ICD↔CPT crosswalk
CPT 97542: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 97542 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 97542 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 |
|---|---|
| A18.01 | Tuberculosis of spine |
| A18.02 | Tuberculous arthritis of other joints |
| A52.16 | Charcot's arthropathy (tabetic) |
| B91 | Sequelae of poliomyelitis |
| E08.40 | Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified |
| E08.41 | Diabetes mellitus due to underlying condition with diabetic mononeuropathy |
| E08.42 | Diabetes mellitus due to underlying condition with diabetic polyneuropathy |
| E08.44 | Diabetes mellitus due to underlying condition with diabetic amyotrophy |
| E08.52 | Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene |
| E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy |
| E08.618 | Diabetes mellitus due to underlying condition with other diabetic arthropathy |
| E09.40 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified |
| E09.41 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy |
| E09.42 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy |
| E09.44 | Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy |
| E09.52 | Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E09.610 | Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy |
| E09.618 | Drug or chemical induced diabetes mellitus with other diabetic arthropathy |
| E10.40 | Type 1 diabetes mellitus with diabetic neuropathy, unspecified |
| E10.41 | Type 1 diabetes mellitus with diabetic mononeuropathy |
| E10.42 | Type 1 diabetes mellitus with diabetic polyneuropathy |
| E10.44 | Type 1 diabetes mellitus with diabetic amyotrophy |
| E10.52 | Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E10.610 | Type 1 diabetes mellitus with diabetic neuropathic arthropathy |
| E10.618 | Type 1 diabetes mellitus with other diabetic arthropathy |
| E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified |
| E11.41 | Type 2 diabetes mellitus with diabetic mononeuropathy |
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy |
| E11.44 | Type 2 diabetes mellitus with diabetic amyotrophy |
| E11.52 | Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy |
| E11.618 | Type 2 diabetes mellitus with other diabetic arthropathy |
| E13.40 | Other specified diabetes mellitus with diabetic neuropathy, unspecified |
| E13.41 | Other specified diabetes mellitus with diabetic mononeuropathy |
| E13.42 | Other specified diabetes mellitus with diabetic polyneuropathy |
| E13.44 | Other specified diabetes mellitus with diabetic amyotrophy |
| E13.52 | Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene |
| E13.610 | Other specified diabetes mellitus with diabetic neuropathic arthropathy |
| E13.618 | Other specified diabetes mellitus with other diabetic arthropathy |
| F02.818 | Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance |
| F02.A18 | Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance |
| F02.B18 | Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance |
| F02.C18 | Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance |
| F07.0 | Personality change due to known physiological condition |
| F07.89 | Other personality and behavioral disorders due to known physiological condition |
| F48.2 | Pseudobulbar affect |
| F50.810 | Binge eating disorder, mild |
| F50.811 | Binge eating disorder, moderate |
| F50.812 | Binge eating disorder, severe |
| F50.813 | Binge eating disorder, extreme |
| F50.814 | Binge eating disorder, in remission |
| F50.819 | Binge eating disorder, unspecified |
| F50.82 | Avoidant/restrictive food intake disorder |
| F50.83 | Pica in adults |
| F50.84 | Rumination disorder in adults |
| F50.9 | Eating disorder, unspecified |
| F81.2 | Mathematics disorder |
| F98.29 | Other feeding disorders of infancy and early childhood |
| G04.1 | Tropical spastic paraplegia |
| G04.82 | Acute flaccid myelitis |
| G11.0 | Congenital nonprogressive ataxia |
| G11.10 | Early-onset cerebellar ataxia, unspecified |
