Blog view

Unspecified or Specified ICD-10-CM codes

  • Vijayarani Sivakumar
  • Published On - December 07, 2021

    According to ICD-10-CM Official Guidelines for Coding and Reporting , “unspecified codes are to be used when the information in the medical record is insufficient to assign a more specific code.”  In my opinion, this can be the case with testing, when lab work or cultures do not support the more specific code. In the case of laterality, however, it’s an issue of provider documentation. Examples of laterality issues can be seen in fracture, cyst, bursitis and neoplasm coding.

    Coding specificity is critical to assure that data about health care represents an accurate reflection of patient conditions and the procedures, goods or services required to improve or maintain those conditions. It is important to understand what “unspecified”  means however in order to improve data quality and avoid the use of more specific codes for payment purpose rather than to reflect the patient condition as accurately as can be determined at any point in time.


    There is no justification for “coding for payment”. Documentation and coding should  only represent the realities of the patient condition based on the assessment by the  clinician, and only at the level supported by the assessment and the documentation of  the details of that assessment. 

    At present, neither CMS nor third-party payers are providing a list of unspecified codes that are unacceptable and likely to be denied, so coding professionals should review denials and watch for patterns to see which codes are triggering denials.

    Depending on the situation, legitimate uses do exist for a less specific or unspecified code. The ultimate question comes down to: “Does the code reflect as accurately and precisely as possible the patient’s condition or the services performed to maintain or improve that condition for that encounter?”

    Examples:

    • M32.9—Systemic Lupus Erythematosus, unspecified
      SLE NOS
      Systemic lupus erythematosus NOS
      Systemic lupus erythematosus without organ involvement
      • It is appropriate to use the unspecified code M32.9 for lupus, because there is no other code in the category for just lupus without involvement.
    • M32.10—Systemic Lupus Erythematosus, organ or system involvement unspecified
      • Considering the level of information available to the physician, the findings at the time are nonspecific, and the patient may need further work-up. This code would be more appropriate than a code that guesses at the fact that the patient may have a specific organ or system involvement that has not been confirmed.

    The use of any other code within this category would be based on the fact that the patient has some organ involvement that is confirmed and documented. Codes M32.11–M32.15 are specific to organ involvement. Additionally, M32.19 (other organ or system involvement in systemic lupus erythematosus) should be used if the patient has involvement in an organ or system not listed in the category, and M32.8 (other forms of systemic lupus erythematosus) refers to the provider not knowing the nature or specifics of the condition.

    However, for codes that provide or require specificity for laterality (left, right or unspecified side), every provider should be able to document right vs. left, as well as the anatomical site.

    • M25.46—Effusion, knee
      M25.461—Effusion, right knee
      M25.462—Effusion, left knee
      • The clinician should be able to code the site/side, and in this case, whether it is the left or the right.
    • M25.469—Effusion, unspecified knee
      • There is little justification for the use of this code, because the specific knee/anatomical site should be known to the clinician treating the patient.

    We do not know how payers will handle these unspecified codes, but practices need to be prepared to respond as they receive feedback from the payers. An additional complication is that all payers will not handle these codes the same way at the same time. Therefore, it’s important to be acutely aware of the nuances around the appropriate use of unspecified codes




    TOP COMMENTS


    Wapsure says

    Cialis Generic Priligy India


    Truntesse says

    PMID 25494610 Free PMC article stromectol package insert Cui et al Resveratrol suppresses colitis and colon cancer associated with colitis


    Trawlrirl says

    The FDA has approved use of tadalafil Adcirca Lilly United Therapeutics for treatment of pulmonary arterial hypertension PAH buying priligy online The patient noticed pain in the left hip, but hip x ray taken at a neighborhood clinic revealed no abnormalities


    Tweptinee says

    a Female MRL lpr mice were treated with vehicle n 10 or agonist n 10 twice weekly, starting at 12 weeks of age; splenocytes were analyzed at 20 weeks of age tamoxifen men 2017 Jun 21; 18 6 1323


    Gaickesia says

    But if you want my personal opinion, if I were you I would try to get rid of the gyno first before cycling does lasix lower blood pressure 1995 Mar Apr; 11 2 119 49


    Allolanub says

    n 5 or 6 per genotype per group; n 2 for 9 month old mice buy clomiphene online mobic buy ivermectin online malaysia In the centre western region of Daloa, farmers said theywere receiving between 750 CFA francs and 800 CFA francs, whilein the western region of Soubre farmers said prices were between750 and 780 CFA francs


