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ICD↔CPT crosswalk

CPT 97530: ICD-10 codes that support medical necessity

27812 covered diagnosis codes under Medicare coverage policies (LCD/NCD)

These ICD-10-CM diagnoses support medical necessity for CPT 97530 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 97530 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
A18.01Tuberculosis of spine
A18.02Tuberculous arthritis of other joints
A52.16Charcot's arthropathy (tabetic)
A69.0Necrotizing ulcerative stomatitis
B91Sequelae of poliomyelitis
C09.0Malignant neoplasm of tonsillar fossa
C09.1Malignant neoplasm of tonsillar pillar (anterior) (posterior)
C09.8Malignant neoplasm of overlapping sites of tonsil
C09.9Malignant neoplasm of tonsil, unspecified
C10.0Malignant neoplasm of vallecula
C10.1Malignant neoplasm of anterior surface of epiglottis
C10.2Malignant neoplasm of lateral wall of oropharynx
C10.3Malignant neoplasm of posterior wall of oropharynx
C10.4Malignant neoplasm of branchial cleft
C10.8Malignant neoplasm of overlapping sites of oropharynx
C10.9Malignant neoplasm of oropharynx, unspecified
C12Malignant neoplasm of pyriform sinus
C13.0Malignant neoplasm of postcricoid region
C13.1Malignant neoplasm of aryepiglottic fold, hypopharyngeal aspect
C13.2Malignant neoplasm of posterior wall of hypopharynx
C13.8Malignant neoplasm of overlapping sites of hypopharynx
C13.9Malignant neoplasm of hypopharynx, unspecified
C14.0Malignant neoplasm of pharynx, unspecified
C14.2Malignant neoplasm of Waldeyer's ring
C14.8Malignant neoplasm of overlapping sites of lip, oral cavity and pharynx
C32.0Malignant neoplasm of glottis
C32.1Malignant neoplasm of supraglottis
C32.2Malignant neoplasm of subglottis
C32.3Malignant neoplasm of laryngeal cartilage
C32.8Malignant neoplasm of overlapping sites of larynx
C32.9Malignant neoplasm of larynx, unspecified
D14.1Benign neoplasm of larynx
D38.0Neoplasm of uncertain behavior of larynx
E08.40Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
E08.41Diabetes mellitus due to underlying condition with diabetic mononeuropathy
E08.42Diabetes mellitus due to underlying condition with diabetic polyneuropathy
E08.44Diabetes mellitus due to underlying condition with diabetic amyotrophy
E08.52Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
E08.610Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
E08.618Diabetes mellitus due to underlying condition with other diabetic arthropathy
E09.40Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified
E09.41Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
E09.42Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
E09.44Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
E09.52Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
E09.610Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
E09.618Drug or chemical induced diabetes mellitus with other diabetic arthropathy
E10.40Type 1 diabetes mellitus with diabetic neuropathy, unspecified
E10.41Type 1 diabetes mellitus with diabetic mononeuropathy
E10.42Type 1 diabetes mellitus with diabetic polyneuropathy
E10.44Type 1 diabetes mellitus with diabetic amyotrophy
E10.52Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.610Type 1 diabetes mellitus with diabetic neuropathic arthropathy
E10.618Type 1 diabetes mellitus with other diabetic arthropathy
E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
E11.41Type 2 diabetes mellitus with diabetic mononeuropathy
E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
E11.44Type 2 diabetes mellitus with diabetic amyotrophy
E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E11.610Type 2 diabetes mellitus with diabetic neuropathic arthropathy
E11.618Type 2 diabetes mellitus with other diabetic arthropathy
E13.40Other specified diabetes mellitus with diabetic neuropathy, unspecified
E13.41Other specified diabetes mellitus with diabetic mononeuropathy
E13.42Other specified diabetes mellitus with diabetic polyneuropathy
E13.44Other specified diabetes mellitus with diabetic amyotrophy
E13.52Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
E13.610Other specified diabetes mellitus with diabetic neuropathic arthropathy
E13.618Other specified diabetes mellitus with other diabetic arthropathy
F01.50Vascular dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.511Vascular dementia, unspecified severity, with agitation
F01.518Vascular dementia, unspecified severity, with other behavioral disturbance
F01.52Vascular dementia, unspecified severity, with psychotic disturbance