| G11.11 | Friedreich ataxia |
| G11.19 | Other early-onset cerebellar ataxia |
| G11.2 | Late-onset cerebellar ataxia |
| G11.3 | Cerebellar ataxia with defective DNA repair |
| G11.4 | Hereditary spastic paraplegia |
| G11.8 | Other hereditary ataxias |
| G11.9 | Hereditary ataxia, unspecified |
| G12.0 | Infantile spinal muscular atrophy, type I [Werdnig-Hoffman] |
| G12.1 | Other inherited spinal muscular atrophy |
| G12.20 | Motor neuron disease, unspecified |
| G12.21 | Amyotrophic lateral sclerosis |
| G12.22 | Progressive bulbar palsy |
| G12.23 | Primary lateral sclerosis |
| G12.24 | Familial motor neuron disease |
| G12.25 | Progressive spinal muscle atrophy |
| G12.29 | Other motor neuron disease |
| G12.8 | Other spinal muscular atrophies and related syndromes |
| G12.9 | Spinal muscular atrophy, unspecified |
| G14 | Postpolio syndrome |
| G20.A1 | Parkinson's disease without dyskinesia, without mention of fluctuations |
| G20.A2 | Parkinson's disease without dyskinesia, with fluctuations |
| G20.B1 | Parkinson's disease with dyskinesia, without mention of fluctuations |
| G20.B2 | Parkinson's disease with dyskinesia, with fluctuations |
| G20.C | Parkinsonism, unspecified |
| G24.01 | Drug induced subacute dyskinesia |
| G24.02 | Drug induced acute dystonia |
| G24.09 | Other drug induced dystonia |
| G24.2 | Idiopathic nonfamilial dystonia |
| G24.3 | Spasmodic torticollis |
| G24.8 | Other dystonia |
| G25.82 | Stiff-man syndrome |
| G25.89 | Other specified extrapyramidal and movement disorders |
| G30.0 | Alzheimer's disease with early onset |
| G30.1 | Alzheimer's disease with late onset |
| G30.8 | Other Alzheimer's disease |
| G31.80 | Leukodystrophy, unspecified |
| G31.85 | Corticobasal degeneration |
| G31.86 | Alexander disease |
| G32.0 | Subacute combined degeneration of spinal cord in diseases classified elsewhere |
| G32.81 | Cerebellar ataxia in diseases classified elsewhere |
| G43.001 | Migraine without aura, not intractable, with status migrainosus |
| G43.009 | Migraine without aura, not intractable, without status migrainosus |
| G43.011 | Migraine without aura, intractable, with status migrainosus |
| G43.019 | Migraine without aura, intractable, without status migrainosus |
| G43.101 | Migraine with aura, not intractable, with status migrainosus |
| G43.109 | Migraine with aura, not intractable, without status migrainosus |
| G43.111 | Migraine with aura, intractable, with status migrainosus |
| G43.119 | Migraine with aura, intractable, without status migrainosus |
| G43.401 | Hemiplegic migraine, not intractable, with status migrainosus |
| G43.409 | Hemiplegic migraine, not intractable, without status migrainosus |
| G43.411 | Hemiplegic migraine, intractable, with status migrainosus |
| G43.419 | Hemiplegic migraine, intractable, without status migrainosus |
| G43.501 | Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus |
| G43.509 | Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus |
| G43.511 | Persistent migraine aura without cerebral infarction, intractable, with status migrainosus |
| G43.519 | Persistent migraine aura without cerebral infarction, intractable, without status migrainosus |
| G43.601 | Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus |
| G43.609 | Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus |
| G43.611 | Persistent migraine aura with cerebral infarction, intractable, with status migrainosus |
| G43.619 | Persistent migraine aura with cerebral infarction, intractable, without status migrainosus |
| G43.701 | Chronic migraine without aura, not intractable, with status migrainosus |
| G43.709 | Chronic migraine without aura, not intractable, without status migrainosus |
| G43.711 | Chronic migraine without aura, intractable, with status migrainosus |
| G43.719 | Chronic migraine without aura, intractable, without status migrainosus |
| G43.801 | Other migraine, not intractable, with status migrainosus |
