Family Practice Superbill – Fill Out and Use This PDF

Infectious & Parasitic Diseases

B00.9 Herpesviral infection, unspecified

A60.9 Anogenital herpesviral infection

B02.9 Zoster without complications

B27.00 Gammaherpesviral mononucleosis without complication

B27.01 Gammaherpesviral mononucleosis with polyneuropathy

B27.02 Gammaherpesviral mononucleosis with meningitis

B27.09 Gammaherpesviral mononucleosis with other complications

B27.10 Cytomegaloviral mononucleosis without complications

B27.11 Cytomegaloviral mononucleosis with polyneuropathy

B27.12 Cytomegaloviral mononucleosis with meningitis

B27.19 Cytomegaloviral mononucleosis with other complication

B27.80 Other infectious mononucleosis without complication

B27.81 Other infectious mononucleosis with polyneuropathy

B27.82 Other infectious mononucleosis with meningitis

B27.89 Other infectious mononucleosis with other complication

B27.90 Infectious mononucleosis, unspecified without complication

B27.91 Infectious mononucleosis, unspecified with polyneuropathy

B27.92 Infectious mononucleosis, unspecified with meningitis

B27.99 Infectious mononucleosis, unspecified with other complication

J02.0 Streptococcal pharyngitis

J03.00 Acute streptococcal tonsillitis, unspecified

J03.01 Acute recurrent streptococcal tonsillitis

J02.0 Streptococcal sore throat

B97.8 Other viral agents as the cause of diseases classified elsewhere

B07 Viral warts

Neoplasms Benign Neoplasms

D49.2 Neoplasm of unspecified behavior of bone, soft tissue, and skin

D23.9 Other benign neoplasm of skin, unspecified

Endocrine, Nutritional & Metabolic Disorders

Endocrine

E10.8 Type 1 diabetes mellitus with unspecified complications

E10.9 Type 1 diabetes mellitus without complications

E11.8 Type 2 diabetes mellitus with unspecified complications

E11.9 Type 2 diabetes mellitus without complications

E05.90 Thyrotoxicosis, unspecified without thyrotoxic crisis or storm

E03.9 Hypothyroidism, unspecified

Metabolic/Other

Mental Disorders

F41.9 Anxiety disorder, unspecified

F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type

F90.9 Attention-deficit hyperactivity disorder, unspecified type

F03 Unspecified dementia

F33.9 Major depressive disorder, recurrent, unspecified

Nervous System & Sense Organ Disorders

Nervous System Diseases

G56.00 Carpal tunnel syndrome, unspecified side

G56.01 Carpal tunnel syndrome, right side

G56.02 Carpal tunnel syndrome, left side

G40.90 Epilepsy, unspecified, not intractable

G40.901 Epilepsy, unspecified, not intractable, with status epilepticus

G40.909 Epilepsy, unspecified, not intractable, without status epilepticus

G43.90 Migraine, unspecified, not intractable

G44.039 Episodic paroxysmal hemicrania, not intractable Episodic paroxysmal hemicrania NOS

G44.049 Chronic paroxysmal hemicrania, not intractable Chronic paroxysmal hemicrania NOS

Eye Diseases

H10.9 Unspecified conjunctivitis

H53.10 Unspecified subjective visual disturbances

H53.11 Day blindness

Ear Diseases

H61.20 Impacted cerumen, unspecified ear

H61.21 Impacted cerumen, right ear

H61.22 Impacted cerumen, left ear

H61.23 Impacted cerumen, bilateral

H60.00 Abscess of external ear, unspecified ear

H60.01 Abscess of right external ear

H60.02 Abscess of left external ear

H60.03 Abscess of external ear, bilateral

H60.10 Cellulitis of external ear, unspecified ear

H60.11 Cellulitis of right external ear

H60.12 Cellulitis of left external ear

H60.13 Cellulitis of external ear, bilateral

H60.311 Diffuse otitis externa, right ear

H60.312 Diffuse otitis externa, left ear

H60.313 Diffuse otitis externa, bilateral

H60.319 Diffuse otitis externa, unspecified ear

H60.32 Hemorrhagic otitis externa

H60.321 Hemorrhagic otitis externa, right ear

H60.322 Hemorrhagic otitis externa, left ear

H60.323 Hemorrhagic otitis externa, bilateral

H60.329 Hemorrhagic otitis externa, unspecified ear

H60.391 Other infective otitis externa, right ear

H60.392 Other infective otitis externa, left ear

H60.393 Other infective otitis externa, bilateral

H60.399 Other infective otitis externa, unspecified ear

H66.001 Acute suppurative otitis media without spontaneous rupture of ear drum, right ear

