ICD↔CPT crosswalk
CPT 21080: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 21080 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 21080 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 |
|---|---|
| C00.0 | Malignant neoplasm of external upper lip |
| C00.1 | Malignant neoplasm of external lower lip |
| C00.3 | Malignant neoplasm of upper lip, inner aspect |
| C00.4 | Malignant neoplasm of lower lip, inner aspect |
| C00.5 | Malignant neoplasm of lip, unspecified, inner aspect |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified |
| C00.8 | Malignant neoplasm of overlapping sites of lip |
| C01 | Malignant neoplasm of base of tongue |
| C02.0 | Malignant neoplasm of dorsal surface of tongue |
| C02.1 | Malignant neoplasm of border of tongue |
| C02.2 | Malignant neoplasm of ventral surface of tongue |
| C02.8 | Malignant neoplasm of overlapping sites of tongue |
| C03.0 | Malignant neoplasm of upper gum |
| C03.1 | Malignant neoplasm of lower gum |
| C04.0 | Malignant neoplasm of anterior floor of mouth |
| C04.1 | Malignant neoplasm of lateral floor of mouth |
| C04.8 | Malignant neoplasm of overlapping sites of floor of mouth |
| C05.0 | Malignant neoplasm of hard palate |
| C05.1 | Malignant neoplasm of soft palate |
| C05.2 | Malignant neoplasm of uvula |
| C05.8 | Malignant neoplasm of overlapping sites of palate |
| C06.0 | Malignant neoplasm of cheek mucosa |
| C06.1 | Malignant neoplasm of vestibule of mouth |
| C06.2 | Malignant neoplasm of retromolar area |
| C06.80 | Malignant neoplasm of overlapping sites of unspecified parts of mouth |
| C06.89 | Malignant neoplasm of overlapping sites of other parts of mouth |
| C07 | Malignant neoplasm of parotid gland |
| C08.0 | Malignant neoplasm of submandibular gland |
| C08.1 | Malignant neoplasm of sublingual gland |
| C08.9 | Malignant neoplasm of major salivary gland, unspecified |
| C09.0 | Malignant neoplasm of tonsillar fossa |
| C09.1 | Malignant neoplasm of tonsillar pillar (anterior) (posterior) |
| C09.8 | Malignant neoplasm of overlapping sites of tonsil |
| C10.0 | Malignant neoplasm of vallecula |
| C10.1 | Malignant neoplasm of anterior surface of epiglottis |
| C10.2 | Malignant neoplasm of lateral wall of oropharynx |
| C10.3 | Malignant neoplasm of posterior wall of oropharynx |
| C10.4 | Malignant neoplasm of branchial cleft |
| C10.8 | Malignant neoplasm of overlapping sites of oropharynx |
| C11.0 | Malignant neoplasm of superior wall of nasopharynx |
| C11.1 | Malignant neoplasm of posterior wall of nasopharynx |
| C11.2 | Malignant neoplasm of lateral wall of nasopharynx |
| C11.3 | Malignant neoplasm of anterior wall of nasopharynx |
| C11.8 | Malignant neoplasm of overlapping sites of nasopharynx |
| C12 | Malignant neoplasm of pyriform sinus |
| C13.0 | Malignant neoplasm of postcricoid region |
| C13.1 | Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect |
| C13.2 | Malignant neoplasm of posterior wall of hypopharynx |
| C13.8 | Malignant neoplasm of overlapping sites of hypopharynx |
| C14.0 | Malignant neoplasm of pharynx, unspecified |
| C14.2 | Malignant neoplasm of Waldeyer's ring |
| C14.8 | Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx |
| C30.0 | Malignant neoplasm of nasal cavity |
| C30.1 | Malignant neoplasm of middle ear |
| C31.0 | Malignant neoplasm of maxillary sinus |
| C31.1 | Malignant neoplasm of ethmoidal sinus |
| C31.2 | Malignant neoplasm of frontal sinus |
| C31.3 | Malignant neoplasm of sphenoid sinus |
| C31.8 | Malignant neoplasm of overlapping sites of accessory sinuses |
| C31.9 | Malignant neoplasm of accessory sinus, unspecified |
| C32.0 | Malignant neoplasm of glottis |
| C32.1 | Malignant neoplasm of supraglottis |
| C32.2 | Malignant neoplasm of subglottis |
| C32.3 | Malignant neoplasm of laryngeal cartilage |
| C32.8 | Malignant neoplasm of overlapping sites of larynx |