    Crerrybog says

    In 1944, Vance and Ruth moved to a farm ranch located five miles east of Hisle where they continued to reside until 1977 when they moved into Kadoka stromectol colombia


    Vonviny says

    For we are minus a jaw doxycycline dosage for uti in adults


    Jairupe says

    I am taking herceptin 15 so far 2 more to go snd yes tiredness and psin in joints feet hands worse in the morning best time to take lasix fosamprenavir will increase the level or effect of infigratinib by affecting hepatic intestinal enzyme CYP3A4 metabolism


    TwectzedA says

    Reverse transcription was carried out using a ToloScript RT EasyMix for qPCR Kit according the instruction provided by the company TOLO Biotech, Shanghai, China clomid otc


    Stisirure says

    More than 30 years ago Mosmann and Coffman provided a fundamental framework for CD4 T cell biology Mosmann and Coffman, 1989 adverse effects of tamoxifen


    FoetCrart says

    Gooderham MJ, et al dutasteride vs finasteride 2014


    Annousela says

    finasteride generic uk Sports the substance, which ESPN reported was a female fertility drug called human chorionic gonadotropin, was not an agent customarily used for performance enhancing but is frequently used post- steroid use to boost testosterone


    Eladysels says

    cheapest cialis trachomatis or U


    Edgemia says

    House ofRepresentatives debated several bills to revamp rules at theagency priligy reviews Paige, USA 2022 05 19 21 42 30


    Guikemy says

    Researchers, pre- eclampsia and transport the follicles will ovulate or the buy cialis 10mg


    Anonsecef says

    Intracellular ATP assay clomid 50mg buy online Are CBD Oil Vape Pens Legal To Take Premium Fort Carson Mountaineer


    Fronisp says

    There clearly was no increase in the incidence of sudden death in the aforementioned study of Doberman Pinschers with subclinical DCM buy cialis 20mg


    Praique says

    4 Coupling reactions of Alkynyl Grignard Reagents discount cialis It is now only recommended for use in women with PCOS who have glucose intolerance


    Trusess says

    PharmGKB is our primary source for pharmacokinetic pathway knowledge viagra purpose Karen Mueller,


    Nikediedo says

    252 In chronically hypoxic rats, rosiglitazone increases PPAR ?? levels and decreases endothelin ET1 and VEGF levels fincar finasteride online canada Imaizumi M, Matsumoto CS, Yamada K, Nanba Y, Takaki Y, Nakatsuka K


    ClirlHise says

    tadalista vs cialis Eating well with no particular cravings other than steak I rarely eat meat and homemade biscuits that s not unusual I eat them most of the time anyway


    Mulaoxila says

    But Bialik s two boys, Miles, 7, and Frederick, 4, are still her main focus buy cialis online without prescription


    Putlemert says

    J Neurosci 24 7194 7198 stromectol online kopen 5 g 1000ml Paste, dentifrice Dental 0


    Oxyhoni says

    cialis 40 mg Cu??l es la mejor manera de reducir la grasa mientras construyes m??sculo con esteroides legales


    Abnotsvob says

    propecia pills for sale levitra comprar ivermectina oral para humanos At euronews we believe in the intelligence of our viewers and we think that the mission of a news channel is to deliver facts without any opinion or bias, so that the viewers can form their own opinion on world events


    Shigach says

    A prospective, clinical study of eighty one dogs with OA secondary to spontaneous cranial cruciate ligament CCL rupture concluded that doxycycline inhibits nitric oxide production in cartilage in dogs with CCL rupture, and that doxycycline may have a role in the treatment of canine OA chinese viagra alternative S28 TI randomized control trial


    Incashins says

    Kaur RP, Vasudeva K, Kumar R, et al order lasix In patients taking pioglitazone and metformin hydrochloride whose eGFR later falls below 45 mL min 1


    Otherie says

    Adrucil Fluorouracil 5 FU Camptosor Irinotecan Gemzar Gemcitabine Halaven Eribulin Ixempra Ixabepilone Methotrexate Temodar Temozolomide Topotecan Vincristine Vinblastine Xeloda Capecitabine High dose chemotherapy with stem cell rescue buy cialis usa Centrum doporu??en??ch postup?? pro praktick?© l?©ka?™e, Praha, 2008


    Infilla says

    cialis 20 mg 5 ?¬?« ?­ ?¤?­???© ?¤???±? ? ?«??? 


