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ICD↔CPT crosswalk

CPT 11646: ICD-10 codes that support medical necessity

297 covered diagnosis codes under Medicare coverage policies (LCD/NCD)

These ICD-10-CM diagnoses support medical necessity for CPT 11646 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 11646 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-10Description
C00.0Malignant neoplasm of external upper lip
C00.1Malignant neoplasm of external lower lip
C00.2Malignant neoplasm of external lip, unspecified
C00.3Malignant neoplasm of upper lip, inner aspect
C00.4Malignant neoplasm of lower lip, inner aspect
C00.5Malignant neoplasm of lip, unspecified, inner aspect
C00.6Malignant neoplasm of commissure of lip, unspecified
C00.8Malignant neoplasm of overlapping sites of lip
C00.9Malignant neoplasm of lip, unspecified
C01Malignant neoplasm of base of tongue
C02.0Malignant neoplasm of dorsal surface of tongue
C02.1Malignant neoplasm of border of tongue
C02.2Malignant neoplasm of ventral surface of tongue
C02.3Malignant neoplasm of anterior two-thirds of tongue, part unspecified
C02.4Malignant neoplasm of lingual tonsil
C02.8Malignant neoplasm of overlapping sites of tongue
C02.9Malignant neoplasm of tongue, unspecified
C03.0Malignant neoplasm of upper gum
C03.1Malignant neoplasm of lower gum
C03.9Malignant neoplasm of gum, unspecified
C04.0Malignant neoplasm of anterior floor of mouth
C04.1Malignant neoplasm of lateral floor of mouth
C04.8Malignant neoplasm of overlapping sites of floor of mouth
C04.9Malignant neoplasm of floor of mouth, unspecified
C05.0Malignant neoplasm of hard palate
C05.1Malignant neoplasm of soft palate
C05.2Malignant neoplasm of uvula
C05.8Malignant neoplasm of overlapping sites of palate
C05.9Malignant neoplasm of palate, unspecified
C06.0Malignant neoplasm of cheek mucosa
C06.1Malignant neoplasm of vestibule of mouth
C06.2Malignant neoplasm of retromolar area
C06.80Malignant neoplasm of overlapping sites of unspecified parts of mouth
C06.89Malignant neoplasm of overlapping sites of other parts of mouth
C06.9Malignant neoplasm of mouth, unspecified
C07Malignant neoplasm of parotid gland
C08.0Malignant neoplasm of submandibular gland
C08.1Malignant neoplasm of sublingual gland
C08.9Malignant neoplasm of major salivary gland, unspecified
C09.0Malignant neoplasm of tonsillar fossa
C09.1Malignant neoplasm of tonsillar pillar (anterior) (posterior)
C09.8Malignant neoplasm of overlapping sites of tonsil
C09.9Malignant neoplasm of tonsil, unspecified
C10.0Malignant neoplasm of vallecula
C10.1Malignant neoplasm of anterior surface of epiglottis
C10.2Malignant neoplasm of lateral wall of oropharynx
C10.3Malignant neoplasm of posterior wall of oropharynx
C10.4Malignant neoplasm of branchial cleft
C10.8Malignant neoplasm of overlapping sites of oropharynx
C10.9Malignant neoplasm of oropharynx, unspecified
C11.0Malignant neoplasm of superior wall of nasopharynx
C11.1Malignant neoplasm of posterior wall of nasopharynx
C11.2Malignant neoplasm of lateral wall of nasopharynx
C11.3Malignant neoplasm of anterior wall of nasopharynx
C11.8Malignant neoplasm of overlapping sites of nasopharynx
C11.9Malignant neoplasm of nasopharynx, unspecified
C12Malignant neoplasm of pyriform sinus
C13.0Malignant neoplasm of postcricoid region
C13.1Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
C13.2Malignant neoplasm of posterior wall of hypopharynx
C13.8Malignant neoplasm of overlapping sites of hypopharynx
C13.9Malignant neoplasm of hypopharynx, unspecified
C14.0Malignant neoplasm of pharynx, unspecified
C14.2Malignant neoplasm of Waldeyer's ring
C14.8Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx
C43.0Malignant melanoma of lip