| C32.9 | Malignant neoplasm of larynx, unspecified |
| C41.0 | Malignant neoplasm of bones of skull and face |
| C41.1 | Malignant neoplasm of mandible |
| C43.0 | Malignant melanoma of lip |
| C43.111 | Malignant melanoma of right upper eyelid, including canthus |
| C43.112 | Malignant melanoma of right lower eyelid, including canthus |
| C43.121 | Malignant melanoma of left upper eyelid, including canthus |
| C43.122 | Malignant melanoma of left lower eyelid, including canthus |
| C43.21 | Malignant melanoma of right ear and external auricular canal |
| C43.22 | Malignant melanoma of left ear and external auricular canal |
| C43.30 | Malignant melanoma of unspecified part of face |
| C43.31 | Malignant melanoma of nose |
| C43.39 | Malignant melanoma of other parts of face |
| C43.4 | Malignant melanoma of scalp and neck |
| C43.8 | Malignant melanoma of overlapping sites of skin |
| C44.1021 | Unspecified malignant neoplasm of skin of right upper eyelid, including canthus |
| C44.1022 | Unspecified malignant neoplasm of skin of right lower eyelid, including canthus |
| C44.1091 | Unspecified malignant neoplasm of skin of left upper eyelid, including canthus |
| C44.1092 | Unspecified malignant neoplasm of skin of left lower eyelid, including canthus |
| C44.1121 | Basal cell carcinoma of skin of right upper eyelid, including canthus |
| C44.1122 | Basal cell carcinoma of skin of right lower eyelid, including canthus |
| C44.1191 | Basal cell carcinoma of skin of left upper eyelid, including canthus |
| C44.1192 | Basal cell carcinoma of skin of left lower eyelid, including canthus |
| C44.1221 | Squamous cell carcinoma of skin of right upper eyelid, including canthus |
| C44.1222 | Squamous cell carcinoma of skin of right lower eyelid, including canthus |
| C44.1291 | Squamous cell carcinoma of skin of left upper eyelid, including canthus |
| C44.1292 | Squamous cell carcinoma of skin of left lower eyelid, including canthus |
| C44.1321 | Sebaceous cell carcinoma of skin of right upper eyelid, including canthus |
| C44.1322 | Sebaceous cell carcinoma of skin of right lower eyelid, including canthus |
| C44.1391 | Sebaceous cell carcinoma of skin of left upper eyelid, including canthus |
| C44.1392 | Sebaceous cell carcinoma of skin of left lower eyelid, including canthus |
| C44.1921 | Other specified malignant neoplasm of skin of right upper eyelid, including canthus |
| C44.1922 | Other specified malignant neoplasm of skin of right lower eyelid, including canthus |
| C44.1991 | Other specified malignant neoplasm of skin of left upper eyelid, including canthus |
| C44.1992 | Other specified malignant neoplasm of skin of left lower eyelid, including canthus |
| C44.212 | Basal cell carcinoma of skin of right ear and external auricular canal |
| C44.219 | Basal cell carcinoma of skin of left ear and external auricular canal |
| C44.222 | Squamous cell carcinoma of skin of right ear and external auricular canal |
| C44.229 | Squamous cell carcinoma of skin of left ear and external auricular canal |
| 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 |
| C44.42 | Squamous cell carcinoma of skin of scalp and neck |
| 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 |
| C47.0 | Malignant neoplasm of peripheral nerves of head, face and neck |
| C49.0 | Malignant neoplasm of connective and soft tissue of head, face and neck |
| C4A.111 | Merkel cell carcinoma of right upper eyelid, including canthus |
| C4A.112 | Merkel cell carcinoma of right lower eyelid, including canthus |
| C4A.121 | Merkel cell carcinoma of left upper eyelid, including canthus |
| C4A.122 | Merkel cell carcinoma of left lower eyelid, including canthus |
| C4A.21 | Merkel cell carcinoma of right ear and external auricular canal |
| C4A.22 | Merkel cell carcinoma of left ear and external auricular canal |
