Covered Illnesses
Below are some of the most common illnesses served by our service, listed from most to least frequent – these ailments represent over 80% of physician consultations.
Allergy
- Runny nose due to allergy to pollen
- Runny nose due to allergy to food
- Runny nose due to allergy to animal hair and dander
- Runny nose due to other allergen not specified by another code
- Runny nose with no cause defined
- Allergy related skin rash
- Allergy related respiratory
- Sudden inner ear infection with fluid related to allergies
- Sudden inner ear infection with mucous due to allergies
- Sudden inner ear infection with blood due to allergies
Asthma
- Asthma caused by exposure to an allergen, allergen not defined
- Asthma, no further information for coding purposes
- Asthma flare up that is not responding to treatment, no further description of the asthma
- Asthma (no defining description) with a recent
- Current flare up
Contusion
- Bruise Contusion of face, scalp, and neck except eye(s)
- Contusion of eye and adnexa
- Contusion of trunk
- Contusion of upper limb
- Contusion of lower limb and of other and unspecified sites
Ears
- External ear infection
- Sudden inner ear infection without pus
- Sudden inner ear infection with fluid
- Sudden inner ear infection with blood
- Persistent or reoccurring inner ear infection with fluid reason unknown
- Persistent or recurring inner ear infection with fluid
- Persistent or recurring inner ear infection with mucous reason unknown
- Not specified disorder of the eustachian tube
- Persistent or chronic inner ear infection without pus not specified/reason unknown
- Inner ear infection without pus not determined if it is sudden or chronic/persistent
- Sudden inner ear infection with pus without ear drum breaking open
- Sudden inner ear infection with pus where the eardrum has broken open on it’s own
- Persistent or recurring inner ear infection with mucous discharge and permanent perforation/open ear drum
- Persistent or recurring inner ear infection with pus no specified reason
- Inner ear infection with pus without specific reason
- Inner ear infection no reason
- Perforation of ear drum no reason
- Earache no reason
Eyes
- Sudden red eyes without known cause
- Red eyes with mucous
- Red, itchy eyes due to allergies repeated or occurring over long period of time
- Pink eye
- Conjunctivitis-pink eye
Fever
- General
Headaches
- General
Influenza(Flu)
- Respiratory illness due to influenza with other respiratory symptoms
- Respiratory illness due to influenza with other symptoms
- Respiratory illness due to Novel influenza A virus with other symptoms
Infection
- Infection specified type of spirochete
- Infection non-specified
- Vaginal yeast infection
- Yeast infection of nonspecific site
Insect
- Insect bite (no bee, wasp, yellow jacket) of elbow and forearm with no infection
Muscular
- Muscular pain nonspecific
- Muscular spasm
Oral
- Ulcerations of gums – mouth – tonsils
- Thrush in mouth
- Oral and dental
Pain
- Illness, discomfort and feeling tired
- Pain in lower back
- General pain involving neck
- General pain limb
- General pain involving foot/ankle
- Convulsions
Respiratory Bronchi
- Tuberculosis of lungs (bronchi)
- Sudden inflammation of upper airway (bronchi)
- Inflammation of upper airway (bronchi) no determination if it is sudden or recurrent -persistent
- Persistent-recurrent inflammation of upper airway (bronchi)
- Flare up or worsening of upper airway (bronchi) inflammation -production of mucous which is a type of COPD (chronic obstructive pulmonary disease)
- Persistent or recurrent inflammation of upper airway (bronchi) with sudden bronchial infection
- Persistent or recurring inflammation of upper airway (bronchi) which isn’t defined by another code
- Persistent or recurring inflammation or upper airway (bronchi) which isn’t defined
- Inflammation of upper airway (bronchi) and lung tissue due to fumes and vapors
- Sudden upper respiratory infection (broad definition of either runny nose, sinusitis, bronchitis, cold,etc.) with multiple sites
- Sudden upper respiratory infection (broad definition of either runny nose, sinusitis, bronchitis, cold,etc.) with no specified/defined site
- Respiratory illness with other symptoms of respiratory system (nose, airway, lungs)
Respiratory
- Sudden croup without obstruction
- Persistent or recurrent inflammation and infection due to organisms
- Respiratory illness with other symptoms
- Enlargement of the bronchi (upper airway) tubes due to a long term
- Disease of lungs due to silica or silicates
- Inflammation of lung tissue because of inhaled food or vomit
- Lung congestion and poor decreased circulation
- Respiratory special
- Cough only
Sinus
- Sudden sinus infection (behind cheekbones)
- Sudden sinus infection (behind forehead)
- Sudden sinus infection (behind bridge of nose)
- Sudden sinus infection (above nose, behind eyes)
- Other sudden sinus infection
- Sudden sinusitis not specific (no reason)
- Persistent or recurrent sinus infection (behind cheekbones)
- Persistent or recurrent sinus infection (forehead)
- Persistent or recurrent sinus infection (behind bridge of nose)
- Persistent or recurrent sinus infection (above nose, behind eyes)
- Other persistent or recurrent sinusitis area not defined by other codes
- Persistent or recurrent sinus infection not defined or enough information given to use other code
- Disease of nose and sinus that is not specified
Skin
- Itchy, red skin and eczema due to chemicals not found in listed codes
- Itchy red skin and eczema from plant exposure
- Itchy, red skin and eczema due to specific agent that is not specified in other codes
- Itchy, red skin and eczema without known cause
- Acne
- Rash with another non specified skin condition
- Inflammation of infection or vagina and vulva due to unknown cause
STD
- Genital herpes (STD)
- Gonorrhea (STD) infection
Stomach
- Intestine Intestinal infection with diarrhea
- Indigestion or upset stomach and other disorders of function of stomach
- Nausea and vomiting
- Diarrhea, no other symptoms
- Belly pain near belly button area
Throat
- Strep Throat
- Sudden sore throat
Urinary
- Urinary Tract Infect UTI
- Painful Urination
Viral
- Exposure to a viral disease that does not have a specific code assigned.