ICD↔CPT crosswalk
CPT 0055T: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 0055T under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 0055T with a diagnosis that isn't covered typically denies as CARC 50 — not medically necessary.
National approximation. Coverage varies by MAC and state — confirm against the specific LCD/NCD and article that applies to your jurisdiction and date of service.
| ICD-10 | Description |
|---|---|
| C40.21 | Malignant neoplasm of long bones of right lower limb |
| C40.22 | Malignant neoplasm of long bones of left lower limb |
| C47.21 | Malignant neoplasm of peripheral nerves of right lower limb, including hip |
| C47.22 | Malignant neoplasm of peripheral nerves of left lower limb, including hip |
| C49.20 | Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip |
| C49.21 | Malignant neoplasm of connective and soft tissue of right lower limb, including hip |
| C49.22 | Malignant neoplasm of connective and soft tissue of left lower limb, including hip |
| D16.21 | Benign neoplasm of long bones of right lower limb |
| D16.22 | Benign neoplasm of long bones of left lower limb |
| D21.21 | Benign neoplasm of connective and other soft tissue of right lower limb, including hip |
| D21.22 | Benign neoplasm of connective and other soft tissue of left lower limb, including hip |
| M05.451 | Rheumatoid myopathy with rheumatoid arthritis of right hip |
| M05.452 | Rheumatoid myopathy with rheumatoid arthritis of left hip |
| M05.461 | Rheumatoid myopathy with rheumatoid arthritis of right knee |
| M05.462 | Rheumatoid myopathy with rheumatoid arthritis of left knee |
| M05.551 | Rheumatoid polyneuropathy with rheumatoid arthritis of right hip |
| M05.552 | Rheumatoid polyneuropathy with rheumatoid arthritis of left hip |
| M05.561 | Rheumatoid polyneuropathy with rheumatoid arthritis of right knee |
| M05.562 | Rheumatoid polyneuropathy with rheumatoid arthritis of left knee |
| M05.59 | Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites |
| M05.751 | Rheumatoid arthritis with rheumatoid factor of right hip without organ or systems involvement |
| M05.752 | Rheumatoid arthritis with rheumatoid factor of left hip without organ or systems involvement |
| M05.761 | Rheumatoid arthritis with rheumatoid factor of right knee without organ or systems involvement |
| M05.762 | Rheumatoid arthritis with rheumatoid factor of left knee without organ or systems involvement |
| M05.79 | Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement |
| M06.051 | Rheumatoid arthritis without rheumatoid factor, right hip |
| M06.052 | Rheumatoid arthritis without rheumatoid factor, left hip |
| M06.061 | Rheumatoid arthritis without rheumatoid factor, right knee |
| M06.062 | Rheumatoid arthritis without rheumatoid factor, left knee |
| M06.261 | Rheumatoid bursitis, right knee |
| M06.262 | Rheumatoid bursitis, left knee |
| M06.361 | Rheumatoid nodule, right knee |
| M06.362 | Rheumatoid nodule, left knee |
| M12.551 | Traumatic arthropathy, right hip |
| M12.552 | Traumatic arthropathy, left hip |
| M12.561 | Traumatic arthropathy, right knee |
| M12.562 | Traumatic arthropathy, left knee |
| M16.0 | Bilateral primary osteoarthritis of hip |
| M16.11 | Unilateral primary osteoarthritis, right hip |
| M16.12 | Unilateral primary osteoarthritis, left hip |
| M16.2 | Bilateral osteoarthritis resulting from hip dysplasia |
| M16.31 | Unilateral osteoarthritis resulting from hip dysplasia, right hip |
| M16.32 | Unilateral osteoarthritis resulting from hip dysplasia, left hip |
| M16.4 | Bilateral post-traumatic osteoarthritis of hip |
| M16.51 | Unilateral post-traumatic osteoarthritis, right hip |
| M16.52 | Unilateral post-traumatic osteoarthritis, left hip |
| M16.6 | Other bilateral secondary osteoarthritis of hip |
| M16.7 | Other unilateral secondary osteoarthritis of hip |
| M17.0 | Bilateral primary osteoarthritis of knee |
| M17.11 | Unilateral primary osteoarthritis, right knee |
| M17.12 | Unilateral primary osteoarthritis, left knee |
| M17.2 | Bilateral post-traumatic osteoarthritis of knee |
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee |
| M17.32 | Unilateral post-traumatic osteoarthritis, left knee |
| M17.4 | Other bilateral secondary osteoarthritis of knee |
| M17.5 | Other unilateral secondary osteoarthritis of knee |
| M17.9 | Osteoarthritis of knee, unspecified |
| M23.51 | Chronic instability of knee, right knee |
| M23.52 | Chronic instability of knee, left knee |
| M24.651 | Ankylosis, right hip |
| M24.652 | Ankylosis, left hip |
| M24.661 | Ankylosis, right knee |
| M24.662 | Ankylosis, left knee |
| M24.7 | Protrusio acetabuli |
| M25.251 | Flail joint, right hip |
| M25.252 | Flail joint, left hip |
| M25.261 | Flail joint, right knee |
| M25.262 | Flail joint, left knee |
| M80.051A | Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture |
| M80.051D | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing |
| M80.051G | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing |
| M80.051K | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion |
