ICD↔CPT crosswalk
CPT 96402: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 96402 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 96402 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 |
|---|---|
| C07 | Malignant neoplasm of parotid gland |
| C08.0 | Malignant neoplasm of submandibular gland |
| C08.1 | Malignant neoplasm of sublingual gland |
| C08.9 | Malignant neoplasm of major salivary gland, unspecified |
| C48.0 | Malignant neoplasm of retroperitoneum |
| C48.1 | Malignant neoplasm of specified parts of peritoneum |
| C48.2 | Malignant neoplasm of peritoneum, unspecified |
| C48.8 | Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast |
| C50.019 | Malignant neoplasm of nipple and areola, unspecified female breast |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast |
| C50.029 | Malignant neoplasm of nipple and areola, unspecified male breast |
| C50.111 | Malignant neoplasm of central portion of right female breast |
| C50.112 | Malignant neoplasm of central portion of left female breast |
| C50.119 | Malignant neoplasm of central portion of unspecified female breast |
| C50.121 | Malignant neoplasm of central portion of right male breast |
| C50.122 | Malignant neoplasm of central portion of left male breast |
| C50.129 | Malignant neoplasm of central portion of unspecified male breast |
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast |
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast |
| C50.219 | Malignant neoplasm of upper-inner quadrant of unspecified female breast |
| C50.221 | Malignant neoplasm of upper-inner quadrant of right male breast |
| C50.222 | Malignant neoplasm of upper-inner quadrant of left male breast |
| C50.229 | Malignant neoplasm of upper-inner quadrant of unspecified male breast |
| C50.311 | Malignant neoplasm of lower-inner quadrant of right female breast |
| C50.312 | Malignant neoplasm of lower-inner quadrant of left female breast |
| C50.319 | Malignant neoplasm of lower-inner quadrant of unspecified female breast |
| C50.321 | Malignant neoplasm of lower-inner quadrant of right male breast |
| C50.322 | Malignant neoplasm of lower-inner quadrant of left male breast |
| C50.329 | Malignant neoplasm of lower-inner quadrant of unspecified male breast |
| C50.411 | Malignant neoplasm of upper-outer quadrant of right female breast |
| C50.412 | Malignant neoplasm of upper-outer quadrant of left female breast |
| C50.419 | Malignant neoplasm of upper-outer quadrant of unspecified female breast |
| C50.421 | Malignant neoplasm of upper-outer quadrant of right male breast |
| C50.422 | Malignant neoplasm of upper-outer quadrant of left male breast |
| C50.429 | Malignant neoplasm of upper-outer quadrant of unspecified male breast |
| C50.511 | Malignant neoplasm of lower-outer quadrant of right female breast |
| C50.512 | Malignant neoplasm of lower-outer quadrant of left female breast |
| C50.519 | Malignant neoplasm of lower-outer quadrant of unspecified female breast |
| C50.521 | Malignant neoplasm of lower-outer quadrant of right male breast |
| C50.522 | Malignant neoplasm of lower-outer quadrant of left male breast |
| C50.529 | Malignant neoplasm of lower-outer quadrant of unspecified male breast |
| C50.611 | Malignant neoplasm of axillary tail of right female breast |
| C50.612 | Malignant neoplasm of axillary tail of left female breast |
| C50.619 | Malignant neoplasm of axillary tail of unspecified female breast |
| C50.621 | Malignant neoplasm of axillary tail of right male breast |
| C50.622 | Malignant neoplasm of axillary tail of left male breast |
| C50.629 | Malignant neoplasm of axillary tail of unspecified male breast |
| C50.811 | Malignant neoplasm of overlapping sites of right female breast |
| C50.812 | Malignant neoplasm of overlapping sites of left female breast |
| C50.819 | Malignant neoplasm of overlapping sites of unspecified female breast |
| C50.821 | Malignant neoplasm of overlapping sites of right male breast |