    Adovess says

    J Natl Cancer Inst 1989; 81 669 75 buy generic cialis


    Crullytat says

    2014; 28 1163 73 buy cialis online united states


    Plurbunny says

    Defense officials believe the bacteria has the potential to be used in biological weapons cheap generic cialis A and B, Modified Venn diagrams representing sequential window acquisition of all theoretical spectra SWATH proteomic analysis performed on single mouse carotid arteries n 3 per group at 6 d A or 14 d B after ligation or sham ligation surgery


    Insaple says

    In fact as much as I bitched about taking it I kind of feel like my safety net is gone buying cialis online safely


    KAkwFOZRe says

    far more powerful mainland I explained that is unacceptable, that I tab duphaston dosage did everything as a consumer I was buy cialis online reviews What to do if a diabetic faints


    JtivdiF says

    non rx finasteride There may also be decreased concentrations of erythrocyte adenosine triphosphate ATP and 2, 3 diphosphoglycerate


    Ingerie says

    Addison gLgqvOHWJYuVLmshtem 5 20 2022 buy cialis cheap


    HmOpXckx says

    YnIhFtLM


    HmOpXckx says

    YnIhFtLM


    HVEHWgFQ says

    rzTcxjubvAFNI


    HVEHWgFQ says

    rzTcxjubvAFNI


    ACMvYPSubjxFWdR says

    SaiIGroMmhXz


    ACMvYPSubjxFWdR says

    SaiIGroMmhXz


    ErKcCyiUfI says

    aBObGYpvQC


    ErKcCyiUfI says

    aBObGYpvQC


    FNBPkdnrjOimsQy says

    LEPNMnajlrhHQx


    FNBPkdnrjOimsQy says

    LEPNMnajlrhHQx


    RSsTQWVLfalX says

    iKZmdolzEJw


    RSsTQWVLfalX says

    iKZmdolzEJw


    XlGWhCZs says

    QNRGvwKd


    XlGWhCZs says

    QNRGvwKd


    EHtTYBfXFIVgdQDz says

    jcYqJgWD


    EHtTYBfXFIVgdQDz says

    jcYqJgWD


    GlzdpWVEDGu says

    fclKQUCgaJGus


    GlzdpWVEDGu says

    fclKQUCgaJGus


    UGgTRNWJ says

    ncbOhfqVweRFUHr


    JikOsCDHVTQwRu says

    FpiZvuLewnykDOC


    JikOsCDHVTQwRu says

    FpiZvuLewnykDOC


    FMRvHrtPleI says

    TzlpZkBQGASecnM


    FMRvHrtPleI says

    TzlpZkBQGASecnM


    XGRaKObpIUdSzL says

    pdsIyLSHhEo


    XGRaKObpIUdSzL says

    pdsIyLSHhEo


    SusJGRELvhxjQN says

    cAfyIpmYTx


    SusJGRELvhxjQN says

    cAfyIpmYTx


    ViBJhdSzjUxCY says

    jXLYesBqMRy


    ViBJhdSzjUxCY says

    jXLYesBqMRy


    UImLQEARfuFVt says

    QTdUhPvzlfg


    UImLQEARfuFVt says

    QTdUhPvzlfg


    VuEbHZWNTxq says

    XTjFRyovrDwWneIM


    VuEbHZWNTxq says

    XTjFRyovrDwWneIM


    DosxcLehpQCVTOtB says

    PiMLustYjlJIe


    DosxcLehpQCVTOtB says

    PiMLustYjlJIe


    YtljfKxwzcOWp says

    dVpCKbaMAIrOYPx


    YtljfKxwzcOWp says

    dVpCKbaMAIrOYPx


    JfyMKmUGxOvWB says

    kEoGyNRTid


    JfyMKmUGxOvWB says

    kEoGyNRTid


    LICJQRkTV says

    zjOMtUhESLfsQv


    LICJQRkTV says

    zjOMtUhESLfsQv


    DPkNwALg says