| M80.051P | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion |
| M80.051S | Age-related osteoporosis with current pathological fracture, right femur, sequela |
| M80.052A | Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture |
| M80.052D | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing |
| M80.052G | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing |
| M80.052K | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion |
| M80.052P | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion |
| M80.052S | Age-related osteoporosis with current pathological fracture, left femur, sequela |
| M80.0B1A | Age-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture |
| M80.0B1D | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing |
| M80.0B1G | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing |
| M80.0B1K | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion |
| M80.0B1P | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion |
| M80.0B1S | Age-related osteoporosis with current pathological fracture, right pelvis, sequela |
| M80.0B2A | Age-related osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture |
| M80.0B2D | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing |
| M80.0B2G | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing |
| M80.0B2K | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion |
| M80.0B2P | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion |
| M80.0B2S | Age-related osteoporosis with current pathological fracture, left pelvis, sequela |
| M80.851A | Other osteoporosis with current pathological fracture, right femur, initial encounter for fracture |
| M80.851D | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing |
| M80.851G | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing |
| M80.851K | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion |
| M80.851P | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion |
| M80.851S | Other osteoporosis with current pathological fracture, right femur, sequela |
| M80.852A | Other osteoporosis with current pathological fracture, left femur, initial encounter for fracture |
| M80.852D | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing |
| M80.852G | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing |
| M80.852K | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion |
| M80.852P | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion |
| M80.852S | Other osteoporosis with current pathological fracture, left femur, sequela |
| M80.8B1A | Other osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture |
| M80.8B1D | Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing |
| M80.8B1G | Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing |
| M80.8B1K | Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion |
| M80.8B1P | Other osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion |
| M80.8B1S | Other osteoporosis with current pathological fracture, right pelvis, sequela |
| M80.8B2A | Other osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture |
| M80.8B2D | Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing |
| M80.8B2G | Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing |
| M80.8B2K | Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion |
| M80.8B2P | Other osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion |
| M80.8B2S | Other osteoporosis with current pathological fracture, left pelvis, sequela |
| M84.350A | Stress fracture, pelvis, initial encounter for fracture |
| M84.350D | Stress fracture, pelvis, subsequent encounter for fracture with routine healing |
| M84.350G | Stress fracture, pelvis, subsequent encounter for fracture with delayed healing |
| M84.350K | Stress fracture, pelvis, subsequent encounter for fracture with nonunion |
| M84.350P | Stress fracture, pelvis, subsequent encounter for fracture with malunion |
| M84.350S | Stress fracture, pelvis, sequela |
| M84.351A | Stress fracture, right femur, initial encounter for fracture |
| M84.351D | Stress fracture, right femur, subsequent encounter for fracture with routine healing |
| M84.351G | Stress fracture, right femur, subsequent encounter for fracture with delayed healing |
| M84.351K | Stress fracture, right femur, subsequent encounter for fracture with nonunion |
| M84.351P | Stress fracture, right femur, subsequent encounter for fracture with malunion |
| M84.351S | Stress fracture, right femur, sequela |
| M84.352A | Stress fracture, left femur, initial encounter for fracture |
| M84.352D | Stress fracture, left femur, subsequent encounter for fracture with routine healing |
| M84.352G | Stress fracture, left femur, subsequent encounter for fracture with delayed healing |
| M84.352K | Stress fracture, left femur, subsequent encounter for fracture with nonunion |
| M84.352P | Stress fracture, left femur, subsequent encounter for fracture with malunion |
| M84.352S | Stress fracture, left femur, sequela |
| M84.451A | Pathological fracture, right femur, initial encounter for fracture |
| M84.451D | Pathological fracture, right femur, subsequent encounter for fracture with routine healing |
