| Code | Display | Comments |
|---|
 001 | Release of Information/MR / Authorization to Disclosure Protected Health Information | |
| 002 | Medical Procedure (invasive) | |
| 003 | Acknowledge Receipt of Privacy Notice | |
| 004 | Abortion | |
| 005 | Abortion/Laminaria | |
| 006 | Accutane - Information | |
| 007 | Accutane - Woman | |
| 008 | Advanced Beneficiary Notice | |
| 009 | AFP (Alpha Fetoprotein) Screening | |
| 010 | Amniocentesis (consent & refusal) | |
| 011 | Anatomical Gift (organ donation) | |
| 012 | Anesthesia - Complications | |
| 013 | Anesthesia - Questionnaire | |
| 014 | Angiogram | |
| 015 | Angioplasty | |
| 016 | Anticancer Drugs | |
| 017 | Antipsychotic Medications | |
| 018 | Arthrogram | |
| 019 | Autopsy | |
| 020 | AZT Therapy | |
| 021 | Biliary Drainage | |
| 022 | Biliary Stone Extraction | |
| 023 | Biopsy | |
| 024 | Bleeding Time Test | |
| 025 | Bronchogram | |
| 026 | Cardiac Catheterization | |
| 027 | Coronary Angiography | |
| 028 | Coronary Angiography w/o Surgery Capability | |
| 029 | Cataract Op/Implant of FDA Aprvd Lens | |
| 030 | Cataract Op/Implant of Investigational Lens | |
| 031 | Cataract Surgery | |
| 032 | Cholera Immunization | |
| 033 | Cholesterol Screening | |
| 034 | Circumcision - Newborn | |
| 035 | Colonoscopy | |
| 036 | Contact Lenses | |
| 037 | CT Scan - Cervical & Lumbar | |
| 038 | CT Scan w/ IV Contrast Media into Vein | |
| 039 | CVS (Chorionic Villus) Sampling | |
| 040 | Cystospy | |
| 041 | Disclosure of Protected Health Information to Family/Friends | |
| 042 | D & C and Conization | |
| 043 | Dacryocystogram | |
| 044 | Diagnostic Isotope | |
| 045 | Drainage of an Abscess | |
| 046 | Drug Screening | |
| 047 | Electronic Monitoring of Labor - Refusal | |
| 048 | Endometrial Biopsy | |
| 049 | Endoscopy/Sclerosis of Esophageal Varices | |
| 050 | ERCP | |
| 051 | Exposure to reportable Communicable Disease | |
| 052 | External Version | |
| 053 | Fluorescein Angioscopy | |
| 054 | Hepatitis B - Consent/Declination | |
| 055 | Herniogram | |
| 056 | HIV Test - Consent Refusal | |
| 057 | HIV Test - Disclosure | |
| 058 | HIV Test - Prenatal | |
| 059 | Home IV Treatment Program | |
| 060 | Home Parenteral Treatment Program | |
| 061 | Hysterectomy | |
| 062 | Hysterosalpingogram | |
| 063 | Injection Slip/ Consent | |
| 064 | Intrauterine Device | |
| 065 | Intrauterine Device/Sterilization | |
| 066 | Intravascular Infusion of Streptokinase/Urokinase | |
| 067 | Intravenous Cholangiogram | |
| 068 | Intravenous Digital Angiography | |
| 069 | Iodine Administration | |
| 070 | ISG | |
| 071 | IVP | |
| 072 | Laser Photocoagulation | |
| 073 | Laser treatment | |
| 074 | Lithium Carbonate | |
| 075 | Liver Biopsy | |
| 076 | Lumbar Puncture | |
| 077 | Lymphangiogram | |
| 078 | MAO Inhibitors | |
| 079 | Med, Psych, and/or Drug/Alcohol | |
| 080 | Medical Treatment - Refusal | |
| 081 | Morning-after Pill | |
| 082 | MRI - Adult | |
| 083 | MRI - Pediatric | |
| 084 | Myelogram | |
| 085 | Needle Biopsy | |
| 086 | Needle Biopsy of Lung | |
| 087 | Newborn Treatment and Release | |
| 088 | Norplant Subdermal Birth Control Implant | |
| 089 | Operations, Anesthesia, Transfusions | |
| 090 | Oral Contraceptives | |
| 091 | Organ Donation | |
| 092 | Patient Permits, Consents | |
| 093 | Patient Treatment Permit, Release & Admission | |
| 094 | Penile Injections | |
| 095 | Percutaneous Nephrostomy | |
| 096 | Percutaneous Transhepatic Cholangiogram | |
| 097 | Photographs | |
| 098 | Photographs - Employee | |
| 099 | Photographs - Medical Research | |
| 100 | Photographs - news Media | |
| 101 | Psychiatric Admission - Next of Kin | |
| 102 | Psychiatric Information During Hospital Stay | |
| 103 | Public Release of Information | |
| 104 | Radiologic Procedure | |
| 105 | Refusal of Treatment | |
| 106 | Release of Body | |
| 107 | Release of Limb | |
| 108 | Rh Immune Globulin | |
| 109 | Rights of Medical Research Participants | |
| 110 | Request to Restrict Access/Disclosure to Medical Record/Protected Health Information | |
| 111 | Request for Remain Anonymous | |
| 112 | Seat Belt Exemption | |
| 113 | Sialogram | |
| 114 | Sigmoidoscopy | |
| 115 | Sterilization - Anesthesia & Medical Services | |
| 116 | Sterilization -Federally Funded | |
| 117 | Sterilization - Female | |
| 118 | Sterilization - Laparoscopy/Pomeroy | |
| 119 | Sterilization - Non-Federally Funded | |
| 120 | Sterilization - Secondary | |
| 121 | Tranquilizers | |
| 122 | Transfer - Acknowledgement | |
| 123 | Transfer - Authorization | |
| 124 | Transfer Certification - Physician | |
| 125 | Transfer/Discharge Request | |
| 126 | Transfer for Non-Medical Reasons | |
| 127 | Transfer - Interfaculty Neonatal | |
| 128 | Transfer Refusal | |
| 129 | Transfer Refusal of Further Treatment | |
| 130 | Treadmill & EKG | |
| 131 | Treadmill, Thallium-201 | |
| 132 | Typhoid | |
| 133 | Use of Investigational Device | |
| 134 | Use of Investigational Drug | |
| 135 | Venogram | |
| 136 | Videotape | |
| 1137 | Voiding Cystogram | |