| C50.822 | Malignant neoplasm of overlapping sites of left male breast |
| C50.829 | Malignant neoplasm of overlapping sites of unspecified male breast |
| C50.911 | Malignant neoplasm of unspecified site of right female breast |
| C50.912 | Malignant neoplasm of unspecified site of left female breast |
| C50.919 | Malignant neoplasm of unspecified site of unspecified female breast |
| C50.921 | Malignant neoplasm of unspecified site of right male breast |
| C50.922 | Malignant neoplasm of unspecified site of left male breast |
| C50.929 | Malignant neoplasm of unspecified site of unspecified male breast |
| C50.A1 | Malignant inflammatory neoplasm of right breast |
| C50.A2 | Malignant inflammatory neoplasm of left breast |
| C56.1 | Malignant neoplasm of right ovary |
| C56.2 | Malignant neoplasm of left ovary |
| C56.3 | Malignant neoplasm of bilateral ovaries |
| C56.9 | Malignant neoplasm of unspecified ovary |
| C57.00 | Malignant neoplasm of unspecified fallopian tube |
| C57.01 | Malignant neoplasm of right fallopian tube |
| C57.02 | Malignant neoplasm of left fallopian tube |
| C57.11 | Malignant neoplasm of right broad ligament |
| C57.12 | Malignant neoplasm of left broad ligament |
| C57.21 | Malignant neoplasm of right round ligament |
| C57.22 | Malignant neoplasm of left round ligament |
| C57.3 | Malignant neoplasm of parametrium |
| C57.4 | Malignant neoplasm of uterine adnexa, unspecified |
| C57.7 | Malignant neoplasm of other specified female genital organs |
| C57.8 | Malignant neoplasm of overlapping sites of female genital organs |
| C61 | Malignant neoplasm of prostate |
| C77.2 | Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes |
| C77.4 | Secondary and unspecified malignant neoplasm of inguinal and lower limb lymph nodes |
| C77.8 | Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions |
| C77.9 | Secondary and unspecified malignant neoplasm of lymph node, unspecified |
| C78.00 | Secondary malignant neoplasm of unspecified lung |
| C78.01 | Secondary malignant neoplasm of right lung |
| C78.02 | Secondary malignant neoplasm of left lung |
| C78.6 | Secondary malignant neoplasm of retroperitoneum and peritoneum |
| C78.7 | Secondary malignant neoplasm of liver and intrahepatic bile duct |
| C79.2 | Secondary malignant neoplasm of skin |
| C79.31 | Secondary malignant neoplasm of brain |
| C79.51 | Secondary malignant neoplasm of bone |
| C79.52 | Secondary malignant neoplasm of bone marrow |
| D05.00 | Lobular carcinoma in situ of unspecified breast |
| D05.01 | Lobular carcinoma in situ of right breast |
| D05.02 | Lobular carcinoma in situ of left breast |
| D05.10 | Intraductal carcinoma in situ of unspecified breast |
| D05.11 | Intraductal carcinoma in situ of right breast |
| D05.12 | Intraductal carcinoma in situ of left breast |
| D05.80 | Other specified type of carcinoma in situ of unspecified breast |
| D05.81 | Other specified type of carcinoma in situ of right breast |
| D05.82 | Other specified type of carcinoma in situ of left breast |
| D05.90 | Unspecified type of carcinoma in situ of unspecified breast |
| D05.91 | Unspecified type of carcinoma in situ of right breast |
| D05.92 | Unspecified type of carcinoma in situ of left breast |
| D07.5 | Carcinoma in situ of prostate |
| D25.0 | Submucous leiomyoma of uterus |
| D25.1 | Intramural leiomyoma of uterus |
| D25.2 | Subserosal leiomyoma of uterus |
| D25.9 | Leiomyoma of uterus, unspecified |
| D50.0 | Iron deficiency anemia secondary to blood loss (chronic) |
| D62 | Acute posthemorrhagic anemia |
| E22.8 | Other hyperfunction of pituitary gland |
| E30.1 | Precocious puberty |
| E30.8 | Other disorders of puberty |
| N60.11 | Diffuse cystic mastopathy of right breast |
| N60.12 | Diffuse cystic mastopathy of left breast |
| N80.01 | Superficial endometriosis of the uterus |
| N80.02 | Deep endometriosis of the uterus |
| N80.03 | Adenomyosis of the uterus |
| N80.101 | Endometriosis of right ovary, unspecified depth |