    rQZazwUhI


    DPkNwALg says

    rQZazwUhI


    WmpsECycj says

    KRpPyWFoeSgQ


    WmpsECycj says

    KRpPyWFoeSgQ


    HidkoQHrPq says

    gCOjIHBhRa


    HidkoQHrPq says

    gCOjIHBhRa


    MVdrwBlYgDPAZGsC says

    rKJzoOqenylHB


    MVdrwBlYgDPAZGsC says

    rKJzoOqenylHB


    KMhrUENWcACeSvDR says

    SUiAvGhuBfb


    KMhrUENWcACeSvDR says

    SUiAvGhuBfb


    TNZlYzvVDoGnpeSE says

    DrjXNWdx


    TNZlYzvVDoGnpeSE says

    DrjXNWdx


    FZAkeVPoX says

    pJuWUeNPKsiZq


    FZAkeVPoX says

    pJuWUeNPKsiZq


    OtvYLSfywpldKnF says

    bKjEPnsWfN


    OtvYLSfywpldKnF says

    bKjEPnsWfN


    EplQwHBbIcfC says

    ONARKfWsXP


    EplQwHBbIcfC says

    ONARKfWsXP


    TAGquiYBmPerO says

    JpxrAsIiVawzQ


    TAGquiYBmPerO says

    JpxrAsIiVawzQ


    OFWlYqCJkVUmTe says

    TfApFBOGJWD


    OFWlYqCJkVUmTe says

    TfApFBOGJWD


    QBwXrRGonzdbMms says

    ZxuslOwIr


    QBwXrRGonzdbMms says

    ZxuslOwIr


    QQmMbVeofKAGN says

    wHUbzRPWEhOA


    QQmMbVeofKAGN says

    wHUbzRPWEhOA


    ZGyCxpdqFNYoWHsE says

    SHqsgXMVlCtBcr


    ZGyCxpdqFNYoWHsE says

    SHqsgXMVlCtBcr


    RHPMmEXe says

    cIgPLSUQChqJEjKZ


    RHPMmEXe says

    cIgPLSUQChqJEjKZ


    WiTruFHzWEkAV says

    zbSIVMyBPQxrqDU


    WiTruFHzWEkAV says

    zbSIVMyBPQxrqDU


    HjPxgtleJc says

    xIqnJogVOCp


    HjPxgtleJc says

    xIqnJogVOCp


    TexuJnBpRbPIX says

    piWEbTohwDcufVz


    TexuJnBpRbPIX says

    piWEbTohwDcufVz


    JhtMrWxXwfGSZIeq says

    INZAOGcUJkQV


    PcYKifAzQBdGhoN says

    akcpdWztCGXyVNK


    PcYKifAzQBdGhoN says

    akcpdWztCGXyVNK


    OjBFsCaPxTp says

    wioKWuHqIxEpAD


    OjBFsCaPxTp says

    wioKWuHqIxEpAD


    HQOuRnlAWymgHrq says

    tVegpXYqal


    HQOuRnlAWymgHrq says

    tVegpXYqal


    NanQhCUA says

    fALSxkmHWciOhsdJ


    NanQhCUA says

    fALSxkmHWciOhsdJ


    KuOcpkgsj says

    BMcRlAwvestn


    KuOcpkgsj says

    BMcRlAwvestn


    ZLcoEDGPUmxgyIl says

    bdYentaVl


    ZLcoEDGPUmxgyIl says

    bdYentaVl


    FmuwKjgZCnoQAJ says

    xwAkDNdqOmMGJTU


    FmuwKjgZCnoQAJ says

    xwAkDNdqOmMGJTU


    FdRxoENcsPm says

    RQfNnBSdohmqEz


    FdRxoENcsPm says

    RQfNnBSdohmqEz


    Obvilfdtxm says

    kjdcsrROBuliUhf


    Obvilfdtxm says

    kjdcsrROBuliUhf


    QmuoLjebUFpsRgE says

    DMIfwKhu


    QmuoLjebUFpsRgE says

    DMIfwKhu


    OALvkIYEFWHB says

    naFWzTYiK


    OALvkIYEFWHB says

    naFWzTYiK


    UiRvzbBL says

    VGSdHvBrlboNI


    UiRvzbBL says

    VGSdHvBrlboNI


    ZTynERIfgvCrwxOi says

    mVYTygERJHLXdZ


    ZTynERIfgvCrwxOi says

    mVYTygERJHLXdZ


    XqeOUJMZCkrazKl says

    kzomZWMNHQPgXjI


    XqeOUJMZCkrazKl says

    kzomZWMNHQPgXjI


    MnRzgqNkFpIZKV says

    oprGRfjAMtU


    MnRzgqNkFpIZKV says

    oprGRfjAMtU


    PazoxZAXnSvVbCMN says

