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ICD↔CPT crosswalk

CPT 94761: ICD-10 codes that support medical necessity

3253 covered diagnosis codes under Medicare coverage policies (LCD/NCD)

These ICD-10-CM diagnoses support medical necessity for CPT 94761 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 94761 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
A15.5Tuberculosis of larynx, trachea and bronchus
A15.8Other respiratory tuberculosis
A15.9Respiratory tuberculosis unspecified
A20.2Pneumonic plague
A21.2Pulmonary tularemia
A22.1Pulmonary anthrax
A37.01Whooping cough due to Bordetella pertussis with pneumonia
A37.11Whooping cough due to Bordetella parapertussis with pneumonia
A37.81Whooping cough due to other Bordetella species with pneumonia
A37.91Whooping cough, unspecified species with pneumonia
A42.0Pulmonary actinomycosis
A43.0Pulmonary nocardiosis
A48.1Legionnaires' disease
A70Chlamydia psittaci infections
B01.2Varicella pneumonia
B25.0Cytomegaloviral pneumonitis
B44.0Invasive pulmonary aspergillosis
B44.81Allergic bronchopulmonary aspergillosis
B58.3Pulmonary toxoplasmosis
B59Pneumocystosis
B77.81Ascariasis pneumonia
C33Malignant neoplasm of trachea
C34.00Malignant neoplasm of unspecified main bronchus
C34.01Malignant neoplasm of right main bronchus
C34.02Malignant neoplasm of left main bronchus
C34.10Malignant neoplasm of upper lobe, unspecified bronchus or lung
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
C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung
C34.31Malignant neoplasm of lower lobe, right bronchus or lung
C34.32Malignant neoplasm of lower lobe, left bronchus or lung
C34.80Malignant neoplasm of overlapping sites of unspecified bronchus and lung
C34.81Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82Malignant neoplasm of overlapping sites of left bronchus and lung
C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
C34.91Malignant neoplasm of unspecified part of right bronchus or lung
C34.92Malignant neoplasm of unspecified part of left bronchus or lung
C38.4Malignant neoplasm of pleura
C45.0Mesothelioma of pleura
C78.00Secondary malignant neoplasm of unspecified lung
C78.01Secondary malignant neoplasm of right lung
C78.02Secondary malignant neoplasm of left lung
C78.2Secondary malignant neoplasm of pleura
C78.39Secondary malignant neoplasm of other respiratory organs
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
D86.3Sarcoidosis of skin
D86.81Sarcoid meningitis
D86.82Multiple cranial nerve palsies in sarcoidosis
D86.83Sarcoid iridocyclitis
D86.84Sarcoid pyelonephritis
D86.85Sarcoid myocarditis
D86.86Sarcoid arthropathy
D86.87Sarcoid myositis
D86.89Sarcoidosis of other sites
D86.9Sarcoidosis, unspecified
E84.0Cystic fibrosis with pulmonary manifestations
E84.8Cystic fibrosis with other manifestations
E84.9Cystic fibrosis, unspecified
F05Delirium due to known physiological condition
F28Other psychotic disorder not due to a substance or known physiological condition
F29Unspecified psychosis not due to a substance or known physiological condition
F51.19Other hypersomnia not due to a substance or known physiological condition
G12.21Amyotrophic lateral sclerosis
G12.25Progressive spinal muscle atrophy
G47.01Insomnia due to medical condition
G47.09Other insomnia
G47.10Hypersomnia, unspecified
G47.11Idiopathic hypersomnia with long sleep time
G47.12Idiopathic hypersomnia without long sleep time
G47.13Recurrent hypersomnia
G47.14Hypersomnia due to medical condition
G47.19Other hypersomnia
G47.20Circadian rhythm sleep disorder, unspecified type
G47.21Circadian rhythm sleep disorder, delayed sleep phase type
G47.22Circadian rhythm sleep disorder, advanced sleep phase type
G47.23Circadian rhythm sleep disorder, irregular sleep wake type
G47.24Circadian rhythm sleep disorder, free running type
G47.25Circadian rhythm sleep disorder, jet lag type
G47.26Circadian rhythm sleep disorder, shift work type
