ICD↔CPT crosswalk
CPT 96365: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 96365 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 96365 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 |
|---|---|
| A41.01 | Sepsis due to Methicillin susceptible Staphylococcus aureus |
| A41.02 | Sepsis due to Methicillin resistant Staphylococcus aureus |
| A41.1 | Sepsis due to other specified staphylococcus |
| A41.2 | Sepsis due to unspecified staphylococcus |
| A41.3 | Sepsis due to Hemophilus influenzae |
| A41.4 | Sepsis due to anaerobes |
| A41.50 | Gram-negative sepsis, unspecified |
| A41.51 | Sepsis due to Escherichia coli [E. coli] |
| A41.52 | Sepsis due to Pseudomonas |
| A41.53 | Sepsis due to Serratia |
| A41.59 | Other Gram-negative sepsis |
| A41.81 | Sepsis due to Enterococcus |
| A41.89 | Other specified sepsis |
| A41.9 | Sepsis, unspecified organism |
| A42.7 | Actinomycotic sepsis |
| A48.3 | Toxic shock syndrome |
| A54.86 | Gonococcal sepsis |
| A92.31 | West Nile virus infection with encephalitis |
| A92.39 | West Nile virus infection with other complications |
| B16.1 | Acute hepatitis B with delta-agent without hepatic coma |
| B16.2 | Acute hepatitis B without delta-agent with hepatic coma |
| B16.9 | Acute hepatitis B without delta-agent and without hepatic coma |
| B17.0 | Acute delta-(super) infection of hepatitis B carrier |
| B18.0 | Chronic viral hepatitis B with delta-agent |
| B18.1 | Chronic viral hepatitis B without delta-agent |
| B19.10 | Unspecified viral hepatitis B without hepatic coma |
| B19.11 | Unspecified viral hepatitis B with hepatic coma |
| B20 | Human immunodeficiency virus [HIV] disease |
| B25.0 | Cytomegaloviral pneumonitis |
| B25.1 | Cytomegaloviral hepatitis |
| B25.2 | Cytomegaloviral pancreatitis |
| B25.8 | Other cytomegaloviral diseases |
| B25.9 | Cytomegaloviral disease, unspecified |
| B34.3 | Parvovirus infection, unspecified |
| B37.7 | Candidal sepsis |
| B97.4 | Respiratory syncytial virus as the cause of diseases classified elsewhere |
| C88.20 | Heavy chain disease not having achieved remission |
| C88.21 | Heavy chain disease, in remission |
| C88.30 | Immunoproliferative small intestinal disease not having achieved remission |
| C88.31 | Immunoproliferative small intestinal disease, in remission |
| C88.40 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] not having achieved remission |
| C88.41 | Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma], in remission |
| C88.80 | Other malignant immunoproliferative diseases not having achieved remission |
| C88.81 | Other malignant immunoproliferative diseases, in remission |
| C88.90 | Malignant immunoproliferative disease, unspecified not having achieved remission |
| C88.91 | Malignant immunoproliferative disease, unspecified, in remission |
| C90.00 | Multiple myeloma not having achieved remission |
| C90.01 | Multiple myeloma in remission |
| C90.02 | Multiple myeloma in relapse |
| C90.10 | Plasma cell leukemia not having achieved remission |
| C90.11 | Plasma cell leukemia in remission |
| C90.12 | Plasma cell leukemia in relapse |
| C90.20 | Extramedullary plasmacytoma not having achieved remission |
| C90.21 | Extramedullary plasmacytoma in remission |
| C90.22 | Extramedullary plasmacytoma in relapse |
| C90.30 | Solitary plasmacytoma not having achieved remission |
| C90.31 | Solitary plasmacytoma in remission |
| C90.32 | Solitary plasmacytoma in relapse |
| C91.10 | Chronic lymphocytic leukemia of B-cell type not having achieved remission |
| C91.11 | Chronic lymphocytic leukemia of B-cell type in remission |
| C91.12 | Chronic lymphocytic leukemia of B-cell type in relapse |
| C91.Z0 | Other lymphoid leukemia not having achieved remission |
| C91.Z2 | Other lymphoid leukemia, in relapse |
| D47.3 | Essential (hemorrhagic) thrombocythemia |
| D59.0 | Drug-induced autoimmune hemolytic anemia |
| D59.10 | Autoimmune hemolytic anemia, unspecified |
| D59.11 | Warm autoimmune hemolytic anemia |
| D59.12 | Cold autoimmune hemolytic anemia |
| D59.13 | Mixed type autoimmune hemolytic anemia |
