CPT 17360: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 17360 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 17360 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 |
|---|---|
| B20 | Human immunodeficiency virus [HIV] disease |
| C30.0 | Malignant neoplasm of nasal cavity |
| C41.0 | Malignant neoplasm of bones of skull and face |
| C43.31 | Malignant melanoma of nose |
| C43.39 | Malignant melanoma of other parts of face |
| C44.300 | Unspecified malignant neoplasm of skin of unspecified part of face |
| C44.301 | Unspecified malignant neoplasm of skin of nose |
| C44.309 | Unspecified malignant neoplasm of skin of other parts of face |
| C44.310 | Basal cell carcinoma of skin of unspecified parts of face |
| C44.311 | Basal cell carcinoma of skin of nose |
| C44.319 | Basal cell carcinoma of skin of other parts of face |
| C44.320 | Squamous cell carcinoma of skin of unspecified parts of face |
| C44.321 | Squamous cell carcinoma of skin of nose |
| C44.329 | Squamous cell carcinoma of skin of other parts of face |
| C44.390 | Other specified malignant neoplasm of skin of unspecified parts of face |
| C44.391 | Other specified malignant neoplasm of skin of nose |
| C44.399 | Other specified malignant neoplasm of skin of other parts of face |
| C44.501 | Unspecified malignant neoplasm of skin of breast |
| C44.511 | Basal cell carcinoma of skin of breast |
| C44.521 | Squamous cell carcinoma of skin of breast |
| C44.591 | Other specified malignant neoplasm of skin of breast |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast |
| C50.111 | Malignant neoplasm of central portion of right female breast |
| C50.112 | Malignant neoplasm of central portion of left female breast |
| C50.121 | Malignant neoplasm of central portion of right male breast |
| C50.122 | Malignant neoplasm of central portion of left male breast |
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast |
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast |
| C50.221 | Malignant neoplasm of upper-inner quadrant of right male breast |
| C50.222 | Malignant neoplasm of upper-inner quadrant of left male breast |
| C50.311 | Malignant neoplasm of lower-inner quadrant of right female breast |
| C50.312 | Malignant neoplasm of lower-inner quadrant of left female breast |
| C50.321 | Malignant neoplasm of lower-inner quadrant of right male breast |
| C50.322 | Malignant neoplasm of lower-inner quadrant of left male breast |
| C50.411 | Malignant neoplasm of upper-outer quadrant of right female breast |
| C50.412 | Malignant neoplasm of upper-outer quadrant of left female breast |
| C50.421 | Malignant neoplasm of upper-outer quadrant of right male breast |
| C50.511 | Malignant neoplasm of lower-outer quadrant of right female breast |
| C50.512 | Malignant neoplasm of lower-outer quadrant of left female breast |
| C50.521 | Malignant neoplasm of lower-outer quadrant of right male breast |
| C50.522 | Malignant neoplasm of lower-outer quadrant of left male breast |
| C50.611 | Malignant neoplasm of axillary tail of right female breast |
| C50.612 | Malignant neoplasm of axillary tail of left female breast |
| C50.621 | Malignant neoplasm of axillary tail of right male breast |
| C50.622 | Malignant neoplasm of axillary tail of left male breast |
| C50.811 | Malignant neoplasm of overlapping sites of right female breast |
| C50.812 | Malignant neoplasm of overlapping sites of left female breast |
| C50.821 | Malignant neoplasm of overlapping sites of right male breast |
| C50.822 | Malignant neoplasm of overlapping sites of left male breast |
| C50.911 | Malignant neoplasm of unspecified site of right female breast |
| C50.912 | Malignant neoplasm of unspecified site of left female breast |
| C50.921 | Malignant neoplasm of unspecified site of right male breast |
| C50.922 | Malignant neoplasm of unspecified site of left male breast |
| C76.0 | Malignant neoplasm of head, face and neck |
| C79.2 | Secondary malignant neoplasm of skin |
| C79.81 | Secondary malignant neoplasm of breast |
| D03.39 | Melanoma in situ of other parts of face |
| D04.30 | Carcinoma in situ of skin of unspecified part of face |
| D04.39 | Carcinoma in situ of skin of other parts of face |
| D04.5 | Carcinoma in situ of skin of trunk |
| D04.8 | Carcinoma in situ of skin of other sites |
| D05.01 | Lobular carcinoma in situ of right breast |
| D05.02 | Lobular carcinoma in situ of left breast |
| D05.11 | Intraductal carcinoma in situ of right breast |
| D05.12 | Intraductal carcinoma in situ of left breast |
| D05.81 | Other specified type of carcinoma in situ of right breast |
| D05.82 | Other specified type of carcinoma in situ of left breast |