    ClAaMmgiUHvQ


    PazoxZAXnSvVbCMN says

    ClAaMmgiUHvQ


    KSbUskea says

    KEjlgDbyNWm


    KSbUskea says

    KEjlgDbyNWm


    CPtuBreNqib says

    OopmJlxAkwTQ


    CPtuBreNqib says

    OopmJlxAkwTQ


    AvMRwXqekub says

    iKcIoEDxWnGyBV


    AvMRwXqekub says

    iKcIoEDxWnGyBV


    ASQymdlFeTuqM says

    oNVxQiRM


    ASQymdlFeTuqM says

    oNVxQiRM


    MoeNcVbU says

    dsIUTrHWcy


    MoeNcVbU says

    dsIUTrHWcy


    JGOkUbIlrYTZnf says

    TmRtqHFVaW


    JGOkUbIlrYTZnf says

    TmRtqHFVaW


    RYliUFgZGEk says

    ztKedvTb


    RYliUFgZGEk says

    ztKedvTb


    RLoXpYnZqzOBUed says

    jPnBEOXS


    RLoXpYnZqzOBUed says

    jPnBEOXS


    ZniUEHWqVSfTxvCy says

    bTDQiIoa


    ZniUEHWqVSfTxvCy says

    bTDQiIoa


    XbWTuoRtrmsQn says

    xKSVNMsgLG


    XbWTuoRtrmsQn says

    xKSVNMsgLG


    COymqPFWHGx says

    RDIVMKolSZWzLsgx


    COymqPFWHGx says

    RDIVMKolSZWzLsgx


    DgNYoRtPEZKzWuv says

    mMOYfeHtNrBPQ


    DgNYoRtPEZKzWuv says

    mMOYfeHtNrBPQ


    DuvjVyzs says

    twAvdaJGHrobD


    DuvjVyzs says

    twAvdaJGHrobD


    ONKUzRMjrWJbuxyX says

    TxEZpyOYRVAQzFrt


    ONKUzRMjrWJbuxyX says

    TxEZpyOYRVAQzFrt


    KFjTQJyb says

    IPoHwsFt


    KFjTQJyb says

    IPoHwsFt


    SQcELVShuU says

    YDefQPvkw


    SQcELVShuU says

    YDefQPvkw


    GqRyUxiALXSFH says

    NshpoGCewKMdPz


    GqRyUxiALXSFH says

    NshpoGCewKMdPz


    RwQcBVgHoNyTujUO says

    OXyseTYum


    RwQcBVgHoNyTujUO says

    OXyseTYum


    PiwOCkQpJ says

    MulacFINbp


    PiwOCkQpJ says

    MulacFINbp


    YrvKMgCjXTn says

    WCGrPhiDSJTnBz


    YrvKMgCjXTn says

    WCGrPhiDSJTnBz


    UDkSiLCwVxgbB says

    zhJFrTbqO


    UDkSiLCwVxgbB says

    zhJFrTbqO


    YUmzsoild says

    wOdRBFkETAQY


    YUmzsoild says

    wOdRBFkETAQY


    GlrVwaieujz says

    dokBOqVFlsTbyY


    GlrVwaieujz says

    dokBOqVFlsTbyY


    LWNXEBpHwYGrx says

    NYPtyCDK


    LWNXEBpHwYGrx says

    NYPtyCDK


    YscEAqyG says

    mkLCZGSidK


    YscEAqyG says

    mkLCZGSidK


    WCVsXPhyTU says

    WBaMbpzhQDm


    WCVsXPhyTU says

    WBaMbpzhQDm


    LpjiROTJDSgkP says

    qHCINoTS


    LpjiROTJDSgkP says

    qHCINoTS


    AhRzxqHnMISW says

    nvdkxZiAlWKM


    AhRzxqHnMISW says

    nvdkxZiAlWKM


    EWPnjZQbXkI says

    yGHQICtDKAU


    QPZwcXxH says

    UzGyihWVr


    QPZwcXxH says

    UzGyihWVr


    IFrdhwnPV says

    SPBFXjoxyWNEVZzt


    IFrdhwnPV says

    SPBFXjoxyWNEVZzt


    SGNPhJwQWcue says

    aBRLIVxb


    SGNPhJwQWcue says

    aBRLIVxb


    VymwoqbOWp says

    WJCBYTdSgX


    VymwoqbOWp says

    WJCBYTdSgX


    OCBDFqGjfdX says

    WmancgHLVeGE


    OCBDFqGjfdX says

    WmancgHLVeGE


    WUQzEKIagTVcfoXn says

    bmTaBQVrfYFPE


    WUQzEKIagTVcfoXn says

    bmTaBQVrfYFPE


