ICD↔CPT crosswalk
CPT 76641: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 76641 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 76641 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 |
|---|---|
| C45.9 | Mesothelioma, unspecified |
| 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 |
| C56.1 | Malignant neoplasm of right ovary |
| C56.2 | Malignant neoplasm of left ovary |
| C77.3 | Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes |
| C78.01 | Secondary malignant neoplasm of right lung |
| C78.02 | Secondary malignant neoplasm of left lung |
| C78.1 | Secondary malignant neoplasm of mediastinum |
| C78.2 | Secondary malignant neoplasm of pleura |
| C78.7 | Secondary malignant neoplasm of liver and intrahepatic bile duct |
| C79.2 | Secondary malignant neoplasm of skin |
| C79.31 | Secondary malignant neoplasm of brain |
| C79.51 | Secondary malignant neoplasm of bone |
| C79.52 | Secondary malignant neoplasm of bone marrow |
| C79.81 | Secondary malignant neoplasm of breast |
| C80.0 | Disseminated malignant neoplasm, unspecified |
| C80.1 | Malignant (primary) neoplasm, unspecified |
| 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 |
| 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 |
| D49.2 | Neoplasm of unspecified behavior of bone, soft tissue, and skin |
| D49.3 | Neoplasm of unspecified behavior of breast |
| I80.8 | Phlebitis and thrombophlebitis of other sites |
| 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 |
| N61.0 | Mastitis without abscess |
| N61.1 | Abscess of the breast and nipple |
| N61.21 | Granulomatous mastitis, right breast |
| N61.22 | Granulomatous mastitis, left breast |
| N61.23 | Granulomatous mastitis, bilateral breast |
| N62 | Hypertrophy of breast |
| N63.11 | Unspecified lump in the right breast, upper outer quadrant |
| N63.12 | Unspecified lump in the right breast, upper inner quadrant |
| N63.13 | Unspecified lump in the right breast, lower outer quadrant |
| N63.14 | Unspecified lump in the right breast, lower inner quadrant |
| N63.15 | Unspecified lump in the right breast, overlapping quadrants |
| N63.21 | Unspecified lump in the left breast, upper outer quadrant |
| N63.22 | Unspecified lump in the left breast, upper inner quadrant |
| N63.23 | Unspecified lump in the left breast, lower outer quadrant |
| N63.24 | Unspecified lump in the left breast, lower inner quadrant |
| N63.25 | Unspecified lump in the left breast, overlapping quadrants |
| N63.31 | Unspecified lump in axillary tail of the right breast |
| N63.32 | Unspecified lump in axillary tail of the left breast |
| N63.41 | Unspecified lump in right breast, subareolar |
| N63.42 | Unspecified lump in left breast, subareolar |
| N64.0 | Fissure and fistula of nipple |
| N64.1 | Fat necrosis of breast |
| N64.2 | Atrophy of breast |
| N64.3 | Galactorrhea not associated with childbirth |
| N64.4 | Mastodynia |
| N64.51 | Induration of breast |
| N64.52 | Nipple discharge |
| N64.53 | Retraction of nipple |
| N64.59 | Other signs and symptoms in breast |
| N64.89 | Other specified disorders of breast |
| N64.9 | Disorder of breast, unspecified |
| N65.0 | Deformity of reconstructed breast |
| N65.1 | Disproportion of reconstructed breast |
| R59.0 | Localized enlarged lymph nodes |
| R59.1 | Generalized enlarged lymph nodes |
| R59.9 | Enlarged lymph nodes, unspecified |
| R92.0 | Mammographic microcalcification found on diagnostic imaging of breast |
| R92.1 | Mammographic calcification found on diagnostic imaging of breast |
| R92.2 | Inconclusive mammogram |
| R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast |
| S20.01XA | Contusion of right breast, initial encounter |
| S20.02XA | Contusion of left breast, initial encounter |
| S21.011A | Laceration without foreign body of right breast, initial encounter |
| S21.012A | Laceration without foreign body of left breast, initial encounter |
| S21.021A | Laceration with foreign body of right breast, initial encounter |
| S21.022A | Laceration with foreign body of left breast, initial encounter |
| S21.031A | Puncture wound without foreign body of right breast, initial encounter |
| S21.032A | Puncture wound without foreign body of left breast, initial encounter |
| S21.041A | Puncture wound with foreign body of right breast, initial encounter |
| S21.042A | Puncture wound with foreign body of left breast, initial encounter |
| S21.051A | Open bite of right breast, initial encounter |
| S21.052A | Open bite of left breast, initial encounter |
| S28.211A | Complete traumatic amputation of right breast, initial encounter |
| S28.212A | Complete traumatic amputation of left breast, initial encounter |
| S28.221A | Partial traumatic amputation of right breast, initial encounter |
| S28.222A | Partial traumatic amputation of left breast, 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 |
| Z03.89 | Encounter for observation for other suspected diseases and conditions ruled out |
| Z08 | Encounter for follow-up examination after completed treatment for malignant neoplasm |
| Z09 | Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm |
| Z12.31 | Encounter for screening mammogram for malignant neoplasm of breast |
| Z77.118 | Contact with and (suspected) exposure to other environmental pollution |
| Z77.123 | Contact with and (suspected) exposure to radon and other naturally occurring radiation |
| Z77.128 | Contact with and (suspected) exposure to other hazards in the physical environment |
| Z77.22 | Contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic) |
| Z77.9 | Other contact with and (suspected) exposures hazardous to health |
| Z85.3 | Personal history of malignant neoplasm of breast |
| Z85.831 | Personal history of malignant neoplasm of soft tissue |
| Z85.89 | Personal history of malignant neoplasm of other organs and systems |
| Z86.000 | Personal history of in-situ neoplasm of breast |
| Z86.018 | Personal history of other benign neoplasm |
| Z86.03 | Personal history of neoplasm of uncertain behavior |
| Z87.42 | Personal history of other diseases of the female genital tract |
| Z92.89 | Personal history of other medical treatment |
| Z98.86 | Personal history of breast implant removal |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 76641?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 173 ICD-10 diagnosis codes that support medical necessity for CPT 76641. 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 76641 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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