| D05.91 | Unspecified type of carcinoma in situ of right breast |
| D05.92 | Unspecified type of carcinoma in situ of left breast |
| D14.0 | Benign neoplasm of middle ear, nasal cavity and accessory sinuses |
| D16.4 | Benign neoplasm of bones of skull and face |
| D22.30 | Melanocytic nevi of unspecified part of face |
| D22.39 | Melanocytic nevi of other parts of face |
| D23.30 | Other benign neoplasm of skin of unspecified part of face |
| D23.39 | Other benign neoplasm of skin of other parts of face |
| D24.1 | Benign neoplasm of right breast |
| D24.2 | Benign neoplasm of left breast |
| D48.5 | Neoplasm of uncertain behavior of skin |
| D48.61 | Neoplasm of uncertain behavior of right breast |
| D48.62 | Neoplasm of uncertain behavior of left breast |
| E65 | Localized adiposity |
| E88.11 | Partial lipodystrophy |
| E88.12 | Generalized lipodystrophy |
| E88.13 | Localized lipodystrophy |
| E88.14 | HIV-associated lipodystrophy |
| E88.19 | Other lipodystrophy, not elsewhere classified |
| J32.0 | Chronic maxillary sinusitis |
| J32.1 | Chronic frontal sinusitis |
| J32.2 | Chronic ethmoidal sinusitis |
| J32.3 | Chronic sphenoidal sinusitis |
| J32.4 | Chronic pansinusitis |
| J34.0 | Abscess, furuncle and carbuncle of nose |
| J34.1 | Cyst and mucocele of nose and nasal sinus |
| J34.2 | Deviated nasal septum |
| J34.8201 | Internal nasal valve collapse, static |
| J34.8202 | Internal nasal valve collapse, dynamic |
| J34.8211 | External nasal valve collapse, static |
| J34.8212 | External nasal valve collapse, dynamic |
| J34.89 | Other specified disorders of nose and nasal sinuses |
| L26 | Exfoliative dermatitis |
| L30.4 | Erythema intertrigo |
| L53.8 | Other specified erythematous conditions |
| L54 | Erythema in diseases classified elsewhere |
| L57.0 | Actinic keratosis |
| L71.0 | Perioral dermatitis |
| L71.1 | Rhinophyma |
| L71.8 | Other rosacea |
| L81.8 | Other specified disorders of pigmentation |
| L81.9 | Disorder of pigmentation, unspecified |
| L95.1 | Erythema elevatum diutinum |
| L98.7 | Excessive and redundant skin and subcutaneous tissue |
| L98.9 | Disorder of the skin and subcutaneous tissue, unspecified |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M54.2 | Cervicalgia |
| M54.6 | Pain in thoracic spine |
| M54.89 | Other dorsalgia |
| M79.3 | Panniculitis, unspecified |
| N60.01 | Solitary cyst of right breast |
| N60.02 | Solitary cyst of left breast |
| N60.11 | Diffuse cystic mastopathy of right breast |
| N60.12 | Diffuse cystic mastopathy of left breast |
| N60.21 | Fibroadenosis of right breast |
| N60.22 | Fibroadenosis of left breast |
| N60.31 | Fibrosclerosis of right breast |
| N60.32 | Fibrosclerosis of left breast |
| N60.41 | Mammary duct ectasia of right breast |
| N60.42 | Mammary duct ectasia of left breast |
| N60.81 | Other benign mammary dysplasias of right breast |
| N60.82 | Other benign mammary dysplasias of left breast |
| N60.91 | Unspecified benign mammary dysplasia of right breast |
| N60.92 | Unspecified benign mammary dysplasia of left breast |
| N62 | Hypertrophy of breast |
| N64.1 | Fat necrosis of breast |
| N64.81 | Ptosis of breast |
| N65.0 | Deformity of reconstructed breast |
| N65.1 | Disproportion of reconstructed breast |
| O91.211 | Nonpurulent mastitis associated with pregnancy, first trimester |
| O91.212 | Nonpurulent mastitis associated with pregnancy, second trimester |
| O91.213 | Nonpurulent mastitis associated with pregnancy, third trimester |
| Q30.0 | Choanal atresia |
| Q30.8 | Other congenital malformations of nose |
| Q35.1 | Cleft hard palate |
| Q35.3 | Cleft soft palate |
| Q35.5 | Cleft hard palate with cleft soft palate |
| Q35.7 | Cleft uvula |
| Q36.0 | Cleft lip, bilateral |
| Q36.1 | Cleft lip, median |
| Q36.9 | Cleft lip, unilateral |
| Q37.0 | Cleft hard palate with bilateral cleft lip |
| Q37.1 | Cleft hard palate with unilateral cleft lip |
| Q37.2 | Cleft soft palate with bilateral cleft lip |
| Q37.3 | Cleft soft palate with unilateral cleft lip |
| Q37.4 | Cleft hard and soft palate with bilateral cleft lip |
| Q37.5 | Cleft hard and soft palate with unilateral cleft lip |
| Q67.0 | Congenital facial asymmetry |
| Q67.1 | Congenital compression facies |
| Q67.4 | Other congenital deformities of skull, face and jaw |
| R04.0 | Epistaxis |
| R09.81 | Nasal congestion |
| R21 | Rash and other nonspecific skin eruption |
| R26.2 | Difficulty in walking, not elsewhere classified |
| S02.2XXA | Fracture of nasal bones, initial encounter for closed fracture |
| S02.2XXB | Fracture of nasal bones, initial encounter for open fracture |
| S02.2XXD | Fracture of nasal bones, subsequent encounter for fracture with routine healing |
