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ICD↔CPT crosswalk

CPT 94375: ICD-10 codes that support medical necessity

1109 covered diagnosis codes under Medicare coverage policies (LCD/NCD)

These ICD-10-CM diagnoses support medical necessity for CPT 94375 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 94375 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-10Description
A15.0Tuberculosis of lung
A15.4Tuberculosis of intrathoracic lymph nodes
A15.5Tuberculosis of larynx, trachea and bronchus
A15.6Tuberculous pleurisy
A15.7Primary respiratory tuberculosis
A15.8Other respiratory tuberculosis
A18.01Tuberculosis of spine
A19.0Acute miliary tuberculosis of a single specified site
A19.1Acute miliary tuberculosis of multiple sites
A19.8Other miliary tuberculosis
A20.2Pneumonic plague
A20.7Septicemic plague
A22.1Pulmonary anthrax
A31.0Pulmonary mycobacterial infection
A36.2Laryngeal diphtheria
A37.00Whooping cough due to Bordetella pertussis without pneumonia
A37.01Whooping cough due to Bordetella pertussis with pneumonia
A37.10Whooping cough due to Bordetella parapertussis without pneumonia
A37.11Whooping cough due to Bordetella parapertussis with pneumonia
A37.80Whooping cough due to other Bordetella species without pneumonia
A37.81Whooping cough due to other Bordetella species with pneumonia
A37.90Whooping cough, unspecified species without pneumonia
A37.91Whooping cough, unspecified species with pneumonia
A42.0Pulmonary actinomycosis
A43.0Pulmonary nocardiosis
A52.72Syphilis of lung and bronchus
A75.3Typhus fever due to Rickettsia tsutsugamushi
A78Q fever
A80.39Other acute paralytic poliomyelitis
B01.2Varicella pneumonia
B05.2Measles complicated by pneumonia
B20Human immunodeficiency virus [HIV] disease
B25.0Cytomegaloviral pneumonitis
B37.1Pulmonary candidiasis
B38.0Acute pulmonary coccidioidomycosis
B38.1Chronic pulmonary coccidioidomycosis
B38.2Pulmonary coccidioidomycosis, unspecified
B39.0Acute pulmonary histoplasmosis capsulati
B39.1Chronic pulmonary histoplasmosis capsulati
B39.2Pulmonary histoplasmosis capsulati, unspecified
B40.0Acute pulmonary blastomycosis
B40.1Chronic pulmonary blastomycosis
B40.7Disseminated blastomycosis
B40.81Blastomycotic meningoencephalitis
B40.89Other forms of blastomycosis
B42.0Pulmonary sporotrichosis
B42.7Disseminated sporotrichosis
B42.81Cerebral sporotrichosis
B42.82Sporotrichosis arthritis
B42.89Other forms of sporotrichosis
B44.0Invasive pulmonary aspergillosis
B44.1Other pulmonary aspergillosis
B44.2Tonsillar aspergillosis
B44.7Disseminated aspergillosis
B44.81Allergic bronchopulmonary aspergillosis
B44.89Other forms of aspergillosis
B44.9Aspergillosis, unspecified
B45.0Pulmonary cryptococcosis
B45.1Cerebral cryptococcosis
B45.3Osseous cryptococcosis
B45.7Disseminated cryptococcosis
B45.8Other forms of cryptococcosis
B48.4Penicillosis
B58.3Pulmonary toxoplasmosis
B59Pneumocystosis
B77.81Ascariasis pneumonia
B91Sequelae of poliomyelitis
C33Malignant neoplasm of trachea
C34.01Malignant neoplasm of right main bronchus
C34.02Malignant neoplasm of left main bronchus
C34.11Malignant neoplasm of upper lobe, right bronchus or lung
C34.12Malignant neoplasm of upper lobe, left bronchus or lung
C34.2Malignant neoplasm of middle lobe, bronchus or lung
C34.31Malignant neoplasm of lower lobe, right bronchus or lung
C34.32Malignant neoplasm of lower lobe, left bronchus or lung
C34.81Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82Malignant neoplasm of overlapping sites of left bronchus and lung
C37Malignant neoplasm of thymus
C38.1Malignant neoplasm of anterior mediastinum
C38.2Malignant neoplasm of posterior mediastinum
C38.4Malignant neoplasm of pleura
C38.8Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