H66.002 Acute suppurative otitis media without spontaneous rupture of ear drum, left ear

H66.003 Acute suppurative otitis media without spontaneous rupture of ear drum, bilateral

H66.004 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, right ear

H66.005 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, left ear

H66.006 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, bilateral

H66.007 Acute suppurative otitis media without spontaneous rupture of ear drum, recurrent, unspecified ear

H66.009 Acute suppurative otitis media without spontaneous rupture of ear drum, unspecified ear

Circulatory System

Arrythmias

I48.0 Atrial fibrillation

Cardiac

I20.8 Other forms of angina pectoris

I20.9 Angina pectoris, unspecified

I25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm

I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm

I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris

I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris

I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris

I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris

I25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm

I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris

I25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris

I25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm

I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris

I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris

I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm

I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris

I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris

I25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm

I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris

I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris

I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm

I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris

I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris

I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm

I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris

I25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris

I50.9 Heart failure, unspecified

I35.0 Nonrheumatic aortic (valve) stenosis

I35.1 Nonrheumatic aortic (valve) insufficiency

I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency

I35.8 Other nonrheumatic aortic valve disorders

I35.9 Nonrheumatic aortic valve disorder, unspecified

I39 Endocarditis and heart valve disorders in diseases classified elsewhere

I25.9 Chronic ischemic heart disease, unspecified

Vascular

R03.0 Elevated blood-pressure reading, without diagnosis of hypertension

I10 Essential (primary) hypertension

I95.1 Orthostatic hypotension

I73.9 Peripheral vascular disease, unspecified

I80.9 Phlebitis and thrombophlebitis of unspecified site

I87.2 Venous insufficiency (chronic) (peripheral)

I87.9 Disorder of vein, unspecified

Respiratory System

Lower Respiratory Tract

Upper Respiratory Tract

J02.8 Acute pharyngitis due to other specified organisms

J02.9 Acute pharyngitis, unspecified

J30.0 Vasomotor rhinitis

J30.9 Allergic rhinitis, unspecified

J01.90 Acute sinusitis, unspecified

J01.91 Acute recurrent sinusitis, unspecified

J01.80 Other acute sinusitis

J01.81 Other acute recurrent sinusitis

J06.9 Acute upper respiratory infection, unspecified

Digestive System

Genitourinary System Urinary System Diseases

N20.2 Calculus of kidney with calculus of ureter

N20.9 Urinary calculus, unspecified

N30.00 Acute cystitis without hematuria

N30.01 Acute cystitis with hematuria

R31.0 Gross hematuria

R31.1 Benign essential microscopic hematuria

R31.2 Other microscopic hematuria

R31.9 Hematuria, unspecified

N28.9 Disorder of kidney and ureter, unspecified

N29 Other disorders of kidney and ureter in diseases classified elsewhere

N39.0 Urinary tract infection, site not specified

Male Genital Organ Diseases

N52.01 Erectile dysfunction due to arterial insufficiency

N52.02 Corporo-venous occlusive erectile dysfunction

N52.03 Combined arterial insufficiency and corporo-venous occlusive erectile dysfunction

