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.