If it is not covered by employer health insurance, in Column E discuss why, and what other insurance or government program would apply. Cod C D A B e Covered by employer health insurance? If not why?, What other insurance / government program applies? Type of patient/ cause ICD or CPT Diagnosis or procedure IDC car accident -37 year old passenger in a car 1) 572.3 fracture of shaft of fumur 2) K08.1 55 year old male who had radiation treatment of head and neck cancer healthy I year old without symptoms of illness CPT yes 3) 90707 under Vaccines, Toxoids ICD 4) k11.5 31 year old male, sudden onset without any apparent cause Sialolithiasis ICD 5) v97.3 yes 41 year old female injured while working at airline job For Person on ground injured in air transport accident If it is not covered by employer health insurance, in Column E discuss why, and what other insurance or government program would apply. Cod C D A B e Covered by employer health insurance? If not why?, What other insurance / government program applies? Type of patient/ cause ICD or CPT Diagnosis or procedure IDC car accident -37 year old passenger in a car 1) 572.3 fracture of shaft of fumur 2) K08.1 55 year old male who had radiation treatment of head and neck cancer healthy I year old without symptoms of illness CPT yes 3) 90707 under Vaccines, Toxoids ICD 4) k11.5 31 year old male, sudden onset without any apparent cause Sialolithiasis ICD 5) v97.3 yes 41 year old female injured while working at airline job For Person on ground injured in air transport accident