| 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 |
| C50.422 | Malignant neoplasm of upper-outer quadrant of left 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 |
| C69.51 | Malignant neoplasm of right lacrimal gland and duct |
| C69.52 | Malignant neoplasm of left lacrimal gland and duct |
| C69.61 | Malignant neoplasm of right orbit |
| C69.62 | Malignant neoplasm of left orbit |
| C76.0 | Malignant neoplasm of head, face and neck |
| C79.2 | Secondary malignant neoplasm of skin |
| C79.81 | Secondary malignant neoplasm of breast |
| C83.11 | Mantle cell lymphoma, lymph nodes of head, face, and neck |
| C83.31 | Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck |
| C83.398 | Diffuse large B-cell lymphoma of other extranodal and solid organ sites |
| C83.81 | Other non-follicular lymphoma, lymph nodes of head, face, and neck |
| C84.41 | Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck |
| C84.4A | Peripheral T-cell lymphoma, not elsewhere classified, in remission |
| C84.61 | Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck |
| C84.6A | Anaplastic large cell lymphoma, ALK-positive, in remission |
| C84.71 | Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck |
| C84.7A | Anaplastic large cell lymphoma, ALK-negative, breast |
| C84.7B | Anaplastic large cell lymphoma, ALK-negative, in remission |
| C85.21 | Mediastinal (thymic) large B-cell lymphoma, lymph nodes of head, face, and neck |
| C85.2A | Mediastinal (thymic) large B-cell lymphoma, in remission |
| D03.0 | Melanoma in situ of lip |
| D03.111 | Melanoma in situ of right upper eyelid, including canthus |
| D03.112 | Melanoma in situ of right lower eyelid, including canthus |
| D03.121 | Melanoma in situ of left upper eyelid, including canthus |
| D03.122 | Melanoma in situ of left lower eyelid, including canthus |
| D03.21 | Melanoma in situ of right ear and external auricular canal |
| D03.22 | Melanoma in situ of left ear and external auricular canal |
| D03.30 | Melanoma in situ of unspecified part of face |
| D03.39 | Melanoma in situ of other parts of face |
| D03.4 | Melanoma in situ of scalp and neck |
| D03.8 | Melanoma in situ of other sites |
| D04.111 | Carcinoma in situ of skin of right upper eyelid, including canthus |
| D04.112 | Carcinoma in situ of skin of right lower eyelid, including canthus |
| D04.121 | Carcinoma in situ of skin of left upper eyelid, including canthus |
| D04.122 | Carcinoma in situ of skin of left lower eyelid, including canthus |
| D04.21 | Carcinoma in situ of skin of right ear and external auricular canal |
| D04.22 | Carcinoma in situ of skin of left ear and external auricular canal |
| 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 |
| 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 |
| D09.21 | Carcinoma in situ of right eye |
| D09.22 | Carcinoma in situ of left eye |
| D10.1 | Benign neoplasm of tongue |
| D10.2 | Benign neoplasm of floor of mouth |
| D10.39 | Benign neoplasm of other parts of mouth |
| D10.4 | Benign neoplasm of tonsil |
| D10.5 | Benign neoplasm of other parts of oropharynx |
| D10.6 | Benign neoplasm of nasopharynx |
| D10.7 | Benign neoplasm of hypopharynx |
| D11.0 | Benign neoplasm of parotid gland |
| D11.7 | Benign neoplasm of other major salivary glands |
| D11.9 | Benign neoplasm of major salivary gland, unspecified |
| D14.0 | Benign neoplasm of middle ear, nasal cavity and accessory sinuses |
| D16.4 | Benign neoplasm of bones of skull and face |
| D22.0 | Melanocytic nevi of lip |
| D22.30 | Melanocytic nevi of unspecified part of face |
| D22.39 | Melanocytic nevi of other parts of face |
| D22.5 | Melanocytic nevi of trunk |
| D23.0 | Other benign neoplasm of skin of lip |
| D23.111 | Other benign neoplasm of skin of right upper eyelid, including canthus |
| D23.112 | Other benign neoplasm of skin of right lower eyelid, including canthus |