C43.10Malignant melanoma of unspecified eyelid, including canthus
C43.111Malignant melanoma of right upper eyelid, including canthus
C43.112Malignant melanoma of right lower eyelid, including canthus
C43.121Malignant melanoma of left upper eyelid, including canthus
C43.122Malignant melanoma of left lower eyelid, including canthus
C43.20Malignant melanoma of unspecified ear and external auricular canal
C43.21Malignant melanoma of right ear and external auricular canal
C43.22Malignant melanoma of left ear and external auricular canal
C43.30Malignant melanoma of unspecified part of face
C43.31Malignant melanoma of nose
C43.39Malignant melanoma of other parts of face
C43.4Malignant melanoma of scalp and neck
C43.51Malignant melanoma of anal skin
C43.52Malignant melanoma of skin of breast
C43.59Malignant melanoma of other part of trunk
C43.60Malignant melanoma of unspecified upper limb, including shoulder
C43.61Malignant melanoma of right upper limb, including shoulder
C43.62Malignant melanoma of left upper limb, including shoulder
C43.70Malignant melanoma of unspecified lower limb, including hip
C43.71Malignant melanoma of right lower limb, including hip
C43.72Malignant melanoma of left lower limb, including hip
C43.8Malignant melanoma of overlapping sites of skin
C44.00Unspecified malignant neoplasm of skin of lip
C44.01Basal cell carcinoma of skin of lip
C44.02Squamous cell carcinoma of skin of lip
C44.09Other specified malignant neoplasm of skin of lip
C44.101Unspecified malignant neoplasm of skin of unspecified eyelid, including canthus
C44.1021Unspecified malignant neoplasm of skin of right upper eyelid, including canthus
C44.1022Unspecified malignant neoplasm of skin of right lower eyelid, including canthus
C44.1091Unspecified malignant neoplasm of skin of left upper eyelid, including canthus
C44.1092Unspecified malignant neoplasm of skin of left lower eyelid, including canthus
C44.111Basal cell carcinoma of skin of unspecified eyelid, including canthus
C44.1121Basal cell carcinoma of skin of right upper eyelid, including canthus
C44.1122Basal cell carcinoma of skin of right lower eyelid, including canthus
C44.1191Basal cell carcinoma of skin of left upper eyelid, including canthus
C44.1192Basal cell carcinoma of skin of left lower eyelid, including canthus
C44.121Squamous cell carcinoma of skin of unspecified eyelid, including canthus
C44.1221Squamous cell carcinoma of skin of right upper eyelid, including canthus
C44.1222Squamous cell carcinoma of skin of right lower eyelid, including canthus
C44.1291Squamous cell carcinoma of skin of left upper eyelid, including canthus
C44.1292Squamous cell carcinoma of skin of left lower eyelid, including canthus
C44.131Sebaceous cell carcinoma of skin of unspecified eyelid, including canthus
C44.1321Sebaceous cell carcinoma of skin of right upper eyelid, including canthus
C44.1322Sebaceous cell carcinoma of skin of right lower eyelid, including canthus
C44.1391Sebaceous cell carcinoma of skin of left upper eyelid, including canthus
C44.1392Sebaceous cell carcinoma of skin of left lower eyelid, including canthus
C44.191Other specified malignant neoplasm of skin of unspecified eyelid, including canthus
C44.1921Other specified malignant neoplasm of skin of right upper eyelid, including canthus
C44.1922Other specified malignant neoplasm of skin of right lower eyelid, including canthus
C44.1991Other specified malignant neoplasm of skin of left upper eyelid, including canthus
C44.1992Other specified malignant neoplasm of skin of left lower eyelid, including canthus
C44.201Unspecified malignant neoplasm of skin of unspecified ear and external auricular canal
C44.202Unspecified malignant neoplasm of skin of right ear and external auricular canal