| M84.451G | Pathological fracture, right femur, subsequent encounter for fracture with delayed healing |
| M84.451K | Pathological fracture, right femur, subsequent encounter for fracture with nonunion |
| M84.451P | Pathological fracture, right femur, subsequent encounter for fracture with malunion |
| M84.451S | Pathological fracture, right femur, sequela |
| M84.452A | Pathological fracture, left femur, initial encounter for fracture |
| M84.452D | Pathological fracture, left femur, subsequent encounter for fracture with routine healing |
| M84.452G | Pathological fracture, left femur, subsequent encounter for fracture with delayed healing |
| M84.452K | Pathological fracture, left femur, subsequent encounter for fracture with nonunion |
| M84.452P | Pathological fracture, left femur, subsequent encounter for fracture with malunion |
| M84.452S | Pathological fracture, left femur, sequela |
| M84.454A | Pathological fracture, pelvis, initial encounter for fracture |
| M84.454D | Pathological fracture, pelvis, subsequent encounter for fracture with routine healing |
| M84.454G | Pathological fracture, pelvis, subsequent encounter for fracture with delayed healing |
| M84.454K | Pathological fracture, pelvis, subsequent encounter for fracture with nonunion |
| M84.454P | Pathological fracture, pelvis, subsequent encounter for fracture with malunion |
| M84.454S | Pathological fracture, pelvis, sequela |
| M84.550A | Pathological fracture in neoplastic disease, pelvis, initial encounter for fracture |
| M84.550D | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with routine healing |
| M84.550G | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with delayed healing |
| M84.550K | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with nonunion |
| M84.550P | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with malunion |
| M84.550S | Pathological fracture in neoplastic disease, pelvis, sequela |
| M84.551A | Pathological fracture in neoplastic disease, right femur, initial encounter for fracture |
| M84.551D | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with routine healing |
| M84.551G | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with delayed healing |
| M84.551K | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with nonunion |
| M84.551P | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with malunion |
| M84.551S | Pathological fracture in neoplastic disease, right femur, sequela |
| M84.552A | Pathological fracture in neoplastic disease, left femur, initial encounter for fracture |
| M84.552D | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with routine healing |
| M84.552G | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with delayed healing |
| M84.552K | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with nonunion |
| M84.552P | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with malunion |
| M84.552S | Pathological fracture in neoplastic disease, left femur, sequela |
| M84.650A | Pathological fracture in other disease, pelvis, initial encounter for fracture |
| M84.650D | Pathological fracture in other disease, pelvis, subsequent encounter for fracture with routine healing |
| M84.650G | Pathological fracture in other disease, pelvis, subsequent encounter for fracture with delayed healing |
| M84.650K | Pathological fracture in other disease, pelvis, subsequent encounter for fracture with nonunion |
| M84.650P | Pathological fracture in other disease, pelvis, subsequent encounter for fracture with malunion |
| M84.650S | Pathological fracture in other disease, pelvis, sequela |
| M84.651A | Pathological fracture in other disease, right femur, initial encounter for fracture |
| M84.651D | Pathological fracture in other disease, right femur, subsequent encounter for fracture with routine healing |
| M84.651G | Pathological fracture in other disease, right femur, subsequent encounter for fracture with delayed healing |
| M84.651K | Pathological fracture in other disease, right femur, subsequent encounter for fracture with nonunion |
| M84.651P | Pathological fracture in other disease, right femur, subsequent encounter for fracture with malunion |
| M84.651S | Pathological fracture in other disease, right femur, sequela |
| M84.652A | Pathological fracture in other disease, left femur, initial encounter for fracture |
| M84.652D | Pathological fracture in other disease, left femur, subsequent encounter for fracture with routine healing |
| M84.652G | Pathological fracture in other disease, left femur, subsequent encounter for fracture with delayed healing |
| M84.652K | Pathological fracture in other disease, left femur, subsequent encounter for fracture with nonunion |
| M84.652P | Pathological fracture in other disease, left femur, subsequent encounter for fracture with malunion |
| M84.652S | Pathological fracture in other disease, left femur, sequela |
| M84.750A | Atypical femoral fracture, unspecified, initial encounter for fracture |
| M84.750D | Atypical femoral fracture, unspecified, subsequent encounter for fracture with routine healing |
