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Download - Gender to Diagnosis Code & Procedure Code Policy, Professional · 2020-05-27 · Title: Gender to Diagnosis Code and Procedure Policy, Professional - Reimbursement Policy - UnitedHealthcare

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  • REIMBURSEMENT POLICY

    CMS-1500 Policy Number 2020R7121B

    Proprietary information of UnitedHealthcare Community Plan. Copyright 2020 United HealthCare Services, Inc. 2020R7121B

    Gender to Diagnosis Code & Procedure Code Policy, Professional

    IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission of accurate claims. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. UnitedHealthcare Community Plan reimbursement policies uses Current Procedural Terminology (CPT®*), Centers for Medicare and Medicaid Services (CMS) or other coding guidelines. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement. This reimbursement policy applies to all health care services billed on CMS 1500 forms and, when specified, to those billed on UB04 for Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy. This information is intended to serve only as a general reference resource regarding UnitedHealthcare Community Plan’s reimbursement policy for the services described and is not intended to address every aspect of a reimbursement situation. Accordingly, UnitedHealthcare Community Plan may use reasonable discretion in interpreting and applying this policy to health care services provided in a particular case. Further, the policy does not address all issues related to reimbursement for health care services provided to UnitedHealthcare Community Plan enrollees. Other factors affecting reimbursement supplement, modify or, in some cases, supersede this policy. These factors include, but are not limited to: federal &/or state regulatory requirements, the physician or other provider contracts,

    the enrollee’s benefit coverage documents, and/or other reimbursement, medical or drug policies. Finally, this policy may not be implemented exactly the same way on the different electronic claims processing systems used by UnitedHealthcare Community Plan due to programming or other constraints; however, UnitedHealthcare Community Plan strives to minimize these variations. UnitedHealthcare Community Plan may modify this reimbursement policy at any time by publishing a new version of the policy on this Website. However, the information presented in this policy is accurate and current as of the date of publication. UnitedHealthcare Community Plan uses a customized version of the Optum Claims Editing System known as iCES Clearinghouse to process claims in accordance with UnitedHealthcare Community Plan reimbursement policies. CPT Copyright American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.

    Application

    This reimbursement policy applies to UnitedHealthcare Community Plan Arizona, Kansas and Missouri Medicaid products. This reimbursement policy applies to services reported using the 1500 Health Insurance Claim Form (a/k/a CMS-1500) or its electronic equivalent or its successor form. This policy applies to all Arizona, Kansas and Missouri Medicaid products and all network and non-network physicians and other qualified health care professionals, including, but not limited to, non-network authorized and percent of charge contract physicians and other qualified health care professionals.

    Policy

    Overview

    Gender designations are assigned to select World Health Organization (WHO) International Classification of Diseases, Ninth Revision (ICD-10-CM) codes based on code descriptions or on publications and guidelines from sources such as professional specialty societies, the Centers for Medicare and Medicaid Services (CMS), the American Medical Association (AMA) or the AHA (American Hospital Association) Coding Clinic. Gender editing can result in incorrect denials for claims for transgender and hermaphrodite members.

    Reimbursement Guidelines

    UnitedHealthcare Community Plan will apply gender edits to Arizona, Kansas and Missouri Medicaid claims when diagnosis &/or procedure codes are reported inappropriately for the patient's gender.

  • REIMBURSEMENT POLICY

    CMS-1500 Policy Number 2020R7121B

    Proprietary information of UnitedHealthcare Community Plan. Copyright 2020 United HealthCare Services, Inc. 2020R7121B

    State Exceptions

    Arizona Arizona Health Care Cost Containment System (AHCCCS), which is the Arizona (AZ) Medicaid program, publishes customized, State identified gender designated CPT and ICD-10 code lists which are included in this policy. AHCCCS requires review of documentation and authorization before denying for inappropriate gender. CPT and HCPCS codes billed with modifier KX are exempt from gender edit requirements for Arizona Medicaid. (i.e. transgender or hermaphrodite members) AHCCCS follows CMS guidelines which state: “Use of the KX modifier will alert the MAC that the physician/practitioner is performing a service on a patient for whom gender specific editing may apply, but should have such editing by-passed for the benef iciary.” (CMS Transmittal 1877) (MLN Matters #MM6638)

    Kansas Kansas Medicaid only applies gender editing to ICD10 Codes. Kansas Medicaid publishes a customized, State identified gender designated ICD-10 code list which is included in this policy.

    Missouri Missouri Medicaid publishes customized, State identified gender designated CPT and ICD-10 code lists which are included in this policy.

    Definitions

    Modifier KX

    Per MLN Matters #6638: “The KX modifier, which is defined as “Requirements specified in the medical policy have been met”, is a multipurpose informational modifier for Part B professional claims. In addition to its other existing uses, the KX modifier should also be used to identify services that are gender specific (i.e., services that are considered female or male only) for effected beneficiaries on claims submitted by physicians and non-physician practitioners to Medicare carriers and MACs. Use of the KX modifier will alert the carrier/MAC that the physician/practitioner is performing a service on a patient for whom gender specific editing may apply, and that the service should be allowed to continue with normal processing. Payment will be made if the coverage and reporting criteria have been met for the service.”

    Attachments

    Arizona Medicaid ICD-10 to Gender Policy List

    ICD-10 codes with designated appropriate gender for Arizona Medicaid.