C44.209Unspecified malignant neoplasm of skin of left ear and external auricular canal
C44.211Basal cell carcinoma of skin of unspecified ear and external auricular canal
C44.212Basal cell carcinoma of skin of right ear and external auricular canal
C44.219Basal cell carcinoma of skin of left ear and external auricular canal
C44.221Squamous cell carcinoma of skin of unspecified ear and external auricular canal
C44.222Squamous cell carcinoma of skin of right ear and external auricular canal
C44.229Squamous cell carcinoma of skin of left ear and external auricular canal
C44.291Other specified malignant neoplasm of skin of unspecified ear and external auricular canal
C44.292Other specified malignant neoplasm of skin of right ear and external auricular canal
C44.299Other specified malignant neoplasm of skin of left ear and external auricular canal
C44.300Unspecified malignant neoplasm of skin of unspecified part of face
C44.301Unspecified malignant neoplasm of skin of nose
C44.309Unspecified malignant neoplasm of skin of other parts of face
C44.310Basal cell carcinoma of skin of unspecified parts of face
C44.311Basal cell carcinoma of skin of nose
C44.319Basal cell carcinoma of skin of other parts of face
C44.320Squamous cell carcinoma of skin of unspecified parts of face
C44.321Squamous cell carcinoma of skin of nose
C44.329Squamous cell carcinoma of skin of other parts of face
C44.390Other specified malignant neoplasm of skin of unspecified parts of face
C44.391Other specified malignant neoplasm of skin of nose
C44.399Other specified malignant neoplasm of skin of other parts of face
C44.40Unspecified malignant neoplasm of skin of scalp and neck
C44.41Basal cell carcinoma of skin of scalp and neck
C44.42Squamous cell carcinoma of skin of scalp and neck
C44.49Other specified malignant neoplasm of skin of scalp and neck
C44.500Unspecified malignant neoplasm of anal skin
C44.501Unspecified malignant neoplasm of skin of breast
C44.509Unspecified malignant neoplasm of skin of other part of trunk
C44.510Basal cell carcinoma of anal skin
C44.511Basal cell carcinoma of skin of breast
C44.519Basal cell carcinoma of skin of other part of trunk
C44.520Squamous cell carcinoma of anal skin
C44.521Squamous cell carcinoma of skin of breast
C44.529Squamous cell carcinoma of skin of other part of trunk
C44.590Other specified malignant neoplasm of anal skin
C44.591Other specified malignant neoplasm of skin of breast
C44.599Other specified malignant neoplasm of skin of other part of trunk
C44.601Unspecified malignant neoplasm of skin of unspecified upper limb, including shoulder
C44.602Unspecified malignant neoplasm of skin of right upper limb, including shoulder
C44.609Unspecified malignant neoplasm of skin of left upper limb, including shoulder
C44.611Basal cell carcinoma of skin of unspecified upper limb, including shoulder
C44.612Basal cell carcinoma of skin of right upper limb, including shoulder
C44.619Basal cell carcinoma of skin of left upper limb, including shoulder
C44.621Squamous cell carcinoma of skin of unspecified upper limb, including shoulder
C44.622Squamous cell carcinoma of skin of right upper limb, including shoulder
C44.629Squamous cell carcinoma of skin of left upper limb, including shoulder
C44.691Other specified malignant neoplasm of skin of unspecified upper limb, including shoulder
C44.692Other specified malignant neoplasm of skin of right upper limb, including shoulder
C44.699Other specified malignant neoplasm of skin of left upper limb, including shoulder
C44.701Unspecified malignant neoplasm of skin of unspecified lower limb, including hip
C44.702Unspecified malignant neoplasm of skin of right lower limb, including hip