F01.53Vascular dementia, unspecified severity, with mood disturbance
F01.54Vascular dementia, unspecified severity, with anxiety
F01.A0Vascular dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.A11Vascular dementia, mild, with agitation
F01.A18Vascular dementia, mild, with other behavioral disturbance
F01.A2Vascular dementia, mild, with psychotic disturbance
F01.A3Vascular dementia, mild, with mood disturbance
F01.A4Vascular dementia, mild, with anxiety
F01.B0Vascular dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.B11Vascular dementia, moderate, with agitation
F01.B18Vascular dementia, moderate, with other behavioral disturbance
F01.B2Vascular dementia, moderate, with psychotic disturbance
F01.B3Vascular dementia, moderate, with mood disturbance
F01.B4Vascular dementia, moderate, with anxiety
F01.C0Vascular dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F01.C11Vascular dementia, severe, with agitation
F01.C18Vascular dementia, severe, with other behavioral disturbance
F01.C2Vascular dementia, severe, with psychotic disturbance
F01.C3Vascular dementia, severe, with mood disturbance
F01.C4Vascular dementia, severe, with anxiety
F02.80Dementia in other diseases classified elsewhere, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.811Dementia in other diseases classified elsewhere, unspecified severity, with agitation
F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
F02.82Dementia in other diseases classified elsewhere, unspecified severity, with psychotic disturbance
F02.83Dementia in other diseases classified elsewhere, unspecified severity, with mood disturbance
F02.84Dementia in other diseases classified elsewhere, unspecified severity, with anxiety
F02.A0Dementia in other diseases classified elsewhere, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.A11Dementia in other diseases classified elsewhere, mild, with agitation
F02.A18Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
F02.A2Dementia in other diseases classified elsewhere, mild, with psychotic disturbance
F02.A3Dementia in other diseases classified elsewhere, mild, with mood disturbance
F02.A4Dementia in other diseases classified elsewhere, mild, with anxiety
F02.B0Dementia in other diseases classified elsewhere, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.B11Dementia in other diseases classified elsewhere, moderate, with agitation
F02.B18Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance
F02.B2Dementia in other diseases classified elsewhere, moderate, with psychotic disturbance
F02.B3Dementia in other diseases classified elsewhere, moderate, with mood disturbance
F02.B4Dementia in other diseases classified elsewhere, moderate, with anxiety
F02.C0Dementia in other diseases classified elsewhere, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F02.C11Dementia in other diseases classified elsewhere, severe, with agitation
F02.C18Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance
F02.C2Dementia in other diseases classified elsewhere, severe, with psychotic disturbance
F02.C3Dementia in other diseases classified elsewhere, severe, with mood disturbance
F02.C4Dementia in other diseases classified elsewhere, severe, with anxiety
F03.90Unspecified dementia, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.911Unspecified dementia, unspecified severity, with agitation
F03.918Unspecified dementia, unspecified severity, with other behavioral disturbance
F03.92Unspecified dementia, unspecified severity, with psychotic disturbance
F03.93Unspecified dementia, unspecified severity, with mood disturbance
F03.94Unspecified dementia, unspecified severity, with anxiety
F03.A0Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.A11Unspecified dementia, mild, with agitation
F03.A18Unspecified dementia, mild, with other behavioral disturbance
F03.A2Unspecified dementia, mild, with psychotic disturbance
F03.A3Unspecified dementia, mild, with mood disturbance
F03.A4Unspecified dementia, mild, with anxiety
F03.B0Unspecified dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.B11Unspecified dementia, moderate, with agitation
F03.B18Unspecified dementia, moderate, with other behavioral disturbance
F03.B2Unspecified dementia, moderate, with psychotic disturbance
F03.B3Unspecified dementia, moderate, with mood disturbance
F03.B4Unspecified dementia, moderate, with anxiety
F03.C0Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.C11Unspecified dementia, severe, with agitation
