ICD↔CPT crosswalk
CPT 43216: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 43216 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 43216 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 |
|---|---|
| B37.81 | Candidal esophagitis |
| 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 |
| C02.3 | Malignant neoplasm of anterior two-thirds of tongue, part unspecified |
| C02.4 | Malignant neoplasm of lingual tonsil |
| C02.8 | Malignant neoplasm of overlapping sites of tongue |
| 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 |
| 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 |
| C13.9 | Malignant neoplasm of hypopharynx, unspecified |
| C15.3 | Malignant neoplasm of upper third of esophagus |
| C15.4 | Malignant neoplasm of middle third of esophagus |
| C15.5 | Malignant neoplasm of lower third of esophagus |
| C15.8 | Malignant neoplasm of overlapping sites of esophagus |
| C15.9 | Malignant neoplasm of esophagus, unspecified |
| C16.0 | Malignant neoplasm of cardia |
| C16.1 | Malignant neoplasm of fundus of stomach |
| C16.2 | Malignant neoplasm of body of stomach |
| C16.3 | Malignant neoplasm of pyloric antrum |
| C16.4 | Malignant neoplasm of pylorus |
| C16.5 | Malignant neoplasm of lesser curvature of stomach, unspecified |
| C16.6 | Malignant neoplasm of greater curvature of stomach, unspecified |
| C16.8 | Malignant neoplasm of overlapping sites of stomach |
| C16.9 | Malignant neoplasm of stomach, unspecified |
| C17.0 | Malignant neoplasm of duodenum |
| C17.1 | Malignant neoplasm of jejunum |
| C17.2 | Malignant neoplasm of ileum |
| C17.3 | Meckel's diverticulum, malignant |
| C17.8 | Malignant neoplasm of overlapping sites of small intestine |
| C17.9 | Malignant neoplasm of small intestine, unspecified |
| C24.1 | Malignant neoplasm of ampulla of Vater |
| C25.0 | Malignant neoplasm of head of pancreas |
| C25.1 | Malignant neoplasm of body of pancreas |
| C25.2 | Malignant neoplasm of tail of pancreas |
| C25.3 | Malignant neoplasm of pancreatic duct |
| C25.4 | Malignant neoplasm of endocrine pancreas |
| C25.7 | Malignant neoplasm of other parts of pancreas |
| C25.8 | Malignant neoplasm of overlapping sites of pancreas |
| C25.9 | Malignant neoplasm of pancreas, 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 |
| C33 | Malignant neoplasm of trachea |
| C49.A1 | Gastrointestinal stromal tumor of esophagus |
| C49.A2 | Gastrointestinal stromal tumor of stomach |
| C49.A3 | Gastrointestinal stromal tumor of small intestine |
| C78.4 | Secondary malignant neoplasm of small intestine |
| C7A.010 | Malignant carcinoid tumor of the duodenum |
| C7A.092 | Malignant carcinoid tumor of the stomach |
| C81.01 | Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.02 | Nodular lymphocyte predominant Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.03 | Nodular lymphocyte predominant Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.0A | Nodular lymphocyte predominant Hodgkin lymphoma, in remission |
| C81.11 | Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.12 | Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.13 | Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.1A | Nodular sclerosis Hodgkin lymphoma, in remission |
| C81.21 | Mixed cellularity Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.22 | Mixed cellularity Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.23 | Mixed cellularity Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.2A | Mixed cellularity Hodgkin lymphoma, in remission |
| C81.31 | Lymphocyte depleted Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.32 | Lymphocyte depleted Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.33 | Lymphocyte depleted Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.3A | Lymphocyte depleted Hodgkin lymphoma, in remission |
| C81.41 | Lymphocyte-rich Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.42 | Lymphocyte-rich Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.43 | Lymphocyte-rich Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.4A | Lymphocyte-rich Hodgkin lymphoma, in remission |