| G43.809 | Other migraine, not intractable, without status migrainosus |
| G43.811 | Other migraine, intractable, with status migrainosus |
| G43.819 | Other migraine, intractable, without status migrainosus |
| G43.821 | Menstrual migraine, not intractable, with status migrainosus |
| G43.829 | Menstrual migraine, not intractable, without status migrainosus |
| G43.831 | Menstrual migraine, intractable, with status migrainosus |
| G43.839 | Menstrual migraine, intractable, without status migrainosus |
| G43.901 | Migraine, unspecified, not intractable, with status migrainosus |
| G43.909 | Migraine, unspecified, not intractable, without status migrainosus |
| G43.911 | Migraine, unspecified, intractable, with status migrainosus |
| G43.919 | Migraine, unspecified, intractable, without status migrainosus |
| G43.A0 | Cyclical vomiting, in migraine, not intractable |
| G43.A1 | Cyclical vomiting, in migraine, intractable |
| G43.B0 | Ophthalmoplegic migraine, not intractable |
| G43.B1 | Ophthalmoplegic migraine, intractable |
| G43.C0 | Periodic headache syndromes in child or adult, not intractable |
| G43.C1 | Periodic headache syndromes in child or adult, intractable |
| G43.D0 | Abdominal migraine, not intractable |
| G43.D1 | Abdominal migraine, intractable |
| G43.E01 | Chronic migraine with aura, not intractable, with status migrainosus |
| G43.E09 | Chronic migraine with aura, not intractable, without status migrainosus |
| G43.E11 | Chronic migraine with aura, intractable, with status migrainosus |
| G43.E19 | Chronic migraine with aura, intractable, without status migrainosus |
| G44.1 | Vascular headache, not elsewhere classified |
| G51.0 | Bell's palsy |
| G54.0 | Brachial plexus disorders |
| G54.1 | Lumbosacral plexus disorders |
| G54.2 | Cervical root disorders, not elsewhere classified |
| G54.3 | Thoracic root disorders, not elsewhere classified |
| G54.4 | Lumbosacral root disorders, not elsewhere classified |
| G54.5 | Neuralgic amyotrophy |
| G54.6 | Phantom limb syndrome with pain |
| G54.7 | Phantom limb syndrome without pain |
| G54.8 | Other nerve root and plexus disorders |
| G54.9 | Nerve root and plexus disorder, unspecified |
| G55 | Nerve root and plexus compressions in diseases classified elsewhere |
| G56.01 | Carpal tunnel syndrome, right upper limb |
| G56.02 | Carpal tunnel syndrome, left upper limb |
| G56.03 | Carpal tunnel syndrome, bilateral upper limbs |
| G56.11 | Other lesions of median nerve, right upper limb |
| G56.12 | Other lesions of median nerve, left upper limb |
| G56.13 | Other lesions of median nerve, bilateral upper limbs |
| G56.21 | Lesion of ulnar nerve, right upper limb |
| G56.22 | Lesion of ulnar nerve, left upper limb |
| G56.23 | Lesion of ulnar nerve, bilateral upper limbs |
| G56.31 | Lesion of radial nerve, right upper limb |
| G56.32 | Lesion of radial nerve, left upper limb |
| G56.33 | Lesion of radial nerve, bilateral upper limbs |
| G56.41 | Causalgia of right upper limb |
| G56.42 | Causalgia of left upper limb |
| G56.43 | Causalgia of bilateral upper limbs |
| G56.81 | Other specified mononeuropathies of right upper limb |
| G56.82 | Other specified mononeuropathies of left upper limb |
| G56.83 | Other specified mononeuropathies of bilateral upper limbs |
| G56.91 | Unspecified mononeuropathy of right upper limb |
| G56.92 | Unspecified mononeuropathy of left upper limb |
| G56.93 | Unspecified mononeuropathy of bilateral upper limbs |
| G57.01 | Lesion of sciatic nerve, right lower limb |
| G57.02 | Lesion of sciatic nerve, left lower limb |
| G57.03 | Lesion of sciatic nerve, bilateral lower limbs |
| G57.11 | Meralgia paresthetica, right lower limb |
| G57.12 | Meralgia paresthetica, left lower limb |
| G57.13 | Meralgia paresthetica, bilateral lower limbs |
| G57.21 | Lesion of femoral nerve, right lower limb |
| G57.22 | Lesion of femoral nerve, left lower limb |
| G57.23 | Lesion of femoral nerve, bilateral lower limbs |
| G57.31 | Lesion of lateral popliteal nerve, right lower limb |