| D23.121 | Other benign neoplasm of skin of left upper eyelid, including canthus |
| D23.122 | Other benign neoplasm of skin of left lower eyelid, including canthus |
| D23.30 | Other benign neoplasm of skin of unspecified part of face |
| D23.39 | Other benign neoplasm of skin of other parts of face |
| D23.5 | Other benign neoplasm of skin of trunk |
| D24.1 | Benign neoplasm of right breast |
| D24.2 | Benign neoplasm of left breast |
| D31.61 | Benign neoplasm of unspecified site of right orbit |
| D31.62 | Benign neoplasm of unspecified site of left orbit |
| D43.3 | Neoplasm of uncertain behavior of cranial nerves |
| D43.8 | Neoplasm of uncertain behavior of other specified parts of central nervous system |
| D48.61 | Neoplasm of uncertain behavior of right breast |
| D48.62 | Neoplasm of uncertain behavior of left breast |
| H05.021 | Osteomyelitis of right orbit |
| H05.022 | Osteomyelitis of left orbit |
| H05.023 | Osteomyelitis of bilateral orbits |
| H05.30 | Unspecified deformity of orbit |
| H05.51 | Retained (old) foreign body following penetrating wound of right orbit |
| H05.52 | Retained (old) foreign body following penetrating wound of left orbit |
| H05.53 | Retained (old) foreign body following penetrating wound of bilateral orbits |
| H05.831 | Thyroid orbitopathy, right orbit |
| H05.832 | Thyroid orbitopathy, left orbit |
| H05.833 | Thyroid orbitopathy, bilateral |
| H05.89 | Other disorders of orbit |
| H44.89 | Other disorders of globe |
| H72.01 | Central perforation of tympanic membrane, right ear |
| H72.02 | Central perforation of tympanic membrane, left ear |
| H72.03 | Central perforation of tympanic membrane, bilateral |
| H72.2X1 | Other marginal perforations of tympanic membrane, right ear |
| H72.2X2 | Other marginal perforations of tympanic membrane, left ear |
| H72.2X3 | Other marginal perforations of tympanic membrane, bilateral |
| J32.0 | Chronic maxillary sinusitis |
| J32.1 | Chronic frontal sinusitis |
| J32.2 | Chronic ethmoidal sinusitis |
| J32.3 | Chronic sphenoidal sinusitis |
| J32.4 | Chronic pansinusitis |
| J32.8 | Other chronic sinusitis |
| J32.9 | Chronic sinusitis, unspecified |
| 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 |
| J34.9 | Unspecified disorder of nose and nasal sinuses |
| J95.01 | Hemorrhage from tracheostomy stoma |
| J95.03 | Malfunction of tracheostomy stoma |
| J95.04 | Tracheo-esophageal fistula following tracheostomy |
| J95.09 | Other tracheostomy complication |
| K09.0 | Developmental odontogenic cysts |
| K09.1 | Developmental (nonodontogenic) cysts of oral region |
| K43.0 | Incisional hernia with obstruction, without gangrene |
| K43.1 | Incisional hernia with gangrene |
| K43.2 | Incisional hernia without obstruction or gangrene |
| K43.3 | Parastomal hernia with obstruction, without gangrene |
| K43.4 | Parastomal hernia with gangrene |
| K43.5 | Parastomal hernia without obstruction or gangrene |
| K43.6 | Other and unspecified ventral hernia with obstruction, without gangrene |
| K43.7 | Other and unspecified ventral hernia with gangrene |
| K43.9 | Ventral hernia without obstruction or gangrene |
| K46.9 | Unspecified abdominal hernia without obstruction or gangrene |
| L26 | Exfoliative dermatitis |
| L30.4 | Erythema intertrigo |
| L53.8 | Other specified erythematous conditions |
| L54 | Erythema in diseases classified elsewhere |
| L57.4 | Cutis laxa senilis |
| L71.0 | Perioral dermatitis |
| L71.1 | Rhinophyma |
| L71.8 | Other rosacea |
| L81.8 | Other specified disorders of pigmentation |
| L87.9 | Transepidermal elimination disorder, unspecified |
| L90.9 | Atrophic disorder of skin, unspecified |
| L91.9 | Hypertrophic disorder of the skin, unspecified |
| L92.0 | Granuloma annulare |
| L95.1 | Erythema elevatum diutinum |
| L98.2 | Febrile neutrophilic dermatosis [Sweet] |