F03.C18Unspecified dementia, severe, with other behavioral disturbance
F03.C2Unspecified dementia, severe, with psychotic disturbance
F03.C3Unspecified dementia, severe, with mood disturbance
F03.C4Unspecified dementia, severe, with anxiety
F05Delirium due to known physiological condition
F06.0Psychotic disorder with hallucinations due to known physiological condition
F06.1Catatonic disorder due to known physiological condition
F06.8Other specified mental disorders due to known physiological condition
F07.0Personality change due to known physiological condition
F07.89Other personality and behavioral disorders due to known physiological condition
F48.2Pseudobulbar affect
F50.810Binge eating disorder, mild
F50.811Binge eating disorder, moderate
F50.812Binge eating disorder, severe
F50.813Binge eating disorder, extreme
F50.814Binge eating disorder, in remission
F50.819Binge eating disorder, unspecified
F50.82Avoidant/restrictive food intake disorder
F50.83Pica in adults
F50.84Rumination disorder in adults
F50.9Eating disorder, unspecified
F80.0Phonological disorder
F80.1Expressive language disorder
F80.2Mixed receptive-expressive language disorder
F80.4Speech and language development delay due to hearing loss
F80.81Childhood onset fluency disorder
F80.82Social pragmatic communication disorder
F80.89Other developmental disorders of speech and language
F80.9Developmental disorder of speech and language, unspecified
F81.0Specific reading disorder
F81.2Mathematics disorder
F81.81Disorder of written expression
F81.89Other developmental disorders of scholastic skills
F82Specific developmental disorder of motor function
F88Other disorders of psychological development
F95.2Tourette's disorder
F98.29Other feeding disorders of infancy and early childhood
F98.5Adult onset fluency disorder
G04.1Tropical spastic paraplegia
G04.82Acute flaccid myelitis
G10Huntington's disease
G11.0Congenital nonprogressive ataxia
G11.10Early-onset cerebellar ataxia, unspecified
G11.11Friedreich ataxia
G11.19Other early-onset cerebellar ataxia
G11.2Late-onset cerebellar ataxia
G11.3Cerebellar ataxia with defective DNA repair
G11.4Hereditary spastic paraplegia
G11.8Other hereditary ataxias
G11.9Hereditary ataxia, unspecified
G12.0Infantile spinal muscular atrophy, type I [Werdnig-Hoffman]
G12.1Other inherited spinal muscular atrophy
G12.20Motor neuron disease, unspecified
G12.21Amyotrophic lateral sclerosis
G12.22Progressive bulbar palsy
G12.23Primary lateral sclerosis
G12.24Familial motor neuron disease
G12.25Progressive spinal muscle atrophy
G12.29Other motor neuron disease
G12.8Other spinal muscular atrophies and related syndromes
G12.9Spinal muscular atrophy, unspecified
G13.2Systemic atrophy primarily affecting the central nervous system in myxedema
G13.8Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere
G14Postpolio syndrome
G20.A1Parkinson's disease without dyskinesia, without mention of fluctuations
G20.A2Parkinson's disease without dyskinesia, with fluctuations
G20.B1Parkinson's disease with dyskinesia, without mention of fluctuations
G20.B2Parkinson's disease with dyskinesia, with fluctuations
G20.CParkinsonism, unspecified
G21.0Malignant neuroleptic syndrome
G21.11Neuroleptic induced parkinsonism
G21.19Other drug induced secondary parkinsonism
G21.2Secondary parkinsonism due to other external agents
G21.3Postencephalitic parkinsonism
G21.4Vascular parkinsonism
G21.8Other secondary parkinsonism
G21.9Secondary parkinsonism, unspecified
G23.0Hallervorden-Spatz disease
G23.1Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski]
G23.2Striatonigral degeneration
G23.8Other specified degenerative diseases of basal ganglia
G23.9Degenerative disease of basal ganglia, unspecified
G24.01Drug induced subacute dyskinesia
G24.02Drug induced acute dystonia
G24.09Other drug induced dystonia
G24.1Genetic torsion dystonia
G24.2Idiopathic nonfamilial dystonia
G24.3Spasmodic torticollis
G24.4Idiopathic orofacial dystonia
G24.5Blepharospasm
G24.8Other dystonia
G24.9Dystonia, unspecified
G25.3Myoclonus
G25.4Drug-induced chorea
G25.5Other chorea
G25.70Drug induced movement disorder, unspecified
G25.71Drug induced akathisia
G25.79Other drug induced movement disorders
G25.81Restless legs syndrome
G25.82Stiff-man syndrome
G25.83Benign shuddering attacks
G25.89Other specified extrapyramidal and movement disorders
G25.9Extrapyramidal and movement disorder, unspecified
G26Extrapyramidal and movement disorders in diseases classified elsewhere
G30.0Alzheimer's disease with early onset
G30.1Alzheimer's disease with late onset