| N80.102 | Endometriosis of left ovary, unspecified depth |
| N80.103 | Endometriosis of bilateral ovaries, unspecified depth |
| N80.109 | Endometriosis of ovary, unspecified side, unspecified depth |
| N80.111 | Superficial endometriosis of right ovary |
| N80.112 | Superficial endometriosis of left ovary |
| N80.113 | Superficial endometriosis of bilateral ovaries |
| N80.121 | Deep endometriosis of right ovary |
| N80.122 | Deep endometriosis of left ovary |
| N80.123 | Deep endometriosis of bilateral ovaries |
| N80.201 | Endometriosis of right fallopian tube, unspecified depth |
| N80.202 | Endometriosis of left fallopian tube, unspecified depth |
| N80.203 | Endometriosis of bilateral fallopian tubes, unspecified depth |
| N80.211 | Superficial endometriosis of right fallopian tube |
| N80.212 | Superficial endometriosis of left fallopian tube |
| N80.213 | Superficial endometriosis of bilateral fallopian tubes |
| N80.219 | Superficial endometriosis of unspecified fallopian tube |
| N80.221 | Deep endometriosis of right fallopian tube |
| N80.222 | Deep endometriosis of left fallopian tube |
| N80.223 | Deep endometriosis of bilateral fallopian tubes |
| N80.229 | Deep endometriosis of unspecified fallopian tube |
| N80.311 | Superficial endometriosis of the anterior cul-de-sac |
| N80.312 | Deep endometriosis of the anterior cul-de-sac |
| N80.319 | Endometriosis of the anterior cul-de-sac, unspecified depth |
| N80.321 | Superficial endometriosis of the posterior cul-de-sac |
| N80.322 | Deep endometriosis of the posterior cul-de-sac |
| N80.329 | Endometriosis of the posterior cul-de-sac, unspecified depth |
| N80.331 | Superficial endometriosis of the right pelvic sidewall |
| N80.332 | Superficial endometriosis of the left pelvic sidewall |
| N80.333 | Superficial endometriosis of bilateral pelvic sidewall |
| N80.341 | Deep endometriosis of the right pelvic sidewall |
| N80.342 | Deep endometriosis of the left pelvic sidewall |
| N80.343 | Deep endometriosis of the bilateral pelvic sidewall |
| N80.351 | Endometriosis of the right pelvic sidewall, unspecified depth |
| N80.352 | Endometriosis of the left pelvic sidewall, unspecified depth |
| N80.353 | Endometriosis of bilateral pelvic sidewall, unspecified depth |
| N80.361 | Superficial endometriosis of the right pelvic brim |
| N80.362 | Superficial endometriosis of the left pelvic brim |
| N80.363 | Superficial endometriosis of bilateral pelvic brim |
| N80.371 | Deep endometriosis of the right pelvic brim |
| N80.372 | Deep endometriosis of the left pelvic brim |
| N80.373 | Deep endometriosis of bilateral pelvic brim |
| N80.381 | Endometriosis of the right pelvic brim, unspecified depth |
| N80.382 | Endometriosis of the left pelvic brim, unspecified depth |
| N80.383 | Endometriosis of bilateral pelvic brim, unspecified depth |
| N80.391 | Superficial endometriosis of the pelvic peritoneum, other specified sites |
| N80.392 | Deep endometriosis of the pelvic peritoneum, other specified sites |
| N80.399 | Endometriosis of the pelvic peritoneum, other specified sites, unspecified depth |
| N80.3A1 | Superficial endometriosis of the right uterosacral ligament |
| N80.3A2 | Superficial endometriosis of the left uterosacral ligament |
| N80.3A3 | Superficial endometriosis of the bilateral uterosacral ligament(s) |
| N80.3B1 | Deep endometriosis of the right uterosacral ligament |
| N80.3B2 | Deep endometriosis of the left uterosacral ligament |
| N80.3B3 | Deep endometriosis of bilateral uterosacral ligament(s) |
| N80.3C1 | Endometriosis of the right uterosacral ligament, unspecified depth |
| N80.3C2 | Endometriosis of the left uterosacral ligament, unspecified depth |
| N80.3C3 | Endometriosis of bilateral uterosacral ligament(s), unspecified depth |
| N80.40 | Endometriosis of rectovaginal septum, unspecified involvement of vagina |
| N80.41 | Endometriosis of rectovaginal septum without involvement of vagina |