C39.9Malignant neoplasm of lower respiratory tract, part unspecified
C45.0Mesothelioma of pleura
C45.2Mesothelioma of pericardium
C45.7Mesothelioma of other sites
C46.51Kaposi's sarcoma of right lung
C46.52Kaposi's sarcoma of left lung
C76.8Malignant neoplasm of other specified ill-defined sites
C78.01Secondary malignant neoplasm of right lung
C78.02Secondary malignant neoplasm of left lung
C78.1Secondary malignant neoplasm of mediastinum
C78.2Secondary malignant neoplasm of pleura
C78.39Secondary malignant neoplasm of other respiratory organs
C96.5Multifocal and unisystemic Langerhans-cell histiocytosis
C96.6Unifocal Langerhans-cell histiocytosis
D02.0Carcinoma in situ of larynx
D02.1Carcinoma in situ of trachea
D02.21Carcinoma in situ of right bronchus and lung
D02.22Carcinoma in situ of left bronchus and lung
D02.3Carcinoma in situ of other parts of respiratory system
D14.1Benign neoplasm of larynx
D14.2Benign neoplasm of trachea
D14.31Benign neoplasm of right bronchus and lung
D14.32Benign neoplasm of left bronchus and lung
D15.2Benign neoplasm of mediastinum
D18.1Lymphangioma, any site
D19.0Benign neoplasm of mesothelial tissue of pleura
D37.1Neoplasm of uncertain behavior of stomach
D37.2Neoplasm of uncertain behavior of small intestine
D37.3Neoplasm of uncertain behavior of appendix
D37.4Neoplasm of uncertain behavior of colon
D37.5Neoplasm of uncertain behavior of rectum
D38.1Neoplasm of uncertain behavior of trachea, bronchus and lung
D38.2Neoplasm of uncertain behavior of pleura
D38.3Neoplasm of uncertain behavior of mediastinum
D38.4Neoplasm of uncertain behavior of thymus
D38.5Neoplasm of uncertain behavior of other respiratory organs
D45Polycythemia vera
D57.01Hb-SS disease with acute chest syndrome
D57.04Hb-SS disease with dactylitis
D57.211Sickle-cell/Hb-C disease with acute chest syndrome
D57.214Sickle-cell/Hb-C disease with dactylitis
D57.411Sickle-cell thalassemia, unspecified, with acute chest syndrome
D57.414Sickle-cell thalassemia, unspecified, with dactylitis
D57.431Sickle-cell thalassemia beta zero with acute chest syndrome
D57.434Sickle-cell thalassemia beta zero with dactylitis
D57.451Sickle-cell thalassemia beta plus with acute chest syndrome
D57.454Sickle-cell thalassemia beta plus with dactylitis
D57.811Other sickle-cell disorders with acute chest syndrome
D57.814Other sickle-cell disorders with dactylitis
D75.1Secondary polycythemia
D81.810Biotinidase deficiency
D84.1Defects in the complement system
D86.0Sarcoidosis of lung
D86.1Sarcoidosis of lymph nodes
D86.2Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.81Sarcoid meningitis
D86.82Multiple cranial nerve palsies in sarcoidosis
D86.85Sarcoid myocarditis
D86.86Sarcoid arthropathy
D86.87Sarcoid myositis
D86.89Sarcoidosis of other sites
E66.2Morbid (severe) obesity with alveolar hypoventilation
E84.0Cystic fibrosis with pulmonary manifestations
E84.11Meconium ileus in cystic fibrosis
E84.19Cystic fibrosis with other intestinal manifestations
E84.8Cystic fibrosis with other manifestations
E84.9Cystic fibrosis, unspecified
E85.0Non-neuropathic heredofamilial amyloidosis
E85.1Neuropathic heredofamilial amyloidosis
E85.2Heredofamilial amyloidosis, unspecified
E85.3Secondary systemic amyloidosis
E85.4Organ-limited amyloidosis
E85.81Light chain (AL) amyloidosis
E85.82Wild-type transthyretin-related (ATTR) amyloidosis
E85.89Other amyloidosis
E85.9Amyloidosis, unspecified
E87.20Acidosis, unspecified
E87.21Acute metabolic acidosis
E87.22Chronic metabolic acidosis
E87.29Other acidosis
E87.3Alkalosis
E88.01Alpha-1-antitrypsin deficiency
E88.02Plasminogen deficiency
E88.3Tumor lysis syndrome
E88.41MELAS syndrome
E88.42MERRF syndrome
E88.49Other mitochondrial metabolism disorders