C44.709Unspecified malignant neoplasm of skin of left lower limb, including hip
C44.711Basal cell carcinoma of skin of unspecified lower limb, including hip
C44.712Basal cell carcinoma of skin of right lower limb, including hip
C44.719Basal cell carcinoma of skin of left lower limb, including hip
C44.721Squamous cell carcinoma of skin of unspecified lower limb, including hip
C44.722Squamous cell carcinoma of skin of right lower limb, including hip
C44.729Squamous cell carcinoma of skin of left lower limb, including hip
C44.791Other specified malignant neoplasm of skin of unspecified lower limb, including hip
C44.792Other specified malignant neoplasm of skin of right lower limb, including hip
C44.799Other specified malignant neoplasm of skin of left lower limb, including hip
C44.80Unspecified malignant neoplasm of overlapping sites of skin
C44.81Basal cell carcinoma of overlapping sites of skin
C44.82Squamous cell carcinoma of overlapping sites of skin
C44.89Other specified malignant neoplasm of overlapping sites of skin
C4A.0Merkel cell carcinoma of lip
C4A.10Merkel cell carcinoma of unspecified eyelid, including canthus
C4A.111Merkel cell carcinoma of right upper eyelid, including canthus
C4A.112Merkel cell carcinoma of right lower eyelid, including canthus
C4A.121Merkel cell carcinoma of left upper eyelid, including canthus
C4A.122Merkel cell carcinoma of left lower eyelid, including canthus
C4A.20Merkel cell carcinoma of unspecified ear and external auricular canal
C4A.21Merkel cell carcinoma of right ear and external auricular canal
C4A.22Merkel cell carcinoma of left ear and external auricular canal
C4A.30Merkel cell carcinoma of unspecified part of face
C4A.31Merkel cell carcinoma of nose
C4A.39Merkel cell carcinoma of other parts of face
C4A.4Merkel cell carcinoma of scalp and neck
C4A.51Merkel cell carcinoma of anal skin
C4A.52Merkel cell carcinoma of skin of breast
C4A.59Merkel cell carcinoma of other part of trunk
C4A.60Merkel cell carcinoma of unspecified upper limb, including shoulder
C4A.61Merkel cell carcinoma of right upper limb, including shoulder
C4A.62Merkel cell carcinoma of left upper limb, including shoulder
C4A.70Merkel cell carcinoma of unspecified lower limb, including hip
C4A.71Merkel cell carcinoma of right lower limb, including hip
C4A.72Merkel cell carcinoma of left lower limb, including hip
C4A.8Merkel cell carcinoma of overlapping sites
C4A.9Merkel cell carcinoma, unspecified
C51.0Malignant neoplasm of labium majus
C51.1Malignant neoplasm of labium minus
C51.2Malignant neoplasm of clitoris
C51.8Malignant neoplasm of overlapping sites of vulva
C51.9Malignant neoplasm of vulva, unspecified
C52Malignant neoplasm of vagina
C57.7Malignant neoplasm of other specified female genital organs
C57.8Malignant neoplasm of overlapping sites of female genital organs
C60.0Malignant neoplasm of prepuce
C60.1Malignant neoplasm of glans penis
C60.2Malignant neoplasm of body of penis
C60.8Malignant neoplasm of overlapping sites of penis
C60.9Malignant neoplasm of penis, unspecified
C63.2Malignant neoplasm of scrotum
C76.0Malignant neoplasm of head, face and neck
C76.1Malignant neoplasm of thorax
C76.2Malignant neoplasm of abdomen
C76.3Malignant neoplasm of pelvis
C76.40Malignant neoplasm of unspecified upper limb
C76.41Malignant neoplasm of right upper limb
C76.42Malignant neoplasm of left upper limb
C76.50Malignant neoplasm of unspecified lower limb
C76.51Malignant neoplasm of right lower limb
C76.52Malignant neoplasm of left lower limb
C76.8Malignant neoplasm of other specified ill-defined sites
C79.2Secondary malignant neoplasm of skin
C79.81Secondary malignant neoplasm of breast
C79.82Secondary malignant neoplasm of genital organs
