| ICD-10 Code | Diagnosis | Coverage |
|---|---|---|
| B02.22 | Postherpetic trigeminal neuralgia | covered |
| B02.23 | Postherpetic polyneuropathy | covered |
| B02.9 | Zoster without complications | covered |
| C00.0 | Malignant neoplasm of external upper lip | covered |
| C00.1 | Malignant neoplasm of external lower lip | covered |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | covered |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | covered |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | covered |
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