| C81.71 | Other Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.72 | Other Hodgkin lymphoma, intrathoracic lymph nodes |
| C81.73 | Other Hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.7A | Other Hodgkin lymphoma, in remission |
| C81.91 | Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck |
| C81.92 | Hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
| C81.93 | Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes |
| C81.9A | Hodgkin lymphoma, unspecified, in remission |
| C82.0A | Follicular lymphoma grade I, in remission |
| C82.1A | Follicular lymphoma grade II, in remission |
| C82.2A | Follicular lymphoma grade III, unspecified, in remission |
| C82.3A | Follicular lymphoma grade IIIa, in remission |
| C82.4A | Follicular lymphoma grade IIIb, in remission |
| C82.51 | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.5A | Diffuse follicle center lymphoma, in remission |
| C82.61 | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.6A | Cutaneous follicle center lymphoma, in remission |
| C82.81 | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.8A | Other types of follicular lymphoma, in remission |
| C83.01 | Small cell B-cell lymphoma, lymph nodes of head, face, and neck |
| C83.02 | Small cell B-cell lymphoma, intrathoracic lymph nodes |
| C83.03 | Small cell B-cell lymphoma, intra-abdominal lymph nodes |
| C83.0A | Small cell B-cell lymphoma, in remission |
| C83.11 | Mantle cell lymphoma, lymph nodes of head, face, and neck |
| C83.12 | Mantle cell lymphoma, intrathoracic lymph nodes |
| C83.13 | Mantle cell lymphoma, intra-abdominal lymph nodes |
| C83.1A | Mantle cell lymphoma, in remission |
| C83.31 | Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck |
| C83.32 | Diffuse large B-cell lymphoma, intrathoracic lymph nodes |
| C83.33 | Diffuse large B-cell lymphoma, intra-abdominal lymph nodes |
| C83.390 | Primary central nervous system lymphoma |
| C83.398 | Diffuse large B-cell lymphoma of other extranodal and solid organ sites |
| C83.3A | Diffuse large B-cell lymphoma, in remission |
| C83.51 | Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck |
| C83.52 | Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes |
| C83.53 | Lymphoblastic (diffuse) lymphoma, intra-abdominal lymph nodes |
| C83.5A | Lymphoblastic (diffuse) lymphoma, in remission |
| C83.71 | Burkitt lymphoma, lymph nodes of head, face, and neck |
| C83.72 | Burkitt lymphoma, intrathoracic lymph nodes |
| C83.73 | Burkitt lymphoma, intra-abdominal lymph nodes |
| C83.7A | Burkitt lymphoma, in remission |
| C83.81 | Other non-follicular lymphoma, lymph nodes of head, face, and neck |
| C83.82 | Other non-follicular lymphoma, intrathoracic lymph nodes |
| C83.83 | Other non-follicular lymphoma, intra-abdominal lymph nodes |
| C83.8A | Other non-follicular lymphoma, in remission |
| C83.91 | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of head, face, and neck |
| C83.92 | Non-follicular (diffuse) lymphoma, unspecified, intrathoracic lymph nodes |
| C83.93 | Non-follicular (diffuse) lymphoma, unspecified, intra-abdominal lymph nodes |
| C83.9A | Non-follicular (diffuse) lymphoma, unspecified, in remission |
| C84.01 | Mycosis fungoides, lymph nodes of head, face, and neck |
| C84.02 | Mycosis fungoides, intrathoracic lymph nodes |
| C84.03 | Mycosis fungoides, intra-abdominal lymph nodes |
| C84.0A | Mycosis fungoides, in remission |
| C84.11 | Sezary disease, lymph nodes of head, face, and neck |
| C84.12 | Sezary disease, intrathoracic lymph nodes |
| C84.13 | Sezary disease, intra-abdominal lymph nodes |
| C84.1A | Sezary disease, in remission |
| C84.41 | Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck |
| C84.42 | Peripheral T-cell lymphoma, not elsewhere classified, intrathoracic lymph nodes |
| C84.43 | Peripheral T-cell lymphoma, not elsewhere classified, intra-abdominal lymph nodes |
| 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 |
| C84.62 | Anaplastic large cell lymphoma, ALK-positive, intrathoracic lymph nodes |
