; Cystocele
  522. Osteoarthritis and Allied Disorders
  523. Metabolic Bone Disease
  524. Symptomatic Impacted Teeth
  525. Unspecified Disease of Hard Tissues of Teeth (Avulsion)
  526. Abscesses and Cysts of Bartholin's Gland and Vulva
  527. Cervicitis, Endocervicitis, Hematoma of vulva, and Non…


  528. Dental Conditions (eg. Tooth loss)
  529. Urinary Incontinence
  530. Hypospadias and Epispadias
  531. Residual Foreign Body in Soft Tissue
  532. Branchial Cleft Cyst
  533. Exfoliation of Teeth Due to Systemic Causes
  534. Ptosis (acquired) with Vision Impairment
  535. Simple and Social Phobias
  536. Retained Dental Root
  537. Peripheral Nerve Entrapment
  538. Incontinence of Feces
  539. Rectal Prolapse
  540. Benign Neoplasm of Kidney and Other Urinary Organs
  541. Urethral Fistula
  542. Thrombosed and Complicated Hemorrhoids
  543. Vaginitis, Trichonomiasis
  544. Balanoposthitis and Other Disorders of Penis
  545. Chronic Anal Fissure; Anal Fistula
  546. Chronic Otitis Media
  547. Acute Conjunctivitis
  548. Cerumen Impaction, Foreign Body in Ear & Nose
  549. Vertiginous Syndromes and other Disorders of Vestibular System


  550. Unspecified Urinary Obstruction and Benign Prostatic Hyperplasia without Obstruction
  551. Phimosis (surgery)
  552. Contact Dermatitis, Ectopic Dermatitis, Eczema
  553. Psoriasis and Similar Disorders
  554. Cystic Acne
  555. Closed Fracture of Great Toe
  556. Symptomatic Urticaria
  557. Dysfunction of Nasolacrimal System