G47.27Circadian rhythm sleep disorder in conditions classified elsewhere
G47.29Other circadian rhythm sleep disorder
G47.30Sleep apnea, unspecified
G47.31Primary central sleep apnea
G47.32High altitude periodic breathing
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
G47.50Parasomnia, unspecified
G47.51Confusional arousals
G47.52REM sleep behavior disorder
G47.53Recurrent isolated sleep paralysis
G47.54Parasomnia in conditions classified elsewhere
G47.59Other parasomnia
G47.69Other sleep related movement disorders
G47.8Other sleep disorders
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
G73.1Lambert-Eaton syndrome in neoplastic disease
G93.31Postviral fatigue syndrome
G93.32Myalgic encephalomyelitis/chronic fatigue syndrome
G93.39Other post infection and related fatigue syndromes
I01.8Other acute rheumatic heart disease
I09.81Rheumatic heart failure
I11.0Hypertensive heart disease with heart failure
I13.0Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I16.0Hypertensive urgency
I16.1Hypertensive emergency
I16.9Hypertensive crisis, unspecified
I20.89Other forms of angina pectoris
I20.9Angina pectoris, unspecified
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
I27.9Pulmonary heart disease, 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
I78.0Hereditary hemorrhagic telangiectasia
J04.0Acute laryngitis
J04.10Acute tracheitis without obstruction
J04.11Acute tracheitis with obstruction
J04.2Acute laryngotracheitis
J04.30Supraglottitis, unspecified, without obstruction
J04.31Supraglottitis, unspecified, with obstruction
J05.0Acute obstructive laryngitis [croup]
J05.10Acute epiglottitis without obstruction
J05.11Acute epiglottitis with obstruction
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
J12.2Parainfluenza virus pneumonia
J12.3Human metapneumovirus pneumonia
J12.81Pneumonia due to SARS-associated coronavirus
J12.82Pneumonia due to coronavirus disease 2019
J12.89Other viral pneumonia
J12.9Viral pneumonia, unspecified
J13Pneumonia due to Streptococcus pneumoniae
J14Pneumonia due to Hemophilus influenzae
J15.0Pneumonia due to Klebsiella pneumoniae
J15.1Pneumonia due to Pseudomonas
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
J15.5Pneumonia due to Escherichia coli
J15.69Pneumonia due to other Gram-negative bacteria
J15.7Pneumonia due to Mycoplasma pneumoniae
J15.8Pneumonia due to other specified bacteria
J15.9Unspecified bacterial pneumonia
J16.0Chlamydial pneumonia
J16.8Pneumonia due to other specified infectious organisms
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
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
J39.9Disease of upper respiratory tract, unspecified
J40Bronchitis, not specified as acute or chronic
J41.0Simple chronic bronchitis
J41.1Mucopurulent chronic bronchitis
J41.8Mixed simple and mucopurulent chronic bronchitis
J42Unspecified 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
J4A.0Restrictive allograft syndrome
J4A.8Other chronic lung allograft dysfunction
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
J67.9Hypersensitivity pneumonitis due to unspecified organic dust
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
J68.3Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapors
J68.4Chronic respiratory conditions due to chemicals, gases, fumes and vapors
J68.8Other respiratory conditions due to chemicals, gases, fumes and vapors
J68.9Unspecified respiratory condition due to chemicals, gases, fumes and vapors
J69.0Pneumonitis due to inhalation of food and vomit
J69.1Pneumonitis due to inhalation of oils and essences
J69.8Pneumonitis due to inhalation of other solids and liquids
J70.0Acute pulmonary manifestations due to radiation
J70.1Chronic and other pulmonary manifestations due to radiation
J70.2Acute drug-induced interstitial lung disorders
J70.3Chronic drug-induced interstitial lung disorders
J70.4Drug-induced interstitial lung disorders, unspecified
J70.5Respiratory conditions due to smoke inhalation