| C84.63 | Anaplastic large cell lymphoma, ALK-positive, intra-abdominal lymph nodes |
| 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 |
| C84.72 | Anaplastic large cell lymphoma, ALK-negative, intrathoracic lymph nodes |
| C84.73 | Anaplastic large cell lymphoma, ALK-negative, intra-abdominal lymph nodes |
| C84.7B | Anaplastic large cell lymphoma, ALK-negative, in remission |
| C84.91 | Mature T/NK-cell lymphomas, unspecified, lymph nodes of head, face, and neck |
| C84.92 | Mature T/NK-cell lymphomas, unspecified, intrathoracic lymph nodes |
| C84.93 | Mature T/NK-cell lymphomas, unspecified, intra-abdominal lymph nodes |
| C84.9A | Mature T/NK-cell lymphomas, unspecified, in remission |
| C84.A1 | Cutaneous T-cell lymphoma, unspecified lymph nodes of head, face, and neck |
| C84.A2 | Cutaneous T-cell lymphoma, unspecified, intrathoracic lymph nodes |
| C84.A3 | Cutaneous T-cell lymphoma, unspecified, intra-abdominal lymph nodes |
| C84.AA | Cutaneous T-cell lymphoma, unspecified, in remission |
| C84.Z1 | Other mature T/NK-cell lymphomas, lymph nodes of head, face, and neck |
| C84.Z2 | Other mature T/NK-cell lymphomas, intrathoracic lymph nodes |
| C84.Z3 | Other mature T/NK-cell lymphomas, intra-abdominal lymph nodes |
| C84.ZA | Other mature T/NK-cell lymphomas, in remission |
| C85.11 | Unspecified B-cell lymphoma, lymph nodes of head, face, and neck |
| C85.12 | Unspecified B-cell lymphoma, intrathoracic lymph nodes |
| C85.13 | Unspecified B-cell lymphoma, intra-abdominal lymph nodes |
| C85.1A | Unspecified B-cell lymphoma, in remission |
| C85.21 | Mediastinal (thymic) large B-cell lymphoma, lymph nodes of head, face, and neck |
| C85.22 | Mediastinal (thymic) large B-cell lymphoma, intrathoracic lymph nodes |
| C85.23 | Mediastinal (thymic) large B-cell lymphoma, intra-abdominal lymph nodes |
| C85.2A | Mediastinal (thymic) large B-cell lymphoma, in remission |
| C85.81 | Other specified types of non-Hodgkin lymphoma, lymph nodes of head, face, and neck |
| C85.82 | Other specified types of non-Hodgkin lymphoma, intrathoracic lymph nodes |
| C85.83 | Other specified types of non-Hodgkin lymphoma, intra-abdominal lymph nodes |
| C85.8A | Other specified types of non-Hodgkin lymphoma, in remission |
| C85.91 | Non-Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck |
| C85.92 | Non-Hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
| C85.93 | Non-Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes |
| C85.9A | Non-Hodgkin lymphoma, unspecified, in remission |
| C86.00 | Extranodal NK/T-cell lymphoma, nasal type not having achieved remission |
| C86.01 | Extranodal NK/T-cell lymphoma, nasal type, in remission |
| C86.10 | Hepatosplenic T-cell lymphoma not having achieved remission |
| C86.11 | Hepatosplenic T-cell lymphoma, in remission |
| C86.20 | Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission |
| C86.21 | Enteropathy-type (intestinal) T-cell lymphoma, in remission |
| C86.30 | Subcutaneous panniculitis-like T-cell lymphoma not having achieved remission |
| C86.31 | Subcutaneous panniculitis-like T-cell lymphoma, in remission |
| C86.40 | Blastic NK-cell lymphoma not having achieved remission |
| C86.41 | Blastic NK-cell lymphoma, in remission |
| C86.50 | Angioimmunoblastic T-cell lymphoma not having achieved remission |
| C86.51 | Angioimmunoblastic T-cell lymphoma, in remission |
| C86.60 | Primary cutaneous CD30-positive T-cell proliferations not having achieved remission |
| C86.61 | Primary cutaneous CD30-positive T-cell proliferations, in remission |
| C88.00 | Waldenstrom macroglobulinemia not having achieved remission |
| C88.01 | Waldenstrom macroglobulinemia, in remission |
| C88.20 | Heavy chain disease not having achieved remission |
| C88.21 | Heavy chain disease, in remission |
| C88.30 | Immunoproliferative small intestinal disease not having achieved remission |
| C88.31 | Immunoproliferative small intestinal disease, in remission |
| C88.40 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission |
| C88.41 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission |
| C88.80 | Other malignant immunoproliferative diseases not having achieved remission |
| C88.81 | Other malignant immunoproliferative diseases, in remission |
| C88.90 | Malignant immunoproliferative disease, unspecified not having achieved remission |
| C88.91 | Malignant immunoproliferative disease, unspecified, in remission |
| D00.1 | Carcinoma in situ of esophagus |
| D00.2 | Carcinoma in situ of stomach |
| D01.7 | Carcinoma in situ of other specified digestive organs |
| D01.9 | Carcinoma in situ of digestive organ, unspecified |
| D13.0 | Benign neoplasm of esophagus |
| D13.1 | Benign neoplasm of stomach |
| D13.2 | Benign neoplasm of duodenum |
| D13.30 | Benign neoplasm of unspecified part of small intestine |
| D13.39 | Benign neoplasm of other parts of small intestine |
| D13.4 | Benign neoplasm of liver |
| D13.5 | Benign neoplasm of extrahepatic bile ducts |
| D13.6 | Benign neoplasm of pancreas |
| D13.7 | Benign neoplasm of endocrine pancreas |
| D17.5 | Benign lipomatous neoplasm of intra-abdominal organs |
| D37.1 | Neoplasm of uncertain behavior of stomach |
| D37.2 | Neoplasm of uncertain behavior of small intestine |
| D37.3 | Neoplasm of uncertain behavior of appendix |
| D37.4 | Neoplasm of uncertain behavior of colon |
| D37.5 | Neoplasm of uncertain behavior of rectum |
| D37.6 | Neoplasm of uncertain behavior of liver, gallbladder and bile ducts |
| D37.8 | Neoplasm of uncertain behavior of other specified digestive organs |
| D3A.010 | Benign carcinoid tumor of the duodenum |
| D3A.092 | Benign carcinoid tumor of the stomach |
| D3A.8 | Other benign neuroendocrine tumors |
| D49.0 | Neoplasm of unspecified behavior of digestive system |
| D50.0 | Iron deficiency anemia secondary to blood loss (chronic) |
| D50.9 | Iron deficiency anemia, unspecified |
| D51.0 | Vitamin B12 deficiency anemia due to intrinsic factor deficiency |
| D62 | Acute posthemorrhagic anemia |
| E10.43 | Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E13.43 | Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy |
| E41 | Nutritional marasmus |
| E43 | Unspecified severe protein-calorie malnutrition |
| E44.0 | Moderate protein-calorie malnutrition |
| E46 | Unspecified protein-calorie malnutrition |
| E64.0 | Sequelae of protein-calorie malnutrition |
| I69.091 | Dysphagia following nontraumatic subarachnoid hemorrhage |
| I69.191 | Dysphagia following nontraumatic intracerebral hemorrhage |
| I69.291 | Dysphagia following other nontraumatic intracranial hemorrhage |
| I69.391 | Dysphagia following cerebral infarction |
| I69.891 | Dysphagia following other cerebrovascular disease |
| I69.991 | Dysphagia following unspecified cerebrovascular disease |
| I77.2 | Rupture of artery |
| I78.0 | Hereditary hemorrhagic telangiectasia |
| I85.00 | Esophageal varices without bleeding |
| I85.01 | Esophageal varices with bleeding |
| I85.10 | Secondary esophageal varices without bleeding |
| I85.11 | Secondary esophageal varices with bleeding |
| I86.4 | Gastric varices |
| J86.0 | Pyothorax with fistula |
| K20.0 | Eosinophilic esophagitis |
| K20.80 | Other esophagitis without bleeding |
| K20.81 | Other esophagitis with bleeding |
| K20.90 | Esophagitis, unspecified without bleeding |
| K20.91 | Esophagitis, unspecified with bleeding |
| K21.00 | Gastro-esophageal reflux disease with esophagitis, without bleeding |
| K21.01 | Gastro-esophageal reflux disease with esophagitis, with bleeding |
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| K22.0 | Achalasia of cardia |
| K22.10 | Ulcer of esophagus without bleeding |
| K22.11 | Ulcer of esophagus with bleeding |
| K22.2 | Esophageal obstruction |
| K22.3 | Perforation of esophagus |
| K22.4 | Dyskinesia of esophagus |
| K22.5 | Diverticulum of esophagus, acquired |
| K22.6 | Gastro-esophageal laceration-hemorrhage syndrome |
| K22.70 | Barrett's esophagus without dysplasia |
| K22.710 | Barrett's esophagus with low grade dysplasia |
| K22.711 | Barrett's esophagus with high grade dysplasia |