| D59.19 | Other autoimmune hemolytic anemia |
| D59.2 | Drug-induced nonautoimmune hemolytic anemia |
| D59.4 | Other nonautoimmune hemolytic anemias |
| D59.9 | Acquired hemolytic anemia, unspecified |
| D60.0 | Chronic acquired pure red cell aplasia |
| D60.1 | Transient acquired pure red cell aplasia |
| D60.8 | Other acquired pure red cell aplasias |
| D60.9 | Acquired pure red cell aplasia, unspecified |
| D61.1 | Drug-induced aplastic anemia |
| D61.2 | Aplastic anemia due to other external agents |
| D61.3 | Idiopathic aplastic anemia |
| D61.89 | Other specified aplastic anemias and other bone marrow failure syndromes |
| D68.01 | Von Willebrand disease, type 1 |
| D68.020 | Von Willebrand disease, type 2A |
| D68.021 | Von Willebrand disease, type 2B |
| D68.022 | Von Willebrand disease, type 2M |
| D68.023 | Von Willebrand disease, type 2N |
| D68.03 | Von Willebrand disease, type 3 |
| D68.04 | Acquired von Willebrand disease |
| D68.09 | Other von Willebrand disease |
| D69.3 | Immune thrombocytopenic purpura |
| D69.41 | Evans syndrome |
| D69.42 | Congenital and hereditary thrombocytopenia purpura |
| D69.49 | Other primary thrombocytopenia |
| D69.51 | Posttransfusion purpura |
| D69.59 | Other secondary thrombocytopenia |
| D70.8 | Other neutropenia |
| D70.9 | Neutropenia, unspecified |
| D80.0 | Hereditary hypogammaglobulinemia |
| D80.1 | Nonfamilial hypogammaglobulinemia |
| D80.2 | Selective deficiency of immunoglobulin A [IgA] |
| D80.3 | Selective deficiency of immunoglobulin G [IgG] subclasses |
| D80.4 | Selective deficiency of immunoglobulin M [IgM] |
| D80.5 | Immunodeficiency with increased immunoglobulin M [IgM] |
| D80.6 | Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia |
| D80.7 | Transient hypogammaglobulinemia of infancy |
| D81.0 | Severe combined immunodeficiency [SCID] with reticular dysgenesis |
| D81.1 | Severe combined immunodeficiency [SCID] with low T- and B-cell numbers |
| D81.2 | Severe combined immunodeficiency [SCID] with low or normal B-cell numbers |
| D81.5 | Purine nucleoside phosphorylase [PNP] deficiency |
| D81.6 | Major histocompatibility complex class I deficiency |
| D81.7 | Major histocompatibility complex class II deficiency |
| D81.82 | Activated Phosphoinositide 3-kinase Delta Syndrome [APDS] |
| D81.89 | Other combined immunodeficiencies |
| D81.9 | Combined immunodeficiency, unspecified |
| D82.0 | Wiskott-Aldrich syndrome |
| D82.1 | Di George's syndrome |
| D82.4 | Hyperimmunoglobulin E [IgE] syndrome |
| D83.0 | Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function |
| D83.1 | Common variable immunodeficiency with predominant immunoregulatory T-cell disorders |
| D83.2 | Common variable immunodeficiency with autoantibodies to B- or T-cells |
| D83.8 | Other common variable immunodeficiencies |
| D83.9 | Common variable immunodeficiency, unspecified |
| D89.810 | Acute graft-versus-host disease |
| D89.811 | Chronic graft-versus-host disease |
| D89.812 | Acute on chronic graft-versus-host disease |
| D89.813 | Graft-versus-host disease, unspecified |
| D89.834 | Cytokine release syndrome, grade 4 |
| G04.81 | Other encephalitis and encephalomyelitis |
| G11.3 | Cerebellar ataxia with defective DNA repair |
| G25.82 | Stiff-man syndrome |
| 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 |
| G40.301 | Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with 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 |
| G40.411 | Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus |
| G40.419 | Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus |
| G57.81 | Other specified mononeuropathies of right lower limb |
| G57.82 | Other specified mononeuropathies of left lower limb |
| G57.83 | Other specified mononeuropathies of bilateral lower limbs |
| G60.0 | Hereditary motor and sensory neuropathy |
| G60.1 | Refsum's disease |
| G60.2 | Neuropathy in association with hereditary ataxia |
| G60.3 | Idiopathic progressive neuropathy |
| G60.8 | Other hereditary and idiopathic neuropathies |
| G61.0 | Guillain-Barre syndrome |
| G61.1 | Serum neuropathy |