| L98.411 | Non-pressure chronic ulcer of buttock limited to breakdown of skin |
| L98.412 | Non-pressure chronic ulcer of buttock with fat layer exposed |
| L98.413 | Non-pressure chronic ulcer of buttock with necrosis of muscle |
| L98.414 | Non-pressure chronic ulcer of buttock with necrosis of bone |
| L98.419 | Non-pressure chronic ulcer of buttock with unspecified severity |
| L98.421 | Non-pressure chronic ulcer of back limited to breakdown of skin |
| L98.422 | Non-pressure chronic ulcer of back with fat layer exposed |
| L98.423 | Non-pressure chronic ulcer of back with necrosis of muscle |
| L98.424 | Non-pressure chronic ulcer of back with necrosis of bone |
| L98.429 | Non-pressure chronic ulcer of back with unspecified severity |
| L98.431 | Non-pressure chronic ulcer of abdomen limited to breakdown of skin |
| L98.432 | Non-pressure chronic ulcer of abdomen with fat layer exposed |
| L98.433 | Non-pressure chronic ulcer of abdomen with necrosis of muscle |
| L98.434 | Non-pressure chronic ulcer of abdomen with necrosis of bone |
| L98.435 | Non-pressure chronic ulcer of abdomen with muscle involvement without evidence of necrosis |
| L98.436 | Non-pressure chronic ulcer of abdomen with bone involvement without evidence of necrosis |
| L98.438 | Non-pressure chronic ulcer of abdomen with other specified severity |
| L98.439 | Non-pressure chronic ulcer of abdomen with unspecified severity |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M27.0 | Developmental disorders of jaws |
| M27.1 | Giant cell granuloma, central |
| M27.2 | Inflammatory conditions of jaws |
| M27.40 | Unspecified cyst of jaw |
| M27.49 | Other cysts of jaw |
| M27.8 | Other specified diseases of jaws |
| M30.1 | Polyarteritis with lung involvement [Churg-Strauss] |
| M31.2 | Lethal midline granuloma |
| M31.30 | Wegener's granulomatosis without renal involvement |
| M31.31 | Wegener's granulomatosis with renal involvement |
| M35.6 | Relapsing panniculitis [Weber-Christian] |
| M54.2 | Cervicalgia |
| M54.6 | Pain in thoracic spine |
| M54.89 | Other dorsalgia |
| M54.9 | Dorsalgia, unspecified |
| M79.3 | Panniculitis, unspecified |
| M87.180 | Osteonecrosis due to drugs, jaw |
| 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 |
| N61.1 | Abscess of the breast and nipple |
| N62 | Hypertrophy of breast |
| N64.1 | Fat necrosis of breast |
| N64.89 | Other specified disorders of breast |
| N65.0 | Deformity of reconstructed breast |
| N65.1 | Disproportion of reconstructed breast |
| Q17.3 | Other misshapen ear |
| Q17.4 | Misplaced ear |
| Q35.1 | Cleft hard palate |
| Q35.3 | Cleft soft palate |
| Q35.5 | Cleft hard palate with cleft soft palate |
| Q35.7 | Cleft uvula |
| Q35.9 | Cleft palate, unspecified |
| 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 |
| Q67.2 | Dolichocephaly |
| Q67.3 | Plagiocephaly |
| Q67.4 | Other congenital deformities of skull, face and jaw |
| Q85.00 | Neurofibromatosis, unspecified |
| Q85.01 | Neurofibromatosis, type 1 |
| Q85.02 | Neurofibromatosis, type 2 |
| Q85.03 | Schwannomatosis |
| Q85.09 | Other neurofibromatosis |
| R09.81 | Nasal congestion |
| R13.0 | Aphagia |
| R13.10 | Dysphagia, unspecified |
| R13.11 | Dysphagia, oral phase |
| R13.12 | Dysphagia, oropharyngeal phase |
| R21 | Rash and other nonspecific skin eruption |
| S01.01XA | Laceration without foreign body of scalp, initial encounter |
| S01.01XD | Laceration without foreign body of scalp, subsequent encounter |
Showing the first 400 of 647 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 21080?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 647 ICD-10 diagnosis codes that support medical necessity for CPT 21080. 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 21080 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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