ICD↔CPT crosswalk
CPT 95115: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 95115 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 95115 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 |
|---|---|
| H10.10 | Acute atopic conjunctivitis, unspecified eye |
| H10.11 | Acute atopic conjunctivitis, right eye |
| H10.12 | Acute atopic conjunctivitis, left eye |
| H10.13 | Acute atopic conjunctivitis, bilateral |
| H10.411 | Chronic giant papillary conjunctivitis, right eye |
| H10.412 | Chronic giant papillary conjunctivitis, left eye |
| H10.413 | Chronic giant papillary conjunctivitis, bilateral |
| H10.45 | Other chronic allergic conjunctivitis |
| J30.0 | Vasomotor rhinitis |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J31.0 | Chronic rhinitis |
| J45.20 | Mild intermittent asthma, uncomplicated |
| J45.21 | Mild intermittent asthma with (acute) exacerbation |
| J45.22 | Mild intermittent asthma with status asthmaticus |
| J45.30 | Mild persistent asthma, uncomplicated |
| J45.31 | Mild persistent asthma with (acute) exacerbation |
| J45.32 | Mild persistent asthma with status asthmaticus |
| J45.40 | Moderate persistent asthma, uncomplicated |
| J45.41 | Moderate persistent asthma with (acute) exacerbation |
| J45.42 | Moderate persistent asthma with status asthmaticus |
| J45.50 | Severe persistent asthma, uncomplicated |
| J45.51 | Severe persistent asthma with (acute) exacerbation |
| J45.52 | Severe persistent asthma with status asthmaticus |
| J45.901 | Unspecified asthma with (acute) exacerbation |
| J45.902 | Unspecified asthma with status asthmaticus |
| J45.909 | Unspecified asthma, uncomplicated |
| L20.84 | Intrinsic (allergic) eczema |
| L20.89 | Other atopic dermatitis |
| T36.0X5A | Adverse effect of penicillins, initial encounter |
| T36.0X5D | Adverse effect of penicillins, subsequent encounter |
| T36.0X5S | Adverse effect of penicillins, sequela |
| T36.1X5A | Adverse effect of cephalosporins and other beta-lactam antibiotics, initial encounter |
| T36.1X5D | Adverse effect of cephalosporins and other beta-lactam antibiotics, subsequent encounter |
| T36.1X5S | Adverse effect of cephalosporins and other beta-lactam antibiotics, sequela |
| T36.4X5A | Adverse effect of tetracyclines, initial encounter |
| T36.4X5D | Adverse effect of tetracyclines, subsequent encounter |
| T36.4X5S | Adverse effect of tetracyclines, sequela |
| T36.8X5A | Adverse effect of other systemic antibiotics, initial encounter |
| T36.8X5D | Adverse effect of other systemic antibiotics, subsequent encounter |
| T36.8X5S | Adverse effect of other systemic antibiotics, sequela |
| T36.AX5A | Adverse effect of fluoroquinolone antibiotics, initial encounter |
| T36.AX5D | Adverse effect of fluoroquinolone antibiotics, subsequent encounter |
| T36.AX5S | Adverse effect of fluoroquinolone antibiotics, sequela |
| T37.0X5A | Adverse effect of sulfonamides, initial encounter |
| T37.0X5D | Adverse effect of sulfonamides, subsequent encounter |
| T37.0X5S | Adverse effect of sulfonamides, sequela |
| T37.1X5A | Adverse effect of antimycobacterial drugs, initial encounter |
| T37.1X5D | Adverse effect of antimycobacterial drugs, subsequent encounter |
| T37.1X5S | Adverse effect of antimycobacterial drugs, sequela |
| T39.015A | Adverse effect of aspirin, initial encounter |
| T39.015D | Adverse effect of aspirin, subsequent encounter |
| T39.015S | Adverse effect of aspirin, sequela |
| T39.095A | Adverse effect of salicylates, initial encounter |
| T39.095D | Adverse effect of salicylates, subsequent encounter |
| T39.095S | Adverse effect of salicylates, sequela |
| T48.6X5A | Adverse effect of antiasthmatics, initial encounter |
| T48.6X5D | Adverse effect of antiasthmatics, subsequent encounter |
| T48.6X5S | Adverse effect of antiasthmatics, sequela |
| T48.995A | Adverse effect of other agents primarily acting on the respiratory system, initial encounter |
| T48.995D | Adverse effect of other agents primarily acting on the respiratory system, subsequent encounter |
| T48.995S | Adverse effect of other agents primarily acting on the respiratory system, sequela |
| T50.8X5A | Adverse effect of diagnostic agents, initial encounter |
| T50.8X5D | Adverse effect of diagnostic agents, subsequent encounter |
| T50.8X5S | Adverse effect of diagnostic agents, sequela |
| T50.995A | Adverse effect of other drugs, medicaments and biological substances, initial encounter |
| T50.995D | Adverse effect of other drugs, medicaments and biological substances, subsequent encounter |
| T50.995S | Adverse effect of other drugs, medicaments and biological substances, sequela |
| T50.Z95A | Adverse effect of other vaccines and biological substances, initial encounter |
| T50.Z95D | Adverse effect of other vaccines and biological substances, subsequent encounter |
| T50.Z95S | Adverse effect of other vaccines and biological substances, sequela |
| T63.421A | Toxic effect of venom of ants, accidental (unintentional), initial encounter |
| T63.421D | Toxic effect of venom of ants, accidental (unintentional), subsequent encounter |
| T63.421S | Toxic effect of venom of ants, accidental (unintentional), sequela |
| T63.422A | Toxic effect of venom of ants, intentional self-harm, initial encounter |
| T63.422D | Toxic effect of venom of ants, intentional self-harm, subsequent encounter |
| T63.422S | Toxic effect of venom of ants, intentional self-harm, sequela |
| T63.423A | Toxic effect of venom of ants, assault, initial encounter |
| T63.423D | Toxic effect of venom of ants, assault, subsequent encounter |