  558. Nasal Polyps, Other Disorders of Nasal Cavity and Sinuses
  559. Sialolithiasis, Mucocele, Disturbance - Salivary Secretion, Other/Unspecified Disease/Salivary Glands
  560. Dental Conditions (eg. Broken appliances)
  561. Impulse Disorders (psychotherapy)
  562. Benign Neoplasm Bone & Articular Cartilage Including Osteoid Osteomas; Benign Neoplasm…
  563. Sexual Dysfunction (medical and surgical treatment, psychotherapy)
  564. Stomatitis and Diseases of Lips
  565. Bell's Palsy, Exposure Keratoconjunctivitis
  566. Hordeolum and Other Deep Inflammation of Eyelid; Chalazion
  567. Ectropion, Trichiasis of Eyelid, Benign Neoplasm of Eyelid
  568. Chondromalacia
  569. Dysmenorrhea
  570. pastic Diplegia
  571. Atrophy of Edentulous Alveolar Ridge
  572. Deformities of Upper Body & all Limbs
  573. Deformities of Foot
  574. Peritoneal Adhesion
  575. Pelvic Pain Syndrome; Dyspareunia
  576. Tension Headaches
  577. Chronic Bronchitis
  578. Disorders of Function of Stomach and Other Functional Digestive Disorders
  579. TMJ Disorder
  580. Urethritis, Non-Sexually Transmitted
  581. Lesion of Plantar Nerve; Plantar Facial..
  582. Granuloma of Muscle, Granuloma of Skin & Subcutaneous Tissue
  583. Dermatophytosis of Nail, Groin, and Foot and Other Dermatomycosis
  584. Internal Derangement of Joint Other than Knee
  585. Stenosis of Nasolacrimal Duct (Acquired)
  586. Peripheral Nerve Disorders
  587. Cavus Deformity of Foot; Flat Foot, Polydactyly and Syndactyly of Toes
  588. Peripheral Enthesopathies (surgery)
  589. Peripheral Enthesopathies (Medical treatment)
  590. Disorders of Soft Tissue
  591. Enophthalmos
  592. Macromastia
  593. Galactorrhea, Mastodynia, Atrophy, Benign Neoplasms and Unspecified Disorders of the Breast
  594. Acute and Chronic Disorders of Spine without Neurologic Impairment
  595. Cysts of Oral Soft Tissues
  596. Female Infertility, Male Infertility
  597. Infertility Due to Annovulation
  598. Postconcussion Syndrome
  599. Simple and Unspecified Goiter, Nontoxic Nodular Goiter
  600. Conductive Hearing Loss
  601. Cancer of Liver and Intrahepatic Bile Ducts (transplant)
  602. Hypotension
  603. Viral Hepatitis, excluding Chronic Viral Hepatitis B and Viral Hepatitis C without Hepatic Coma
  604. Benign Neoplasms of Skin and Other Soft Tissues
  605. Redundant Prepuce
  606. Benign Neoplasms of Digestive System
  607. Other Noninfectious Gastroenteritis and Colitis
  608. Factitious Disorders
  609. Hypochondriasis; Somatoform Disorder; Nos and Undifferentiated
  610. Conversion Disorder, Adult
  611. Spinal Deformity, not Clinically significant
  612. Asymptomatic Urticaria
  613. Circumscribed Scleroderma; Senile Purpura
  614. Dermatitis Due to Substances Taken Internally
  615. Allergic Rhinitis and Conjunctivitis/Chronic Rhinitis
  616. Pleurisy
  617. Conjunctival Cyst
  618. Hematoma of Auricle or Pinna/Hematoma of External Ear
  619. Acute Non-Suppurative Labyrinthitis
  620. Infectious Mononucleosis
  621. Aseptic Meningitis
  622. Congenital Anomalies of Female Genital Organs, excluding Vagina
  623. Congenital Deformities of Knee
  624. Uncomplicated Hernia in Adults age 18 or Over
  625. Acute Anal Fissure
  626. Cyst of Kidney, Acquired
  627. PICA
  628. Disorders of Sleep without Sleep Apnea
  629. Cyst, Hemorrhage, and Infarction of Thyroid
  630. Deviated Nasal Septum, Acquired Deformity of Nose, Other Disease of Upper Respiratory Tract
  631. Erythema Multiforme
  632. Herpes Simplex without Complications
  633. Congenital Anomalies of the Ear without Impairment of Hearing; Unilateral Anomalies of the Ear
  634. Blepharitis
  635. Hypertelorism of Orbit
  636. Infertility Due to Tubal Disease
  637. Keratoderma, Acanthosis Nigricans, Striae Atrophicae/Other Hypertrophic/Atrophic Conditions - Skin
  638. Lichen Planus
  639. Obesity (nutritional/lifestyle counseling)
  640. Morbid Obesity (gastroplasty)
  641. Chronic Disease of Tonsils and Adenoids (Tonsillectomy and adenoidectomy)
  642. Hydrocele
  643. Keloid Scar; Other Abnormal Granulation Tissue
  644. Noninflammatory Disorders of Cervix; Hypertrophy of Labia
  645. Sprains of Joints and Adjacent Muscles, Grade 1
  646. Synovitis and Tenosynovitis
  647. Other Disorders of Synovium, Tendon and Bursa, Costochondritis, and Chondrodystrophy
  648. Disease of Nails, Hair and Hair Follicles