E88.82Obesity due to disruption of MC4R pathway
E88.89Other specified metabolic disorders
G12.21Amyotrophic lateral sclerosis
G12.22Progressive bulbar palsy
G12.23Primary lateral sclerosis
G12.24Familial motor neuron disease
G12.25Progressive spinal muscle atrophy
G14Postpolio syndrome
G47.30Sleep apnea, unspecified
G47.31Primary central sleep apnea
G47.33Obstructive sleep apnea (adult) (pediatric)
G47.34Idiopathic sleep related nonobstructive alveolar hypoventilation
G47.35Congenital central alveolar hypoventilation syndrome
G47.36Sleep related hypoventilation in conditions classified elsewhere
G47.37Central sleep apnea in conditions classified elsewhere
G47.39Other sleep apnea
G61.0Guillain-Barre syndrome
G70.00Myasthenia gravis without (acute) exacerbation
G70.01Myasthenia gravis with (acute) exacerbation
G70.80Lambert-Eaton syndrome, unspecified
G70.81Lambert-Eaton syndrome in disease classified elsewhere
G71.00Muscular dystrophy, unspecified
G71.01Duchenne or Becker muscular dystrophy
G71.02Facioscapulohumeral muscular dystrophy
G71.031Autosomal dominant limb girdle muscular dystrophy
G71.032Autosomal recessive limb girdle muscular dystrophy due to calpain-3 dysfunction
G71.033Limb girdle muscular dystrophy due to dysferlin dysfunction
G71.0340Limb girdle muscular dystrophy due to sarcoglycan dysfunction, unspecified
G71.0341Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction
G71.0342Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction
G71.0349Limb girdle muscular dystrophy due to other sarcoglycan dysfunction
G71.035Limb girdle muscular dystrophy due to anoctamin-5 dysfunction
G71.036Limb girdle muscular dystrophy due to fukutin related protein dysfunction
G71.038Other limb girdle muscular dystrophy
G71.09Other specified muscular dystrophies
G71.11Myotonic muscular dystrophy
G71.12Myotonia congenita
G71.13Myotonic chondrodystrophy
G71.14Drug induced myotonia
G71.19Other specified myotonic disorders
G72.41Inclusion body myositis [IBM]
G72.49Other inflammatory and immune myopathies, not elsewhere classified
G73.1Lambert-Eaton syndrome in neoplastic disease
I26.01Septic pulmonary embolism with acute cor pulmonale
I26.02Saddle embolus of pulmonary artery with acute cor pulmonale
I26.03Cement embolism of pulmonary artery with acute cor pulmonale
I26.04Fat embolism of pulmonary artery with acute cor pulmonale
I26.09Other pulmonary embolism with acute cor pulmonale
I26.90Septic pulmonary embolism without acute cor pulmonale
I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
I26.93Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
I26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
I26.95Cement embolism of pulmonary artery without acute cor pulmonale
I26.96Fat embolism of pulmonary artery without acute cor pulmonale
I26.99Other pulmonary embolism without acute cor pulmonale
I27.0Primary pulmonary hypertension
I27.1Kyphoscoliotic heart disease
I27.20Pulmonary hypertension, unspecified
I27.21Secondary pulmonary arterial hypertension
I27.22Pulmonary hypertension due to left heart disease
I27.23Pulmonary hypertension due to lung diseases and hypoxia
I27.24Chronic thromboembolic pulmonary hypertension
I27.29Other secondary pulmonary hypertension
I27.81Cor pulmonale (chronic)
I27.82Chronic pulmonary embolism
I27.83Eisenmenger's syndrome
I27.840Fontan-associated liver disease [FALD]
I27.841Fontan-associated lymphatic dysfunction
I27.848Other Fontan-associated condition
I27.849Fontan related circulation, unspecified
I27.89Other specified pulmonary heart diseases
I28.0Arteriovenous fistula of pulmonary vessels
I28.8Other diseases of pulmonary vessels
I37.0Nonrheumatic pulmonary valve stenosis
I37.1Nonrheumatic pulmonary valve insufficiency