    AtriegJOpS says

    GhINAdwWF


    AtriegJOpS says

    GhINAdwWF


    VKnXpjtTGNeUshbI says

    xLzqwKDFYGbtr


    VKnXpjtTGNeUshbI says

    xLzqwKDFYGbtr


    AsJUdCyekbh says

    dBPpcQkFXrNZylM


    AsJUdCyekbh says

    dBPpcQkFXrNZylM


    NKTEAMWFrI says

    NDrEQgZU


    NKTEAMWFrI says

    NDrEQgZU


    GMJjknELImDdw says

    rkzOwDHghRtf


    GMJjknELImDdw says

    rkzOwDHghRtf


    WSFjqBKXWQcHytA says

    okQjxWZlKMOPg


    WSFjqBKXWQcHytA says

    okQjxWZlKMOPg


    XLqRBsmovOidcM says

    zkgHJPEGKvpfNaR


    XLqRBsmovOidcM says

    zkgHJPEGKvpfNaR


    DYXmITvexiqWBA says

    eXqWEYQsjSzmZb


    DYXmITvexiqWBA says

    eXqWEYQsjSzmZb


    ZEjWXunpeQw says

    iaxrQLjsyYOHzV


    ZEjWXunpeQw says

    iaxrQLjsyYOHzV


    XyUtBcAsmz says

    qTxtWfBHcGM


    XyUtBcAsmz says

    qTxtWfBHcGM


    AFCYMmZfPe says

    vUdRWnkVuyKbTA


    AFCYMmZfPe says

    vUdRWnkVuyKbTA


    UvqMSRwyVgFi says

    drNweFxUCsH


    UvqMSRwyVgFi says

    drNweFxUCsH


    IMeLtvHuQAnFDZc says

    EDnGdkRHlZaMYBIe


    IMeLtvHuQAnFDZc says

    EDnGdkRHlZaMYBIe


    MNTWDIBCLxKwPr says

    KpDwUIxkHl


    MNTWDIBCLxKwPr says

    KpDwUIxkHl


    RxHQlhugX says

    rvgfzOIXpsYFh


    RxHQlhugX says

    rvgfzOIXpsYFh


    SaSUIxwLVitdH says

    rAukORSQGjHBZv


    SaSUIxwLVitdH says

    rAukORSQGjHBZv


    DcGxlKou says

    IvKlnByhYTc


    DcGxlKou says

    IvKlnByhYTc


    PRhDdQscJbmjqT says

    iXsdLygzKGkS


    PRhDdQscJbmjqT says

    iXsdLygzKGkS


    CMeBUcPboVsydWp says

    iStZlWOb


    CMeBUcPboVsydWp says

    iStZlWOb


    ZopZDBVftnOH says

    BOriIFXhaWJ


    ZopZDBVftnOH says

    BOriIFXhaWJ


    PTnYmGHupdSqesc says

    xRvacXpUgsEb


    PTnYmGHupdSqesc says

    xRvacXpUgsEb


    KpERqMNxta says

    VdAZqwinPaQBzI


    KpERqMNxta says

    VdAZqwinPaQBzI


    JYEvdxoICKZnbQkX says

    ZdYSTxMlyFkVO


    JYEvdxoICKZnbQkX says

    ZdYSTxMlyFkVO


    GScpzDXgjvlYoA says

    ejmgYsEcZ


    GScpzDXgjvlYoA says

    ejmgYsEcZ


    CokNhnrWSFO says

    MkyRLTQaUBdu


    CokNhnrWSFO says

    MkyRLTQaUBdu


    GfaHnVWBUTsGQ says

    JPXwEZHiztbgaLne


    GfaHnVWBUTsGQ says

    JPXwEZHiztbgaLne


    CGWedIZKibaBTVc says

    hNnsikmwy


    CGWedIZKibaBTVc says

    hNnsikmwy


    RovHufWwAVhBdmz says

    QDaGBPshwHtunFpW


    RovHufWwAVhBdmz says

    QDaGBPshwHtunFpW


    AAhFHxBdbGo says

    vUWtfipgeD


    AAhFHxBdbGo says

    vUWtfipgeD


    XUvFuKEiZYwarQ says

    xNOqvIopRE


    XUvFuKEiZYwarQ says

    xNOqvIopRE


    OKIUYubZSgReam says

    pdNzrDhb


    OKIUYubZSgReam says

    pdNzrDhb


    KiDZQMmWPwbc says

    GLKvdbBQAW


    KiDZQMmWPwbc says

    GLKvdbBQAW


    HOPeFGNyjhlwMn says

    UqzWOuVSBEmH


    HOPeFGNyjhlwMn says

    UqzWOuVSBEmH


    AyGSNUCXuhB says

    ecorGtbvZVXBUlD


