ICD↔CPT crosswalk
CPT 81231: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 81231 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 81231 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 |
|---|---|
| A03.8 | Other shigellosis |
| A03.9 | Shigellosis, unspecified |
| A04.4 | Other intestinal Escherichia coli infections |
| A15.9 | Respiratory tuberculosis unspecified |
| A17.9 | Tuberculosis of nervous system, unspecified |
| A18.01 | Tuberculosis of spine |
| A18.02 | Tuberculous arthritis of other joints |
| A18.03 | Tuberculosis of other bones |
| A18.09 | Other musculoskeletal tuberculosis |
| A18.10 | Tuberculosis of genitourinary system, unspecified |
| A18.11 | Tuberculosis of kidney and ureter |
| A18.12 | Tuberculosis of bladder |
| A18.13 | Tuberculosis of other urinary organs |
| A18.14 | Tuberculosis of prostate |
| A18.15 | Tuberculosis of other male genital organs |
| A18.16 | Tuberculosis of cervix |
| A18.17 | Tuberculous female pelvic inflammatory disease |
| A18.18 | Tuberculosis of other female genital organs |
| A18.2 | Tuberculous peripheral lymphadenopathy |
| A18.31 | Tuberculous peritonitis |
| A18.32 | Tuberculous enteritis |
| A18.39 | Retroperitoneal tuberculosis |
| A18.4 | Tuberculosis of skin and subcutaneous tissue |
| A18.50 | Tuberculosis of eye, unspecified |
| A18.51 | Tuberculous episcleritis |
| A18.52 | Tuberculous keratitis |
| A18.53 | Tuberculous chorioretinitis |
| A18.54 | Tuberculous iridocyclitis |
| A18.59 | Other tuberculosis of eye |
| A18.6 | Tuberculosis of (inner) (middle) ear |
| A18.7 | Tuberculosis of adrenal glands |
| A18.81 | Tuberculosis of thyroid gland |
| A18.82 | Tuberculosis of other endocrine glands |
| A18.83 | Tuberculosis of digestive tract organs, not elsewhere classified |
| A18.84 | Tuberculosis of heart |
| A18.85 | Tuberculosis of spleen |
| A18.89 | Tuberculosis of other sites |
| A19.8 | Other miliary tuberculosis |
| A19.9 | Miliary tuberculosis, unspecified |
| B18.0 | Chronic viral hepatitis B with delta-agent |
| B18.1 | Chronic viral hepatitis B without delta-agent |
| B18.2 | Chronic viral hepatitis C |
| B20 | Human immunodeficiency virus [HIV] disease |
| B37.81 | Candidal esophagitis |
| B37.89 | Other sites of candidiasis |
| B44.0 | Invasive pulmonary aspergillosis |
| B48.8 | Other specified mycoses |
| B51.0 | Plasmodium vivax malaria with rupture of spleen |
| B51.8 | Plasmodium vivax malaria with other complications |
| B51.9 | Plasmodium vivax malaria without complication |
| B59 | Pneumocystosis |
| B96.20 | Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere |
| C00.0 | Malignant neoplasm of external upper lip |
| C00.1 | Malignant neoplasm of external lower lip |
| C00.2 | Malignant neoplasm of external lip, unspecified |
| 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 |
| C00.9 | Malignant neoplasm of lip, unspecified |
| 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 |
| C02.9 | Malignant neoplasm of tongue, unspecified |
| C03.0 | Malignant neoplasm of upper gum |
| C03.1 | Malignant neoplasm of lower gum |
| C03.9 | Malignant neoplasm of gum, unspecified |
| 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 |
| C04.9 | Malignant neoplasm of floor of mouth, unspecified |
| 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 |
| C05.9 | Malignant neoplasm of palate, unspecified |
| 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 |
| C06.9 | Malignant neoplasm of mouth, unspecified |
| 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 |
| C09.9 | Malignant neoplasm of tonsil, unspecified |
| 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 |
| C10.9 | Malignant neoplasm of oropharynx, unspecified |
| 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 |
| C11.9 | Malignant neoplasm of nasopharynx, unspecified |
| 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 |
| 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 |
| 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 |
| 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 |
| C18.0 | Malignant neoplasm of cecum |
| C18.1 | Malignant neoplasm of appendix |
| C18.2 | Malignant neoplasm of ascending colon |
| C18.3 | Malignant neoplasm of hepatic flexure |
| C18.4 | Malignant neoplasm of transverse colon |
| C18.5 | Malignant neoplasm of splenic flexure |
| C18.6 | Malignant neoplasm of descending colon |
| C18.7 | Malignant neoplasm of sigmoid colon |
| C18.8 | Malignant neoplasm of overlapping sites of colon |
| C18.9 | Malignant neoplasm of colon, unspecified |
| C19 | Malignant neoplasm of rectosigmoid junction |
| C20 | Malignant neoplasm of rectum |
| C21.0 | Malignant neoplasm of anus, unspecified |