| N80.42 | Endometriosis of rectovaginal septum with involvement of vagina |
| N80.511 | Superficial endometriosis of the rectum |
| N80.512 | Deep endometriosis of the rectum |
| N80.519 | Endometriosis of the rectum, unspecified depth |
| N80.521 | Superficial endometriosis of the sigmoid colon |
| N80.522 | Deep endometriosis of the sigmoid colon |
| N80.529 | Endometriosis of the sigmoid colon, unspecified depth |
| N80.531 | Superficial endometriosis of the cecum |
| N80.532 | Deep endometriosis of the cecum |
| N80.539 | Endometriosis of the cecum, unspecified depth |
| N80.541 | Superficial endometriosis of the appendix |
| N80.542 | Deep endometriosis of the appendix |
| N80.549 | Endometriosis of the appendix, unspecified depth |
| N80.551 | Superficial endometriosis of other parts of the colon |
| N80.552 | Deep endometriosis of other parts of the colon |
| N80.559 | Endometriosis of other parts of the colon, unspecified depth |
| N80.561 | Superficial endometriosis of the small intestine |
| N80.562 | Deep endometriosis of the small intestine |
| N80.569 | Endometriosis of the small intestine, unspecified depth |
| N80.6 | Endometriosis in cutaneous scar |
| N80.8 | Other endometriosis |
| N80.9 | Endometriosis, unspecified |
| N80.A0 | Endometriosis of bladder, unspecified depth |
| N80.A1 | Superficial endometriosis of bladder |
| N80.A2 | Deep endometriosis of bladder |
| N80.A41 | Superficial endometriosis of right ureter |
| N80.A42 | Superficial endometriosis of left ureter |
| N80.A43 | Superficial endometriosis of bilateral ureters |
| N80.A51 | Deep endometriosis of right ureter |
| N80.A52 | Deep endometriosis of left ureter |
| N80.A53 | Deep endometriosis of bilateral ureters |
| N80.A61 | Endometriosis of right ureter, unspecified depth |
| N80.A62 | Endometriosis of left ureter, unspecified depth |
| N80.A63 | Endometriosis of bilateral ureters, unspecified depth |
| N80.B1 | Endometriosis of pleura |
| N80.B2 | Endometriosis of lung |
| N80.B31 | Superficial endometriosis of diaphragm |
| N80.B32 | Deep endometriosis of diaphragm |
| N80.B39 | Endometriosis of diaphragm, unspecified depth |
| N80.B4 | Endometriosis of the pericardial space |
| N80.B5 | Endometriosis of the mediastinal space |
| N80.B6 | Endometriosis of cardiothoracic space |
| N80.C10 | Endometriosis of the anterior abdominal wall, subcutaneous tissue |
| N80.C11 | Endometriosis of the anterior abdominal wall, fascia and muscular layers |
| N80.C19 | Endometriosis of the anterior abdominal wall, unspecified depth |
| N80.C2 | Endometriosis of the umbilicus |
| N80.C3 | Endometriosis of the inguinal canal |
| N80.C4 | Endometriosis of extra-pelvic abdominal peritoneum |
| N80.C9 | Endometriosis of other site of abdomen |
| N80.D1 | Endometriosis of the sacral splanchnic nerves |
| N80.D2 | Endometriosis of the sacral nerve roots |
| N80.D3 | Endometriosis of the obturator nerve |
| N80.D4 | Endometriosis of the sciatic nerve |
| N80.D5 | Endometriosis of the pudendal nerve |
| N80.D6 | Endometriosis of the femoral nerve |
| N80.D9 | Endometriosis of other pelvic nerve |
| N85.01 | Benign endometrial hyperplasia |
| N89.7 | Hematocolpos |
| N92.5 | Other specified irregular menstruation |
| N93.8 | Other specified abnormal uterine and vaginal bleeding |
| R10.21 | Pelvic and perineal pain right side |
| R10.22 | Pelvic and perineal pain left side |
| R10.23 | Pelvic and perineal pain bilateral |
| R10.24 | Suprapubic pain |
| Z85.3 | Personal history of malignant neoplasm of breast |
| Z85.46 | Personal history of malignant neoplasm of prostate |
| Z85.4A | Personal history of malignant neoplasm of fallopian tube(s) |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 96402?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 246 ICD-10 diagnosis codes that support medical necessity for CPT 96402. 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 96402 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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