| M84.750G | Atypical femoral fracture, unspecified, subsequent encounter for fracture with delayed healing |
| M84.750K | Atypical femoral fracture, unspecified, subsequent encounter for fracture with nonunion |
| M84.750P | Atypical femoral fracture, unspecified, subsequent encounter for fracture with malunion |
| M84.750S | Atypical femoral fracture, unspecified, sequela |
| M84.751A | Incomplete atypical femoral fracture, right leg, initial encounter for fracture |
| M84.751D | Incomplete atypical femoral fracture, right leg, subsequent encounter for fracture with routine healing |
| M84.751G | Incomplete atypical femoral fracture, right leg, subsequent encounter for fracture with delayed healing |
| M84.751K | Incomplete atypical femoral fracture, right leg, subsequent encounter for fracture with nonunion |
| M84.751P | Incomplete atypical femoral fracture, right leg, subsequent encounter for fracture with malunion |
| M84.751S | Incomplete atypical femoral fracture, right leg, sequela |
| M84.752A | Incomplete atypical femoral fracture, left leg, initial encounter for fracture |
| M84.752D | Incomplete atypical femoral fracture, left leg, subsequent encounter for fracture with routine healing |
| M84.752G | Incomplete atypical femoral fracture, left leg, subsequent encounter for fracture with delayed healing |
| M84.752K | Incomplete atypical femoral fracture, left leg, subsequent encounter for fracture with nonunion |
| M84.752P | Incomplete atypical femoral fracture, left leg, subsequent encounter for fracture with malunion |
| M84.752S | Incomplete atypical femoral fracture, left leg, sequela |
| M84.754A | Complete transverse atypical femoral fracture, right leg, initial encounter for fracture |
| M84.754D | Complete transverse atypical femoral fracture, right leg, subsequent encounter for fracture with routine healing |
| M84.754G | Complete transverse atypical femoral fracture, right leg, subsequent encounter for fracture with delayed healing |
| M84.754K | Complete transverse atypical femoral fracture, right leg, subsequent encounter for fracture with nonunion |
| M84.754P | Complete transverse atypical femoral fracture, right leg, subsequent encounter for fracture with malunion |
| M84.754S | Complete transverse atypical femoral fracture, right leg, sequela |
| M84.755A | Complete transverse atypical femoral fracture, left leg, initial encounter for fracture |
| M84.755D | Complete transverse atypical femoral fracture, left leg, subsequent encounter for fracture with routine healing |
| M84.755G | Complete transverse atypical femoral fracture, left leg, subsequent encounter for fracture with delayed healing |
| M84.755K | Complete transverse atypical femoral fracture, left leg, subsequent encounter for fracture with nonunion |
| M84.755P | Complete transverse atypical femoral fracture, left leg, subsequent encounter for fracture with malunion |
| M84.755S | Complete transverse atypical femoral fracture, left leg, sequela |
| M84.757A | Complete oblique atypical femoral fracture, right leg, initial encounter for fracture |
| M84.757D | Complete oblique atypical femoral fracture, right leg, subsequent encounter for fracture with routine healing |
| M84.757G | Complete oblique atypical femoral fracture, right leg, subsequent encounter for fracture with delayed healing |
| M84.757K | Complete oblique atypical femoral fracture, right leg, subsequent encounter for fracture with nonunion |
| M84.757P | Complete oblique atypical femoral fracture, right leg, subsequent encounter for fracture with malunion |
| M84.757S | Complete oblique atypical femoral fracture, right leg, sequela |
| M84.758A | Complete oblique atypical femoral fracture, left leg, initial encounter for fracture |
| M84.758D | Complete oblique atypical femoral fracture, left leg, subsequent encounter for fracture with routine healing |
| M84.758G | Complete oblique atypical femoral fracture, left leg, subsequent encounter for fracture with delayed healing |
| M84.758K | Complete oblique atypical femoral fracture, left leg, subsequent encounter for fracture with nonunion |
| M84.758P | Complete oblique atypical femoral fracture, left leg, subsequent encounter for fracture with malunion |
| M84.758S | Complete oblique atypical femoral fracture, left leg, sequela |
| M87.050 | Idiopathic aseptic necrosis of pelvis |
| M87.051 | Idiopathic aseptic necrosis of right femur |
| M87.052 | Idiopathic aseptic necrosis of left femur |
| M87.150 | Osteonecrosis due to drugs, pelvis |
| M87.151 | Osteonecrosis due to drugs, right femur |
| M87.152 | Osteonecrosis due to drugs, left femur |
| M87.250 | Osteonecrosis due to previous trauma, pelvis |
| M87.251 | Osteonecrosis due to previous trauma, right femur |
| M87.252 | Osteonecrosis due to previous trauma, left femur |
| M87.350 | Other secondary osteonecrosis, pelvis |
| M87.351 | Other secondary osteonecrosis, right femur |
| M87.352 | Other secondary osteonecrosis, left femur |
| M88.851 | Osteitis deformans of right thigh |