| G61.81 | Chronic inflammatory demyelinating polyneuritis |
| G61.82 | Multifocal motor neuropathy |
| G61.89 | Other inflammatory polyneuropathies |
| G62.0 | Drug-induced polyneuropathy |
| G62.81 | Critical illness polyneuropathy |
| G62.89 | Other specified polyneuropathies |
| G64 | Other disorders of peripheral nervous system |
| G70.00 | Myasthenia gravis without (acute) exacerbation |
| G70.01 | Myasthenia gravis with (acute) exacerbation |
| G70.80 | Lambert-Eaton syndrome, unspecified |
| G70.81 | Lambert-Eaton syndrome in disease classified elsewhere |
| G72.41 | Inclusion body myositis [IBM] |
| G72.49 | Other inflammatory and immune myopathies, not elsewhere classified |
| G73.1 | Lambert-Eaton syndrome in neoplastic disease |
| G73.3 | Myasthenic syndromes in other diseases classified elsewhere |
| G93.45 | Developmental and epileptic encephalopathy |
| G93.49 | Other encephalopathy |
| H20.011 | Primary iridocyclitis, right eye |
| H20.012 | Primary iridocyclitis, left eye |
| H20.013 | Primary iridocyclitis, bilateral |
| H20.021 | Recurrent acute iridocyclitis, right eye |
| H20.022 | Recurrent acute iridocyclitis, left eye |
| H20.023 | Recurrent acute iridocyclitis, bilateral |
| H20.031 | Secondary infectious iridocyclitis, right eye |
| H20.032 | Secondary infectious iridocyclitis, left eye |
| H20.033 | Secondary infectious iridocyclitis, bilateral |
| H20.041 | Secondary noninfectious iridocyclitis, right eye |
| H20.042 | Secondary noninfectious iridocyclitis, left eye |
| H20.043 | Secondary noninfectious iridocyclitis, bilateral |
| H20.051 | Hypopyon, right eye |
| H20.052 | Hypopyon, left eye |
| H20.053 | Hypopyon, bilateral |
| H20.11 | Chronic iridocyclitis, right eye |
| H20.12 | Chronic iridocyclitis, left eye |
| H20.13 | Chronic iridocyclitis, bilateral |
| H20.21 | Lens-induced iridocyclitis, right eye |
| H20.22 | Lens-induced iridocyclitis, left eye |
| H20.23 | Lens-induced iridocyclitis, bilateral |
| H20.811 | Fuchs' heterochromic cyclitis, right eye |
| H20.812 | Fuchs' heterochromic cyclitis, left eye |
| H20.813 | Fuchs' heterochromic cyclitis, bilateral |
| H20.821 | Vogt-Koyanagi syndrome, right eye |
| H20.822 | Vogt-Koyanagi syndrome, left eye |
| H20.823 | Vogt-Koyanagi syndrome, bilateral |
| H35.89 | Other specified retinal disorders |
| H46.8 | Other optic neuritis |
| I30.8 | Other forms of acute pericarditis |
| I40.8 | Other acute myocarditis |
| I44.0 | Atrioventricular block, first degree |
| I44.1 | Atrioventricular block, second degree |
| I44.2 | Atrioventricular block, complete |
| I44.39 | Other atrioventricular block |
| I45.0 | Right fascicular block |
| I45.19 | Other right bundle-branch block |
| I45.2 | Bifascicular block |
| I45.3 | Trifascicular block |
| I45.4 | Nonspecific intraventricular block |
| I45.5 | Other specified heart block |
| I45.6 | Pre-excitation syndrome |
| I45.81 | Long QT syndrome |
| I45.89 | Other specified conduction disorders |
| I47.0 | Re-entry ventricular arrhythmia |
| I47.21 | Torsades de pointes |
| I47.29 | Other ventricular tachycardia |
| I78.8 | Other diseases of capillaries |
| J20.5 | Acute bronchitis due to respiratory syncytial virus |
| L10.0 | Pemphigus vulgaris |
| L10.1 | Pemphigus vegetans |
| L10.2 | Pemphigus foliaceous |
| L10.3 | Brazilian pemphigus [fogo selvagem] |
| L10.4 | Pemphigus erythematosus |
| L10.5 | Drug-induced pemphigus |
| L10.81 | Paraneoplastic pemphigus |
| L10.89 | Other pemphigus |
| L10.9 | Pemphigus, unspecified |
| L12.0 | Bullous pemphigoid |
| L12.1 | Cicatricial pemphigoid |
| L12.30 | Acquired epidermolysis bullosa, unspecified |
| L12.31 | Epidermolysis bullosa due to drug |
| L12.35 | Other acquired epidermolysis bullosa |
| L12.8 | Other pemphigoid |
| L12.9 | Pemphigoid, unspecified |
| L13.8 | Other specified bullous disorders |
| L14 | Bullous disorders in diseases classified elsewhere |
| L51.1 | Stevens-Johnson syndrome |
| L51.2 | Toxic epidermal necrolysis [Lyell] |
| L51.3 | Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome |
| L88 | Pyoderma gangrenosum |