| G57.32 | Lesion of lateral popliteal nerve, left lower limb |
| G57.33 | Lesion of lateral popliteal nerve, bilateral lower limbs |
| G57.41 | Lesion of medial popliteal nerve, right lower limb |
| G57.42 | Lesion of medial popliteal nerve, left lower limb |
| G57.43 | Lesion of medial popliteal nerve, bilateral lower limbs |
| G57.51 | Tarsal tunnel syndrome, right lower limb |
| G57.52 | Tarsal tunnel syndrome, left lower limb |
| G57.53 | Tarsal tunnel syndrome, bilateral lower limbs |
| G57.61 | Lesion of plantar nerve, right lower limb |
| G57.62 | Lesion of plantar nerve, left lower limb |
| G57.63 | Lesion of plantar nerve, bilateral lower limbs |
| G57.71 | Causalgia of right lower limb |
| G57.72 | Causalgia of left lower limb |
| G57.73 | Causalgia of bilateral lower limbs |
| 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 |
| G57.91 | Unspecified mononeuropathy of right lower limb |
| G57.92 | Unspecified mononeuropathy of left lower limb |
| G57.93 | Unspecified mononeuropathy of bilateral lower limbs |
| G58.0 | Intercostal neuropathy |
| G58.7 | Mononeuritis multiplex |
| G58.8 | Other specified mononeuropathies |
| G58.9 | Mononeuropathy, unspecified |
| G59 | Mononeuropathy in diseases classified elsewhere |
| 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 |
| G60.9 | Hereditary and idiopathic neuropathy, unspecified |
| G61.0 | Guillain-Barre syndrome |
| G61.82 | Multifocal motor neuropathy |
| G62.0 | Drug-induced polyneuropathy |
| G62.1 | Alcoholic polyneuropathy |
| G62.2 | Polyneuropathy due to other toxic agents |
| G62.81 | Critical illness polyneuropathy |
| G70.80 | Lambert-Eaton syndrome, unspecified |
| G70.81 | Lambert-Eaton syndrome in disease classified elsewhere |
| G71.00 | Muscular dystrophy, unspecified |
| G71.01 | Duchenne or Becker muscular dystrophy |
| G71.02 | Facioscapulohumeral muscular dystrophy |
| G71.031 | Autosomal dominant limb girdle muscular dystrophy |
| G71.032 | Autosomal recessive limb girdle muscular dystrophy due to calpain-3 dysfunction |
| G71.033 | Limb girdle muscular dystrophy due to dysferlin dysfunction |
| G71.0340 | Limb girdle muscular dystrophy due to sarcoglycan dysfunction, unspecified |
| G71.0341 | Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction |
| G71.0342 | Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction |
| G71.0349 | Limb girdle muscular dystrophy due to other sarcoglycan dysfunction |
| G71.035 | Limb girdle muscular dystrophy due to anoctamin-5 dysfunction |
| G71.036 | Limb girdle muscular dystrophy due to fukutin related protein dysfunction |
| G71.038 | Other limb girdle muscular dystrophy |
| G71.09 | Other specified muscular dystrophies |
| G71.11 | Myotonic muscular dystrophy |
| G71.12 | Myotonia congenita |
| G71.13 | Myotonic chondrodystrophy |
| G71.14 | Drug induced myotonia |
| G71.19 | Other specified myotonic disorders |
| G71.20 | Congenital myopathy, unspecified |
| G71.21 | Nemaline myopathy |
| G71.220 | X-linked myotubular myopathy |
| G71.228 | Other centronuclear myopathy |
| G71.29 | Other congenital myopathy |
| G72.0 | Drug-induced myopathy |
| G72.1 | Alcoholic myopathy |
| G72.2 | Myopathy due to other toxic agents |
| G72.41 | Inclusion body myositis [IBM] |
| G72.49 | Other inflammatory and immune myopathies, not elsewhere classified |
| G72.81 | Critical illness myopathy |
| G73.1 | Lambert-Eaton syndrome in neoplastic disease |
| G80.0 | Spastic quadriplegic cerebral palsy |
| G80.1 | Spastic diplegic cerebral palsy |
| G80.2 | Spastic hemiplegic cerebral palsy |
| G80.3 | Athetoid cerebral palsy |
| G80.4 | Ataxic cerebral palsy |
| G80.8 | Other cerebral palsy |
| G80.9 | Cerebral palsy, unspecified |
| G81.01 | Flaccid hemiplegia affecting right dominant side |
| G81.02 | Flaccid hemiplegia affecting left dominant side |
| G81.03 | Flaccid hemiplegia affecting right nondominant side |
| G81.04 | Flaccid hemiplegia affecting left nondominant side |