    Arizona Medicaid Procedure to Gender Policy List

    CPT codes with designated appropriate gender for Arizona Medicaid

  • Diagnosis Positive Gender

    A1814 M

    A1815 M

    A1816 F

    A1817 F

    A1818 F

    A34 F

    A5142 F

    A5402 F

    A5403 F

    A5422 M

    A5423 M

    A5424 F

    A5602 F

    A5611 F

    A5901 F

    A5902 M

    A6001 M

    A6002 M

    A6003 F

    A6004 F

    B260 M

    B373 F

    B3742 M

    B3881 M

    C50011 F

    C50012 F

    C50019 F

    C50021 M

    C50022 M

    C50029 M

    C50111 F

    C50112 F

    C50119 F

    C50121 M

    C50122 M

    C50129 M

    C50211 F

    C50212 F

    C50219 F

    C50221 M

    C50222 M

    C50229 M

    C50311 F

    C50312 F

    C50319 F

    C50321 M

    Arizona Medicaid ICD-10 to

    Gender Policy List

  • C50322 M

    C50329 M

    C50411 F

    C50412 F

    C50419 F

    C50421 M

    C50422 M

    C50429 M

    C50511 F

    C50512 F

    C50519 F

    C50521 M

    C50522 M

    C50529 M

    C50611 F

    C50612 F

    C50619 F

    C50621 M

    C50622 M

    C50629 M

    C50811 F

    C50812 F

    C50819 F

    C50821 M

    C50822 M

    C50829 M

    C541 F

    C50911 F

    C50912 F

    C50919 F

    C50921 M

    C50922 M

    C50929 M

    C510 F

    C511 F

    C512 F

    C518 F

    C519 F

    C52 F

    C530 F

    C531 F

    C538 F

    C539 F

    C540 F

    C542 F

    C543 F

    C548 F

    C549 F

    C55 F

    C561 F

    C562 F

    C569 F

  • C5700 F

    C5701 F

    C5702 F

    C5710 F

    C5711 F

    C5712 F

    C5720 F

    C5721 F

    C5722 F

    C573 F

    C574 F

    C577 F

    C578 F

    C579 F

    C58 F

    C600 M

    C601 M

    C602 M

    C608 M

    C609 M

    C61 M

    C6200 M

    C6201 M

    C6202 M

    C6210 M

    C6211 M

    C6212 M

    C6290 M

    C6291 M

    C6292 M

    C6300 M

    C6301 M

    C6302 M

    C6310 M

    C6311 M

    C6312 M

    C632 M

    C637 M

    C638 M

    C639 M

    C7960 F

    C7961 F

    C7962 F

    D060 F

    D061 F

    D067 F

    D069 F

    D070 F

    D071 F

    D072 F

    D0730 F

    D0739 F

  • D074 M

    D075 M

    D0760 M

    D0761 M

    D0769 M

    D176 M

    D261 F

    D250 F

    D251 F

    D252 F

    D259 F

    D260 F

    D267 F

    D269 F

    D270 F

    D271 F

    D279 F

    D280 F

    D281 F

    D282 F

    D287 F

    D289 F

    D290 M

    D291 M

    D2920 M

    D2921 M

    D2922 M

    D2930 M

    D2931 M

    D2932 M

    D294 M

    D298 M

    D299 M

    D390 F

    D3910 F

    D3911 F

    D3912 F

    D392 F

    D398 F

    D399 F

    D400 M

    D4010 M

    D4011 M

    D4012 M

    D408 M

    D409 M

    E280 F

    E281 F

    E282 F

    E28310 F

    E28319 F

    E2839 F

  • E288 F

    E289 F

    E290 M

    E291 M

    E298 M

    E299 M

    E8940 F

    E8941 F

    E895 M

    F5221 M

    F5222 F

    F5231 F

    F5232 M

    F524 M

    F525 F

    F526 F

    G43821 F

    G43829 F

    G43831 F

    G43839 F

    I861 M

    I863 F

    J8481 F

    L291 M

    L292 F

    N411 M

    N400 M

    N401 M

    N402 M

    N403 M

    N410 M

    N412 M

    N413 M

    N414 M

    N418 M

    N419 M

    N420 M

    N421 M

    N423 M

    N4281 M

    N4282 M

    N4283 M

    N4289 M

    N429 M

    N430 M

    N431 M

    N432 M

    N433 M

    N4340 M

    N4341 M

    N4342 M

    N4400 M

  • N4401 M

    N4402 M

    N4403 M

    N4404 M

    N441 M

    N442 M

    N448 M

    N451 M

    N452 M

    N453 M

    N454 M

    N4601 M

    N46021 M

    N46022 M

    N46023 M

    N46024 M

    N46025 M

    N46029 M

    N4611 M

    N46121 M

    N46122 M

    N46123 M

    N46124 M

    N46125 M

    N46129 M

    N468 M

    N469 M

    N470 M

    N471 M

    N472 M

    N473 M

    N474 M

    N475 M

    N476 M

    N477 M

    N478 M

    N480 M

    N481 M

    N4821 M

    N4822 M

    N4829 M

    N4830 M

    N4831 M

    N4832 M

    N4833 M

    N4839 M

    N485 M

    N486 M

    N4881 M

    N4882 M

    N4883 M

    N4889 M

  • N489 M

    N490 M

    N491 M

    N492 M

    N493 M

    N498 M

    N499 M

    N500 M

    N501 M

    N503 M

    N508 M

    N509 M

    N51 M

    N5201 M

    N5202 M

    N5203 M

    N521 M

    N522 M

    N5231 M

    N5232 M

    N5233 M

    N5234 M

    N5239 M

    N528 M

    N529 M

    N5311 M

    N5312 M

    N5313 M

    N5314 M

    N5319 M

    N538 M

    N539 M

    N7001 F

    N7002 F

    N7003 F

    N7011 F

    N7012 F

    N7013 F

    N7091 F

    N7092 F

    N7093 F

    N710 F

    N711 F

    N719 F

    N72 F

    N730 F

    N8181 F

    N731 F

    N732 F

    N733 F

    N734 F

    N735 F

  • N736 F

    N738 F

    N739 F

    N74 F

    N750 F

    N751 F

    N758 F

    N759 F

    N760 F

    N761 F

    N762 F

    N763 F

    N764 F

    N765 F

    N766 F

    N7681 F

    N7689 F

    N770 F

    N771 F

    N800 F

    N801 F

    N802 F

    N803 F

    N804 F

    N805 F

    N806 F

    N808 F

    N809 F

    N810 F

    N8110 F

    N8111 F

    N8112 F

    N812 F

    N813 F

    N814 F

    N815 F

    N816 F

    N8182 F

    N8183 F

    N8184 F

    N8185 F

    N8189 F

    N819 F

    N820 F

    N821 F

    N822 F

    N823 F

    N824 F

    N825 F

    N828 F

    N829 F

    N830 F

  • N831 F

    N8320 F

    N8329 F

    N8331 F

    N8332 F

    N8333 F

    N834 F

    N8351 F

    N8352 F

    N8353 F

    N836 F

    N837 F

    N838 F

    N839 F

    N840 F

    N841 F

    N842 F

    N843 F

    N848 F

    N849 F

    N8500 F

    N8501 F

    N8502 F

    N852 F

    N853 F

    N854 F

    N855 F

    N856 F

    N857 F

    N858 F

    N859 F

    N86 F

    N870 F

    N871 F

    N879 F

    N880 F

    N881 F

    N882 F

    N883 F

    N884 F

    N888 F

    N889 F

    N890 F

    N891 F

    N893 F

    N894 F

    N895 F

    N896 F

    N897 F

    N898 F

    N899 F

    N900 F

  • N901 F

    N903 F

    N904 F

    N905 F

    N906 F

    N907 F

    N90810 F

    N90811 F

    N90812 F

    N90813 F

    N90818 F

    N9089 F

    N909 F

    N910 F

    N911 F

    N912 F

    N913 F

    N914 F

    N915 F

    N920 F

    N921 F

    N922 F

    N923 F

    N924 F

    N925 F

    N926 F

    N930 F

    N938 F

    N939 F

    N940 F

    N941 F

    N942 F

    N943 F

    N944 F

    N945 F

    N946 F

    N94810 F

    N94818 F

    N94819 F

    N9489 F

    N949 F

    N950 F

    N951 F

    N952 F

    N958 F

    N959 F

    N96 F

    N970 F

    N971 F

    N972 F

    N978 F

    N979 F

  • N981 F

    N982 F

    N983 F

    N988 F

    N989 F

    N99110 M

    N99114 M

    N9912 F

    N992 F

    N993 F

    N9983 F

    O000 F

    O001 F

    O002 F

    O008 F

    O009 F

    O021 F

    O0289 F

    O030 F

    O031 F

    O0333 F

    O0335 F

    O0338 F

    O035 F

    O036 F

    O037 F

    O0380 F

    O0381 F

    O0382 F

    O0383 F

    O0384 F

    O0385 F

    O0386 F

    O0387 F

    O0388 F

    O0389 F

    O039 F

    O045 F

    O046 F

    O047 F

    O0480 F

    O0481 F

    O0482 F

    O0483 F

    O0484 F

    O0485 F

    O0486 F

    O0488 F

    O070 F

    O071 F

    O0730 F

    O0732 F

  • O0733 F

    O0734 F

    O0735 F

    O0737 F

    O0739 F

    O074 F

    O080 F

    O081 F

    O086 F

    O087 F

    O0883 F

    O089 F

    O0900 F

    O0901 F

    O0902 F

    O0903 F

    O0910 F

    O0911 F

    O0912 F

    O0913 F

    O09211 F

    O09212 F

    O09213 F

    O09219 F

    O09291 F

    O09292 F

    O09293 F

    O09299 F

    O0930 F

    O0931 F

    O0932 F

    O0933 F

    O0941 F

    O0942 F

    O0943 F

    O0970 F

    O0971 F

    O0972 F

    O0973 F

    O09811 F

    O09813 F

    O09819 F

    O09821 F

    O09822 F

    O09829 F

    O09891 F

    O09892 F

    O09899 F

    O0990 F

    O0991 F

    O0992 F

    O0993 F

  • O10011 F

    O10013 F

    O10019 F

    O1002 F

    O1003 F

    O10112 F

    O10113 F

    O10119 F

    O1012 F

    O1013 F

    O10211 F

    O10212 F

    O10213 F

    O10219 F

    O1022 F

    O1023 F

    O10311 F

    O10319 F

    O1033 F

    O10411 F

    O10412 F

    O10413 F

    O10419 F

    O1042 F

    O1043 F

    O10911 F

    O10912 F

    O10913 F

    O10919 F

    O1092 F

    O1093 F

    O111 F

    O112 F

    O113 F

    O119 F

    O1200 F

    O1201 F

    O1203 F

    O1210 F

    O1212 F

    O133 F

    O1423 F

    O2201 F

    O2202 F

    O2203 F

    O2210 F

    O2223 F

    O2242 F

    O2243 F

    O2250 F

    O2251 F

    O2252 F

  • O2253 F

    O228X1 F

    O228X9 F

    O2290 F

    O2291 F

    O2292 F

    O2293 F

    O2330 F

    O2331 F

    O2332 F

    O2333 F

    O2340 F

    O2341 F

    O2342 F

    O2343 F

    O23591 F

    O23592 F

    O23593 F

    O23599 F

    O2390 F

    O2392 F

    O2393 F

    O24011 F

    O24013 F

    O24019 F

    O2403 F

    O24111 F

    O24112 F

    O24113 F

    O24119 F

    O2412 F

    O2413 F

    O24311 F

    O24312 F

    O24319 F

    O24414 F

    O24419 F

    O24424 F

    O24429 F

    O24430 F

    O24434 F

    O24439 F

    O24811 F

    O24812 F

    O24813 F

    O24819 F

    O2482 F

    O2483 F

    O24911 F

    O24919 F

    O2620 F

    O2622 F

  • O2623 F

    O2630 F

    O2631 F

    O2632 F

    O2633 F

    O2640 F

    O2641 F

    O2642 F

    O2643 F

    O2650 F

    O2651 F

    O26611 F

    O26613 F

    O26619 F

    O2662 F

    O26711 F

    O26712 F

    O26719 F

    O26819 F

    O26821 F

    O26891 F

    O26893 F

    O26899 F

    O2690 F

    O281 F

    O282 F

    O284 F

    O285 F

    O289 F

    O29011 F

    O29012 F

    O29013 F

    O29019 F

    O29021 F

    O29022 F

    O29023 F

    O29029 F

    O29091 F

    O29092 F

    O29093 F

    O29099 F

    O29111 F

    O29112 F

    O29113 F

    O29119 F

    O29121 F

    O29122 F

    O29123 F

    O29129 F

    O29191 F

    O29192 F

    O29193 F

  • O29199 F

    O29211 F

    O29212 F

    O29213 F

    O29219 F

    O29291 F

    O29292 F

    O29293 F

    O29299 F

    O293X1 F

    O293X2 F

    O293X3 F

    O293X9 F

    O2940 F

    O2941 F

    O2942 F

    O2943 F

    O295X1 F

    O295X2 F

    O295X3 F

    O295X9 F

    O2960 F

    O2962 F

    O2963 F

    O298X1 F

    O298X2 F

    O298X3 F

    O298X9 F

    O2990 F

    O2991 F

    O2992 F

    O2993 F

    O30001 F

    O30002 F

    O30003 F

    O30009 F

    O30011 F

    O30019 F

    O30021 F

    O30039 F

    O30049 F

    O30091 F

    O30099 F

    O30101 F

    O30102 F

    O30103 F

    O30111 F

    O30113 F

    O30119 F

    O30121 F

    O3090 F

    O30122 F

  • O30123 F

    O30129 F

    O30192 F

    O30201 F

    O30202 F

    O30203 F

    O30209 F

    O30211 F

    O30212 F