| T63.423S | Toxic effect of venom of ants, assault, sequela |
| T63.424A | Toxic effect of venom of ants, undetermined, initial encounter |
| T63.424D | Toxic effect of venom of ants, undetermined, subsequent encounter |
| T63.424S | Toxic effect of venom of ants, undetermined, sequela |
| T63.441A | Toxic effect of venom of bees, accidental (unintentional), initial encounter |
| T63.441D | Toxic effect of venom of bees, accidental (unintentional), subsequent encounter |
| T63.441S | Toxic effect of venom of bees, accidental (unintentional), sequela |
| T63.442A | Toxic effect of venom of bees, intentional self-harm, initial encounter |
| T63.442D | Toxic effect of venom of bees, intentional self-harm, subsequent encounter |
| T63.442S | Toxic effect of venom of bees, intentional self-harm, sequela |
| T63.443A | Toxic effect of venom of bees, assault, initial encounter |
| T63.443D | Toxic effect of venom of bees, assault, subsequent encounter |
| T63.443S | Toxic effect of venom of bees, assault, sequela |
| T63.444A | Toxic effect of venom of bees, undetermined, initial encounter |
| T63.444D | Toxic effect of venom of bees, undetermined, subsequent encounter |
| T63.444S | Toxic effect of venom of bees, undetermined, sequela |
| T63.451A | Toxic effect of venom of hornets, accidental (unintentional), initial encounter |
| T63.451D | Toxic effect of venom of hornets, accidental (unintentional), subsequent encounter |
| T63.451S | Toxic effect of venom of hornets, accidental (unintentional), sequela |
| T63.452A | Toxic effect of venom of hornets, intentional self-harm, initial encounter |
| T63.452D | Toxic effect of venom of hornets, intentional self-harm, subsequent encounter |
| T63.452S | Toxic effect of venom of hornets, intentional self-harm, sequela |
| T63.453A | Toxic effect of venom of hornets, assault, initial encounter |
| T63.453D | Toxic effect of venom of hornets, assault, subsequent encounter |
| T63.453S | Toxic effect of venom of hornets, assault, sequela |
| T63.454A | Toxic effect of venom of hornets, undetermined, initial encounter |
| T63.454D | Toxic effect of venom of hornets, undetermined, subsequent encounter |
| T63.454S | Toxic effect of venom of hornets, undetermined, sequela |
| T63.461A | Toxic effect of venom of wasps, accidental (unintentional), initial encounter |
| T63.461D | Toxic effect of venom of wasps, accidental (unintentional), subsequent encounter |
| T63.461S | Toxic effect of venom of wasps, accidental (unintentional), sequela |
| T63.462A | Toxic effect of venom of wasps, intentional self-harm, initial encounter |
| T63.462D | Toxic effect of venom of wasps, intentional self-harm, subsequent encounter |
| T63.462S | Toxic effect of venom of wasps, intentional self-harm, sequela |
| T63.463A | Toxic effect of venom of wasps, assault, initial encounter |
| T63.463D | Toxic effect of venom of wasps, assault, subsequent encounter |
| T63.463S | Toxic effect of venom of wasps, assault, sequela |
| T63.464A | Toxic effect of venom of wasps, undetermined, initial encounter |
| T63.464D | Toxic effect of venom of wasps, undetermined, subsequent encounter |
| T63.464S | Toxic effect of venom of wasps, undetermined, sequela |
| T63.481A | Toxic effect of venom of other arthropod, accidental (unintentional), initial encounter |
| T63.481D | Toxic effect of venom of other arthropod, accidental (unintentional), subsequent encounter |
| T63.481S | Toxic effect of venom of other arthropod, accidental (unintentional), sequela |
| T63.482A | Toxic effect of venom of other arthropod, intentional self-harm, initial encounter |
| T63.482D | Toxic effect of venom of other arthropod, intentional self-harm, subsequent encounter |
| T63.482S | Toxic effect of venom of other arthropod, intentional self-harm, sequela |
| T63.483A | Toxic effect of venom of other arthropod, assault, initial encounter |
| T63.483D | Toxic effect of venom of other arthropod, assault, subsequent encounter |
| T63.483S | Toxic effect of venom of other arthropod, assault, sequela |
| T63.484A | Toxic effect of venom of other arthropod, undetermined, initial encounter |
| T63.484D | Toxic effect of venom of other arthropod, undetermined, subsequent encounter |
| T63.484S | Toxic effect of venom of other arthropod, undetermined, sequela |
| T78.49XA | Other allergy, initial encounter |
| T78.49XD | Other allergy, subsequent encounter |
| T78.49XS | Other allergy, sequela |
| T80.51XA | Anaphylactic reaction due to administration of blood and blood products, initial encounter |
| T80.51XD | Anaphylactic reaction due to administration of blood and blood products, subsequent encounter |
| T80.51XS | Anaphylactic reaction due to administration of blood and blood products, sequela |
| T80.52XA | Anaphylactic reaction due to vaccination, initial encounter |
| T80.52XD | Anaphylactic reaction due to vaccination, subsequent encounter |
| T80.52XS | Anaphylactic reaction due to vaccination, sequela |
| T80.59XA | Anaphylactic reaction due to other serum, initial encounter |
| T80.59XD | Anaphylactic reaction due to other serum, subsequent encounter |
| T80.59XS | Anaphylactic reaction due to other serum, sequela |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 95115?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 145 ICD-10 diagnosis codes that support medical necessity for CPT 95115. 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 95115 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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