| G81.11 | Spastic hemiplegia affecting right dominant side |
| G81.12 | Spastic hemiplegia affecting left dominant side |
| G81.13 | Spastic hemiplegia affecting right nondominant side |
| G81.14 | Spastic hemiplegia affecting left nondominant side |
| G81.91 | Hemiplegia, unspecified affecting right dominant side |
| G81.92 | Hemiplegia, unspecified affecting left dominant side |
| G81.93 | Hemiplegia, unspecified affecting right nondominant side |
| G81.94 | Hemiplegia, unspecified affecting left nondominant side |
| G82.21 | Paraplegia, complete |
| G82.22 | Paraplegia, incomplete |
| G82.51 | Quadriplegia, C1-C4 complete |
| G82.52 | Quadriplegia, C1-C4 incomplete |
| G82.53 | Quadriplegia, C5-C7 complete |
| G82.54 | Quadriplegia, C5-C7 incomplete |
| G83.0 | Diplegia of upper limbs |
| G83.11 | Monoplegia of lower limb affecting right dominant side |
| G83.12 | Monoplegia of lower limb affecting left dominant side |
| G83.13 | Monoplegia of lower limb affecting right nondominant side |
| G83.14 | Monoplegia of lower limb affecting left nondominant side |
| G83.21 | Monoplegia of upper limb affecting right dominant side |
| G83.22 | Monoplegia of upper limb affecting left dominant side |
| G83.23 | Monoplegia of upper limb affecting right nondominant side |
| G83.24 | Monoplegia of upper limb affecting left nondominant side |
| G83.31 | Monoplegia, unspecified affecting right dominant side |
| G83.32 | Monoplegia, unspecified affecting left dominant side |
| G83.33 | Monoplegia, unspecified affecting right nondominant side |
| G83.34 | Monoplegia, unspecified affecting left nondominant side |
| G83.4 | Cauda equina syndrome |
| G83.5 | Locked-in state |
| G83.81 | Brown-Sequard syndrome |
| G83.82 | Anterior cord syndrome |
| G83.83 | Posterior cord syndrome |
| G83.84 | Todd's paralysis (postepileptic) |
| G83.89 | Other specified paralytic syndromes |
| G83.9 | Paralytic syndrome, unspecified |
| G90.2 | Horner's syndrome |
| G90.4 | Autonomic dysreflexia |
| G90.511 | Complex regional pain syndrome I of right upper limb |
| G90.512 | Complex regional pain syndrome I of left upper limb |
| G90.513 | Complex regional pain syndrome I of upper limb, bilateral |
| G90.521 | Complex regional pain syndrome I of right lower limb |
| G90.522 | Complex regional pain syndrome I of left lower limb |
| G90.523 | Complex regional pain syndrome I of lower limb, bilateral |
| G90.59 | Complex regional pain syndrome I of other specified site |
| G95.0 | Syringomyelia and syringobulbia |
| G95.11 | Acute infarction of spinal cord (embolic) (nonembolic) |
| G95.19 | Other vascular myelopathies |
| G95.20 | Unspecified cord compression |
| G95.29 | Other cord compression |
| G95.81 | Conus medullaris syndrome |
| G95.89 | Other specified diseases of spinal cord |
| G95.9 | Disease of spinal cord, unspecified |
| G99.2 | Myelopathy in diseases classified elsewhere |
| H53.411 | Scotoma involving central area, right eye |
| H53.412 | Scotoma involving central area, left eye |
| H53.413 | Scotoma involving central area, bilateral |
| H53.461 | Homonymous bilateral field defects, right side |
| H53.462 | Homonymous bilateral field defects, left side |
| H53.469 | Homonymous bilateral field defects, unspecified side |
| H53.47 | Heteronymous bilateral field defects |
| H53.481 | Generalized contraction of visual field, right eye |
| H53.482 | Generalized contraction of visual field, left eye |
| H53.483 | Generalized contraction of visual field, bilateral |
| H54.0X33 | Blindness right eye category 3, blindness left eye category 3 |
| H54.0X34 | Blindness right eye category 3, blindness left eye category 4 |
| H54.0X35 | Blindness right eye category 3, blindness left eye category 5 |
| H54.0X43 | Blindness right eye category 4, blindness left eye category 3 |
| H54.0X44 | Blindness right eye category 4, blindness left eye category 4 |
| H54.0X45 | Blindness right eye category 4, blindness left eye category 5 |
| H54.0X53 | Blindness right eye category 5, blindness left eye category 3 |