| M88.852 | Osteitis deformans of left thigh |
| M96.65 | Fracture of pelvis following insertion of orthopedic implant, joint prosthesis, or bone plate |
| M96.661 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg |
| M96.662 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg |
| M96.669 | Fracture of femur following insertion of orthopedic implant, joint prosthesis, or bone plate, unspecified leg |
| M96.671 | Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, right leg |
| M96.672 | Fracture of tibia or fibula following insertion of orthopedic implant, joint prosthesis, or bone plate, left leg |
| M97.01XA | Periprosthetic fracture around internal prosthetic right hip joint, initial encounter |
| M97.01XD | Periprosthetic fracture around internal prosthetic right hip joint, subsequent encounter |
| M97.01XS | Periprosthetic fracture around internal prosthetic right hip joint, sequela |
| M97.02XA | Periprosthetic fracture around internal prosthetic left hip joint, initial encounter |
| M97.02XD | Periprosthetic fracture around internal prosthetic left hip joint, subsequent encounter |
| M97.02XS | Periprosthetic fracture around internal prosthetic left hip joint, sequela |
| M97.11XA | Periprosthetic fracture around internal prosthetic right knee joint, initial encounter |
| M97.11XD | Periprosthetic fracture around internal prosthetic right knee joint, subsequent encounter |
| M97.11XS | Periprosthetic fracture around internal prosthetic right knee joint, sequela |
| M97.12XA | Periprosthetic fracture around internal prosthetic left knee joint, initial encounter |
| M97.12XD | Periprosthetic fracture around internal prosthetic left knee joint, subsequent encounter |
| M97.12XS | Periprosthetic fracture around internal prosthetic left knee joint, sequela |
| Q65.01 | Congenital dislocation of right hip, unilateral |
| Q65.02 | Congenital dislocation of left hip, unilateral |
| Q65.89 | Other specified congenital deformities of hip |
| S32.311A | Displaced avulsion fracture of right ilium, initial encounter for closed fracture |
| S32.311B | Displaced avulsion fracture of right ilium, initial encounter for open fracture |
| S32.311D | Displaced avulsion fracture of right ilium, subsequent encounter for fracture with routine healing |
| S32.311G | Displaced avulsion fracture of right ilium, subsequent encounter for fracture with delayed healing |
| S32.311K | Displaced avulsion fracture of right ilium, subsequent encounter for fracture with nonunion |
| S32.311S | Displaced avulsion fracture of right ilium, sequela |
| S32.312A | Displaced avulsion fracture of left ilium, initial encounter for closed fracture |
| S32.312B | Displaced avulsion fracture of left ilium, initial encounter for open fracture |
| S32.312D | Displaced avulsion fracture of left ilium, subsequent encounter for fracture with routine healing |
| S32.312G | Displaced avulsion fracture of left ilium, subsequent encounter for fracture with delayed healing |
| S32.312K | Displaced avulsion fracture of left ilium, subsequent encounter for fracture with nonunion |
| S32.312S | Displaced avulsion fracture of left ilium, sequela |
| S32.314A | Nondisplaced avulsion fracture of right ilium, initial encounter for closed fracture |
| S32.314B | Nondisplaced avulsion fracture of right ilium, initial encounter for open fracture |
| S32.314D | Nondisplaced avulsion fracture of right ilium, subsequent encounter for fracture with routine healing |
| S32.314G | Nondisplaced avulsion fracture of right ilium, subsequent encounter for fracture with delayed healing |
| S32.314K | Nondisplaced avulsion fracture of right ilium, subsequent encounter for fracture with nonunion |
| S32.314S | Nondisplaced avulsion fracture of right ilium, sequela |
| S32.315A | Nondisplaced avulsion fracture of left ilium, initial encounter for closed fracture |
| S32.315B | Nondisplaced avulsion fracture of left ilium, initial encounter for open fracture |
| S32.315D | Nondisplaced avulsion fracture of left ilium, subsequent encounter for fracture with routine healing |
| S32.315G | Nondisplaced avulsion fracture of left ilium, subsequent encounter for fracture with delayed healing |
| S32.315K | Nondisplaced avulsion fracture of left ilium, subsequent encounter for fracture with nonunion |
| S32.315S | Nondisplaced avulsion fracture of left ilium, sequela |
| S32.411A | Displaced fracture of anterior wall of right acetabulum, initial encounter for closed fracture |
| S32.411B | Displaced fracture of anterior wall of right acetabulum, initial encounter for open fracture |
| S32.411D | Displaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.411G | Displaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.411K | Displaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.411S | Displaced fracture of anterior wall of right acetabulum, sequela |
| S32.412A | Displaced fracture of anterior wall of left acetabulum, initial encounter for closed fracture |
| S32.412B | Displaced fracture of anterior wall of left acetabulum, initial encounter for open fracture |