G30.8Other Alzheimer's disease
G30.9Alzheimer's disease, unspecified
G31.01Pick's disease
G31.09Other frontotemporal neurocognitive disorder
G31.1Senile degeneration of brain, not elsewhere classified
G31.2Degeneration of nervous system due to alcohol
G31.80Leukodystrophy, unspecified
G31.83Neurocognitive disorder with Lewy bodies
G31.84Mild cognitive impairment of uncertain or unknown etiology
G31.85Corticobasal degeneration
G31.86Alexander disease
G31.87Primary progressive apraxia of speech
G31.89Other specified degenerative diseases of nervous system
G31.9Degenerative disease of nervous system, unspecified
G32.0Subacute combined degeneration of spinal cord in diseases classified elsewhere
G32.81Cerebellar ataxia in diseases classified elsewhere
G36.0Neuromyelitis optica [Devic]
G36.1Acute and subacute hemorrhagic leukoencephalitis [Hurst]
G36.8Other specified acute disseminated demyelination
G36.9Acute disseminated demyelination, unspecified
G37.0Diffuse sclerosis of central nervous system
G37.1Central demyelination of corpus callosum
G37.2Central pontine myelinolysis
G37.3Acute transverse myelitis in demyelinating disease of central nervous system
G37.4Subacute necrotizing myelitis of central nervous system
G37.5Concentric sclerosis [Balo] of central nervous system
G37.89Other specified demyelinating diseases of central nervous system
G37.9Demyelinating disease of central nervous system, unspecified
G43.001Migraine without aura, not intractable, with status migrainosus
G43.009Migraine without aura, not intractable, without status migrainosus
G43.011Migraine without aura, intractable, with status migrainosus
G43.019Migraine without aura, intractable, without status migrainosus
G43.101Migraine with aura, not intractable, with status migrainosus
G43.109Migraine with aura, not intractable, without status migrainosus
G43.111Migraine with aura, intractable, with status migrainosus
G43.119Migraine with aura, intractable, without status migrainosus
G43.401Hemiplegic migraine, not intractable, with status migrainosus
G43.409Hemiplegic migraine, not intractable, without status migrainosus
G43.411Hemiplegic migraine, intractable, with status migrainosus
G43.419Hemiplegic migraine, intractable, without status migrainosus
G43.501Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus
G43.509Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus
G43.511Persistent migraine aura without cerebral infarction, intractable, with status migrainosus
G43.519Persistent migraine aura without cerebral infarction, intractable, without status migrainosus
G43.601Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus
G43.609Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus
G43.611Persistent migraine aura with cerebral infarction, intractable, with status migrainosus
G43.619Persistent migraine aura with cerebral infarction, intractable, without status migrainosus
G43.701Chronic migraine without aura, not intractable, with status migrainosus
G43.709Chronic migraine without aura, not intractable, without status migrainosus
G43.711Chronic migraine without aura, intractable, with status migrainosus
G43.719Chronic migraine without aura, intractable, without status migrainosus
G43.801Other migraine, not intractable, with status migrainosus
G43.809Other migraine, not intractable, without status migrainosus
G43.811Other migraine, intractable, with status migrainosus
G43.819Other migraine, intractable, without status migrainosus
G43.821Menstrual migraine, not intractable, with status migrainosus
G43.829Menstrual migraine, not intractable, without status migrainosus
G43.831Menstrual migraine, intractable, with status migrainosus
G43.839Menstrual migraine, intractable, without status migrainosus
G43.901Migraine, unspecified, not intractable, with status migrainosus
G43.909Migraine, unspecified, not intractable, without status migrainosus
G43.911Migraine, unspecified, intractable, with status migrainosus
G43.919Migraine, unspecified, intractable, without status migrainosus
G43.A0Cyclical vomiting, in migraine, not intractable
G43.A1Cyclical vomiting, in migraine, intractable
G43.B0Ophthalmoplegic migraine, not intractable
G43.B1Ophthalmoplegic migraine, intractable
G43.C0Periodic headache syndromes in child or adult, not intractable
G43.C1Periodic headache syndromes in child or adult, intractable
G43.D0Abdominal migraine, not intractable
G43.D1Abdominal migraine, intractable
G43.E01Chronic migraine with aura, not intractable, with status migrainosus