| L90.1 | Anetoderma of Schweninger-Buzzi |
| L90.2 | Anetoderma of Jadassohn-Pellizzari |
| L90.6 | Striae atrophicae |
| L95.0 | Livedoid vasculitis |
| L98.5 | Mucinosis of the skin |
| M06.4 | Inflammatory polyarthropathy |
| M30.0 | Polyarteritis nodosa |
| M30.1 | Polyarteritis with lung involvement [Churg-Strauss] |
| M30.2 | Juvenile polyarteritis |
| M30.3 | Mucocutaneous lymph node syndrome [Kawasaki] |
| M31.30 | Wegener's granulomatosis without renal involvement |
| M31.31 | Wegener's granulomatosis with renal involvement |
| M31.7 | Microscopic polyangiitis |
| M32.0 | Drug-induced systemic lupus erythematosus |
| M32.10 | Systemic lupus erythematosus, organ or system involvement unspecified |
| M32.11 | Endocarditis in systemic lupus erythematosus |
| M32.12 | Pericarditis in systemic lupus erythematosus |
| M32.13 | Lung involvement in systemic lupus erythematosus |
| M32.14 | Glomerular disease in systemic lupus erythematosus |
| M32.15 | Tubulo-interstitial nephropathy in systemic lupus erythematosus |
| M32.19 | Other organ or system involvement in systemic lupus erythematosus |
| M32.8 | Other forms of systemic lupus erythematosus |
| M32.9 | Systemic lupus erythematosus, unspecified |
| M33.00 | Juvenile dermatomyositis, organ involvement unspecified |
| M33.01 | Juvenile dermatomyositis with respiratory involvement |
| M33.02 | Juvenile dermatomyositis with myopathy |
| M33.03 | Juvenile dermatomyositis without myopathy |
| M33.09 | Juvenile dermatomyositis with other organ involvement |
| M33.10 | Other dermatomyositis, organ involvement unspecified |
| M33.11 | Other dermatomyositis with respiratory involvement |
| M33.12 | Other dermatomyositis with myopathy |
| M33.13 | Other dermatomyositis without myopathy |
| M33.19 | Other dermatomyositis with other organ involvement |
| M33.20 | Polymyositis, organ involvement unspecified |
| M33.21 | Polymyositis with respiratory involvement |
| M33.22 | Polymyositis with myopathy |
| M33.29 | Polymyositis with other organ involvement |
| M33.90 | Dermatopolymyositis, unspecified, organ involvement unspecified |
| M33.91 | Dermatopolymyositis, unspecified with respiratory involvement |
| M33.92 | Dermatopolymyositis, unspecified with myopathy |
| M33.93 | Dermatopolymyositis, unspecified without myopathy |
| M33.99 | Dermatopolymyositis, unspecified with other organ involvement |
| M35.5 | Multifocal fibrosclerosis |
| M35.81 | Multisystem inflammatory syndrome |
| M35.89 | Other specified systemic involvement of connective tissue |
| M36.0 | Dermato(poly)myositis in neoplastic disease |
| M60.9 | Myositis, unspecified |
| N02.8 | Recurrent and persistent hematuria with other morphologic changes |
| N28.9 | Disorder of kidney and ureter, unspecified |
| O09.891 | Supervision of other high risk pregnancies, first trimester |
| O09.892 | Supervision of other high risk pregnancies, second trimester |
| O09.893 | Supervision of other high risk pregnancies, third trimester |
| O09.899 | Supervision of other high risk pregnancies, unspecified trimester |
| P61.0 | Transient neonatal thrombocytopenia |
| R65.20 | Severe sepsis without septic shock |
| R65.21 | Severe sepsis with septic shock |
| S01.00XA | Unspecified open wound of scalp, initial encounter |
| S01.01XA | Laceration without foreign body of scalp, initial encounter |
| S01.02XA | Laceration with foreign body of scalp, initial encounter |
| S01.03XA | Puncture wound without foreign body of scalp, initial encounter |
| S01.04XA | Puncture wound with foreign body of scalp, initial encounter |
| S01.101A | Unspecified open wound of right eyelid and periocular area, initial encounter |
| S01.102A | Unspecified open wound of left eyelid and periocular area, initial encounter |
| S01.111A | Laceration without foreign body of right eyelid and periocular area, initial encounter |
| S01.112A | Laceration without foreign body of left eyelid and periocular area, initial encounter |
| S01.121A | Laceration with foreign body of right eyelid and periocular area, initial encounter |
| S01.122A | Laceration with foreign body of left eyelid and periocular area, initial encounter |