D00.00Carcinoma in situ of oral cavity, unspecified site
D00.01Carcinoma in situ of labial mucosa and vermilion border
D00.02Carcinoma in situ of buccal mucosa
D00.03Carcinoma in situ of gingiva and edentulous alveolar ridge
D00.04Carcinoma in situ of soft palate
D00.05Carcinoma in situ of hard palate
D00.06Carcinoma in situ of floor of mouth
D00.07Carcinoma in situ of tongue
D00.08Carcinoma in situ of pharynx
D03.0Melanoma in situ of lip
D03.10Melanoma in situ of unspecified eyelid, including canthus
D03.111Melanoma in situ of right upper eyelid, including canthus
D03.112Melanoma in situ of right lower eyelid, including canthus
D03.121Melanoma in situ of left upper eyelid, including canthus
D03.122Melanoma in situ of left lower eyelid, including canthus
D03.20Melanoma in situ of unspecified ear and external auricular canal
D03.21Melanoma in situ of right ear and external auricular canal
D03.22Melanoma in situ of left ear and external auricular canal
D03.30Melanoma in situ of unspecified part of face
D03.39Melanoma in situ of other parts of face
D03.4Melanoma in situ of scalp and neck
D03.51Melanoma in situ of anal skin
D03.52Melanoma in situ of breast (skin) (soft tissue)
D03.59Melanoma in situ of other part of trunk
D03.60Melanoma in situ of unspecified upper limb, including shoulder
D03.61Melanoma in situ of right upper limb, including shoulder
D03.62Melanoma in situ of left upper limb, including shoulder
D03.70Melanoma in situ of unspecified lower limb, including hip
D03.71Melanoma in situ of right lower limb, including hip
D03.72Melanoma in situ of left lower limb, including hip
D03.8Melanoma in situ of other sites
D04.0Carcinoma in situ of skin of lip
D04.10Carcinoma in situ of skin of unspecified eyelid, including canthus
D04.111Carcinoma in situ of skin of right upper eyelid, including canthus
D04.112Carcinoma in situ of skin of right lower eyelid, including canthus
D04.121Carcinoma in situ of skin of left upper eyelid, including canthus
D04.122Carcinoma in situ of skin of left lower eyelid, including canthus
D04.20Carcinoma in situ of skin of unspecified ear and external auricular canal
D04.21Carcinoma in situ of skin of right ear and external auricular canal
D04.22Carcinoma in situ of skin of left ear and external auricular canal
D04.30Carcinoma in situ of skin of unspecified part of face
D04.39Carcinoma in situ of skin of other parts of face
D04.4Carcinoma in situ of skin of scalp and neck
D04.5Carcinoma in situ of skin of trunk
D04.60Carcinoma in situ of skin of unspecified upper limb, including shoulder
D04.61Carcinoma in situ of skin of right upper limb, including shoulder
D04.62Carcinoma in situ of skin of left upper limb, including shoulder
D04.70Carcinoma in situ of skin of unspecified lower limb, including hip
D04.71Carcinoma in situ of skin of right lower limb, including hip
D04.72Carcinoma in situ of skin of left lower limb, including hip
D04.8Carcinoma in situ of skin of other sites
D07.1Carcinoma in situ of vulva
D07.2Carcinoma in situ of vagina
D07.30Carcinoma in situ of unspecified female genital organs
D07.39Carcinoma in situ of other female genital organs
D07.4Carcinoma in situ of penis
D07.60Carcinoma in situ of unspecified male genital organs
D07.61Carcinoma in situ of scrotum
D07.69Carcinoma in situ of other male genital organs
D48.5Neoplasm of uncertain behavior of skin

Frequently asked questions

Which ICD-10 codes support medical necessity for CPT 11646?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 297 ICD-10 diagnosis codes that support medical necessity for CPT 11646. 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 11646 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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