CPT 15278: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 15278 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 15278 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 |
|---|---|
| E08.621 | Diabetes mellitus due to underlying condition with foot ulcer |
| E09.621 | Drug or chemical induced diabetes mellitus with foot ulcer |
| E10.621 | Type 1 diabetes mellitus with foot ulcer |
| E11.621 | Type 2 diabetes mellitus with foot ulcer |
| E13.621 | Other specified diabetes mellitus with foot ulcer |
| I83.011 | Varicose veins of right lower extremity with ulcer of thigh |
| I83.012 | Varicose veins of right lower extremity with ulcer of calf |
| I83.013 | Varicose veins of right lower extremity with ulcer of ankle |
| I83.014 | Varicose veins of right lower extremity with ulcer of heel and midfoot |
| I83.015 | Varicose veins of right lower extremity with ulcer other part of foot |
| I83.018 | Varicose veins of right lower extremity with ulcer other part of lower leg |
| I83.021 | Varicose veins of left lower extremity with ulcer of thigh |
| I83.022 | Varicose veins of left lower extremity with ulcer of calf |
| I83.023 | Varicose veins of left lower extremity with ulcer of ankle |
| I83.024 | Varicose veins of left lower extremity with ulcer of heel and midfoot |
| I83.025 | Varicose veins of left lower extremity with ulcer other part of foot |
| I83.028 | Varicose veins of left lower extremity with ulcer other part of lower leg |
| I83.211 | Varicose veins of right lower extremity with both ulcer of thigh and inflammation |
| I83.212 | Varicose veins of right lower extremity with both ulcer of calf and inflammation |
| I83.213 | Varicose veins of right lower extremity with both ulcer of ankle and inflammation |
| I83.214 | Varicose veins of right lower extremity with both ulcer of heel and midfoot and inflammation |
| I83.215 | Varicose veins of right lower extremity with both ulcer other part of foot and inflammation |
| I83.218 | Varicose veins of right lower extremity with both ulcer of other part of lower extremity and inflammation |
| I83.221 | Varicose veins of left lower extremity with both ulcer of thigh and inflammation |
| I83.222 | Varicose veins of left lower extremity with both ulcer of calf and inflammation |
| I83.223 | Varicose veins of left lower extremity with both ulcer of ankle and inflammation |
| I83.224 | Varicose veins of left lower extremity with both ulcer of heel and midfoot and inflammation |
| I83.225 | Varicose veins of left lower extremity with both ulcer other part of foot and inflammation |
| I83.228 | Varicose veins of left lower extremity with both ulcer of other part of lower extremity and inflammation |
| I87.011 | Postthrombotic syndrome with ulcer of right lower extremity |
| I87.012 | Postthrombotic syndrome with ulcer of left lower extremity |
| I87.013 | Postthrombotic syndrome with ulcer of bilateral lower extremity |
| I87.031 | Postthrombotic syndrome with ulcer and inflammation of right lower extremity |
| I87.032 | Postthrombotic syndrome with ulcer and inflammation of left lower extremity |
| I87.033 | Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity |
| I87.311 | Chronic venous hypertension (idiopathic) with ulcer of right lower extremity |
| I87.312 | Chronic venous hypertension (idiopathic) with ulcer of left lower extremity |
| I87.313 | Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity |
| I87.331 | Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity |
| I87.332 | Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower extremity |
| I87.333 | Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity |
| XX0.00 |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 15278?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 42 ICD-10 diagnosis codes that support medical necessity for CPT 15278. 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 15278 view of that relationship.
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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