| K22.719 | Barrett's esophagus with dysplasia, unspecified |
| K22.81 | Esophageal polyp |
| K22.82 | Esophagogastric junction polyp |
| K22.89 | Other specified disease of esophagus |
| K25.0 | Acute gastric ulcer with hemorrhage |
| K25.1 | Acute gastric ulcer with perforation |
| K25.2 | Acute gastric ulcer with both hemorrhage and perforation |
| K25.3 | Acute gastric ulcer without hemorrhage or perforation |
| K25.4 | Chronic or unspecified gastric ulcer with hemorrhage |
| K25.5 | Chronic or unspecified gastric ulcer with perforation |
| K25.6 | Chronic or unspecified gastric ulcer with both hemorrhage and perforation |
| K25.7 | Chronic gastric ulcer without hemorrhage or perforation |
| K25.9 | Gastric ulcer, unspecified as acute or chronic, without hemorrhage or perforation |
| K26.0 | Acute duodenal ulcer with hemorrhage |
| K26.1 | Acute duodenal ulcer with perforation |
| K26.2 | Acute duodenal ulcer with both hemorrhage and perforation |
| K26.3 | Acute duodenal ulcer without hemorrhage or perforation |
| K26.4 | Chronic or unspecified duodenal ulcer with hemorrhage |
| K26.5 | Chronic or unspecified duodenal ulcer with perforation |
| K26.6 | Chronic or unspecified duodenal ulcer with both hemorrhage and perforation |
| K26.7 | Chronic duodenal ulcer without hemorrhage or perforation |
| K26.9 | Duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation |
| K27.0 | Acute peptic ulcer, site unspecified, with hemorrhage |
| K27.1 | Acute peptic ulcer, site unspecified, with perforation |
| K27.2 | Acute peptic ulcer, site unspecified, with both hemorrhage and perforation |
| K27.3 | Acute peptic ulcer, site unspecified, without hemorrhage or perforation |
| K27.4 | Chronic or unspecified peptic ulcer, site unspecified, with hemorrhage |
| K27.5 | Chronic or unspecified peptic ulcer, site unspecified, with perforation |
| K27.6 | Chronic or unspecified peptic ulcer, site unspecified, with both hemorrhage and perforation |
| K27.7 | Chronic peptic ulcer, site unspecified, without hemorrhage or perforation |
| K27.9 | Peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation |
| K28.0 | Acute gastrojejunal ulcer with hemorrhage |
| K28.1 | Acute gastrojejunal ulcer with perforation |
| K28.2 | Acute gastrojejunal ulcer with both hemorrhage and perforation |
| K28.3 | Acute gastrojejunal ulcer without hemorrhage or perforation |
| K28.4 | Chronic or unspecified gastrojejunal ulcer with hemorrhage |
| K28.5 | Chronic or unspecified gastrojejunal ulcer with perforation |
| K28.6 | Chronic or unspecified gastrojejunal ulcer with both hemorrhage and perforation |
| K28.7 | Chronic gastrojejunal ulcer without hemorrhage or perforation |
| K28.9 | Gastrojejunal ulcer, unspecified as acute or chronic, without hemorrhage or perforation |
| K29.00 | Acute gastritis without bleeding |
| K29.01 | Acute gastritis with bleeding |
| K29.20 | Alcoholic gastritis without bleeding |
| K29.21 | Alcoholic gastritis with bleeding |
| K29.30 | Chronic superficial gastritis without bleeding |
| K29.31 | Chronic superficial gastritis with bleeding |
| K29.40 | Chronic atrophic gastritis without bleeding |
| K29.41 | Chronic atrophic gastritis with bleeding |
| K29.50 | Unspecified chronic gastritis without bleeding |
| K29.51 | Unspecified chronic gastritis with bleeding |
| K29.60 | Other gastritis without bleeding |
| K29.61 | Other gastritis with bleeding |
| K29.70 | Gastritis, unspecified, without bleeding |
| K29.71 | Gastritis, unspecified, with bleeding |
| K29.80 | Duodenitis without bleeding |
| K29.81 | Duodenitis with bleeding |
| K29.90 | Gastroduodenitis, unspecified, without bleeding |
| K29.91 | Gastroduodenitis, unspecified, with bleeding |
| K30 | Functional dyspepsia |
| K31.0 | Acute dilatation of stomach |
| K31.1 | Adult hypertrophic pyloric stenosis |
| K31.2 | Hourglass stricture and stenosis of stomach |
| K31.3 | Pylorospasm, not elsewhere classified |
| K31.4 | Gastric diverticulum |
| K31.5 | Obstruction of duodenum |
| K31.6 | Fistula of stomach and duodenum |