| S01.131A | Puncture wound without foreign body of right eyelid and periocular area, initial encounter |
| S01.132A | Puncture wound without foreign body of left eyelid and periocular area, initial encounter |
| S01.141A | Puncture wound with foreign body of right eyelid and periocular area, initial encounter |
| S01.142A | Puncture wound with foreign body of left eyelid and periocular area, initial encounter |
| S01.151A | Open bite of right eyelid and periocular area, initial encounter |
| S01.152A | Open bite of left eyelid and periocular area, initial encounter |
| S01.20XA | Unspecified open wound of nose, initial encounter |
| S01.21XA | Laceration without foreign body of nose, initial encounter |
| S01.22XA | Laceration with foreign body of nose, initial encounter |
| S01.23XA | Puncture wound without foreign body of nose, initial encounter |
| S01.24XA | Puncture wound with foreign body of nose, initial encounter |
| S01.25XA | Open bite of nose, initial encounter |
| S01.301A | Unspecified open wound of right ear, initial encounter |
| S01.302A | Unspecified open wound of left ear, initial encounter |
| S01.311A | Laceration without foreign body of right ear, initial encounter |
| S01.312A | Laceration without foreign body of left ear, initial encounter |
| S01.321A | Laceration with foreign body of right ear, initial encounter |
| S01.322A | Laceration with foreign body of left ear, initial encounter |
| S01.331A | Puncture wound without foreign body of right ear, initial encounter |
| S01.332A | Puncture wound without foreign body of left ear, initial encounter |
| S01.341A | Puncture wound with foreign body of right ear, initial encounter |
| S01.342A | Puncture wound with foreign body of left ear, initial encounter |
| S01.351A | Open bite of right ear, initial encounter |
| S01.352A | Open bite of left ear, initial encounter |
| S01.401A | Unspecified open wound of right cheek and temporomandibular area, initial encounter |
| S01.402A | Unspecified open wound of left cheek and temporomandibular area, initial encounter |
| S01.411A | Laceration without foreign body of right cheek and temporomandibular area, initial encounter |
| S01.412A | Laceration without foreign body of left cheek and temporomandibular area, initial encounter |
| S01.421A | Laceration with foreign body of right cheek and temporomandibular area, initial encounter |
| S01.422A | Laceration with foreign body of left cheek and temporomandibular area, initial encounter |
| S01.431A | Puncture wound without foreign body of right cheek and temporomandibular area, initial encounter |
| S01.432A | Puncture wound without foreign body of left cheek and temporomandibular area, initial encounter |
| S01.441A | Puncture wound with foreign body of right cheek and temporomandibular area, initial encounter |
| S01.442A | Puncture wound with foreign body of left cheek and temporomandibular area, initial encounter |
| S01.451A | Open bite of right cheek and temporomandibular area, initial encounter |
| S01.452A | Open bite of left cheek and temporomandibular area, initial encounter |
| S01.501A | Unspecified open wound of lip, initial encounter |
| S01.502A | Unspecified open wound of oral cavity, initial encounter |
| S01.511A | Laceration without foreign body of lip, initial encounter |
| S01.512A | Laceration without foreign body of oral cavity, initial encounter |
| S01.521A | Laceration with foreign body of lip, initial encounter |
| S01.522A | Laceration with foreign body of oral cavity, initial encounter |
| S01.531A | Puncture wound without foreign body of lip, initial encounter |
| S01.532A | Puncture wound without foreign body of oral cavity, initial encounter |
| S01.541A | Puncture wound with foreign body of lip, initial encounter |
| S01.542A | Puncture wound with foreign body of oral cavity, initial encounter |
| S01.551A | Open bite of lip, initial encounter |
| S01.552A | Open bite of oral cavity, initial encounter |
| S01.80XA | Unspecified open wound of other part of head, initial encounter |