| S02.2XXG | Fracture of nasal bones, subsequent encounter for fracture with delayed healing |
| S02.2XXK | Fracture of nasal bones, subsequent encounter for fracture with nonunion |
| S02.2XXS | Fracture of nasal bones, sequela |
| S09.10XA | Unspecified injury of muscle and tendon of head, initial encounter |
| S09.11XA | Strain of muscle and tendon of head, initial encounter |
| S09.19XA | Other specified injury of muscle and tendon of head, initial encounter |
| S09.8XXA | Other specified injuries of head, initial encounter |
| T20.06XA | Burn of unspecified degree of forehead and cheek, initial encounter |
| T20.06XD | Burn of unspecified degree of forehead and cheek, subsequent encounter |
| T20.06XS | Burn of unspecified degree of forehead and cheek, sequela |
| T20.16XA | Burn of first degree of forehead and cheek, initial encounter |
| T20.16XD | Burn of first degree of forehead and cheek, subsequent encounter |
| T20.16XS | Burn of first degree of forehead and cheek, sequela |
| T20.26XA | Burn of second degree of forehead and cheek, initial encounter |
| T20.36XA | Burn of third degree of forehead and cheek, initial encounter |
| T20.66XA | Corrosion of second degree of forehead and cheek, initial encounter |
| T20.76XA | Corrosion of third degree of forehead and cheek, initial encounter |
| T85.41XA | Breakdown (mechanical) of breast prosthesis and implant, initial encounter |
| T85.41XD | Breakdown (mechanical) of breast prosthesis and implant, subsequent encounter |
| T85.41XS | Breakdown (mechanical) of breast prosthesis and implant, sequela |
| T85.42XA | Displacement of breast prosthesis and implant, initial encounter |
| T85.42XD | Displacement of breast prosthesis and implant, subsequent encounter |
| T85.42XS | Displacement of breast prosthesis and implant, sequela |
| T85.43XA | Leakage of breast prosthesis and implant, initial encounter |
| T85.43XD | Leakage of breast prosthesis and implant, subsequent encounter |
| T85.43XS | Leakage of breast prosthesis and implant, sequela |
| T85.44XA | Capsular contracture of breast implant, initial encounter |
| T85.44XD | Capsular contracture of breast implant, subsequent encounter |
| T85.44XS | Capsular contracture of breast implant, sequela |
| T85.49XA | Other mechanical complication of breast prosthesis and implant, initial encounter |
| T85.49XD | Other mechanical complication of breast prosthesis and implant, subsequent encounter |
| T85.49XS | Other mechanical complication of breast prosthesis and implant, sequela |
| T85.79XA | Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.79XD | Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, subsequent encounter |
| T85.79XS | Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, sequela |
| T85.818A | Embolism due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.828A | Fibrosis due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.838A | Hemorrhage due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.848A | Pain due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.858A | Stenosis due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.868A | Thrombosis due to other internal prosthetic devices, implants and grafts, initial encounter |
| T85.898A | Other specified complication of other internal prosthetic devices, implants and grafts, initial encounter |
| Z15.01 | Genetic susceptibility to malignant neoplasm of breast |
| Z42.1 | Encounter for breast reconstruction following mastectomy |
| Z42.8 | Encounter for other plastic and reconstructive surgery following medical procedure or healed injury |
| Z44.31 | Encounter for fitting and adjustment of external right breast prosthesis |
| Z44.32 | Encounter for fitting and adjustment of external left breast prosthesis |
| Z45.811 | Encounter for adjustment or removal of right breast implant |
| Z45.812 | Encounter for adjustment or removal of left breast implant |
| Z48.3 | Aftercare following surgery for neoplasm |
| Z48.89 | Encounter for other specified surgical aftercare |
| Z74.09 | Other reduced mobility |
| Z80.3 | Family history of malignant neoplasm of breast |
| Z85.3 | Personal history of malignant neoplasm of breast |
| Z90.11 | Acquired absence of right breast and nipple |
| Z90.12 | Acquired absence of left breast and nipple |
| Z90.13 | Acquired absence of bilateral breasts and nipples |
| Z98.82 | Breast implant status |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 17360?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 226 ICD-10 diagnosis codes that support medical necessity for CPT 17360. 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 17360 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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