CPT 64494: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 64494 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 64494 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 |
|---|---|
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region |
| M47.892 | Other spondylosis, cervical region |
| M47.893 | Other spondylosis, cervicothoracic region |
| M47.894 | Other spondylosis, thoracic region |
| M47.895 | Other spondylosis, thoracolumbar region |
| M47.896 | Other spondylosis, lumbar region |
| M47.897 | Other spondylosis, lumbosacral region |
| M48.12 | Ankylosing hyperostosis [Forestier], cervical region |
| M48.13 | Ankylosing hyperostosis [Forestier], cervicothoracic region |
| M48.14 | Ankylosing hyperostosis [Forestier], thoracic region |
| M48.15 | Ankylosing hyperostosis [Forestier], thoracolumbar region |
| M48.16 | Ankylosing hyperostosis [Forestier], lumbar region |
| M48.17 | Ankylosing hyperostosis [Forestier], lumbosacral region |
| M53.82 | Other specified dorsopathies, cervical region |
| M53.83 | Other specified dorsopathies, cervicothoracic region |
| M53.84 | Other specified dorsopathies, thoracic region |
| M53.85 | Other specified dorsopathies, thoracolumbar region |
| M53.86 | Other specified dorsopathies, lumbar region |
| M53.87 | Other specified dorsopathies, lumbosacral region |
| M71.30 | Other bursal cyst, unspecified site |
| M71.38 | Other bursal cyst, other site |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 64494?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 26 ICD-10 diagnosis codes that support medical necessity for CPT 64494. 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 64494 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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