| C21.1 | Malignant neoplasm of anal canal |
| C21.2 | Malignant neoplasm of cloacogenic zone |
| C21.8 | Malignant neoplasm of overlapping sites of rectum, anus and anal canal |
| C22.0 | Liver cell carcinoma |
| C22.1 | Intrahepatic bile duct carcinoma |
| C22.2 | Hepatoblastoma |
| C22.3 | Angiosarcoma of liver |
| C22.4 | Other sarcomas of liver |
| C22.7 | Other specified carcinomas of liver |
| C22.8 | Malignant neoplasm of liver, primary, unspecified as to type |
| C23 | Malignant neoplasm of gallbladder |
| C24.0 | Malignant neoplasm of extrahepatic bile duct |
| C24.1 | Malignant neoplasm of ampulla of Vater |
| C24.8 | Malignant neoplasm of overlapping sites of biliary tract |
| C24.9 | Malignant neoplasm of biliary tract, unspecified |
| 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 |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| 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 |
| C43.31 | Malignant melanoma of nose |
| C43.39 | Malignant melanoma of other parts of face |
| C43.4 | Malignant melanoma of scalp and neck |
| C43.51 | Malignant melanoma of anal skin |
| C43.52 | Malignant melanoma of skin of breast |
| C43.59 | Malignant melanoma of other part of trunk |
| C43.61 | Malignant melanoma of right upper limb, including shoulder |
| C43.62 | Malignant melanoma of left upper limb, including shoulder |
| C43.71 | Malignant melanoma of right lower limb, including hip |
| C43.72 | Malignant melanoma of left lower limb, including hip |
| C43.8 | Malignant melanoma of overlapping sites of skin |
| C43.9 | Malignant melanoma of skin, unspecified |
| C49.9 | Malignant neoplasm of connective and soft tissue, unspecified |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast |
| C50.019 | Malignant neoplasm of nipple and areola, unspecified female breast |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast |
| C50.029 | Malignant neoplasm of nipple and areola, unspecified male breast |
| C50.111 | Malignant neoplasm of central portion of right female breast |
| C50.112 | Malignant neoplasm of central portion of left female breast |
| C50.119 | Malignant neoplasm of central portion of unspecified female breast |
| C50.121 | Malignant neoplasm of central portion of right male breast |
| C50.122 | Malignant neoplasm of central portion of left male breast |
| C50.129 | Malignant neoplasm of central portion of unspecified 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 |
| C50.219 | Malignant neoplasm of upper-inner quadrant of unspecified 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 |
| C50.229 | Malignant neoplasm of upper-inner quadrant of unspecified 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 |
| C50.319 | Malignant neoplasm of lower-inner quadrant of unspecified 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 |
| C50.329 | Malignant neoplasm of lower-inner quadrant of unspecified 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 |
| C50.419 | Malignant neoplasm of upper-outer quadrant of unspecified 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 |
| C50.429 | Malignant neoplasm of upper-outer quadrant of unspecified 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 |
| C50.519 | Malignant neoplasm of lower-outer quadrant of unspecified 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 |
| C50.529 | Malignant neoplasm of lower-outer quadrant of unspecified male breast |
| C50.611 | Malignant neoplasm of axillary tail of right female breast |
| C50.612 | Malignant neoplasm of axillary tail of left female breast |
| C50.619 | Malignant neoplasm of axillary tail of unspecified female breast |
| C50.621 | Malignant neoplasm of axillary tail of right male breast |
| C50.622 | Malignant neoplasm of axillary tail of left male breast |
| C50.629 | Malignant neoplasm of axillary tail of unspecified male breast |
| C50.811 | Malignant neoplasm of overlapping sites of right female breast |
| C50.812 | Malignant neoplasm of overlapping sites of left female breast |
| C50.819 | Malignant neoplasm of overlapping sites of unspecified female breast |
| C50.821 | Malignant neoplasm of overlapping sites of right male breast |
| C50.822 | Malignant neoplasm of overlapping sites of left male breast |
| C50.829 | Malignant neoplasm of overlapping sites of unspecified male breast |
| C50.919 | Malignant neoplasm of unspecified site of unspecified female breast |
| C50.929 | Malignant neoplasm of unspecified site of unspecified male breast |
| C50.A1 | Malignant inflammatory neoplasm of right breast |
| C50.A2 | Malignant inflammatory neoplasm of left breast |
| C53.0 | Malignant neoplasm of endocervix |
| C53.1 | Malignant neoplasm of exocervix |