N52.1 Erectile dysfunction due to diseases classified elsewhere

N52.2 Drug-induced erectile dysfunction

N52.31 Erectile dysfunction following radical prostatectomy

N52.32 Erectile dysfunction following radical cystectomy

N52.33 Erectile dysfunction following urethral surgery

N52.34 Erectile dysfunction following simple prostatectomy

N52.39 Other post-surgical erectile dysfunction

N53.8 Other male sexual dysfunction

N53.9 Unspecified male sexual dysfunction

F52.21 Male erectile disorder

N41.9 Inflammatory disease of prostate, unspecified

Breast Diseases

N63 Unspecified lump in breast

Female Genital Organ Diseases

Z87.44 Personal history of cervical dysplasia

N72 Inflammatory disease of cervix uteri

N87.9 Dysplasia of cervix uteri, unspecified

N76.0 Acute vaginitis

N76.1 Subacute and chronic vaginitis

N76.2 Acute vulvitis

N76.3 Subacute and chronic vulvitis

N76.4 Abscess of vulva

Disorders of Menstruation

N91.0 Primary amenorrhea

N91.1 Secondary amenorrhea

N91.2 Amenorrhea, unspecified

N95.9 Unspecified menopausal and perimenopausal disorder

N92.0 Excessive and frequent menstruation with regular cycle

N92.1 Excessive and frequent menstruation with irregular cycle

N94.4 Primary dysmenorrhea

N94.5 Secondary dysmenorrhea

N94.6 Dysmenorrhea, unspecified

N92.1 Excessive and frequent menstruation with irregular cycle

Pregnancy, Childbirth

O46.90 Antepartum hemorrhage, unspecified, unspecified trimester

Z39.2 Encounter for routine postpartum follow-up

Z33.1 Pregnant state, incidental

Z34.00 Encounter for supervision of normal first pregnancy, unspecified trimester

Z34.01 Encounter for supervision of normal first pregnancy, unspecified trimester

Z34.02 Encounter for supervision of normal first pregnancy, second trimester

Z34.03 Encounter for supervision of normal first pregnancy, third trimester

V22.1 Prenatal care, normal, other pregnancy

Z34.80 Encounter for supervision of other normal pregnancy, unspecified trimester

Z34.81 Encounter for supervision of other normal pregnancy, first trimester

Z34.82 Encounter for supervision of other normal pregnancy, second trimester

Z34.83 Encounter for supervision of other normal pregnancy, third trimester

Z34.90 Encounter for supervision of normal pregnancy, unspecified, unspecified trimester

Z34.91 Encounter for supervision of normal pregnancy, unspecified, first trimester

Z34.92 Encounter for supervision of normal pregnancy, unspecified, second trimester

Z34.93 Encounter for supervision of normal pregnancy, unspecified, third trimester

Skin, Subcutaneous Tissue

L70.0 Acne vulgaris

L70.1 Acne conglobata

L70.3 Acne tropica

L70.4 Infantile acne

L70.5 Acné excoriée des jeunes filles

L70.8 Other acne

L70.9 Acne, unspecified

L73.0 Acne keloid

L57.0 Actinic keratosis

L03.90 Cellulitis, unspecified

L03.91 Acute lymphangitis, unspecified

L03.129 Acute lymphangitis of unspecified part of limb

L03.119 Cellulitis of unspecified part of limb

L98.3 Eosinophilic cellulitis [Wells]

L23.9 Allergic contact dermatitis, unspecified cause

L24.9 Irritant contact dermatitis, unspecified cause

L25.9 Unspecified contact dermatitis, unspecified cause

L30.0 Nummular dermatitis

L30.2 Cutaneous autosensitization

L30.8 Other specified dermatitis

L30.9 Dermatitis, unspecified

L20.8 Other atopic dermatitis

L20.81 Atopic neurodermatitis

L20.82 Flexural eczema

L20.83 Infantile (acute) (chronic) eczema

L20.84 Intrinsic (allergic) eczema

L20.89 Other atopic dermatitis

L20.9 Atopic dermatitis, unspecified

L21.8 Other seborrheic dermatitis

L60.0 Ingrowing nail

B35.1 Tinea unguium

L44.9 Papulosquamous disorder, unspecified

L45 Papulosquamous disorders in diseases classified elsewhere

L98.9 Disorder of the skin and subcutaneous tissue, unspecified

L40.0 Psoriasis vulgaris

L40.1 Generalized pustular psoriasis

L40.2 Acrodermatitis continua

L40.3 Pustulosis palmaris et plantaris

L40.4 Guttate psoriasis

L40.8 Other psoriasis

L40.9 Psoriasis, unspecified

L71.0 Perioral dermatitis

L71.1 Rhinophyma

L71.8 Other rosacea

L71.9 Rosacea, unspecified

L72.0 Epidermal cyst

L72.1 Trichodermal cyst

L72.2 Steatocystoma multiplex

L72.8 Other follicular cysts of the skin and subcutaneous tissue

L72.9 Follicular cyst of the skin and subcutaneous tissue, unspecified

L82.0 Inflamed seborrheic keratosis

L82.1 Other seborrheic keratosis

L98.491 Non-pressure chronic ulcer of skin of other sites limited to breakdown of skin