| S32.412D | Displaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.412G | Displaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.412K | Displaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.412S | Displaced fracture of anterior wall of left acetabulum, sequela |
| S32.414A | Nondisplaced fracture of anterior wall of right acetabulum, initial encounter for closed fracture |
| S32.414B | Nondisplaced fracture of anterior wall of right acetabulum, initial encounter for open fracture |
| S32.414D | Nondisplaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.414G | Nondisplaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.414K | Nondisplaced fracture of anterior wall of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.414S | Nondisplaced fracture of anterior wall of right acetabulum, sequela |
| S32.415A | Nondisplaced fracture of anterior wall of left acetabulum, initial encounter for closed fracture |
| S32.415B | Nondisplaced fracture of anterior wall of left acetabulum, initial encounter for open fracture |
| S32.415D | Nondisplaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.415G | Nondisplaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.415K | Nondisplaced fracture of anterior wall of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.415S | Nondisplaced fracture of anterior wall of left acetabulum, sequela |
| S32.421A | Displaced fracture of posterior wall of right acetabulum, initial encounter for closed fracture |
| S32.421B | Displaced fracture of posterior wall of right acetabulum, initial encounter for open fracture |
| S32.421D | Displaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.421G | Displaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.421K | Displaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.421S | Displaced fracture of posterior wall of right acetabulum, sequela |
| S32.422A | Displaced fracture of posterior wall of left acetabulum, initial encounter for closed fracture |
| S32.422B | Displaced fracture of posterior wall of left acetabulum, initial encounter for open fracture |
| S32.422D | Displaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.422G | Displaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.422K | Displaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.422S | Displaced fracture of posterior wall of left acetabulum, sequela |
| S32.424A | Nondisplaced fracture of posterior wall of right acetabulum, initial encounter for closed fracture |
| S32.424B | Nondisplaced fracture of posterior wall of right acetabulum, initial encounter for open fracture |
| S32.424D | Nondisplaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.424G | Nondisplaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.424K | Nondisplaced fracture of posterior wall of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.424S | Nondisplaced fracture of posterior wall of right acetabulum, sequela |
| S32.425A | Nondisplaced fracture of posterior wall of left acetabulum, initial encounter for closed fracture |
| S32.425B | Nondisplaced fracture of posterior wall of left acetabulum, initial encounter for open fracture |
| S32.425D | Nondisplaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.425G | Nondisplaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.425K | Nondisplaced fracture of posterior wall of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.425S | Nondisplaced fracture of posterior wall of left acetabulum, sequela |
| S32.431A | Displaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for closed fracture |
| S32.431B | Displaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for open fracture |
| S32.431D | Displaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.431G | Displaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.431K | Displaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.431S | Displaced fracture of anterior column [iliopubic] of right acetabulum, sequela |
| S32.432A | Displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture |
| S32.432B | Displaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for open fracture |
| S32.432D | Displaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.432G | Displaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.432K | Displaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.432S | Displaced fracture of anterior column [iliopubic] of left acetabulum, sequela |
| S32.434A | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for closed fracture |
| S32.434B | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for open fracture |
| S32.434D | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.434G | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.434K | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.434S | Nondisplaced fracture of anterior column [iliopubic] of right acetabulum, sequela |
| S32.435A | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture |
| S32.435B | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for open fracture |