| C53.8 | Malignant neoplasm of overlapping sites of cervix uteri |
| C53.9 | Malignant neoplasm of cervix uteri, unspecified |
| C54.0 | Malignant neoplasm of isthmus uteri |
| C54.1 | Malignant neoplasm of endometrium |
| C54.2 | Malignant neoplasm of myometrium |
| C54.3 | Malignant neoplasm of fundus uteri |
| C54.8 | Malignant neoplasm of overlapping sites of corpus uteri |
| C54.9 | Malignant neoplasm of corpus uteri, unspecified |
| C55 | Malignant neoplasm of uterus, part unspecified |
| C56.1 | Malignant neoplasm of right ovary |
| C56.2 | Malignant neoplasm of left ovary |
| C56.3 | Malignant neoplasm of bilateral ovaries |
| C56.9 | Malignant neoplasm of unspecified ovary |
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis |
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis |
| C64.9 | Malignant neoplasm of unspecified kidney, except renal pelvis |
| C65.1 | Malignant neoplasm of right renal pelvis |
| C65.2 | Malignant neoplasm of left renal pelvis |
| C66.1 | Malignant neoplasm of right ureter |
| C66.2 | Malignant neoplasm of left ureter |
| C67.0 | Malignant neoplasm of trigone of bladder |
| C67.1 | Malignant neoplasm of dome of bladder |
| C67.2 | Malignant neoplasm of lateral wall of bladder |
| C67.3 | Malignant neoplasm of anterior wall of bladder |
| C67.4 | Malignant neoplasm of posterior wall of bladder |
| C67.5 | Malignant neoplasm of bladder neck |
| C67.6 | Malignant neoplasm of ureteric orifice |
| C67.7 | Malignant neoplasm of urachus |
| C67.8 | Malignant neoplasm of overlapping sites of bladder |
| C67.9 | Malignant neoplasm of bladder, unspecified |
| C68.0 | Malignant neoplasm of urethra |
| C68.1 | Malignant neoplasm of paraurethral glands |
| C68.8 | Malignant neoplasm of overlapping sites of urinary organs |
| C7A.093 | Malignant carcinoid tumor of the kidney |
| C84.40 | Peripheral T-cell lymphoma, not elsewhere classified, unspecified site |
| C84.48 | Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of multiple sites |
| C91.00 | Acute lymphoblastic leukemia not having achieved remission |
| C91.01 | Acute lymphoblastic leukemia, in remission |
| C91.02 | Acute lymphoblastic leukemia, in relapse |
| C91.40 | Hairy cell leukemia not having achieved remission |
| C91.50 | Adult T-cell lymphoma/leukemia (HTLV-1-associated) not having achieved remission |
| C91.60 | Prolymphocytic leukemia of T-cell type not having achieved remission |
| C91.A0 | Mature B-cell leukemia Burkitt-type not having achieved remission |
| C91.Z0 | Other lymphoid leukemia not having achieved remission |
| C92.00 | Acute myeloblastic leukemia, not having achieved remission |
| C92.01 | Acute myeloblastic leukemia, in remission |
| C92.02 | Acute myeloblastic leukemia, in relapse |
| C92.10 | Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission |
| C92.12 | Chronic myeloid leukemia, BCR/ABL-positive, in relapse |
| D13.7 | Benign neoplasm of endocrine pancreas |
| D18.02 | Hemangioma of intracranial structures |
| D32.0 | Benign neoplasm of cerebral meninges |
| D32.1 | Benign neoplasm of spinal meninges |
| D33.0 | Benign neoplasm of brain, supratentorial |
| D33.1 | Benign neoplasm of brain, infratentorial |
| D33.3 | Benign neoplasm of cranial nerves |
| D33.4 | Benign neoplasm of spinal cord |
| D33.7 | Benign neoplasm of other specified parts of central nervous system |
| D74.8 | Other methemoglobinemias |
| D84.89 | Other immunodeficiencies |
| D84.9 | Immunodeficiency, unspecified |
| E11.8 | Type 2 diabetes mellitus with unspecified complications |
| E11.9 | Type 2 diabetes mellitus without complications |
| E16.4 | Increased secretion of gastrin |
| E31.20 | Multiple endocrine neoplasia [MEN] syndrome, unspecified |
| E31.8 | Other polyglandular dysfunction |
| E46 | Unspecified protein-calorie malnutrition |
| E75.22 | Gaucher disease |
| E78.00 | Pure hypercholesterolemia, unspecified |
| E78.010 | Homozygous familial hypercholesterolemia [HoFH] |
| E78.011 | Heterozygous familial hypercholesterolemia [HeFH] |
| E78.019 | Familial hypercholesterolemia, unspecified |
| E78.1 | Pure hyperglyceridemia |
| E78.2 | Mixed hyperlipidemia |
| E78.49 | Other hyperlipidemia |
| E79.9 | Disorder of purine and pyrimidine metabolism, unspecified |
| E84.8 | Cystic fibrosis with other manifestations |
| F11.23 | Opioid dependence with withdrawal |
| F20.0 | Paranoid schizophrenia |
| F20.1 | Disorganized schizophrenia |
| F20.2 | Catatonic schizophrenia |
| F20.3 | Undifferentiated schizophrenia |
| F20.5 | Residual schizophrenia |
| F20.81 | Schizophreniform disorder |
| F20.89 | Other schizophrenia |
| F31.0 | Bipolar disorder, current episode hypomanic |
| F31.11 | Bipolar disorder, current episode manic without psychotic features, mild |