  649. Candidiasis of Mouth, Skin and Nails
  650. Benign Lesions of Tongue
  651. Minor Burns
  652. Minor Head Injury: Hematoma/Edema with No Loss of Consciousness
  653. Congenital Deformity of Knee
  654. Phlebitis and Thrombophlebitis, Superficial
  655. Prolapsed Urethral Mucosa
  656. Rupture of Synovium (removal of baker's cyst)
  657. Personality Disorders excluding Borderline, Schizotypal and Anti-Social
  658. Gender Identification Disorder, Paraphilias and Other Psychosexual Disorders
  659. Fingertip Avulsion
  660. Anomalies of Relationship of Jaw to Cranial Base, Major Anomalies - Jaw Size, Other…Dentofacial
  661. Cervical Rib
  662. Gynecomastia (Mastectomy)
  663. Viral, Self-Limiting Encephalitis, Myelitis and Encephalomyelitis
  664. Gallstones without Cholecystitis
  665. Benign Neoplasm of Nasal Cavities, Middle Ear & Accessory Sinuses
  666. Acute Tonsillitis other than Beta-Streptococcal
  667. Edema and Other Conditions Involving the Integument of the Fetus and Newborn
  668. Acute Upper Respiratory Infections and Common Cold
  669. Diaper Rash
  670. Disorders of Sweat Glands
  671. Other Viral Infections, excluding Pneumonia due to Respiratory Syncytial Virus - Persons under age 3
  672. Pharyngitis and Laryngitis and Other Disease of Vocal Cords
  673. Corns and Calluses
  674. Viral Warts excluding Venereal Warts
  675. Old Laceration of Cervix and Vagina
  676. Tongue Tie and Other Anomalies of Tongue
  677. Open Wound of Internal Structures of Mouth without Complication
  678. Central Serous Retinopathy
  679. Seborrheic Keratosis, Dyschromia and Vascular Disorders, Scar Conditions, and Fibrosis of Skin
  680. Uncomplicated Hemorrhoids
  681. Ganglion (excision)
  682. Chronic Conjunctivitis, Blepharoconjunctivitis
  683. Toxic Erythema, Acne Rosacea, Discoid Lupus
  684. Peripheral Nerve Disorders
  685. Other Complications of a Procedure
  686. Raynaud's Syndrome
  687. TMJ Disorders (TMJ surgery)
  688. Varicose Veins of Lower Extremities without Ulcer or Inflammation
  689. Vulval Varices
  690. Chronic Pancreatitis
  691. Chronic Prostatitis, other disorders of Prostate
  692. Muscular Calcification and Ossification
  693. Cancer of Various sites with Distant Metastases where treatment will not result in 5%- 5yr survival
  694. Agenesis of Lung
  695. Disease of Capillaries (excision)
  696. Benign Polyps of Vocal Cords
  697. Fractures of Ribs and Sternum, Closed
  698. Closed Fracture of One or More Phalanges of the Foot not including the Great Toe
  699. Disease of Thymus Gland
  700. Dental Conditions where Treatment Results in Marginal Improvement
  701. Anti-Social Personality Disorder
  702. Sebaceous Cyst
  703. Central Retinal Artery Occlusion
  704. Oral Aphthae
  705. Sublingual, Scrotal, and Pelvic Varices
  706. Superficial Wounds without Infection and Contusions
  707. Unspecified Retinal Vascular Occlusion
  708. Benign Neoplasm of External Female Genital Organs
  709. Benign Neoplasm of Male Genital Organs; Testis, Prostate, Epididymis
  710. Xerosis
  711. Congenital Cystic Lung - Severe
  712. Ichthyosis
  713. Lymphedema
  714. Dermatological Conditions with no effective treatment or no treatment necessary
  715. Infectious Conditions with no effective treatment or no treatment necessary
  716. Respiratory Conditions with no effective treatment or no treatment necessary
  717. Genitourinary Conditions with no effective treatment or no treatment necessary
  718. Cardiovascular Conditions with no effective treatment or no treatment necessary
  719. Musculoskeletal Conditions with no effective treatment or no treatment necessary
  720. Intracranial Conditions with no effective treatment or no treatment necessary
  721. Sensory Organ Conditions with no effective treatment or no treatment necessary
  722. Endocrine and Metabolic Conditions with no effective treatment or no treatment necessary
  723. Gastrointestinal Conditions with no effective treatment or no treatment necessary
  724. Mental Conditions with no effective treatment or no treatment necessary
  725. Neurologic Conditions with no effective treatment or no treatment necessary
  726. Dental Conditions (cosmetic dental services)
  727. Tubal Dysfunction and Other Causes of Infertility (in-vitro fertilization)
  728. Hepatorenal Syndrome
  729. Spastic Dysphonia
  730. Disorders of Refraction and Accommodation (Radial Keratotomy)