| K31.7 | Polyp of stomach and duodenum |
| K31.811 | Angiodysplasia of stomach and duodenum with bleeding |
| K31.819 | Angiodysplasia of stomach and duodenum without bleeding |
| K31.82 | Dieulafoy lesion (hemorrhagic) of stomach and duodenum |
| K31.84 | Gastroparesis |
| K31.89 | Other diseases of stomach and duodenum |
| K31.A11 | Gastric intestinal metaplasia without dysplasia, involving the antrum |
| K31.A12 | Gastric intestinal metaplasia without dysplasia, involving the body (corpus) |
| K31.A13 | Gastric intestinal metaplasia without dysplasia, involving the fundus |
| K31.A14 | Gastric intestinal metaplasia without dysplasia, involving the cardia |
| K31.A15 | Gastric intestinal metaplasia without dysplasia, involving multiple sites |
| K31.A19 | Gastric intestinal metaplasia without dysplasia, unspecified site |
| K31.A21 | Gastric intestinal metaplasia with low grade dysplasia |
| K31.A22 | Gastric intestinal metaplasia with high grade dysplasia |
| K44.0 | Diaphragmatic hernia with obstruction, without gangrene |
| K50.00 | Crohn's disease of small intestine without complications |
| K50.011 | Crohn's disease of small intestine with rectal bleeding |
| K50.014 | Crohn's disease of small intestine with abscess |
| K50.018 | Crohn's disease of small intestine with other complication |
| K50.80 | Crohn's disease of both small and large intestine without complications |
| K50.811 | Crohn's disease of both small and large intestine with rectal bleeding |
| K50.813 | Crohn's disease of both small and large intestine with fistula |
| K50.814 | Crohn's disease of both small and large intestine with abscess |
| K50.818 | Crohn's disease of both small and large intestine with other complication |
| K52.0 | Gastroenteritis and colitis due to radiation |
| K52.1 | Toxic gastroenteritis and colitis |
| K52.21 | Food protein-induced enterocolitis syndrome |
| K52.22 | Food protein-induced enteropathy |
| K52.29 | Other allergic and dietetic gastroenteritis and colitis |
| K52.3 | Indeterminate colitis |
| K52.81 | Eosinophilic gastritis or gastroenteritis |
| K52.831 | Collagenous colitis |
| K52.832 | Lymphocytic colitis |
| K52.838 | Other microscopic colitis |
| K52.839 | Microscopic colitis, unspecified |
| K52.89 | Other specified noninfective gastroenteritis and colitis |
| K52.9 | Noninfective gastroenteritis and colitis, unspecified |
| K55.011 | Focal (segmental) acute (reversible) ischemia of small intestine |
| K55.012 | Diffuse acute (reversible) ischemia of small intestine |
| K55.019 | Acute (reversible) ischemia of small intestine, extent unspecified |
| K55.021 | Focal (segmental) acute infarction of small intestine |
| K55.022 | Diffuse acute infarction of small intestine |
| K55.029 | Acute infarction of small intestine, extent unspecified |
| K55.051 | Focal (segmental) acute (reversible) ischemia of intestine, part unspecified |
| K55.052 | Diffuse acute (reversible) ischemia of intestine, part unspecified |
| K55.059 | Acute (reversible) ischemia of intestine, part and extent unspecified |
| K55.061 | Focal (segmental) acute infarction of intestine, part unspecified |
| K55.062 | Diffuse acute infarction of intestine, part unspecified |
| K55.069 | Acute infarction of intestine, part and extent unspecified |
| K55.1 | Chronic vascular disorders of intestine |
| K55.20 | Angiodysplasia of colon without hemorrhage |
| K55.21 | Angiodysplasia of colon with hemorrhage |
| K55.30 | Necrotizing enterocolitis, unspecified |
| K55.31 | Stage 1 necrotizing enterocolitis |
| K55.32 | Stage 2 necrotizing enterocolitis |
| K55.33 | Stage 3 necrotizing enterocolitis |
| K55.8 | Other vascular disorders of intestine |
Showing the first 400 of 727 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 43216?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 727 ICD-10 diagnosis codes that support medical necessity for CPT 43216. 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 43216 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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