| F31.12 | Bipolar disorder, current episode manic without psychotic features, moderate |
| F31.13 | Bipolar disorder, current episode manic without psychotic features, severe |
| F31.2 | Bipolar disorder, current episode manic severe with psychotic features |
| F31.31 | Bipolar disorder, current episode depressed, mild |
| F31.32 | Bipolar disorder, current episode depressed, moderate |
| F31.4 | Bipolar disorder, current episode depressed, severe, without psychotic features |
| F31.5 | Bipolar disorder, current episode depressed, severe, with psychotic features |
| F31.61 | Bipolar disorder, current episode mixed, mild |
| F31.62 | Bipolar disorder, current episode mixed, moderate |
| F31.63 | Bipolar disorder, current episode mixed, severe, without psychotic features |
| F31.64 | Bipolar disorder, current episode mixed, severe, with psychotic features |
| F31.71 | Bipolar disorder, in partial remission, most recent episode hypomanic |
| F31.73 | Bipolar disorder, in partial remission, most recent episode manic |
| F31.75 | Bipolar disorder, in partial remission, most recent episode depressed |
| F31.77 | Bipolar disorder, in partial remission, most recent episode mixed |
| F32.1 | Major depressive disorder, single episode, moderate |
| F32.2 | Major depressive disorder, single episode, severe without psychotic features |
| F32.3 | Major depressive disorder, single episode, severe with psychotic features |
| F32.4 | Major depressive disorder, single episode, in partial remission |
| F32.81 | Premenstrual dysphoric disorder |
| F32.9 | Major depressive disorder, single episode, unspecified |
| F33.1 | Major depressive disorder, recurrent, moderate |
| F33.2 | Major depressive disorder, recurrent severe without psychotic features |
| F33.3 | Major depressive disorder, recurrent, severe with psychotic symptoms |
| F33.41 | Major depressive disorder, recurrent, in partial remission |
| F33.9 | Major depressive disorder, recurrent, unspecified |
| F40.01 | Agoraphobia with panic disorder |
| F40.11 | Social phobia, generalized |
| F41.0 | Panic disorder [episodic paroxysmal anxiety] |
| F41.1 | Generalized anxiety disorder |
| F41.3 | Other mixed anxiety disorders |
| F41.8 | Other specified anxiety disorders |
| F43.11 | Post-traumatic stress disorder, acute |
| F43.12 | Post-traumatic stress disorder, chronic |
| F52.0 | Hypoactive sexual desire disorder |
| F60.5 | Obsessive-compulsive personality disorder |
| F84.0 | Autistic disorder |
| F90.0 | Attention-deficit hyperactivity disorder, predominantly inattentive type |
| F90.1 | Attention-deficit hyperactivity disorder, predominantly hyperactive type |
| F90.2 | Attention-deficit hyperactivity disorder, combined type |
| F90.8 | Attention-deficit hyperactivity disorder, other type |
| F95.2 | Tourette's disorder |
| G10 | Huntington's disease |
| G24.01 | Drug induced subacute dyskinesia |
| G35.A | Relapsing-remitting multiple sclerosis |
| G35.B0 | Primary progressive multiple sclerosis, unspecified |
| G35.B1 | Active primary progressive multiple sclerosis |
| G35.B2 | Non-active primary progressive multiple sclerosis |
| G35.C0 | Secondary progressive multiple sclerosis, unspecified |
| G35.C1 | Active secondary progressive multiple sclerosis |
| G35.C2 | Non-active secondary progressive multiple sclerosis |
| G40.101 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus |
| G40.109 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus |
| G40.111 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus |
| G40.119 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus |
| G40.201 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus |
| G40.209 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus |
| G40.211 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus |
| G40.219 | Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus |
| G40.301 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.309 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus |
| G40.311 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.319 | Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus |
| G40.401 | Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus |
| G40.409 | Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus |
| G40.411 | Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus |
Showing the first 400 of 776 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 81231?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 776 ICD-10 diagnosis codes that support medical necessity for CPT 81231. 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 81231 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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