| L3360 | Sole wedge, outside sole |
| S0274 | Nurse practitioner visit at member's home, outside of a capitation arrangement |
| G8938 | Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible |
| L6200 | Elbow disarticulation, molded socket, outside locking hinge, forearm |
| S0273 | Physician visit at member's home, outside of a capitation arrangement |
| G9716 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
| M1286 | Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
| M1276 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
| S9989 | Services provided outside of the united states of america (list in addition to code(s) for service(s)) |