I37.2Nonrheumatic pulmonary valve stenosis with insufficiency
I37.8Other nonrheumatic pulmonary valve disorders
I37.9Nonrheumatic pulmonary valve disorder, unspecified
I46.2Cardiac arrest due to underlying cardiac condition
I46.8Cardiac arrest due to other underlying condition
I46.9Cardiac arrest, cause unspecified
I50.1Left ventricular failure, unspecified
I50.20Unspecified systolic (congestive) heart failure
I50.21Acute systolic (congestive) heart failure
I50.22Chronic systolic (congestive) heart failure
I50.23Acute on chronic systolic (congestive) heart failure
I50.30Unspecified diastolic (congestive) heart failure
I50.31Acute diastolic (congestive) heart failure
I50.32Chronic diastolic (congestive) heart failure
I50.33Acute on chronic diastolic (congestive) heart failure
I50.40Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.810Right heart failure, unspecified
I50.811Acute right heart failure
I50.812Chronic right heart failure
I50.813Acute on chronic right heart failure
I50.814Right heart failure due to left heart failure
I50.82Biventricular heart failure
I50.83High output heart failure
I50.84End stage heart failure
I50.89Other heart failure
I50.9Heart failure, unspecified
J04.10Acute tracheitis without obstruction
J04.11Acute tracheitis with obstruction
J04.2Acute laryngotracheitis
J05.0Acute obstructive laryngitis [croup]
J05.10Acute epiglottitis without obstruction
J05.11Acute epiglottitis with obstruction
J06.0Acute laryngopharyngitis
J09.X1Influenza due to identified novel influenza A virus with pneumonia
J09.X2Influenza due to identified novel influenza A virus with other respiratory manifestations
J09.X3Influenza due to identified novel influenza A virus with gastrointestinal manifestations
J09.X9Influenza due to identified novel influenza A virus with other manifestations
J10.00Influenza due to other identified influenza virus with unspecified type of pneumonia
J10.01Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia
J10.08Influenza due to other identified influenza virus with other specified pneumonia
J10.1Influenza due to other identified influenza virus with other respiratory manifestations
J11.00Influenza due to unidentified influenza virus with unspecified type of pneumonia
J11.08Influenza due to unidentified influenza virus with specified pneumonia
J11.1Influenza due to unidentified influenza virus with other respiratory manifestations
J12.0Adenoviral pneumonia
J12.1Respiratory syncytial virus pneumonia
J12.82Pneumonia due to coronavirus disease 2019
J12.9Viral pneumonia, unspecified
J13Pneumonia due to Streptococcus pneumoniae
J15.20Pneumonia due to staphylococcus, unspecified
J15.211Pneumonia due to Methicillin susceptible Staphylococcus aureus
J15.212Pneumonia due to Methicillin resistant Staphylococcus aureus
J15.29Pneumonia due to other staphylococcus
J15.3Pneumonia due to streptococcus, group B
J15.4Pneumonia due to other streptococci
J15.61Pneumonia due to Acinetobacter baumannii
J15.69Pneumonia due to other Gram-negative bacteria
J15.7Pneumonia due to Mycoplasma pneumoniae
J16.0Chlamydial pneumonia
J17Pneumonia in diseases classified elsewhere
J18.0Bronchopneumonia, unspecified organism
J18.1Lobar pneumonia, unspecified organism
J18.2Hypostatic pneumonia, unspecified organism
J18.8Other pneumonia, unspecified organism
J18.9Pneumonia, unspecified organism
J20.0Acute bronchitis due to Mycoplasma pneumoniae
J20.1Acute bronchitis due to Hemophilus influenzae
J20.2Acute bronchitis due to streptococcus
J20.3Acute bronchitis due to coxsackievirus
J20.4Acute bronchitis due to parainfluenza virus
J20.5Acute bronchitis due to respiratory syncytial virus
J20.6Acute bronchitis due to rhinovirus
J20.7Acute bronchitis due to echovirus
J20.8Acute bronchitis due to other specified organisms