    O3102X2 F

    O30213 F

    O30219 F

    O30221 F

    O30222 F

    O30223 F

    O30229 F

    O30291 F

    O30292 F

    O30293 F

    O30801 F

    O30802 F

    O30803 F

    O30809 F

    O30811 F

    O30813 F

    O30821 F

    O30822 F

    O30823 F

    O30829 F

    O30892 F

    O30899 F

    O3092 F

    O3100X1 F

    O3101X1 F

    O3102X1 F

    O3102X3 F

    O3102X4 F

    O3102X5 F

    O3102X9 F

    O3103X0 F

    O3110X1 F

    O3110X4 F

    O3111X0 F

    O3111X1 F

    O3111X3 F

    O3111X4 F

    O3111X5 F

    O3112X1 F

    O3112X4 F

    O3112X5 F

    O3113X0 F

    O3113X3 F

  • O3113X9 F

    O3120X0 F

    O3120X2 F

    O3120X5 F

    O3121X1 F

    O3121X2 F

    O3121X4 F

    O3122X0 F

    O3122X3 F

    O3122X4 F

    O3122X9 F

    O3123X2 F

    O3123X4 F

    O3123X5 F

    O3130X0 F

    O3130X3 F

    O3130X9 F

    O3131X0 F

    O3131X1 F

    O3131X2 F

    O3131X3 F

    O3131X4 F

    O3131X5 F

    O3131X9 F

    O3132X0 F

    O3132X1 F

    O3132X2 F

    O3132X4 F

    O3133X0 F

    O3133X1 F

    O3133X3 F

    O3133X9 F

    O318X11 F

    O318X12 F

    O318X14 F

    O318X19 F

    O318X20 F

    O318X21 F

    O318X23 F

    O318X29 F

    O318X30 F

    O318X33 F

    O318X39 F

    O318X90 F

    O318X92 F

    O318X93 F

    O318X94 F

    O318X99 F

    O320XX1 F

    O321XX1 F

    O322XX2 F

    O323XX4 F

  • O323XX9 F

    O324XX0 F

    O324XX1 F

    O324XX2 F

    O324XX3 F

    O324XX4 F

    O324XX5 F

    O324XX9 F

    O329XX0 F

    O329XX1 F

    O329XX4 F

    O329XX5 F

    O330 F

    O331 F

    O333XX0 F

    O333XX2 F

    O333XX9 F

    O334XX1 F

    O334XX2 F

    O334XX4 F

    O334XX5 F

    O334XX9 F

    O335XX1 F

    O335XX2 F

    O335XX3 F

    O335XX5 F

    O335XX9 F

    O336XX2 F

    O336XX3 F

    O336XX5 F

    O336XX9 F

    O337 F

    O338 F

    O339 F

    O3400 F

    O3401 F

    O3402 F

    O3403 F

    O3410 F

    O3411 F

    O3412 F

    O3413 F

    O3421 F

    O3429 F

    O3430 F

    O3440 F

    O3442 F

    O3443 F

    O34511 F

    O34513 F

    O34519 F

    O34529 F

  • O34531 F

    O34532 F

    O34539 F

    O34593 F

    O34599 F

    O3460 F

    O3471 F

    O3472 F

    O3480 F

    O3481 F

    O3482 F

    O3483 F

    O3490 F

    O3491 F

    O3492 F

    O3493 F

    O350XX0 F

    O350XX1 F

    O350XX2 F

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    O350XX5 F

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    O351XX0 F

    O351XX1 F

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    O352XX0 F

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    O355XX0 F

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    O355XX9 F

    O356XX0 F

    O356XX1 F

    O356XX3 F

    O356XX4 F

    O1500 F

    O1502 F

    O1503 F

    O151 F

    O152 F

  • O24012 F

    O2402 F

    O4401 F

    O356XX5 F

    O356XX9 F

    O357XX0 F

    O357XX1 F

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    O357XX3 F

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    O358XX0 F

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    O359XX0 F

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    O360110 F

    O360111 F

    O360113 F

    O360114 F

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    O360120 F

    O360123 F

    O360124 F

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    O360131 F

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    O360134 F

    O360139 F

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    O360194 F

    O360199 F

    O360910 F

    O360911 F

    O360912 F

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    O360914 F

    O360915 F

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    O360920 F

    O360921 F

    O360922 F

    O360923 F

    O360924 F

    O360925 F

  • O360929 F

    O360930 F

    O360931 F

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    O360933 F

    O360934 F

    O360935 F

    O360939 F

    O360990 F

    O360991 F

    O360992 F

    O360993 F

    O361110 F

    O361111 F

    O361112 F

    O361114 F

    O361115 F

    O361120 F

    O361122 F

    O361124 F

    O361125 F

    O361129 F

    O361131 F

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    O361190 F

    O361191 F

    O361192 F

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    O361195 F

    O361199 F

    O361910 F

    O361911 F

    O361912 F

    O361913 F

    O361914 F

    O361915 F

    O361919 F

    O361920 F

    O361921 F

    O361922 F

    O361923 F

    O361924 F

    O361925 F

    O361929 F

    O361930 F

    O361931 F

    O361932 F

    O361933 F

  • O361934 F

    O361935 F

    O361939 F

    O361990 F

    O361991 F

    O361992 F

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    O361994 F

    O361995 F

    O361999 F

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    O3620X1 F

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    O3622X4 F

    O3622X9 F

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    O364XX0 F

    O364XX1 F

    O3661X4 F

    O365111 F

    O365114 F

    O365115 F

    O365120 F

    O365123 F

    O365129 F

    O365132 F

    O365133 F

    O365135 F

    O365191 F

    O365194 F

    O365195 F

    O365910 F

    O365913 F

    O365919 F

    O365920 F

    O365922 F

    O365925 F

  • O365931 F

    O365932 F

    O365934 F

    O365990 F

    O365993 F

    O365994 F

    O365995 F

    O365999 F

    O3660X0 F

    O3660X1 F

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    O3663X0 F

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    O3670X0 F

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    O3671X1 F

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    O3672X1 F

    O3672X4 F

    O3672X5 F

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    O3673X0 F

    O3673X3 F

    O3673X4 F

    O3673X5 F

  • O3673X9 F

    O3680X0 F

    O3680X1 F

    O3680X2 F

    O3680X3 F

    O3680X4 F

    O3680X5 F

    O368210 F

    O368219 F

    O368220 F

    O368230 F

    O368239 F

    O368290 F

    O368292 F

    O368293 F

    O368294 F

    O368299 F

    O368912 F

    O368913 F

    O368914 F

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    O368920 F

    O368921 F

    O368922 F

    O368923 F

    O368924 F

    O368925 F

    O368929 F

    O368930 F

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    O368933 F

    O368934 F

    O368935 F

    O368939 F

    O368990 F

    O368991 F

    O368992 F

    O368993 F

    O368994 F

    O368995 F

    O368999 F

    O3690X0 F

    O3690X1 F

    O3690X2 F

    O3690X3 F

    O3690X9 F

    O3691X0 F

    O3691X1 F

    O3691X2 F

    O3691X3 F

    O3691X4 F

  • O3691X5 F

    O3691X9 F

    O3692X0 F

    O3692X1 F

    O3692X2 F

    O3692X3 F

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    O3692X5 F

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    O3693X0 F

    O3693X1 F

    O3693X3 F

    O3693X4 F

    O3693X5 F

    O3693X9 F

    O401XX0 F

    O401XX3 F

    O401XX4 F

    O401XX5 F

    O401XX9 F

    O402XX0 F

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    O402XX5 F

    O403XX1 F

    O409XX1 F

    O4100X1 F

    O4101X0 F

    O4102X1 F

    O4103X1 F

    O411010 F

    O411011 F

    O411013 F

    O411019 F

    O411020 F

    O411023 F

    O411025 F

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    O411431 F

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    O411094 F

    O411099 F

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  • O411219 F

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    O411491 F

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    O4193X3 F

    O4193X5 F

    O4193X9 F

    O4200 F

    O42011 F

    O42012 F

    O42013 F

    O42019 F

    O4202 F

    O4210 F

    O42111 F

    O42112 F

    O42113 F

    O4212 F

    O4290 F

    O42912 F

    O42919 F

    O4292 F

    O43012 F

    O43021 F

    O43022 F

  • O43023 F

    O43029 F

    O43101 F

    O43111 F

    O43112 F

    O43113 F

    O43119 F

    O43121 F

    O43122 F

    O43129 F

    O43233 F

    O4400 F

    O4403 F

    O45001 F

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    O45003 F

    O45009 F

    O45011 F

    O45012 F

    O45013 F

    O45019 F

    O45023 F

    O45029 F

    O45091 F

    O45092 F

    O45099 F

    O458X1 F

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    O4590 F

    O4591 F

    O4592 F

    O4593 F

    O46001 F

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    O46003 F

    O46009 F

    O46011 F

    O46012 F

    O46013 F

    O46019 F

    O46021 F

    O46022 F

    O46023 F

    O46029 F

    O46091 F

    O46092 F

    O46093 F

    O46099 F

    O4700 F

    O4703 F

    O6010X1 F

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  • O6010X3 F

    O6010X5 F

    O6010X9 F

    O6012X0 F

    O6012X3 F

    O6012X9 F

    O6013X0 F

    O6013X3 F

    O4402 F

    O4410 F

    O4411 F

    O4412 F

    O4413 F

    O6013X4 F

    O6013X5 F

    O6013X9 F

    O6014X0 F

    O6014X1 F

    O6014X2 F

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    O6020X0 F

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    O6020X4 F

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    O6023X9 F

    O640XX0 F

    O640XX1 F

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    O648XX2 F

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    O648XX5 F

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  • O649XX0 F

    O649XX1 F

    O649XX4 F

    O649XX9 F

    O653 F

    O654 F

    O655 F

    O659 F

    O6641 F

    O669 F

    O670 F

    O678 F

    O679 F

    O68 F

    O690XX0 F

    O690XX9 F

    O691XX0 F

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    O6981X0 F

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    O6981X3 F

    O9903 F

    O6981X5 F

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    O699XX0 F

  • O699XX1 F

    O699XX2 F

    O699XX3 F

    O699XX4 F

    O699XX5 F

    O699XX9 F

    O704 F

    O7100 F

    O731 F

    O740 F

    O741 F

    O742 F

    O743 F

    O745 F

    O746 F

    O749 F

    O753 F

    O755 F

    O7582 F

    O76 F

    O770 F

    O771 F

    O778 F

    O779 F

    O80 F

    O8802 F

    O8822 F

    O8823 F

    O88311 F

    O88312 F

    O88313 F

    O88319 F

    O8832 F

    O8901 F

    O8909 F

    O892 F

    O894 F

    O895 F

    O898 F

    O902 F

    O91012 F

    O91013 F

    O91019 F

    O91119 F

    O9112 F

    O91211 F

    O91212 F

    O91219 F

    O9122 F

    O92019 F

    O92112 F

    O92113 F

  • O92119 F

    O9212 F

    O9213 F

    O9220 F

    O9229 F

    O923 F

    O924 F

    O925 F

    O926 F

    O94 F