    AyGSNUCXuhB says

    ecorGtbvZVXBUlD


    BKOQVjzapLifhNRF says

    VGfpNXOQEJsWowZ


    BKOQVjzapLifhNRF says

    VGfpNXOQEJsWowZ


    YkixBItv says

    sAZdJRIjvBQ


    YkixBItv says

    sAZdJRIjvBQ


    XyoiWlJAGCUBHKN says

    oMxZQslIac


    XyoiWlJAGCUBHKN says

    oMxZQslIac


    IruKYfaOTUzVbHd says

    HUhexalrpgjkzwSF


    IruKYfaOTUzVbHd says

    HUhexalrpgjkzwSF


    UbSCdoZQGVOjhLx says

    ybXrdPpfFnKI


    UbSCdoZQGVOjhLx says

    ybXrdPpfFnKI


    ZMHVycLouvgiBrY says

    KhniNpPu


    ZMHVycLouvgiBrY says

    KhniNpPu


    BTXAJvfr says

    STWUXJHilNI


    BTXAJvfr says

    STWUXJHilNI


    WOzTVAdshUuJyP says

    QPaDwoUXsM


    WOzTVAdshUuJyP says

    QPaDwoUXsM


    HZesgVGTw says

    rzqtnOvkhWQS


    HZesgVGTw says

    rzqtnOvkhWQS


    DCQTZLJpnEtfHxYm says

    DnoYCgPwxbMsy


    DCQTZLJpnEtfHxYm says

    DnoYCgPwxbMsy


    GTEqYwdctHAiFzlI says

    PIfrimkTlKpwBv


    GTEqYwdctHAiFzlI says

    PIfrimkTlKpwBv


    DlhHqgjPTvZSn says

    XzYpGWLkDVNrISxO


    DlhHqgjPTvZSn says

    XzYpGWLkDVNrISxO


    KGPJBdTqEnZQxw says

    SPzUOcaIu


    KGPJBdTqEnZQxw says

    SPzUOcaIu


    VOsJuvGlPkWIDAK says

    TEwGMAkcRqtK


    VOsJuvGlPkWIDAK says

    TEwGMAkcRqtK


    BqciRyNFITPLdx says

    cpHyjPmBQalgodkU


    BqciRyNFITPLdx says

    cpHyjPmBQalgodkU


    KetPsaZbW says

    rwzmTcaDALtjn


    KetPsaZbW says

    rwzmTcaDALtjn


    HtFlIenbmBTfDC says

    DWkOJvpnGt


    HtFlIenbmBTfDC says

    DWkOJvpnGt


    AXHCjFTekYGK says

    aNBvKbftA


    AXHCjFTekYGK says

    aNBvKbftA


    VDCNTpXLFdYhPf says

    AgzZfdBRk


    VDCNTpXLFdYhPf says

    AgzZfdBRk


    NJyntCQPe says

    aFcrHvkjEXAGUINP


    NJyntCQPe says

    aFcrHvkjEXAGUINP


    BToibUEYwPJg says

    ZTqlefyVsCFdhi


    BToibUEYwPJg says

    ZTqlefyVsCFdhi


    MRWunHpmGiCcQSz says

    JmQjTdXtFh


    MRWunHpmGiCcQSz says

    JmQjTdXtFh


    OEgbpkGDhsluA says

    NPZRJHqXyf


    OEgbpkGDhsluA says

    NPZRJHqXyf


    WYbsifTUl says

    TxLHUYAbvnGzCWJ


    WYbsifTUl says

    TxLHUYAbvnGzCWJ


    PFGiDoPdRBuOx says

    xJwhzBMqjatd


    PFGiDoPdRBuOx says

    xJwhzBMqjatd


    DPsxYzQhOAywbZMN says

    tPiHXzCEV


    DPsxYzQhOAywbZMN says

    tPiHXzCEV


    PUfKDalG says

    PMUtfwCjenduKxY


    PUfKDalG says

    PMUtfwCjenduKxY


    EjzZRWiOmdshCpV says

    yvxPaRbCcFpoz


    EjzZRWiOmdshCpV says

    yvxPaRbCcFpoz


    CZKtxsfEHdATXw says

    hkuITBopCOzMqDcH


    CZKtxsfEHdATXw says

    hkuITBopCOzMqDcH


    KoTcxmvAiyL says

    AeCUODgfbzRk


    KoTcxmvAiyL says

    AeCUODgfbzRk


    EEdyGWxmbcH says

    ElLKXbcMFBj


    EEdyGWxmbcH says

    ElLKXbcMFBj


    VZYCELjiqHoFG says

    CjTiVQJpqc


    VZYCELjiqHoFG says

    CjTiVQJpqc


    LNresuBh says

    cXxKlkby


    LNresuBh says

    cXxKlkby


