| 77599-9 | Additional documentation | required |
| 77598-1 | Externally defined CDEs Doc | required |
| 77597-3 | Orders placed Doc | required |
| 18776-5 | Plan of care note | required |
| 29762-2 | Social hx note | required |
| 48765-2 | Allergies &or adverse reactions Doc | required |
| 59774-0 | Anesthesia | required |
| 51847-2 | Eval+Plan note | required |
| 51848-0 | Eval note | required |
| 46239-0 | Chief complaint+Reason for visit | required |
| 10154-3 | Chief complaint Reported | required |
| 55109-3 | Complications Doc | required |
| 10157-6 | Hx of fam member ds note | required |
| 11348-0 | Hx of Past illness note | required |
| 10164-2 | Hx of Pres illness | required |
| 11329-0 | Hx general Reported | required |
| 46264-8 | Hx medical device use | required |
| 29549-3 | Medication administered | required |
| 10160-0 | Hx of Medication use | required |
| 48768-6 | Payment sources Doc | required |
| 29545-1 | Physical findings note | required |
| 59772-4 | Planned procedure | required |
| 59769-0 | Postprocedure Dx | required |
| 29554-3 | Proc | required |
| 59775-7 | Disposition | required |
| 59770-8 | Estimated blood loss | required |
| 59776-5 | Findings | required |
| 59771-6 | Implants | required |
| 59768-2 | Procedure indications Imp | required |
| 59773-2 | Specimens taken | required |
| 47519-4 | Procedures Hx Doc | required |
| 29299-5 | Reason for visit | required |
| 10187-3 | Review of systems | required |
| 81244-6 | Encd Proced Nte CDP1 R1.0+R1.1 | |