L98.492 Non-pressure chronic ulcer of skin of other sites with fat layer exposed

L98.493 Non-pressure chronic ulcer of skin of other sites with necrosis of muscle

L98.494 Non-pressure chronic ulcer of skin of other sites with necrosis of bone

L98.499 Non-pressure chronic ulcer of skin of other sites with unspecified severity

L50.9 Urticaria, unspecified

Musculoskeletal & Connective Tissue

General

M12.9 Arthropathy, unspecified

M60.80 Other myositis, unspecified site

M60.811 Other myositis, right shoulder

M60.812 Other myositis, left shoulder

M60.819 Other myositis, unspecified shoulder

M60.821 Other myositis, right upper arm

M60.822 Other myositis, left upper arm

M60.829 Other myositis, unspecified upper arm

M60.831 Other myositis, right forearm

M60.832 Other myositis, left forearm

M60.839 Other myositis, unspecified forearm

M60.841 Other myositis, right hand

M60.842 Other myositis, left hand

M60.849 Other myositis, unspecified hand

M60.851 Other myositis, right thigh

M60.852 Other myositis, left thigh

M05.76 Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement

M05.761 Rheumatoid arthritis with rheumatoid factor of right knee without organ or systems involvement

M05.762 Rheumatoid arthritis with rheumatoid factor of left knee without organ or systems involvement

M05.769 Rheumatoid arthritis with rheumatoid factor of unspecified knee without organ or systems involvement

M05.77 Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement

M05.771 Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement

M05.772 Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or systems involvement

M05.779 Rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot without organ or systems involvement

M05.79 Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement

M05.80 Other rheumatoid arthritis with rheumatoid factor of unspecified site

M05.811 Other rheumatoid arthritis with rheumatoid factor of right shoulder

M05.812 Other rheumatoid arthritis with rheumatoid factor of left shoulder

M05.819 Other rheumatoid arthritis with rheumatoid factor of unspecified shoulder

M05.82 Other rheumatoid arthritis with rheumatoid factor of elbow

M05.821 Other rheumatoid arthritis with rheumatoid factor of right elbow

M05.822 Other rheumatoid arthritis with rheumatoid factor of left elbow

M05.829 Other rheumatoid arthritis with rheumatoid factor of unspecified elbow

M05.83 Other rheumatoid arthritis with rheumatoid factor of wrist

M05.831 Other rheumatoid arthritis with rheumatoid factor of right wrist

M05.832 Other rheumatoid arthritis with rheumatoid factor of left wrist

M05.839 Other rheumatoid arthritis with rheumatoid factor of unspecified wrist

M05.84 Other rheumatoid arthritis with rheumatoid factor of hand

M05.841 Other rheumatoid arthritis with rheumatoid factor of right hand

M05.842 Other rheumatoid arthritis with rheumatoid factor of left hand

M05.849 Other rheumatoid arthritis with rheumatoid factor of unspecified hand

M05.85 Other rheumatoid arthritis with rheumatoid factor of hip

M05.851 Other rheumatoid arthritis with rheumatoid factor of right hip

M05.852 Other rheumatoid arthritis with rheumatoid factor of left hip

M05.859 Other rheumatoid arthritis with rheumatoid factor of unspecified hip

M05.86 Other rheumatoid arthritis with rheumatoid factor of knee

M05.861 Other rheumatoid arthritis with rheumatoid factor of right knee

M05.862 Other rheumatoid arthritis with rheumatoid factor of left knee

M05.869 Other rheumatoid arthritis with rheumatoid factor of unspecified knee

M05.87 Other rheumatoid arthritis with rheumatoid factor of ankle and foot