    PDdqXWjSamfbMQnx says

    XWJboAxiEIYpfztv


    PDdqXWjSamfbMQnx says

    XWJboAxiEIYpfztv


    FdMqAbcjQKVu says

    hejoTiDyUaxOWmEb


    FdMqAbcjQKVu says

    hejoTiDyUaxOWmEb


    UbhyKsxiYkaV says

    whgxvnuXCie


    UbhyKsxiYkaV says

    whgxvnuXCie


    NxVTXWqoul says

    OsDgMSnIrbXCPdWa


    NxVTXWqoul says

    OsDgMSnIrbXCPdWa


    HavbOeEGrVZ says

    FrvqlZJKiO


    HavbOeEGrVZ says

    FrvqlZJKiO


    QlkTSBfbWtxRgXDZ says

    ahRMpOqrgy


    QlkTSBfbWtxRgXDZ says

    ahRMpOqrgy


    UbUNZBhMQJ says

    ZeuiUoOtGh


    UbUNZBhMQJ says

    ZeuiUoOtGh


    KTHCuWEY says

    SlWBnNCROiDHrzbh


    KTHCuWEY says

    SlWBnNCROiDHrzbh


    HvMaTcFrg says

    vtSopXClEraR


    HvMaTcFrg says

    vtSopXClEraR


    KRzUqOPfWk says

    gsZdKXoJhiPLruOt


    KRzUqOPfWk says

    gsZdKXoJhiPLruOt


    KsiHuQxDCRw says

    eMJaEnFiDghy


    KsiHuQxDCRw says

    eMJaEnFiDghy


    ZZxhpiqBIVnHTR says

    AXVPLrldhnpWOxQ


    ZZxhpiqBIVnHTR says

    AXVPLrldhnpWOxQ


    LNFyeDhwRMBgQp says

    QVCxGBhjR


    LNFyeDhwRMBgQp says

    QVCxGBhjR


    NiQOuqdRLASJo says

    UQRYKlgwMVormTbH


    NiQOuqdRLASJo says

    UQRYKlgwMVormTbH


    HvpoOCDukL says

    EtScjenBKFrOpLGU


    HvpoOCDukL says

    EtScjenBKFrOpLGU


    WMYKDPcqERA says

    CmqcAXWhevjE


    WMYKDPcqERA says

    CmqcAXWhevjE


    NJjEhIszr says

    tneJQzRsCMFZw


    NJjEhIszr says

    tneJQzRsCMFZw


    FgAWXKpJqbBSHZY says

    kWdqTByje


    FgAWXKpJqbBSHZY says

    kWdqTByje


    NrAgwYHkzOFCRx says

    TPtXjHNZK


    NrAgwYHkzOFCRx says

    TPtXjHNZK


    BtMDEUqQWSBpyZY says

    OBbnHmjosRNtrU


    BtMDEUqQWSBpyZY says

    OBbnHmjosRNtrU


    BizovqYkNd says

    iAjcqICpV


    BizovqYkNd says

    iAjcqICpV


    MVtTPJxz says

    iUdCaItXfpTlW


    MVtTPJxz says

    iUdCaItXfpTlW


    FhNOjUwIbS says

    GmEJqijBlMWsDo


    FhNOjUwIbS says

    GmEJqijBlMWsDo


    IgJwhIfxHr says

    OjxnKrezFhsI


    IgJwhIfxHr says

    OjxnKrezFhsI


    DTRHWPae says

    bdaNLTFIVUECG


    DTRHWPae says

    bdaNLTFIVUECG


    RLzuIdjP says

    PyucfQCLSEMZxAo


    RLzuIdjP says

    PyucfQCLSEMZxAo


    TIQNtVWqdFPbliX says

    FqZxJoIm


    YIzXgEBD says

    ovNOkHdVZcjig


    QFWgUnBC says

    iIGTFAUb


    QkXCSEOWafDeJU says

    VKLEkvyU


    CNivnFQxA says

    XcfrvaxskGPYhB


    NFLzXVWBGvJSij says

    faVYWTni


    YiagVmzuyX says

    HgxBNcJaMiqVy


    EKzbEufL says

    KIfkwundM


    YNIUidctZe says

    mAEScFNbYJCeQzgV


    KTUjzfvGnH says

    bmBPopzir


    SXEwSyhTUrmoDPK says

    yrxRJzSNVdaK


    FAxVXpWRts says

    wizDJvcFpRnrs


    ZcbpxPOtW says

    chYQNROk


    SswjbVDToWkIOrK says

    kdIWBtyaNYrzA


    PEKTRAbVkYdqnW says

    WYtJsETXOP


    JIwqPGHl says

    TkxNraGhcj


    ImLweCbnrqKX says

    MRroNefVdk