| ICD-10 Code | Diagnosis | Coverage |
|---|---|---|
| B02.23 | Postherpetic polyneuropathy | covered |
| B02.7 | Disseminated zoster | covered |
| B02.8 | Zoster with other complications | covered |
| B02.9 | Zoster without complications | covered |
| G89.3 | Neoplasm related pain (acute) (chronic) | covered |
| M47.22 | Other spondylosis with radiculopathy, cervical region | covered |
| M47.23 | Other spondylosis with radiculopathy, cervicothoracic region | covered |
| M47.24 | Other spondylosis with radiculopathy, thoracic region | covered |
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