| S01.81XA | Laceration without foreign body of other part of head, initial encounter |
| S01.82XA | Laceration with foreign body of other part of head, initial encounter |
| S01.83XA | Puncture wound without foreign body of other part of head, initial encounter |
| S01.84XA | Puncture wound with foreign body of other part of head, initial encounter |
| S01.85XA | Open bite of other part of head, initial encounter |
| S01.90XA | Unspecified open wound of unspecified part of head, initial encounter |
| S01.91XA | Laceration without foreign body of unspecified part of head, initial encounter |
| S01.92XA | Laceration with foreign body of unspecified part of head, initial encounter |
| S01.93XA | Puncture wound without foreign body of unspecified part of head, initial encounter |
| S01.94XA | Puncture wound with foreign body of unspecified part of head, initial encounter |
| S01.95XA | Open bite of unspecified part of head, initial encounter |
| S05.20XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, unspecified eye, initial encounter |
| S05.21XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, right eye, initial encounter |
| S05.22XA | Ocular laceration and rupture with prolapse or loss of intraocular tissue, left eye, initial encounter |
| S05.30XA | Ocular laceration without prolapse or loss of intraocular tissue, unspecified eye, initial encounter |
| S05.31XA | Ocular laceration without prolapse or loss of intraocular tissue, right eye, initial encounter |
| S05.32XA | Ocular laceration without prolapse or loss of intraocular tissue, left eye, initial encounter |
| S05.40XA | Penetrating wound of orbit with or without foreign body, unspecified eye, initial encounter |
| S05.41XA | Penetrating wound of orbit with or without foreign body, right eye, initial encounter |
| S05.42XA | Penetrating wound of orbit with or without foreign body, left eye, initial encounter |
| S05.50XA | Penetrating wound with foreign body of unspecified eyeball, initial encounter |
| S05.51XA | Penetrating wound with foreign body of right eyeball, initial encounter |
| S05.52XA | Penetrating wound with foreign body of left eyeball, initial encounter |
| S05.60XA | Penetrating wound without foreign body of unspecified eyeball, initial encounter |
| S05.61XA | Penetrating wound without foreign body of right eyeball, initial encounter |
| S05.62XA | Penetrating wound without foreign body of left eyeball, initial encounter |
| S05.71XA | Avulsion of right eye, initial encounter |
| S05.72XA | Avulsion of left eye, initial encounter |
| S05.8X1A | Other injuries of right eye and orbit, initial encounter |
| S05.8X2A | Other injuries of left eye and orbit, initial encounter |
| S05.91XA | Unspecified injury of right eye and orbit, initial encounter |
| S05.92XA | Unspecified injury of left eye and orbit, initial encounter |
| S08.0XXA | Avulsion of scalp, initial encounter |
| S08.111A | Complete traumatic amputation of right ear, initial encounter |
| S08.112A | Complete traumatic amputation of left ear, initial encounter |
| S08.119A | Complete traumatic amputation of unspecified ear, initial encounter |
| S08.121A | Partial traumatic amputation of right ear, initial encounter |
| S08.122A | Partial traumatic amputation of left ear, initial encounter |
| S08.129A | Partial traumatic amputation of unspecified ear, initial encounter |
| S08.811A | Complete traumatic amputation of nose, initial encounter |
| S08.812A | Partial traumatic amputation of nose, initial encounter |
| S08.89XA | Traumatic amputation of other parts of head, initial encounter |
| S09.12XA | Laceration of muscle and tendon of head, initial encounter |
| S09.20XA | Traumatic rupture of unspecified ear drum, initial encounter |
Showing the first 400 of 1341 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 96365?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 1341 ICD-10 diagnosis codes that support medical necessity for CPT 96365. 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 96365 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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