    O98312 F

    O9832 F

    O9902 F

    O98412 F

    O98512 F

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    O9852 F

    O9862 F

    O98711 F

    O98712 F

    O98719 F

    O9872 F

    O9873 F

    O98811 F

    O98812 F

    O98813 F

    O98819 F

    O9882 F

    O9883 F

    O98911 F

    O98912 F

    O98913 F

    O98919 F

    O9892 F

    O9893 F

    O99011 F

    O99012 F

    O99013 F

    O99019 F

    O99112 F

    O99119 F

    O9913 F

    O99281 F

    O99282 F

    O99283 F

    O99284 F

    O99285 F

    O99330 F

    O99340 F

    O99341 F

    O99342 F

    O99343 F

  • O99344 F

    O99345 F

    O99350 F

    O99351 F

    O99352 F

    O99353 F

    O99354 F

    O99411 F

    O99412 F

    O99413 F

    O99419 F

    O9942 F

    O9943 F

    O99511 F

    O99512 F

    O99513 F

    O9972 F

    O99519 F

    O9953 F

    O99611 F

    O99612 F

    O99613 F

    O99619 F

    O99711 F

    O99712 F

    O99713 F

    O99719 F

    O99810 F

    O99834 F

    O99835 F

    O99840 F

    O99841 F

    O99842 F

    O99843 F

    O9989 F

    O9A119 F

    O9A211 F

    O9A213 F

    O9A23 F

    O9A519 F

    P835 M

    Q522 F

    Q5001 F

    Q5002 F

    Q501 F

    Q502 F

    Q5031 F

    Q5032 F

    Q5039 F

    Q504 F

    Q505 F

    Q506 F

  • Q510 F

    Q5110 F

    Q5111 F

    Q512 F

    Q513 F

    Q514 F

    Q515 F

    Q516 F

    Q517 F

    Q51810 F

    Q51811 F

    Q51818 F

    Q51820 F

    Q51821 F

    Q51828 F

    Q519 F

    Q520 F

    Q5210 F

    Q5211 F

    Q5212 F

    Q523 F

    Q524 F

    Q525 F

    Q526 F

    Q5270 F

    Q5271 F

    Q5279 F

    Q528 F

    Q529 F

    Q5300 M

    Q5301 M

    Q5302 M

    Q5310 M

    Q5311 M

    Q5312 M

    Q5320 M

    Q5321 M

    Q5322 M

    Q539 M

    Q540 M

    Q541 M

    Q542 M

    Q543 M

    Q544 M

    Q548 M

    Q549 M

    Q550 M

    Q551 M

    Q5520 M

    Q5521 M

    Q5522 M

    Q5523 M

  • Q5529 M

    Q553 M

    Q554 M

    Q555 M

    Q5561 M

    Q5562 M

    Q5563 M

    Q5564 M

    Q5569 M

    Q557 M

    Q558 M

    Q559 M

    Q561 M

    Q562 F

    Q640 M

    Q960 F

    Q961 F

    Q962 F

    Q963 F

    Q964 F

    Q968 F

    Q969 F

    Q970 F

    Q971 F

    Q972 F

    Q973 F

    Q978 F

    Q979 F

    Q980 M

    Q981 M

    Q983 M

    Q984 M

    Q985 M

    Q986 M

    Q987 M

    Q988 M

    Q989 M

    R361 M

    R860 M

    R861 M

    R862 M

    R863 M

    R864 M

    R865 M

    R866 M

    R867 M

    R868 M

    R869 M

    R870 F

    R871 F

    R872 F

    R873 F

  • R874 F

    R875 F

    R87610 F

    R87611 F

    R87612 F

    R87613 F

    R87614 F

    R87615 F

    R87616 F

    R87618 F

    R87619 F

    R87620 F

    R87621 F

    R87622 F

    R87623 F

    R87624 F

    R87625 F

    R87628 F

    R87629 F

    R8769 F

    R877 F

    R87810 F

    R87811 F

    R87820 F

    R87821 F

    R8789 F

    R879 F

    S30812A M

    S30201A M

    S30201D M

    S30201S M

    S30202A F

    S30202D F

    S30202S F

    S3021XA M

    S3021XD M

    S3021XS M

    S3022XA M

    S3022XD M

    S3022XS M

    S3023XA F

    S3023XD F

    S3023XS F

    S30812D M

    S30812S M

    S30813A M

    S30813D M

    S30813S M

    S30814A F

    S30814D F

    S30814S F

    S30815A M

  • S30815D M

    S30815S M

    S30816A F

    S30816D F

    S30816S F

    S30822A M

    S30822D M

    S30822S M

    S30823A M

    S30823D M

    S30823S M

    S30824A F

    S30824D F

    S30824S F

    S30825A M

    S30825D M

    S30825S M

    S30826A F

    S30826D F

    S30844S F

    S30826S F

    S30842A M

    S30842D M

    S30842S M

    S30843A M

    S30843D M

    S30843S M

    S30844A F

    S30844D F

    S30845A M

    S30845D M

    S30845S M

    S30846A F

    S30846D F

    S30846S F

    S30852A M

    S30852D M

    S30852S M

    S30853A M

    S30853D M

    S30853S M

    S30854A F

    S30854D F

    S30854S F

    S30855A M

    S30855D M

    S30855S M

    S30856A F

    S30856D F

    S30856S F

    S30862A M

    S30862D M

  • S30862S M

    S30863A M

    S30863D M

    S30863S M

    S30864A F

    S30864D F

    S30864S F

    S30865A M

    S30865D M

    S30865S M

    S30866A F

    S30866D F

    S30866S F

    S30872A M

    S30872D M

    S30872S M

    S30873A M

    S30873D M

    S30873S M

    S30874A F

    S30874D F

    S30874S F

    S3093XS M

    S30875A M

    S30875D M

    S30875S M

    S30876A F

    S30876D F

    S30876S F

    S3093XA M

    S3093XD M

    S3094XA M

    S3094XD M

    S3094XS M

    S3095XA F

    S3095XD F

    S3095XS F

    S3096XA M

    S3096XD M

    S3096XS M

    S3097XA F

    S3097XD F

    S3097XS F

    S3120XA M

    S3120XD M

    S3120XS M

    S3121XA M

    S3121XD M

    S3121XS M

    S3122XA M

    S3122XD M

    S3122XS M

  • S3123XA M

    S3123XD M

    S3123XS M

    S3124XA M

    S3124XD M

    S3124XS M

    S3125XA M

    S3125XD M

    S3125XS M

    S3130XA M

    S3130XD M

    S3130XS M

    S3131XA M

    S3131XD M

    S3131XS M

    S3132XA M

    S3132XD M

    S3132XS M

    S3133XA M

    S3133XD M

    S3133XS M

    S3134XA M

    S3144XA F

    S3134XD M

    S3134XS M

    S3135XA M

    S3135XD M

    S3135XS M

    S3140XA F

    S3140XD F

    S3140XS F

    S3141XA F

    S3141XD F

    S3141XS F

    S3142XA F

    S3142XD F

    S3142XS F

    S3143XA F

    S3143XD F

    S3143XS F

    S3144XD F

    S3144XS F

    S3145XA F

    S3145XD F

    S3145XS F

    S31501A M

    S31501D M

    S31501S M

    S31502A F

    S31502D F

    S31502S F

    S31511A M

  • S31511D M

    S31511S M

    S31512A F

    S31512D F

    S31512S F

    S31521A M

    S31521D M

    S31521S M

    S31522A F

    S31522D F

    S31522S F

    S31531A M

    S31531D M

    S31531S M

    S31532A F

    S31532D F

    S31532S F

    S31541A M

    S31541D M

    S31541S M

    S31542A F

    S31542D F

    S31542S F

    S31551A M

    S31551D M

    S31551S M

    S31552A F

    S31552D F

    S31552S F

    S35531A F

    S35531D F

    S35531S F

    S35532A F

    S35532D F

    S35532S F

    S35533A F

    S35533D F

    S35533S F

    S35534A F

    S35534D F

    S35534S F

    S35535A F

    S35535D F

    S35535S F

    S35536A F

    S35536D F

    S35536S F

    S358X1D F

    S358X1S F

    S358X8D F

    S358X8S F

    S37401A F

  • S37401D F

    S37401S F

    S37402A F

    S37402D F

    S37402S F

    S37409A F

    S37409D F

    S37409S F

    S37421A F

    S37421D F

    S37421S F

    S37422A F

    S37422D F

    S37422S F

    S37429A F

    S37429D F

    S37429S F

    S37431A F

    S37431D F

    S37431S F

    S37432A F

    S37432D F

    S37432S F

    S37439A F

    S37439D F

    S37439S F

    S37491A F

    S37491D F

    S37491S F

    S37492A F

    S37492D F

    S37492S F

    S37499A F

    S37499D F

    S37499S F

    S37501A F

    S37501D F

    S37501S F

    S37502A F

    S37502D F

    S37502S F

    S37509A F

    S37509D F

    S37509S F

    S37511A F

    S37511D F

    S37511S F

    S37512A F

    S37512D F

    S37512S F

    S37519A F

    S37519D F

  • S37519S F

    S37521A F

    S37521D F

    S37521S F

    S37522A F

    S37522D F

    S37522S F

    S37529A F

    S37529D F

    S37529S F

    S37531A F

    S37531D F

    S37531S F

    S37532A F

    S37532D F

    S37532S F

    S37539A F

    S37539D F

    S37539S F

    S37591A F

    S37591D F

    S37591S F

    S37592A F

    S37592D F

    S37592S F

    S37599A F

    S37599D F

    S37599S F

    S3760XA F

    S3760XD F

    S3760XS F

    S3762XA F

    S3762XD F

    S3762XS F

    S3763XA F

    S3763XD F

    S3763XS F

    S3769XA F

    S3769XD F

    S3769XS F

    S37822A M

    S37822D M

    S37822S M

    S37823A M

    S37823D M

    S37823S M

    S37828A M

    S37828D M

    S37828S M

    S37829A M

    S37829D M

    S37829S M

  • S3801XS M

    S38001A M

    S38001D M

    S38001S M

    S38002A F

    S38002D F

    S38002S F

    S3801XA M

    S3801XD M

    S3802XA M

    S3802XD M

    S3802XS M

    S3803XA F

    S3803XD F

    S3803XS F

    S38211A F

    S38211D F

    S38211S F

    S38212A F

    S38212D F

    S38212S F

    S38221A M

    S38221D M

    S38221S M

    S38222A M

    S38222D M

    S38222S M

    S38231A M

    S38231D M

    S38231S M

    S38232A M

    S38232D M

    S38232S M

    S39840A M

    S39840D M

    S39840S M

    T192XXA F

    T193XXA F

    T194XXA M

    T283XXA F

    T288XXA F

    T8331XA F

    T8331XD F

    T8331XS F

    T8332XA F

    T8332XD F

    T8332XS F

    T8339XA F

    T8339XD F

    T8339XS F

    T83410A M

    T83410D M

  • T83410S M

    T83418S M

    T83420A M

    T83420D M

    T83420S M

    T83490A M

    T83490D M

    T83490S M

    T83711A F

    T83711D F

    T83711S F

    T83721A F

    T83721D F

    T83721S F

    Z01411 F

    Z0142 F

    Z0371 F

    Z0372 F

    Z0379 F

    Z124 F

    Z125 M

    Z1271 M

    Z1272 F

    Z1273 F

    Z1502 F

    Z1503 M

    Z1504 F

    Z30011 F

    Z30012 F

    Z30013 F

    Z30014 F

    Z3041 F

    Z3042 F

    Z30430 F

    Z30431 F

    Z30432 F

    Z30433 F

    Z308 F

    Z31430 F

    Z31438 F

    Z31440 M

    Z31441 M

    Z31448 M

    Z3181 F

    Z3182 F

    Z3183 F

    Z3200 F

    Z3201 F

    Z3202 F

    Z331 F

    Z3400 F

    Z3401 F

  • Z3402 F

    Z3403 F

    Z3480 F

    Z3481 F

    Z3482 F

    Z3490 F

    Z3491 F

    Z3493 F

    Z370 F

    Z371 F

    Z372 F

    Z373 F

    Z3754 F

    Z390 F

    Z3A19 F

    Z4002 F

    Z412 M

    Z437 F

    Z4430 F

    Z4431 F

    Z4432 F

    Z45811 F

    Z45812 F

    Z45819 F

    Z52810 F

    Z52811 F

    Z52812 F

    Z52813 F

    Z52819 F

    Z780 F

    Z8043 M

    Z8540 F

    Z8541 F

    Z8542 F

    Z8543 F

    Z8544 F

    Z8545 M

    Z8546 M

    Z8547 M

    Z8548 M

    Z8549 M

    Z86001 F

    Z8632 F

    Z87410 F

    Z87411 F

    Z87412 F

    Z8742 F

    Z87430 M

    Z87438 M

    Z8751 F

    Z8759 F

    Z87710 M

  • Z90710 F

    Z90711 F

    Z90712 F

    Z90721 F

    Z90722 F

    Z975 F

    Z9851 F

    Z9852 M

    Z98870 F

    N35814 M

    O00102 F

    O00109 F

    O00111 F

    O00112 F

    O00119 F

    O00202 F

    O00209 F

    O00211 F

    O00212 F

    O00219 F

    O010 F

    O011 F

    O019 F

    O020 F

    O0281 F

    O029 F

    O032 F

    O0330 F

    O0331 F

    O0332 F

    O0334 F

    O0336 F

    O0337 F

    O0339 F

    O034 F

    O0487 F

    O0489 F

    O072 F

    O0731 F

    O0736 F

    O0738 F

    O082 F

    O083 F

    O084 F

    O085 F

    O0881 F

    O0882 F

    O0889 F

    O0940 F

    O09511 F

    O09512 F

    O09513 F

  • O09519 F

    O09521 F

    O09522 F

    O09523 F

    O09529 F