| H54.0X54 | Blindness right eye category 5, blindness left eye category 4 |
| H54.0X55 | Blindness right eye category 5, blindness left eye category 5 |
| H54.10 | Blindness, one eye, low vision other eye, unspecified eyes |
| H54.1131 | Blindness right eye category 3, low vision left eye category 1 |
| H54.1132 | Blindness right eye category 3, low vision left eye category 2 |
| H54.1141 | Blindness right eye category 4, low vision left eye category 1 |
| H54.1142 | Blindness right eye category 4, low vision left eye category 2 |
| H54.1151 | Blindness right eye category 5, low vision left eye category 1 |
| H54.1152 | Blindness right eye category 5, low vision left eye category 2 |
| H54.1213 | Low vision right eye category 1, blindness left eye category 3 |
| H54.1214 | Low vision right eye category 1, blindness left eye category 4 |
| H54.1215 | Low vision right eye category 1, blindness left eye category 5 |
| H54.1223 | Low vision right eye category 2, blindness left eye category 3 |
| H54.1224 | Low vision right eye category 2, blindness left eye category 4 |
| H54.1225 | Low vision right eye category 2, blindness left eye category 5 |
| H54.2X11 | Low vision right eye category 1, low vision left eye category 1 |
| H54.2X12 | Low vision right eye category 1, low vision left eye category 2 |
| H54.2X21 | Low vision right eye category 2, low vision left eye category 1 |
| H54.2X22 | Low vision right eye category 2, low vision left eye category 2 |
| H54.3 | Unqualified visual loss, both eyes |
| H54.40 | Blindness, one eye, unspecified eye |
| H54.413A | Blindness right eye category 3, normal vision left eye |
| H54.414A | Blindness right eye category 4, normal vision left eye |
| H54.415A | Blindness right eye category 5, normal vision left eye |
| H54.42A3 | Blindness left eye category 3, normal vision right eye |
| H54.42A4 | Blindness left eye category 4, normal vision right eye |
| H54.42A5 | Blindness left eye category 5, normal vision right eye |
| H54.50 | Low vision, one eye, unspecified eye |
| H54.511A | Low vision right eye category 1, normal vision left eye |
| H54.512A | Low vision right eye category 2, normal vision left eye |
| H54.52A1 | Low vision left eye category 1, normal vision right eye |
| H54.52A2 | Low vision left eye category 2, normal vision right eye |
| H54.60 | Unqualified visual loss, one eye, unspecified |
| H54.61 | Unqualified visual loss, right eye, normal vision left eye |
| H54.62 | Unqualified visual loss, left eye, normal vision right eye |
| H54.7 | Unspecified visual loss |
| H54.8 | Legal blindness, as defined in USA |
| H81.11 | Benign paroxysmal vertigo, right ear |
| H81.12 | Benign paroxysmal vertigo, left ear |
| H81.13 | Benign paroxysmal vertigo, bilateral |
| H81.21 | Vestibular neuronitis, right ear |
| H81.22 | Vestibular neuronitis, left ear |
| H81.23 | Vestibular neuronitis, bilateral |
| H83.2X1 | Labyrinthine dysfunction, right ear |
| H83.2X2 | Labyrinthine dysfunction, left ear |
| H83.2X3 | Labyrinthine dysfunction, bilateral |
| I20.81 | Angina pectoris with coronary microvascular dysfunction |
| I20.89 | Other forms of angina pectoris |
| I20.9 | Angina pectoris, unspecified |
| I25.111 | Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm |
| I25.118 | Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris |
| I25.711 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm |
| I25.718 | Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris |
| I25.721 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm |
| I25.728 | Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris |
Showing the first 400 of 27004 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 97542?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 27004 ICD-10 diagnosis codes that support medical necessity for CPT 97542. 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 97542 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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