J70.8Respiratory conditions due to other specified external agents
J70.9Respiratory conditions due to unspecified external agent
J80Acute respiratory distress syndrome
J81.0Acute pulmonary edema
J81.1Chronic pulmonary edema
J82.81Chronic eosinophilic pneumonia
J82.82Acute eosinophilic pneumonia
J82.83Eosinophilic asthma
J82.89Other pulmonary eosinophilia, not elsewhere classified
J84.01Alveolar proteinosis
J84.02Pulmonary alveolar microlithiasis
J84.03Idiopathic pulmonary hemosiderosis
J84.09Other alveolar and parieto-alveolar conditions
J84.10Pulmonary fibrosis, unspecified
J84.111Idiopathic interstitial pneumonia, not otherwise specified
J84.112Idiopathic pulmonary fibrosis
J84.113Idiopathic non-specific interstitial pneumonitis
J84.114Acute interstitial pneumonitis
J84.115Respiratory bronchiolitis interstitial lung disease
J84.116Cryptogenic organizing pneumonia
J84.117Desquamative interstitial pneumonia
J84.170Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
J84.178Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere
J84.2Lymphoid interstitial pneumonia
J84.81Lymphangioleiomyomatosis
J84.82Adult pulmonary Langerhans cell histiocytosis
J84.83Surfactant mutations of the lung
J84.843Alveolar capillary dysplasia with vein misalignment
J84.848Other interstitial lung diseases of childhood
J84.89Other specified interstitial pulmonary diseases
J84.9Interstitial pulmonary disease, unspecified
J85.0Gangrene and necrosis of lung
J85.1Abscess of lung with pneumonia
J85.2Abscess of lung without pneumonia
J85.3Abscess of mediastinum
J86.0Pyothorax with fistula
J86.9Pyothorax without fistula
J90Pleural effusion, not elsewhere classified
J91.0Malignant pleural effusion
J91.8Pleural effusion in other conditions classified elsewhere
J92.0Pleural plaque with presence of asbestos
J92.9Pleural plaque without asbestos
J93.0Spontaneous tension pneumothorax
J93.11Primary spontaneous pneumothorax
J93.12Secondary spontaneous pneumothorax
J93.81Chronic pneumothorax
J93.82Other air leak
J93.83Other pneumothorax
J93.9Pneumothorax, unspecified
J94.0Chylous effusion
J94.1Fibrothorax
J94.2Hemothorax
J94.8Other specified pleural conditions
J94.9Pleural condition, unspecified
J95.1Acute pulmonary insufficiency following thoracic surgery
J95.2Acute pulmonary insufficiency following nonthoracic surgery
J95.3Chronic pulmonary insufficiency following surgery
J95.4Chemical pneumonitis due to anesthesia
J95.5Postprocedural subglottic stenosis
J95.811Postprocedural pneumothorax
J95.812Postprocedural air leak
J95.821Acute postprocedural respiratory failure
J95.822Acute and chronic postprocedural respiratory failure
J95.84Transfusion-related acute lung injury (TRALI)
J95.851Ventilator associated pneumonia
J95.859Other complication of respirator [ventilator]
J95.860Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure
J95.861Postprocedural hematoma of a respiratory system organ or structure following other procedure
J95.862Postprocedural seroma of a respiratory system organ or structure following a respiratory system procedure
J95.863Postprocedural seroma of a respiratory system organ or structure following other procedure
J95.87Transfusion-associated dyspnea (TAD)
J95.88Other intraoperative complications of respiratory system, not elsewhere classified
J95.89Other postprocedural complications and disorders of respiratory system, not elsewhere classified
J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.01Acute respiratory failure with hypoxia
J96.02Acute respiratory failure with hypercapnia

Showing the first 400 of 3253 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 94761?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 3253 ICD-10 diagnosis codes that support medical necessity for CPT 94761. 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 94761 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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