    O09611 F

    O09612 F

    O09613 F

    O09619 F

    O09621 F

    O09622 F

    O09623 F

    O09629 F

    O09812 F

    O09893 F

    O10012 F

    O10111 F

    O10312 F

    O10313 F

    O1032 F

    O1211 F

    O1213 F

    O1220 F

    O1221 F

    O1222 F

    O1223 F

    O131 F

    O132 F

    O1413 F

    O1420 F

    O1422 F

    O1490 F

    O1492 F

    O1493 F

    O159 F

    F530 F

    F531 F

    N35016 M

    N35116 M

    N35811 M

    N35812 M

    N35813 M

    N35816 M

    N35819 M

    N3582 F

    N35911 M

    N35912 M

    N35913 M

    N35914 M

    N35916 M

    N35919 M

    N3592 F

  • N99116 M

    O30131 F

    O30132 F

    O30133 F

    O30139 F

    O30231 F

    O30232 F

    O00101 F

    O00201 F

    O368310 F

    O368311 F

    O368312 F

    O368313 F

    Q53111 M

    Q53112 M

    Q5313 M

    Q53211 M

    Q53212 M

    Q5323 M

    R3983 M

    R3984 M

    Q5120 F

    Q5121 F

    Q5122 F

    Q5128 F

    R93811 M

    R93812 M

    R93813 M

    R93819 M

    Z1332 F

    O8600 F

    O8601 F

    O8602 F

    O8603 F

    O8604 F

    O8609 F

    O368399 F

    Z01419 F

    O161 F

    O162 F

    O163 F

    O169 F

    O200 F

    O208 F

    O209 F

    O2200 F

    O2211 F

    O2212 F

    O2213 F

    O2220 F

    O2221 F

    O2222 F

  • O2230 F

    O2231 F

    O2232 F

    O2233 F

    O2240 F

    O2241 F

    O228X2 F

    O228X3 F

    O2300 F

    O2301 F

    O2302 F

    O2303 F

    Z3A33 F

    Z3A34 F

    Z3A35 F

    Z3A36 F

    Z3A37 F

    Z3A38 F

    Z3A39 F

    Z3A40 F

    Z3A41 F

    O43103 F

    O43109 F

    O43123 F

    O43191 F

    O9823 F

    O98311 F

    O98313 F

    O98319 F

    O9833 F

    O91011 F

    O9102 F

    O9103 F

    O91111 F

    O91112 F

    O91113 F

    O9113 F

    O91213 F

    O9123 F

    O3661X1 F

    O98411 F

    O43193 F

    O43199 F

    O43211 F

    O135 F

    O43212 F

    O43213 F

    O43219 F

    O43221 F

    O43222 F

    O43223 F

    O43229 F

  • O43231 F

    O43232 F

    O43239 F

    O43811 F

    O43812 F

    O43813 F

    O4390 F

    O4391 F

    O4392 F

    O4393 F

    O45021 F

    O45022 F

    O45093 F

    O458X2 F

    O458X3 F

    O468X1 F

    O468X2 F

    O468X3 F

    O468X9 F

    O4690 F

    O4691 F

    O4692 F

    O4693 F

    O4702 F

    O471 F

    O479 F

    O480 F

    O481 F

    O6000 F

    O6002 F

    O6003 F

    O6010X0 F

    O6010X4 F

    O6012X1 F

    O6012X2 F

    O6012X4 F

    O6012X5 F

    O6013X1 F

    O6022X1 F

    O6022X2 F

    O6022X3 F

    O6022X4 F

    O6022X5 F

    O6023X1 F

    O6023X2 F

    O6023X3 F

    O6023X4 F

    O6023X5 F

    O610 F

    O611 F

    O618 F

    O619 F

  • O620 F

    O621 F

    O622 F

    O623 F

    O624 F

    O628 F

    O629 F

    O641XX5 F

    O641XX9 F

    O642XX0 F

    O642XX2 F

    O642XX3 F

    O642XX4 F

    O642XX5 F

    O642XX9 F

    O643XX1 F

    O643XX2 F

    O643XX5 F

    O643XX9 F

    O644XX1 F

    O644XX2 F

    O644XX3 F

    O644XX4 F

    O644XX5 F

    O644XX9 F

    O645XX1 F

    O645XX2 F

    O645XX3 F

    O645XX4 F

    O645XX5 F

    O648XX0 F

    O649XX2 F

    O649XX3 F

    O649XX5 F

    O650 F

    O651 F

    O652 F

    O658 F

    O660 F

    O661 F

    O662 F

    O663 F

    O6640 F

    O665 F

    O666 F

    O668 F

    O690XX1 F

    O690XX2 F

    O690XX3 F

    O43192 F

    O2310 F

    O2311 F

  • O2312 F

    O2313 F

    O2320 F

    O2321 F

    O2322 F

    O2323 F

    O23511 F

    O23512 F

    O23513 F

    O23519 F

    O690XX4 F

    O690XX5 F

    O691XX2 F

    O92011 F

    O92012 F

    O92013 F

    O9202 F

    O9203 F

    O92111 F

    O9270 F

    O9279 F

    O98011 F

    O98012 F

    O98013 F

    O98019 F

    O9802 F

    O9803 F

    O98111 F

    O98112 F

    O98212 F

    O98213 F

    O98219 F

    O9822 F

    Z0373 F

    Z0374 F

    Z0375 F

    Z332 F

    Z3483 F

    Z3492 F

    Z36 F

    Z374 F

    Z3750 F

    Z3751 F

    Z3752 F

    Z3753 F

    Z3759 F

    Z3760 F

    Z3761 F

    Z3762 F

    Z3763 F

    Z3764 F

    Z3769 F

  • Z377 F

    Z379 F

    Z391 F

    Z392 F

    Z3A00 F

    Z3A01 F

    Z3A08 F

    Z3A09 F

    Z3A10 F

    Z3A11 F

    Z3A12 F

    Z3A13 F

    Z3A14 F

    Z3A15 F

    Z3A16 F

    Z3A17 F

    Z3A18 F

    Z3A20 F

    Z3A21 F

    Z3A22 F

    Z3A23 F

    Z3A24 F

    Z3A25 F

    Z3A26 F

    Z3A27 F

    Z3A28 F

    Z3A29 F

    Z3A30 F

    Z3A31 F

    O23521 F

    O23522 F

    O23523 F

    O23529 F

    O2391 F

    O24912 F

    O24913 F

    O2492 F

    O2493 F

    O2510 F

    O2511 F

    O2512 F

    O2513 F

    O252 F

    O253 F

    O2600 F

    O2601 F

    O2602 F

    O2603 F

    O2610 F

    O2611 F

    O2612 F

    O2613 F

  • O2621 F

    Z3A32 F

    Z3A42 F

    Z3A49 F

    O368233 F

    O368234 F

    O368235 F

    O368291 F

    O368295 F

    O2652 F

    O2653 F

    O26612 F

    O2663 F

    O26713 F

    O2672 F

    O2673 F

    O26811 F

    O26812 F

    O26813 F

    O26822 F

    O26823 F

    O26829 F

    O26831 F

    O26832 F

    O26833 F

    O26839 F

    O26841 F

    O26842 F

    O26843 F

    O26849 F

    O26851 F

    O26852 F

    O26879 F

    O26892 F

    O2691 F

    O2692 F

    O2693 F

    O280 F

    O283 F

    O288 F

    O2961 F

    O30012 F

    O30013 F

    O30022 F

    O30023 F

    O30029 F

    O30031 F

    O30032 F

    O30033 F

    O30041 F

    O30042 F

    O30043 F

  • O30092 F

    O30093 F

    O30109 F

    O30112 F

    O30191 F

    O30193 F

    O30199 F

    O30233 F

    O30239 F

    O30299 F

    O30812 F

    O30819 F

    O30831 F

    O30832 F

    O30833 F

    O30839 F

    O30891 F

    O30893 F

    O3091 F

    O3093 F

    O3100X0 F

    O3100X2 F

    O3100X3 F

    O3100X4 F

    O3100X5 F

    O3100X9 F

    O3101X0 F

    O3101X2 F

    O3101X3 F

    O3101X4 F

    O3101X5 F

    O3101X9 F

    O3102X0 F

    O3103X1 F

    O3103X2 F

    O3103X3 F

    O3103X4 F

    O3103X5 F

    O3103X9 F

    O3111X2 F

    O3111X9 F

    O3112X0 F

    O3112X2 F

    O3112X3 F

    O411015 F

    O411021 F

    O411022 F

    O411024 F

    O3112X9 F

    O3113X1 F

    O3113X2 F

    O3113X4 F

  • O3113X5 F

    O3120X1 F

    O3120X3 F

    O3120X4 F

    O3120X9 F

    O3121X0 F

    O3121X3 F

    O3121X5 F

    O3121X9 F

    O3122X1 F

    O3122X2 F

    O3122X5 F

    O3123X0 F

    O3123X1 F

    O3123X3 F

    O3123X9 F

    O3130X1 F

    O3130X2 F

    O3130X4 F

    O3130X5 F

    O3132X3 F

    O3132X5 F

    O3132X9 F

    O3133X2 F

    O3133X4 F

    O3133X5 F

    O318X10 F

    O318X13 F

    O318X15 F

    O318X22 F

    O318X24 F

    O318X25 F

    O318X95 F

    O320XX0 F

    O320XX2 F

    O320XX3 F

    O320XX4 F

    O320XX5 F

    O320XX9 F

    O321XX0 F

    O321XX9 F

    O322XX0 F

    O322XX1 F

    O322XX3 F

    O322XX4 F

    O322XX5 F

    O322XX9 F

    O323XX0 F

    O323XX1 F

    O323XX2 F

    O323XX3 F

    O323XX5 F

  • O326XX0 F

    O326XX1 F

    O326XX2 F

    O326XX3 F

    O326XX4 F

    O326XX5 F

    O326XX9 F

    O328XX0 F

    O328XX1 F

    O328XX2 F

    O328XX3 F

    O328XX4 F

    O328XX5 F

    O328XX9 F

    O329XX2 F

    O329XX3 F

    O329XX9 F

    O332 F

    O333XX1 F

    O333XX3 F

    O333XX4 F

    O333XX5 F

    O334XX0 F

    O334XX3 F

    O335XX0 F

    O335XX4 F

    O336XX0 F

    O336XX1 F

    O336XX4 F

    O3431 F

    O3432 F

    O3433 F

    O3441 F

    O34523 F

    O34533 F

    O34591 F

    O34592 F

    O3461 F

    O3462 F

    O3463 F

    O3470 F

    O3473 F

    O351XX4 F

    O352XX1 F

    O352XX4 F

    O352XX9 F

    O353XX0 F

    O353XX1 F

    O353XX3 F

    O353XX4 F

    O353XX5 F

    O353XX9 F

  • O354XX2 F

    O354XX5 F

    O355XX2 F

    O355XX3 F

    O355XX5 F

    O356XX2 F

    O358XX1 F

    O358XX5 F

    O359XX1 F

    O359XX2 F

    O359XX4 F

    O359XX5 F

    O360112 F

    O360115 F

    O360121 F

    O360122 F

    O360125 F

    O418X93 F

    O418X94 F

    O418X99 F

    O360132 F

    O360135 F

    O360192 F

    O360195 F

    O360994 F

    O360995 F

    O360999 F

    O361113 F

    O361119 F

    O361121 F

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    O361130 F

    O361133 F

    O3621X4 F

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    O3622X5 F

    O3623X2 F

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    O3623X4 F

    O3623X5 F

    O364XX2 F

    O364XX3 F

    O364XX4 F

    O364XX5 F

    O364XX9 F

    O365110 F

    O365112 F

    O365113 F

    O365119 F

    O365121 F

    O365122 F

    O365124 F

  • O365125 F

    O365130 F

    O365131 F

    O365134 F

    O365139 F

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    O365192 F

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    O365199 F

    O365911 F

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    O365935 F

    O365939 F

    O365991 F

    O365992 F

    O3670X3 F

    O3670X9 F

    O368120 F

    O368121 F

    O368122 F

    O368123 F

    O368124 F

    O368125 F

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    O368130 F

    O368131 F

    O368132 F

    O368133 F

    O368134 F

    O368135 F

    O368139 F

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    O368191 F

    O368192 F

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    O368194 F

    O368195 F

    O368199 F

    O368211 F

    O368212 F

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    O368221 F

  • O368222 F

    O368223 F

    O368224 F

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    O368231 F

    O368232 F

    O3683 F

    O36831 F

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    O368334 F

    O368335 F

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    O368394 F

    O368395 F

    O368910 F

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    O3690X4 F

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    O3693X2 F

    O401XX1 F

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    O409XX0 F

    O409XX2 F

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    O409XX5 F

    O409XX9 F

  • O4100X0 F

    O4100X2 F

    O4100X3 F

    O4100X4 F

    O4100X5 F

    O4100X9 F

    O4101X9 F

    O6013X2 F

    O6014X4 F

    O6014X9 F

    O6020X3 F

    Z30015 F

    Z30016 F

    Z30017 F

    Z3044 F

    Z3045 F

    Z3046 F

    Z317 F

    Z333 F

    O1202 F

    O4102X0 F

    O4102X2 F

    O4102X3 F

    O4102X4 F

    O4102X5 F

    O4102X9 F

    O4103X0 F

    O4103X2 F

    O4103X3 F

    O4103X4 F

    O4103X5 F

    O4103X9 F

    O411012 F

    O411014 F

    O411031 F

    O411034 F

    O411039 F

    O411091 F

    O411092 F

    O411095 F

    O411221 F

    O411222 F

    O411223 F

    O411224 F

    O411225 F

    O411229 F