J20.9Acute bronchitis, unspecified
J21.0Acute bronchiolitis due to respiratory syncytial virus
J21.1Acute bronchiolitis due to human metapneumovirus
J21.8Acute bronchiolitis due to other specified organisms
J21.9Acute bronchiolitis, unspecified
J22Unspecified acute lower respiratory infection
J37.1Chronic laryngotracheitis
J38.01Paralysis of vocal cords and larynx, unilateral
J38.02Paralysis of vocal cords and larynx, bilateral
J38.4Edema of larynx
J38.5Laryngeal spasm
J38.6Stenosis of larynx
J38.7Other diseases of larynx
J39.3Upper respiratory tract hypersensitivity reaction, site unspecified
J39.8Other specified diseases of upper respiratory tract
J40Bronchitis, not specified as acute or chronic
J41.0Simple chronic bronchitis
J41.1Mucopurulent chronic bronchitis
J41.8Mixed simple and mucopurulent chronic bronchitis
J43.0Unilateral pulmonary emphysema [MacLeod's syndrome]
J43.1Panlobular emphysema
J43.2Centrilobular emphysema
J43.8Other emphysema
J43.9Emphysema, unspecified
J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.1Chronic obstructive pulmonary disease with (acute) exacerbation
J44.81Bronchiolitis obliterans and bronchiolitis obliterans syndrome
J44.89Other specified chronic obstructive pulmonary disease
J44.9Chronic obstructive pulmonary disease, unspecified
J45.20Mild intermittent asthma, uncomplicated
J45.21Mild intermittent asthma with (acute) exacerbation
J45.22Mild intermittent asthma with status asthmaticus
J45.30Mild persistent asthma, uncomplicated
J45.31Mild persistent asthma with (acute) exacerbation
J45.32Mild persistent asthma with status asthmaticus
J45.40Moderate persistent asthma, uncomplicated
J45.41Moderate persistent asthma with (acute) exacerbation
J45.42Moderate persistent asthma with status asthmaticus
J45.50Severe persistent asthma, uncomplicated
J45.51Severe persistent asthma with (acute) exacerbation
J45.52Severe persistent asthma with status asthmaticus
J45.901Unspecified asthma with (acute) exacerbation
J45.902Unspecified asthma with status asthmaticus
J45.909Unspecified asthma, uncomplicated
J45.990Exercise induced bronchospasm
J45.991Cough variant asthma
J45.998Other asthma
J47.0Bronchiectasis with acute lower respiratory infection
J47.1Bronchiectasis with (acute) exacerbation
J47.9Bronchiectasis, uncomplicated
J60Coalworker's pneumoconiosis
J61Pneumoconiosis due to asbestos and other mineral fibers
J62.0Pneumoconiosis due to talc dust
J62.8Pneumoconiosis due to other dust containing silica
J63.0Aluminosis (of lung)
J63.1Bauxite fibrosis (of lung)
J63.2Berylliosis
J63.3Graphite fibrosis (of lung)
J63.4Siderosis
J63.5Stannosis
J63.6Pneumoconiosis due to other specified inorganic dusts
J64Unspecified pneumoconiosis
J65Pneumoconiosis associated with tuberculosis
J66.0Byssinosis
J66.1Flax-dressers' disease
J66.2Cannabinosis
J66.8Airway disease due to other specific organic dusts
J67.0Farmer's lung
J67.1Bagassosis
J67.2Bird fancier's lung
J67.3Suberosis
J67.4Maltworker's lung
J67.5Mushroom-worker's lung
J67.6Maple-bark-stripper's lung
J67.7Air conditioner and humidifier lung
J67.8Hypersensitivity pneumonitis due to other organic dusts
J68.0Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors
J68.1Pulmonary edema due to chemicals, gases, fumes and vapors
J68.2Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified

Showing the first 400 of 1109 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 94375?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 1109 ICD-10 diagnosis codes that support medical necessity for CPT 94375. 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 94375 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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