CPT 88275: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 88275 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 88275 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 |
|---|---|
| C94.6 | Myelodysplastic disease, not elsewhere classified |
| D46.0 | Refractory anemia without ring sideroblasts, so stated |
| D46.1 | Refractory anemia with ring sideroblasts |
| D46.20 | Refractory anemia with excess of blasts, unspecified |
| D46.21 | Refractory anemia with excess of blasts 1 |
| D46.22 | Refractory anemia with excess of blasts 2 |
| D46.A | Refractory cytopenia with multilineage dysplasia |
| D46.B | Refractory cytopenia with multilineage dysplasia and ring sideroblasts |
| D46.C | Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality |
| D46.Z | Other myelodysplastic syndromes |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 88275?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 10 ICD-10 diagnosis codes that support medical necessity for CPT 88275. 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 88275 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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