    O411230 F

    O411232 F

    O411233 F

    O411234 F

    O411235 F

    O411239 F

  • O411291 F

    O411292 F

    O411293 F

    O411294 F

    O411295 F

    O411299 F

    O411410 F

    O411412 F

    O411413 F

    O411414 F

    O411415 F

    O411419 F

    O411420 F

    O411421 F

    O411422 F

    O411423 F

    O411424 F

    O411425 F

    O411429 F

    O411430 F

    O411432 F

    O411434 F

    O411435 F

    O411439 F

    O411490 F

    O411492 F

    O411493 F

    O411494 F

    O411495 F

    O411499 F

    O418X10 F

    O418X11 F

    O418X13 F

    O418X14 F

    O418X19 F

    O418X20 F

    O418X22 F

    O418X23 F

    O418X29 F

    O418X31 F

    O418X32 F

    O418X34 F

    O418X35 F

    O418X91 F

    O4190X1 F

    O4190X2 F

    O4190X4 F

    O4190X5 F

    O4191X1 F

    O4191X3 F

    O4191X5 F

    O4192X2 F

  • O4192X3 F

    O4192X5 F

    O4193X2 F

    O4193X4 F

    O42119 F

    O42911 F

    O42913 F

    O43011 F

    O43013 F

    O43019 F

    O43102 F

    O98113 F

    O98119 F

    O9812 F

    O9813 F

    O98211 F

    O98413 F

    O98419 F

    O9842 F

    O9843 F

    O98511 F

    O98519 F

    O9853 F

    O98611 F

    O98612 F

    O98613 F

    O98619 F

    O9863 F

    O98713 F

    O99111 F

    O99113 F

    O9912 F

    O99210 F

    O99211 F

    O99212 F

    O139 F

    O1400 F

    O1402 F

    O1403 F

    O1410 F

    O1412 F

    O210 F

    O211 F

    O212 F

    O218 F

    O219 F

    N9985 F

    N50811 M

    N50812 M

    N50819 M

    N5082 M

    N5089 M

  • N5235 M

    N5236 M

    N5237 M

    N8300 F

    N8301 F

    N8302 F

    N8310 F

    N8311 F

    N8312 F

    N83201 F

    N83202 F

    N83209 F

    N83291 F

    N83292 F

    N83299 F

    N83311 F

    N83312 F

    N83319 F

    N83321 F

    N83322 F

    N83329 F

    N83331 F

    N83332 F

    N83339 F

    N8340 F

    N8341 F

    N8342 F

    O99215 F

    O99280 F

    O99310 F

    O99311 F

    O99312 F

    O99313 F

    O99213 F

    O99214 F

    O99314 F

    O99315 F

    O99320 F

    O99321 F

    O99322 F

    O99323 F

    O99324 F

    O99325 F

    O24313 F

    O2432 F

    O2433 F

    O24410 F

    O24420 F

    O26853 F

    O26859 F

    O2686 F

    O26872 F

  • O26873 F

    N83511 F

    N83512 F

    N83519 F

    N83521 F

    N83522 F

    N83529 F

    N9060 F

    N9061 F

    N9069 F

    N931 F

    N9410 F

    N9411 F

    N9412 F

    N99115 M

    O0000 F

    O0001 F

    O0010 F

    O0011 F

    O0020 F

    O0021 F

    O0080 F

    O0081 F

    O0090 F

    O0091 F

    O09A0 F

    O09A1 F

    O09A2 F

    O09A3 F

    O114 F

    O115 F

    O1204 F

    O1205 F

    O1214 F

    O1215 F

    O1224 F

    O1225 F

    O134 F

    O1404 F

    O1405 F

    O1414 F

    O1415 F

    O1424 F

    O1425 F

    O1494 F

    O1495 F

    O164 F

    O165 F

    O24415 F

    O24425 F

    O24435 F

    O337XX0 F

  • O337XX1 F

    O337XX2 F

    O337XX3 F

    O337XX4 F

    O337XX5 F

    O337XX9 F

    O34211 F

    O34212 F

    O34219 F

    O4420 F

    O4421 F

    O4422 F

    O4423 F

    O4430 F

    O4431 F

    O4432 F

    O4433 F

    O4440 F

    O4441 F

    O4442 F

    O4443 F

    O4450 F

    O4451 F

    O4452 F

    O4453 F

    O7020 F

    O7021 F

    O7022 F

    O99331 F

    O99332 F

    O99333 F

    O99334 F

    O99335 F

    O99355 F

    O9952 F

    O9962 F

    O9963 F

    O9973 F

    O99814 F

    O99815 F

    O99830 F

    O99844 F

    O99845 F

    O9A111 F

    O9A112 F

    O9A113 F

    O3110X0 F

    O3110X2 F

    O3110X3 F

    O3110X5 F

    O3110X9 F

    O321XX2 F

  • O321XX3 F

    O321XX4 F

    O321XX5 F

    O7023 F

    Q52120 F

    Q52121 F

    Q52122 F

    Q52123 F

    Q52124 F

    Q52129 F

    R9720 M

    R9721 M

    O9A12 F

    O9A13 F

    O9A212 F

    O9A219 F

    O9A22 F

    O9A311 F

    O9A312 F

    O9A313 F

    O9A319 F

    O9A32 F

    O9A33 F

    O9A411 F

    O9A412 F

    O9A413 F

    O9A419 F

    O9A42 F

    O9A43 F

    O9A511 F

    O9A512 F

    O9A513 F

    O9A52 F

    O9A53 F

    O318X31 F

    O318X32 F

    O318X34 F

    O318X35 F

    O318X91 F

    O43819 F

    O43891 F

    O43892 F

    O43893 F

    O43899 F

    O34512 F

    O34521 F

    O34522 F

    O693XX3 F

    O693XX4 F

    O693XX5 F

    O693XX9 F

    O694XX1 F

  • O630 F

    O631 F

    O632 F

    O639 F

    O641XX0 F

    O641XX1 F

    O641XX2 F

    O641XX4 F

    O691XX3 F

    O691XX5 F

    O693XX2 F

    O7589 F

    O759 F

    O82 F

    O85 F

    O860 F

    O8611 F

    O8612 F

    O8613 F

    O8619 F

    O8620 F

    O8621 F

    O8622 F

    O8629 F

    O864 F

    O8681 F

    O8689 F

    O870 F

    O871 F

    O872 F

    O873 F

    O874 F

    O878 F

    O879 F

    O88011 F

    O88012 F

    O88013 F

    O88019 F

    O8803 F

    O88111 F

    O88112 F

    O88113 F

    O88119 F

    O8812 F

    O8813 F

    O88211 F

    O88212 F

    O88213 F

    O88219 F

    O8833 F

    O88811 F

    O88812 F

  • O88813 F

    O88819 F

    O8882 F

    O8883 F

    O891 F

    O893 F

    O896 F

    O899 F

    O900 F

    O901 F

    O903 F

    O904 F

    O905 F

    O906 F

    O9081 F

    O9089 F

    O909 F

    O3671X2 F

    O3671X3 F

    O3672X0 F

    O3672X2 F

    O3672X3 F

    O3673X1 F

    O3673X2 F

    O3680X9 F

    O401XX2 F

    O402XX2 F

    O402XX3 F

    O402XX4 F

    O402XX9 F

    O403XX0 F

    O403XX2 F

    O4101X1 F

    O4101X2 F

    O4101X3 F

    O4101X4 F

    O4101X5 F

    O694XX2 F

    O694XX3 F

    O694XX4 F

    O694XX5 F

    O694XX9 F

    O695XX4 F

    O6981X2 F

    O6981X4 F

    O6981X9 F

    O6982X1 F

    O6982X3 F

    O6982X5 F

    O6989X1 F

    O700 F

    O701 F

  • O702 F

    O703 F

    O709 F

    O7102 F

    O7103 F

    O711 F

    O712 F

    O713 F

    O714 F

    O715 F

    O716 F

    O717 F

    O7181 F

    O7182 F

    O7189 F

    O719 F

    O720 F

    O721 F

    O722 F

    O723 F

    O730 F

    O744 F

    O747 F

    O748 F

    O750 F

    O751 F

    O752 F

    O754 F

    O7581 F

    bschwarcFile Attachment04052020 AZ ICD10 to Gender Policy List.pdf

  • PROCEDURE GENDER

    0003T F

    0009T F

    0021T F

    0031T F

    00402 F

    0046T F

    0047T F

    00855 F

    00857 F

    00865 M

    00869 M

    00842 F

    00846 F

    00850 F

    00851 F

    00946 F

    00948 F

    00950 F

    00952 F

    00955 F

    00906 F

    00908 M

    00914 M

    00920 M

    00921 M

    00922 M

    00924 M

    00926 M

    00928 M

    00930 M

    00932 M

    00934 M

    00936 M

    00938 M

    00940 F

    00942 F

    00944 F

    0102U F

    01900 F

    01967 F

    01968 F

    01969 F

    Arizona Medicaid Procedure

    to Gender Policy List

  • 0193T F

    01958 F

    01960 F

    01961 F

    01962 F

    01963 F

    01964 F

    01965 F

    01966 F

    0336T F

    0421T M

    0443T M

    0478T F

    0567T F

    0568T F

    0582T M

    0500F F

    0501F F

    0503F F

    0404T F

    11975 F

    11976 F

    11977 F

    19324 F

    19325 F

    19110 F

    19112 F

    19357 F

    19361 F

    19140 M

    19364 F

    19366 F

    19367 F

    19368 F

    19369 F

    19300 M

    19396 F

    3015F F

    3294F F

    3323F F

    36460 F

    37788 M

    37790 M

    46744 F

    46746 F

    46748 F

    49510 M

  • 49515 M

    51900 F

    51920 F

    51925 F

    51990 F

    51992 F

    52010 M

    50722 F

    51845 F

    54692 M

    54699 M

    54700 M

    54800 M

    53449 M

    54304 M

    54305 M

    54308 M

    54312 M

    54316 M

    54820 M

    54830 M

    54840 M

    54860 M

    54861 M

    53500 F

    53502 F

    53505 M

    54318 M

    54320 M

    54322 M

    54324 M

    54865 M

    54900 M

    54901 M

    55000 M

    53515 M

    53520 M

    53600 M

    53601 M

    53605 M

    54325 M

    54326 M

    54328 M

    54330 M

    54332 M

    55040 M

    55041 M

  • 55060 M

    55100 M

    52441 M

    52442 M

    52450 M

    53620 M

    53621 M

    53640 M

    53660 F

    54336 M

    54340 M

    54344 M

    54348 M

    55110 M

    55120 M

    55150 M

    55170 M

    55175 M

    52510 M

    52601 M

    52606 M

    53661 F

    53665 F

    54352 M

    54360 M

    54380 M

    54385 M

    55180 M

    55200 M

    55250 M

    55300 M

    52612 M

    52614 M

    52620 M

    52630 M

    53850 M

    53852 M

    53853 M

    53854 M

    53855 M

    54390 M

    54400 M

    54401 M

    54402 M

    54405 M

    55400 M

    55401 M

  • 55450 M

    55500 M

    52640 M

    52647 M

    52648 M

    52649 M

    52650 M

    53860 F

    54000 M

    54001 M

    54406 M

    54407 M

    54408 M

    54409 M

    52700 M

    54015 M

    54050 M

    54055 M

    54056 M

    54410 M

    54411 M

    54415 M

    54416 M

    54417 M

    54057 M

    54060 M

    54065 M

    54100 M

    54105 M

    54420 M

    54430 M

    54435 M

    54437 M

    54438 M

    54440 M

    52270 F

    52275 M

    53060 F

    54110 M

    54111 M

    54112 M

    54115 M

    54450 M

    54500 M

    54505 M

    54506 M

    53210 F

  • 53215 M

    53230 F

    54120 M

    54125 M

    54130 M

    54135 M

    54150 M

    54510 M

    54512 M

    54520 M

    54521 M

    52285 F

    53235 M

    53250 M

    54152 M

    54160 M

    54161 M

    54522 M

    54530 M

    54535 M

    54550 M

    54555 M

    53270 F

    54162 M

    54163 M

    54164 M

    54200 M

    54560 M

    54565 M

    54600 M

    54620 M

    53410 M

    53415 M

    53420 M

    53425 M

    54205 M

    54220 M

    54230 M

    54231 M

    54640 M

    54641 M

    54645 M

    54650 M

    54660 M

    53430 F

    53440 M

    53442 M

  • 54235 M

    54240 M

    54250 M

    54300 M

    54661 M

    54670 M

    54680 M

    54690 M

    53444 M

    58275 F

    58280 F

    58285 F

    58290 F

    58291 F

    56301 F

    56302 F

    56303 F

    56635 F

    56636 F

    56637 F

    56640 F

    57305 F

    57307 F

    57308 F

    57310 F

    58292 F

    58293 F

    58294 F

    58300 F

    56307 F

    56308 F

    56641 F

    56680 F

    56685 F

    56700 F

    57311 F

    57320 F

    57330 F

    57335 F

    58301 F

    58310 F

    58311 F

    58320 F

    56309 F

    56710 F

    56720 F

    56740 F

  • 56800 F

    56805 F

    57400 F

    57410 F

    57415 F

    57420 F

    57421 F

    58321 F

    58322 F

    58323 F

    58340 F

    56810 F

    56820 F

    56821 F

    57000 F

    57423 F

    57425 F

    57426 F

    57450 F

    58345 F

    58346 F

    58350 F

    58353 F

    56318 M

    56320 M

    57010 F

    57020 F

    57022 F

    57023 F

    57451 F

    57452 F

