CPT 33992: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 33992 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 33992 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 |
|---|---|
| I50.21 | Acute systolic (congestive) heart failure |
| I50.23 | Acute on chronic systolic (congestive) heart failure |
| I50.41 | Acute combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.43 | Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I97.110 | Postprocedural cardiac insufficiency following cardiac surgery |
| I97.111 | Postprocedural cardiac insufficiency following other surgery |
| I97.130 | Postprocedural heart failure following cardiac surgery |
| I97.131 | Postprocedural heart failure following other surgery |
| I97.790 | Other intraoperative cardiac functional disturbances during cardiac surgery |
| I97.791 | Other intraoperative cardiac functional disturbances during other surgery |
| I97.88 | Other intraoperative complications of the circulatory system, not elsewhere classified |
| I97.89 | Other postprocedural complications and disorders of the circulatory system, not elsewhere classified |
| R57.0 | Cardiogenic shock |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 33992?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 13 ICD-10 diagnosis codes that support medical necessity for CPT 33992. 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 33992 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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