| S32.435D | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.435G | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.435K | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.435S | Nondisplaced fracture of anterior column [iliopubic] of left acetabulum, sequela |
| S32.441A | Displaced fracture of posterior column [ilioischial] of right acetabulum, initial encounter for closed fracture |
| S32.441B | Displaced fracture of posterior column [ilioischial] of right acetabulum, initial encounter for open fracture |
| S32.441D | Displaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.441G | Displaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.441K | Displaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.441S | Displaced fracture of posterior column [ilioischial] of right acetabulum, sequela |
| S32.442A | Displaced fracture of posterior column [ilioischial] of left acetabulum, initial encounter for closed fracture |
| S32.442B | Displaced fracture of posterior column [ilioischial] of left acetabulum, initial encounter for open fracture |
| S32.442D | Displaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.442G | Displaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.442K | Displaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.442S | Displaced fracture of posterior column [ilioischial] of left acetabulum, sequela |
| S32.444A | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, initial encounter for closed fracture |
| S32.444B | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, initial encounter for open fracture |
| S32.444D | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.444G | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.444K | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.444S | Nondisplaced fracture of posterior column [ilioischial] of right acetabulum, sequela |
| S32.445A | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, initial encounter for closed fracture |
| S32.445B | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, initial encounter for open fracture |
| S32.445D | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.445G | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.445K | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.445S | Nondisplaced fracture of posterior column [ilioischial] of left acetabulum, sequela |
| S32.451A | Displaced transverse fracture of right acetabulum, initial encounter for closed fracture |
| S32.451B | Displaced transverse fracture of right acetabulum, initial encounter for open fracture |
| S32.451D | Displaced transverse fracture of right acetabulum, subsequent encounter for fracture with routine healing |
| S32.451G | Displaced transverse fracture of right acetabulum, subsequent encounter for fracture with delayed healing |
| S32.451K | Displaced transverse fracture of right acetabulum, subsequent encounter for fracture with nonunion |
| S32.451S | Displaced transverse fracture of right acetabulum, sequela |
| S32.452A | Displaced transverse fracture of left acetabulum, initial encounter for closed fracture |
| S32.452B | Displaced transverse fracture of left acetabulum, initial encounter for open fracture |
| S32.452D | Displaced transverse fracture of left acetabulum, subsequent encounter for fracture with routine healing |
| S32.452G | Displaced transverse fracture of left acetabulum, subsequent encounter for fracture with delayed healing |
| S32.452K | Displaced transverse fracture of left acetabulum, subsequent encounter for fracture with nonunion |
| S32.452S | Displaced transverse fracture of left acetabulum, sequela |
| S32.454A | Nondisplaced transverse fracture of right acetabulum, initial encounter for closed fracture |
| S32.454B | Nondisplaced transverse fracture of right acetabulum, initial encounter for open fracture |
| S32.454D | Nondisplaced transverse fracture of right acetabulum, subsequent encounter for fracture with routine healing |
Showing the first 400 of 1313 covered codes — this procedure has a large covered-diagnosis set; see the governing LCD/article for the complete list.
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 0055T?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 1313 ICD-10 diagnosis codes that support medical necessity for CPT 0055T. The covered codes are listed on this page. Coverage varies by MAC/state — always confirm against the policy that applies to you.
What is a medical-necessity (LCD/NCD) crosswalk?
A claim whose procedure isn't supported by a covered diagnosis denies as "not medically necessary" (CARC 50). CMS coverage policies define which diagnoses justify a procedure; this page is the ICD-10 → CPT 0055T view of that relationship.
Catch medical-necessity denials before you bill. CareNiva scrubs claims against LCD/NCD coverage and flags unsupported diagnoses — in the same platform you run visits and billing.
More free billing tools: all crosswalks · NCCI edits · Medicare fees · denial codes
Informational only, not coding, billing, or legal advice. Based on CMS Medicare Coverage Database data; verify the current LCD/NCD for your MAC before billing.
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