    57454 F

    57455 F

    57050 F

    57057 F

    57060 F

    57061 F

    57063 F

    57456 F

    57460 F

    57461 F

    57500 F

    55520 M

    55530 M

    55535 M

    55540 M

    56343 F

  • 56344 F

    57065 F

    57100 F

    57105 F

    57106 F

    57505 F

    57510 F

    57511 F

    57513 F

    55550 M

    55559 M

    55600 M

    55601 M

    55605 M

    56351 F

    57107 F

    57108 F

    57109 F

    57110 F

    57520 F

    57522 F

    57530 F

    57531 F

    55650 M

    55651 M

    55680 M

    55700 M

    56352 F

    56353 F

    56354 F

    56355 F

    56356 F

    57111 F

    57112 F

    57120 F

    57130 F

    57135 F

    57540 F

    57545 F

    57550 F

    57555 F

    57556 F

    55705 M

    55720 M

    55725 M

    57150 F

    57155 F

  • 57156 F

    57160 F

    57558 F

    57700 F

    55740 M

    55801 M

    55810 M

    55812 M

    55815 M

    56400 F

    56405 F

    56420 F

    57170 F

    57180 F

    57200 F

    57210 F

    57720 F

    57800 F

    57820 F

    58100 F

    55821 M

    55831 M

    55840 M

    55842 M

    56440 F

    56441 F

    56442 F

    57220 F

    57230 F

    57240 F

    57250 F

    58101 F

    58102 F

    58103 F

    55845 M

    55859 M

    55860 M

    55862 M

    55865 M

    56501 F

    57260 F

    57265 F

    57267 F

    57268 F

    57270 F

    58120 F

    58140 F

  • 58145 F

    58146 F

    55866 M

    55870 M

    55873 M

    55874 M

    55875 M

    56515 F

    56600 F

    57280 F

    57282 F

    57283 F

    57284 F

    58150 F

    58152 F

    58180 F

    58200 F

    55876 M

    55899 M

    55970 M

    56605 F

    56606 F

    56620 F

    56625 F

    57285 F

    57287 F

    57288 F

    57289 F

    58210 F

    58240 F

    58260 F

    58262 F

    55980 F

    56000 F

    56100 F

    56200 F

    56630 F

    56631 F

    56632 F

    56633 F

    56634 F

    57291 F

    57292 F

    57296 F

    57300 F

    58263 F

    58265 F

  • 58267 F

    58270 F

    58673 F

    58674 F

    58679 F

    58700 F

    58720 F

    59120 F

    59121 F

    59840 F

    59841 F

    59850 F

    59851 F

    59852 F

    58740 F

    58750 F

    58752 F

    58760 F

    59130 F

    59135 F

    59136 F

    59140 F

    59150 F

    59855 F

    59856 F

    59857 F

    59866 F

    58770 F

    58800 F

    58805 F

    58820 F

    58822 F

    59870 F

    59871 F

    59897 F

    59898 F

    58823 F

    58825 F

    58900 F

    58920 F

    59151 F

    59160 F

    59200 F

    59300 F

    59899 F

    58925 F

    58940 F

  • 58943 F

    59305 F

    59320 F

    59325 F

    59350 F

    58950 F

    58951 F

    58952 F

    58953 F

    59351 F

    59400 F

    59409 F

    59410 F

    58954 F

    58956 F

    58957 F

    58958 F

    59412 F

    59414 F

    59420 F

    58540 F

    58541 F

    58542 F

    58543 F

    58960 F

    58970 F

    58972 F

    58974 F

    59425 F

    59426 F

    59430 F

    59500 F

    58544 F

    58545 F

    58546 F

    58548 F

    58550 F

    58976 F

    58982 F

    58983 F

    58984 F

    59501 F

    59510 F

    59514 F

    58551 F

    58552 F

    58553 F

  • 58554 F

    58985 F

    58986 F

    58987 F

    58988 F

    59515 F

    59520 F

    59521 F

    59525 F

    58555 F

    58558 F

    58559 F

    58560 F

    58990 F

    58992 F

    58994 F

    58995 F

    59560 F

    59561 F

    58561 F

    58562 F

    58563 F

    58996 F

    58999 F

    59000 F

    59001 F

    59010 F

    59580 F

    59581 F

    59610 F

    59612 F

    58570 F

    58571 F

    58572 F

    59011 F

    59012 F

    59015 F

    59020 F

    59614 F

    59618 F

    59620 F

    59622 F

    58575 F

    58578 F

    58579 F

    58600 F

    58605 F

  • 58611 F

    59025 F

    59030 F

    59050 F

    59800 F

    59801 F

    59810 F

    59811 F

    59812 F

    58615 F

    58660 F

    58661 F

    59051 F

    59070 F

    59072 F

    59074 F

    59820 F

    59821 F

    59830 F

    58662 F

    58670 F

    58671 F

    58672 F

    59076 F

    59100 F

    59101 F

    59105 F

    59106 F

    58400 F

    58410 F

    58520 F

    74440 M

    74445 M

    74446 M

    74710 F

    74712 F

    74713 F

    74725 F

    74740 F

    74741 F

    74742 F

    77052 F

    77057 F

    76801 F

    76802 F

    76805 F

    76810 F

  • 76811 F

    76812 F

    76813 F

    76814 F

    76815 F

    76816 F

    76817 F

    76818 F

    76083 F

    76085 F

    76086 F

    76088 F

    76819 F

    76820 F

    76821 F

    76825 F

    76826 F

    76827 F

    76092 F

    76828 F

    76830 F

    76831 F

    76870 M

    76873 M

    76941 F

    76945 F

    76946 F

    76947 F

    76948 F

    80055 F

    80057 M

    78760 M

    78761 M

    81266 F

    80426 F

    81500 F

    81503 F

    81508 F

    81509 F

    81511 F

    81512 F

    81542 M

    80080 M

    81025 F

    80414 M

    80415 F

    80068 F

  • 82106 F

    82120 F

    82143 F

    82731 F

    82757 M

    82677 F

    83661 F

    83662 F

    83663 F

    83664 F

    83950 F

    84065 M

    84066 M

    84830 F

    84135 F

    84136 F

    84138 F

    84139 F

    84152 M

    84153 M

    84154 M

    84163 F

    85461 F

    86305 F

    86336 F

    89310 M

    89320 M

    89321 M

    88165 F

    88166 F

    88167 F

    89322 M

    89325 M

    89329 M

    89331 M

    89335 M

    89337 F

    89342 F

    89343 M

    89346 F

    89352 F

    89353 F

    88235 F

    88141 F

    88142 F

    88143 F

    88144 F

  • 88145 F

    88147 F

    88148 F

    88150 F

    88151 F

    88152 F

    88153 F

    88269 F

    88154 F

    88155 F

    88156 F

    89264 M

    89268 F

    88157 F

    89272 F

    89281 F

    88164 F

    89290 F

    89291 F

    89300 M

    90384 F

    90385 F

    90386 F

    89356 F

    93980 M

    93981 M

    98912 F

    99500 F

    99501 F

    99553 F

    A4326 M

    A4327 F

    A4328 F

    A4470 F

    A4480 F

    A4348 M

    A4561 F

    A4562 F

    A4563 F

    A4260 F

    A4261 F

    A4264 F

    A4266 F

    A4267 M

    A4268 F

    A4269 F

    A4280 F

  • A4281 F

    A4282 F

    A4283 F

    A4284 F

    A4285 F

    A4286 F

    A9507 M

    C2622 M

    C1789 F

    C1813 M

    C9736 F

    C9739 M

    C9740 M

    C9747 M

    C9748 M

    C9713 M

    C9714 F

    C9273 M

    C9276 M

    C9715 F

    E0325 M

    E0326 F

    C9023 M

    C9055 F

    E0602 F

    E0603 F

    E0604 F

    G0027 M

    G0123 F

    G0124 F

    G0141 F

    G0143 F

    G0144 F

    G0145 F

    G0147 F

    G0148 F

    G0101 F

    G0102 M

    G0103 M

    G0416 M

    G0417 M

    G0418 M

    G0419 M

    G0236 F

    G0256 M

    G0261 M

    G0458 M

  • G0202 F

    G8051 F

    G8052 F

    G8053 F

    G8107 F

    G8111 F

    G8112 F

    G8113 F

    G8114 F

    G8116 F

    G8117 F

    G8802 F

    G8803 F

    G8805 F

    G8806 F

    G8807 F

    G8808 F

    G8809 F

    G8810 F

    G8811 F

    G8822 M

    G8823 F

    G8824 F

    G8827 F

    G8828 M

    G8829 M

    G8830 M

    G8831 F

    G8832 F

    H1000 F

    H1001 F

    H1002 F

    H1003 F

    H1004 F

    H1005 F

    J0128 M

    G9113 F

    G9114 F

    G9115 F

    G9116 F

    G9117 F

    J0270 M

    J0275 M

    G9126 F

    G9071 F

    G9072 F

    G9074 F

  • G9075 F

    G9076 F

    G9077 M

    G9078 M

    G9079 M

    G9081 M

    G9082 M

    G9083 M

    G9361 F

    J1056 F

    J7296 F

    J7297 F

    J7298 F

    J7300 F

    J1640 F

    J7301 F

    J7302 F

    J7303 F

    J7306 F

    J7307 F

    J2788 F

    J1725 F

    J1726 F

    J1729 F

    K0410 M

    K0411 M

    J9175 M

    L3215 F

    L3216 F

    L3217 F

    L3219 M

    L3221 M

    L3222 M

    L3224 F

    L3225 M

    L8330 M

    L8600 F

    M1016 F

    L7900 M

    L7902 M

    L8000 F

    L8001 F

    L8002 F

    L8010 F

    L8015 F

    L8020 F

    L8030 F

  • L8035 F

    Q0090 F

    Q0091 F

    Q0111 F

    Q0114 F

    Q0115 F

    P3000 F

    P3001 F

    Q0187 M

    Q9984 F

    Q9985 F

    Q9986 F

    S4005 F

    S4011 F

    S4013 F

    S4014 F

    S4015 F

    S2260 F

    S2262 F

    S2265 F

    S2266 F

    S2267 F

    S4016 F

    S4017 F

    S4018 F

    S4020 F

    S4021 F

    S4022 F

    S0610 F

    S0612 F

    S2270 F

    S4023 F

    S4027 F

    S4028 M

    S4030 M

    S4031 M

    S4035 F

    S4036 F

    S2400 F

    S2401 F

    S2402 F

    S4981 F

    S4989 F

    S4993 F

    S2403 F

    S2404 F

    S2405 F

  • S2409 F

    S2411 F

    S0180 F

    S0190 F

    S0191 F

    S2066 F

    S2067 F

    S2068 F

    S3626 F

    S3628 F

    S0199 F

    S2078 F

    S3650 F

    S3652 F

    S3655 F

    S3721 M

    S3820 F

    S3822 F

    S3823 F

    S2250 F

    S9442 F

    S9443 F

    S8055 F

    S9208 F

    S9209 F

    S9211 F

    S9212 F

    S9213 F

    S9214 F

    S8415 F

    S9349 F

    T4545 M

    0032T F

    bschwarcFile Attachment04052020 AZ Medicaid Procedure to Gender Policy List.pdf

  • REIMBURSEMENT POLICY

    CMS-1500 Policy Number 2020R7121B

    Proprietary information of UnitedHealthcare Community Plan. Copyright 2020 United HealthCare Services, Inc. 2020R7121B

    Kansas Medicaid ICD-10 to Gender Policy List

    ICD-10 codes with designated appropriate gender for Kansas Medicaid.

    Missouri Medicaid ICD-10 to Gender Policy List

    ICD-10 codes with designated inappropriate gender for Missouri Medicaid.

    Missouri Medicaid Procedure to Gender Policy List

    CPT codes with designated inappropriate gender for Missouri Medicaid

    Resources

    Individual state Medicaid regulations, manuals & fee schedules

    American Medical Association, Current Procedural Terminology ( CPT® ) Professional Edition and associated publications and services

    Centers for Medicare and Medicaid Services, CMS Manual System and other CMS publications and services

    Centers for Medicare and Medicaid Services, Healthcare Common Procedure Coding System, HCPCS Release and Code Sets

    History

    4/5/2020 AZ CPT and DX lists updated History Section: Entries prior to 4/5/2018 archived

    2/24/2020 Missouri Medicaid CPT Gender List updated

    12/6/2019 Annual Approval Date Change (No new version)

    9/29/2019 Title Section: Updated to Gender to Diagnosis Code & Procedure Code Policy Application Section: Updated to include Kansas Attachments Section: Kansas Medicaid ICD-10 to Gender List added

    8/6/2019 Arizona Medicaid ICD-10 to Gender List updated

    1/13/2019 Arizona Medicaid CPT Gender List updated

    5/19/2008 Age & Gender to Diagnosis & Procedure Codes Policy implementation by UnitedHealthcare Community Plan