G43.E09Chronic migraine with aura, not intractable, without status migrainosus
G43.E11Chronic migraine with aura, intractable, with status migrainosus
G43.E19Chronic migraine with aura, intractable, without status migrainosus
G44.1Vascular headache, not elsewhere classified
G45.0Vertebro-basilar artery syndrome
G45.1Carotid artery syndrome (hemispheric)
G45.2Multiple and bilateral precerebral artery syndromes
G45.8Other transient cerebral ischemic attacks and related syndromes
G45.9Transient cerebral ischemic attack, unspecified
G46.0Middle cerebral artery syndrome
G46.1Anterior cerebral artery syndrome
G46.2Posterior cerebral artery syndrome
G51.0Bell's palsy
G52.1Disorders of glossopharyngeal nerve
G52.2Disorders of vagus nerve
G52.3Disorders of hypoglossal nerve
G52.7Disorders of multiple cranial nerves
G52.8Disorders of other specified cranial nerves
G54.0Brachial plexus disorders
G54.1Lumbosacral plexus disorders
G54.2Cervical root disorders, not elsewhere classified
G54.3Thoracic root disorders, not elsewhere classified
G54.4Lumbosacral root disorders, not elsewhere classified
G54.5Neuralgic amyotrophy
G54.6Phantom limb syndrome with pain
G54.7Phantom limb syndrome without pain
G54.8Other nerve root and plexus disorders
G54.9Nerve root and plexus disorder, unspecified
G55Nerve root and plexus compressions in diseases classified elsewhere
G56.01Carpal tunnel syndrome, right upper limb
G56.02Carpal tunnel syndrome, left upper limb
G56.03Carpal tunnel syndrome, bilateral upper limbs
G56.11Other lesions of median nerve, right upper limb
G56.12Other lesions of median nerve, left upper limb
G56.13Other lesions of median nerve, bilateral upper limbs
G56.21Lesion of ulnar nerve, right upper limb
G56.22Lesion of ulnar nerve, left upper limb
G56.23Lesion of ulnar nerve, bilateral upper limbs
G56.31Lesion of radial nerve, right upper limb
G56.32Lesion of radial nerve, left upper limb
G56.33Lesion of radial nerve, bilateral upper limbs
G56.41Causalgia of right upper limb
G56.42Causalgia of left upper limb
G56.43Causalgia of bilateral upper limbs
G56.81Other specified mononeuropathies of right upper limb
G56.82Other specified mononeuropathies of left upper limb
G56.83Other specified mononeuropathies of bilateral upper limbs
G56.91Unspecified mononeuropathy of right upper limb
G56.92Unspecified mononeuropathy of left upper limb
G56.93Unspecified mononeuropathy of bilateral upper limbs
G57.01Lesion of sciatic nerve, right lower limb
G57.02Lesion of sciatic nerve, left lower limb
G57.03Lesion of sciatic nerve, bilateral lower limbs
G57.11Meralgia paresthetica, right lower limb
G57.12Meralgia paresthetica, left lower limb
G57.13Meralgia paresthetica, bilateral lower limbs
G57.21Lesion of femoral nerve, right lower limb
G57.22Lesion of femoral nerve, left lower limb
G57.23Lesion of femoral nerve, bilateral lower limbs
G57.31Lesion of lateral popliteal nerve, right lower limb
G57.32Lesion of lateral popliteal nerve, left lower limb
G57.33Lesion of lateral popliteal nerve, bilateral lower limbs
G57.41Lesion of medial popliteal nerve, right lower limb
G57.42Lesion of medial popliteal nerve, left lower limb
G57.43Lesion of medial popliteal nerve, bilateral lower limbs
G57.51Tarsal tunnel syndrome, right lower limb
G57.52Tarsal tunnel syndrome, left lower limb
G57.53Tarsal tunnel syndrome, bilateral lower limbs
G57.61Lesion of plantar nerve, right lower limb
G57.62Lesion of plantar nerve, left lower limb
G57.63Lesion of plantar nerve, bilateral lower limbs
G57.71Causalgia of right lower limb
G57.72Causalgia of left lower limb
G57.73Causalgia of bilateral lower limbs
G57.81Other specified mononeuropathies of right lower limb
G57.82Other specified mononeuropathies of left lower limb
G57.83Other specified mononeuropathies of bilateral lower limbs
G57.91Unspecified mononeuropathy of right lower limb
G57.92Unspecified mononeuropathy of left lower limb
G57.93Unspecified mononeuropathy of bilateral lower limbs
G58.0Intercostal neuropathy
G58.7Mononeuritis multiplex
G58.8Other specified mononeuropathies
G58.9Mononeuropathy, unspecified
G59Mononeuropathy in diseases classified elsewhere

Showing the first 400 of 27812 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 97530?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 27812 ICD-10 diagnosis codes that support medical necessity for CPT 97530. 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 97530 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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