  • Kansas Medicaid ICD10 to Gender Policy List

    Diagnosis Code Allowed Gender

    A18.14 M

    A18.15 M

    A18.16 F

    A18.17 F

    A18.18 F

    A34 F

    A51.42 F

    A54.02 F

    A54.03 F

    A54.22 M

    A54.23 M

    A54.24 F

    A56.02 F

    A56.11 F

    A59.01 F

    A59.02 M

    A60.01 M

    A60.02 M

    A60.03 F

    A60.04 F

    B26.0 M

    B37.3 F

    B38.81 M

    C50.011 F

    C50.012 F

    C50.019 F

    C50.021 M

    C50.022 M

    C50.029 M

    C50.111 F

    C50.112 F

    C50.119 F

    C50.121 M

    C50.122 M

    C50.129 M

    C50.211 F

    C50.212 F

    C50.219 F

    C50.221 M

    C50.222 M

    C50.229 M

    C50.311 F

    C50.312 F

    C50.319 F

    C50.321 M

    C50.322 M

    C50.329 M

    C50.411 F

    C50.412 F

    C50.419 F

  • C50.421 M

    C50.422 M

    C50.429 M

    C50.511 F

    C50.512 F

    C50.519 F

    C50.521 M

    C50.522 M

    C50.529 M

    C50.611 F

    C50.612 F

    C50.619 F

    C50.621 M

    C50.622 M

    C50.629 M

    C50.811 F

    C50.812 F

    C50.819 F

    C50.821 M

    C50.822 M

    C50.829 M

    C50.911 F

    C50.912 F

    C50.919 F

    C50.921 M

    C50.922 M

    C50.929 M

    C51.0 F

    C51.1 F

    C51.2 F

    C51.8 F

    C51.9 F

    C52 F

    C53.0 F

    C53.1 F

    C53.8 F

    C53.9 F

    C54.0 F

    C54.1 F

    C54.2 F

    C54.3 F

    C54.8 F

    C54.9 F

    C55 F

    C56.1 F

    C56.2 F

    C56.9 F

    C57.00 F

    C57.01 F

    C57.02 F

    C57.10 F

    C57.11 F

  • C57.12 F

    C57.20 F

    C57.21 F

    C57.22 F

    C57.3 F

    C57.4 F

    C57.7 F

    C57.8 F

    C57.9 F

    C58 F

    C60.0 M

    C60.1 M

    C60.2 M

    C60.8 M

    C60.9 M

    C61 M

    C62.00 M

    C62.01 M

    C62.02 M

    C62.10 M

    C62.11 M

    C62.12 M

    C62.90 M

    C62.91 M

    C62.92 M

    C63.00 M

    C63.01 M

    C63.02 M

    C63.10 M

    C63.11 M

    C63.12 M

    C63.2 M

    C63.7 M

    C63.8 M

    C63.9 M

    C79.60 F

    C79.61 F

    C79.62 F

    D06.0 F

    D06.1 F

    D06.7 F

    D06.9 F

    D07.0 F

    D07.1 F

    D07.2 F

    D07.30 F

    D07.39 F

    D07.4 M

    D07.5 M

    D07.60 M

    D07.61 M

    D07.69 M

  • D17.6 M

    D25.0 F

    D25.1 F

    D25.2 F

    D25.9 F

    D26.0 F

    D26.1 F

    D26.7 F

    D26.9 F

    D27.0 F

    D27.1 F

    D27.9 F

    D28.0 F

    D28.1 F

    D28.2 F

    D28.7 F

    D28.9 F

    D29.0 M

    D29.1 M

    D29.20 M

    D29.21 M

    D29.22 M

    D29.30 M

    D29.31 M

    D29.32 M

    D29.4 M

    D29.8 M

    D29.9 M

    D39.0 F

    D39.10 F

    D39.11 F

    D39.12 F

    D39.2 F

    D39.8 F

    D39.9 F

    D40.0 M

    D40.10 M

    D40.11 M

    D40.12 M

    D40.8 M

    D40.9 M

    E28.0 F

    E28.1 F

    E28.2 F

    E28.310 F

    E28.319 F

    E28.39 F

    E28.8 F

    E28.9 F

    E29.0 M

    E29.1 M

    E29.8 M

  • E29.9 M

    E89.40 F

    E89.41 F

    E89.5 M

    F32.81 F

    F52.21 M

    F52.22 F

    F52.31 F

    F52.32 M

    F52.4 M

    F52.5 F

    F52.6 F

    F53.0 F

    F53.1 F

    G43.821 F

    G43.829 F

    G43.831 F

    G43.839 F

    I86.1 M

    I86.3 F

    J84.81 F

    L29.1 M

    L29.2 F

    M83.0 F

    N35.010 M

    N35.014 M

    N35.016 M

    N35.021 F

    N35.028 F

    N35.111 M

    N35.116 M

    N35.119 M

    N35.12 F

    N35.811 M

    N35.812 M

    N35.813 M

    N35.814 M

    N35.816 M

    N35.819 M

    N35.82 F

    N35.911 M

    N35.912 M

    N35.913 M

    N35.914 M

    N35.916 M

    N35.919 M

    N35.92 F

    N40.0 M

    N40.1 M

    N40.2 M

    N40.3 M

    N41.0 M

  • N41.1 M

    N41.2 M

    N41.3 M

    N41.4 M

    N41.8 M

    N41.9 M

    N42.0 M

    N42.1 M

    N42.30 M

    N42.31 M

    N42.32 M

    N42.39 M

    N42.81 M

    N42.82 M

    N42.83 M

    N42.89 M

    N42.9 M

    N43.0 M

    N43.1 M

    N43.2 M

    N43.3 M

    N43.40 M

    N43.41 M

    N43.42 M

    N44.00 M

    N44.01 M

    N44.02 M

    N44.03 M

    N44.04 M

    N44.1 M

    N44.2 M

    N44.8 M

    N45.1 M

    N45.2 M

    N45.3 M

    N45.4 M

    N46.01 M

    N46.021 M

    N46.022 M

    N46.023 M

    N46.024 M

    N46.025 M

    N46.029 M

    N46.11 M

    N46.121 M

    N46.122 M

    N46.123 M

    N46.124 M

    N46.125 M

    N46.129 M

    N46.8 M

    N46.9 M

  • N47.0 M

    N47.1 M

    N47.2 M

    N47.3 M

    N47.4 M

    N47.5 M

    N47.6 M

    N47.7 M

    N47.8 M

    N48.0 M

    N48.1 M

    N48.21 M

    N48.22 M

    N48.29 M

    N48.30 M

    N48.31 M

    N48.32 M

    N48.33 M

    N48.39 M

    N48.5 M

    N48.6 M

    N48.81 M

    N48.82 M

    N48.83 M

    N48.89 M

    N48.9 M

    N49.0 M

    N49.1 M

    N49.2 M

    N49.3 M

    N49.8 M

    N49.9 M

    N50.0 M

    N50.1 M

    N50.3 M

    N50.811 M

    N50.812 M

    N50.819 M

    N50.82 M

    N50.89 M

    N50.9 M

    N51 M

    N52.01 M

    N52.02 M

    N52.03 M

    N52.1 M

    N52.2 M

    N52.31 M

    N52.32 M

    N52.33 M

    N52.34 M

    N52.35 M

  • N52.36 M

    N52.37 M

    N52.39 M

    N52.8 M

    N52.9 M

    N53.11 M

    N53.12 M

    N53.13 M

    N53.14 M

    N53.19 M

    N53.8 M

    N53.9 M

    N70.01 F

    N70.02 F

    N70.03 F

    N70.11 F

    N70.12 F

    N70.13 F

    N70.91 F

    N70.92 F

    N70.93 F

    N71.0 F

    N71.1 F

    N71.9 F

    N72 F

    N73.0 F

    N73.1 F

    N73.2 F

    N73.3 F

    N73.4 F

    N73.5 F

    N73.6 F

    N73.8 F

    N73.9 F

    N74 F

    N75.0 F

    N75.1 F

    N75.8 F

    N75.9 F

    N76.0 F

    N76.1 F

    N76.2 F

    N76.3 F

    N76.4 F

    N76.5 F

    N76.6 F

    N76.81 F

    N76.89 F

    N77.0 F

    N77.1 F

    N80.0 F

    N80.1 F

  • N80.2 F

    N80.3 F

    N80.4 F

    N80.5 F

    N80.6 F

    N80.8 F

    N80.9 F

    N81.0 F

    N81.10 F

    N81.11 F

    N81.12 F

    N81.2 F

    N81.3 F

    N81.4 F

    N81.5 F

    N81.6 F

    N81.81 F

    N81.82 F

    N81.83 F

    N81.84 F

    N81.85 F

    N81.89 F

    N81.9 F

    N82.0 F

    N82.1 F

    N82.2 F

    N82.3 F

    N82.4 F

    N82.5 F

    N82.8 F

    N82.9 F

    N83.00 F

    N83.01 F

    N83.02 F

    N83.10 F

    N83.11 F

    N83.12 F

    N83.201 F

    N83.202 F

    N83.209 F

    N83.291 F

    N83.292 F

    N83.299 F

    N83.311 F

    N83.312 F

    N83.319 F

    N83.321 F

    N83.322 F

    N83.329 F

    N83.331 F

    N83.332 F

    N83.339 F

  • N83.40 F

    N83.41 F

    N83.42 F

    N83.511 F

    N83.512 F

    N83.519 F

    N83.521 F

    N83.522 F

    N83.529 F

    N83.53 F

    N83.6 F

    N83.7 F

    N83.8 F

    N83.9 F

    N84.0 F

    N84.1 F

    N84.2 F

    N84.3 F

    N84.8 F

    N84.9 F

    N85.00 F

    N85.01 F

    N85.02 F

    N85.2 F

    N85.3 F

    N85.4 F

    N85.5 F

    N85.6 F

    N85.7 F

    N85.8 F

    N85.9 F

    N86 F

    N87.0 F

    N87.1 F

    N87.9 F

    N88.0 F

    N88.1 F

    N88.2 F

    N88.3 F

    N88.4 F

    N88.8 F

    N88.9 F

    N89.0 F

    N89.1 F

    N89.3 F

    N89.4 F

    N89.5 F

    N89.6 F

    N89.7 F

    N89.8 F

    N89.9 F

    N90.0 F

  • N90.1 F

    N90.3 F

    N90.4 F

    N90.5 F

    N90.60 F

    N90.61 F

    N90.69 F

    N90.7 F

    N90.810 F

    N90.811 F

    N90.812 F

    N90.813 F

    N90.818 F

    N90.89 F

    N90.9 F

    N91.0 F

    N91.1 F

    N91.2 F

    N91.3 F

    N91.4 F

    N91.5 F

    N92.0 F

    N92.1 F

    N92.2 F

    N92.3 F

    N92.4 F

    N92.5 F

    N92.6 F

    N93.0 F

    N93.1 F

    N93.8 F

    N93.9 F

    N94.0 F

    N94.10 F

    N94.11 F

    N94.12 F

    N94.19 F

    N94.2 F

    N94.3 F

    N94.4 F

    N94.5 F

    N94.6 F

    N94.810 F

    N94.818 F

    N94.819 F

    N94.89 F

    N94.9 F

    N95.0 F

    N95.1 F

    N95.2 F

    N95.8 F

    N95.9 F

  • N96 F

    N97.0 F

    N97.1 F

    N97.2 F

    N97.8 F

    N97.9 F

    N98.0 F

    N98.1 F

    N98.2 F

    N98.3 F

    N98.8 F

    N98.9 F

    N99.110 M

    N99.114 M

    N99.116 M

    N99.12 F

    N99.2 F

    N99.3 F

    N99.83 F

    N99.89 F

    O00.00 F

    O00.01 F

    O00.101 F

    O00.102 F

    O00.109 F

    O00.111 F

    O00.112 F

    O00.119 F

    O00.201 F

    O00.202 F

    O00.209 F

    O00.211 F

    O00.212 F

    O00.219 F

    O00.80 F

    O00.81 F

    O00.90 F

    O00.91 F

    O01.0 F

    O01.1 F

    O01.9 F

    O02.0 F

    O02.1 F

    O02.81 F

    O02.89 F

    O02.9 F

    O03.0 F

    O03.1 F

    O03.2 F

    O03.30 F

    O03.31 F

    O03.32 F

  • O03.33 F

    O03.34 F

    O03.35 F

    O03.36 F

    O03.37 F

    O03.38 F

    O03.39 F

    O03.4 F

    O03.5 F

    O03.6 F

    O03.7 F

    O03.80 F

    O03.81 F

    O03.82 F

    O03.83 F

    O03.84 F

    O03.85 F

    O03.86 F

    O03.87 F

    O03.88 F

    O03.89 F

    O03.9 F

    O04.5 F

    O04.6 F

    O04.7 F

    O04.80 F

    O04.81 F

    O04.82 F

    O04.83 F

    O04.84 F

    O04.85 F

    O04.86 F

    O04.87 F

    O04.88 F

    O04.89 F

    O07.0 F

    O07.1 F

    O07.2 F

    O07.30 F

    O07.31 F

    O07.32 F

    O07.33 F

    O07.34 F

    O07.35 F

    O07.36 F

    O07.37 F

    O07.38 F

    O07.39 F

    O07.4 F

    O08.0 F

    O08.1 F

    O08.2 F

  • O08.3 F

    O08.4 F

    O08.5 F

    O08.6 F

    O08.7 F

    O08.81 F

    O08.82 F

    O08.83 F

    O08.89 F

    O08.9 F

    O09.00 F

    O09.01 F

    O09.02 F

    O09.03 F

    O09.10 F

    O09.11 F

    O09.12 F

    O09.13 F

    O09.211 F

    O09.212 F

    O09.213 F

    O09.219 F

    O09.291 F

    O09.292 F

    O09.293 F

    O09.299 F

    O09.30 F

    O09.31 F

    O09.32 F

    O09.33 F

    O09.40 F

    O09.41 F

    O09.42 F

    O09.43 F

    O09.511 F

    O09.512 F

    O09.513 F

    O09.519 F

    O09.521 F

    O09.522 F

    O09.523 F

    O09.529 F

    O09.611 F

    O09.612 F

    O09.613 F

    O09.619 F

    O09.621 F

    O09.622 F

    O09.623 F

    O09.629 F

    O09.70 F

    O09.71 F

  • O09.72 F

    O09.73 F

    O09.811 F

    O09.812 F

    O09.813 F

    O09.819 F

    O09.821 F

    O09.822 F

    O09.823 F

    O09.829 F

    O09.891 F

    O09.892 F

    O09.893 F

    O09.899 F

    O09.90 F

    O09.91 F

    O09.92 F

    O09.93 F

    O09.A0 F

    O09.A1 F

    O09.A2 F

    O09.A3 F

    O10.011 F

    O10.012 F

    O10.013 F

    O10.019 F

    O10.02 F

    O10.03 F

    O10.111 F

    O10.112 F

    O10.113 F

    O10.119 F

    O10.12 F

    O10.13 F

    O10.211 F

    O10.212 F

    O10.213 F

    O10.219 F

    O10.22 F

    O10.23 F

    O10.311 F

    O10.312 F

    O10.313 F

    O10.319 F

    O10.32 F

    O10.33


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