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ICD↔CPT crosswalk

CPT 97550: ICD-10 codes that support medical necessity

24447 covered diagnosis codes under Medicare coverage policies (LCD/NCD)

These ICD-10-CM diagnoses support medical necessity for CPT 97550 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 97550 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)
A52.17General paresis
A81.00Creutzfeldt-Jakob disease, unspecified
A81.01Variant Creutzfeldt-Jakob disease
A81.09Other Creutzfeldt-Jakob disease
B91Sequelae of poliomyelitis
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
E75.00GM2 gangliosidosis, unspecified
E75.01Sandhoff disease
E75.02Tay-Sachs disease
E75.09Other GM2 gangliosidosis
E75.11Mucolipidosis IV
E75.19Other gangliosidosis
E75.27Pelizaeus-Merzbacher disease
E75.28Canavan disease
E75.4Neuronal ceroid lipofuscinosis
E83.01Wilson's disease
E83.09Other disorders of copper metabolism
F01.518Vascular dementia, unspecified severity, with other behavioral disturbance
F01.A18Vascular dementia, mild, with other behavioral disturbance
F01.B18Vascular dementia, moderate, with other behavioral disturbance
F01.C18Vascular dementia, severe, with other behavioral disturbance
F02.818Dementia in other diseases classified elsewhere, unspecified severity, with other behavioral disturbance
F02.A18Dementia in other diseases classified elsewhere, mild, with other behavioral disturbance
F02.B18Dementia in other diseases classified elsewhere, moderate, with other behavioral disturbance
F02.C18Dementia in other diseases classified elsewhere, severe, with other behavioral disturbance
F07.0Personality change due to known physiological condition
F07.81Postconcussional syndrome
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
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
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
G24.01Drug induced subacute dyskinesia
G24.02Drug induced acute dystonia
G24.09Other drug induced dystonia
G24.2Idiopathic nonfamilial dystonia
G24.3Spasmodic torticollis
G24.4Idiopathic orofacial dystonia
G24.8Other dystonia
G25.82Stiff-man syndrome
G25.89Other specified extrapyramidal and movement disorders
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
G31.80Leukodystrophy, unspecified
G31.83Neurocognitive disorder with Lewy bodies
G31.85Corticobasal degeneration
G31.86Alexander disease
G31.87Primary progressive apraxia of speech
G32.0Subacute combined degeneration of spinal cord in diseases classified elsewhere
G32.81Cerebellar ataxia in diseases classified elsewhere
G35.ARelapsing-remitting multiple sclerosis
G35.B0Primary progressive multiple sclerosis, unspecified
G35.B1Active primary progressive multiple sclerosis
G35.B2Non-active primary progressive multiple sclerosis
G35.C0Secondary progressive multiple sclerosis, unspecified
G35.C1Active secondary progressive multiple sclerosis
G35.C2Non-active secondary progressive multiple sclerosis
G35.DMultiple sclerosis, unspecified
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
G40.001Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, with status epilepticus
G40.009Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, not intractable, without status epilepticus
G40.011Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, with status epilepticus
G40.019Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus
G40.101Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, with status epilepticus
G40.109Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, not intractable, without status epilepticus
G40.111Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus
G40.119Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus
G40.201Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, with status epilepticus
G40.209Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus
G40.211Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, with status epilepticus
G40.219Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus
G40.301Generalized idiopathic epilepsy and epileptic syndromes, not intractable, with status epilepticus
G40.309Generalized idiopathic epilepsy and epileptic syndromes, not intractable, without status epilepticus
G40.311Generalized idiopathic epilepsy and epileptic syndromes, intractable, with status epilepticus
G40.319Generalized idiopathic epilepsy and epileptic syndromes, intractable, without status epilepticus
G40.401Other generalized epilepsy and epileptic syndromes, not intractable, with status epilepticus
G40.409Other generalized epilepsy and epileptic syndromes, not intractable, without status epilepticus
G40.411Other generalized epilepsy and epileptic syndromes, intractable, with status epilepticus
G40.419Other generalized epilepsy and epileptic syndromes, intractable, without status epilepticus
G40.42Cyclin-Dependent Kinase-Like 5 Deficiency Disorder
G40.501Epileptic seizures related to external causes, not intractable, with status epilepticus
G40.509Epileptic seizures related to external causes, not intractable, without status epilepticus
G40.801Other epilepsy, not intractable, with status epilepticus
G40.802Other epilepsy, not intractable, without status epilepticus
G40.803Other epilepsy, intractable, with status epilepticus
G40.804Other epilepsy, intractable, without status epilepticus
G40.811Lennox-Gastaut syndrome, not intractable, with status epilepticus
G40.812Lennox-Gastaut syndrome, not intractable, without status epilepticus
G40.813Lennox-Gastaut syndrome, intractable, with status epilepticus
G40.814Lennox-Gastaut syndrome, intractable, without status epilepticus
G40.821Epileptic spasms, not intractable, with status epilepticus
G40.822Epileptic spasms, not intractable, without status epilepticus
G40.823Epileptic spasms, intractable, with status epilepticus
G40.824Epileptic spasms, intractable, without status epilepticus
G40.833Dravet syndrome, intractable, with status epilepticus
G40.834Dravet syndrome, intractable, without status epilepticus
G40.841KCNQ2-related epilepsy, not intractable, with status epilepticus
G40.842KCNQ2-related epilepsy, not intractable, without status epilepticus
G40.843KCNQ2-related epilepsy, intractable, with status epilepticus
G40.844KCNQ2-related epilepsy, intractable, without status epilepticus
G40.89Other seizures
G40.901Epilepsy, unspecified, not intractable, with status epilepticus
G40.909Epilepsy, unspecified, not intractable, without status epilepticus
G40.911Epilepsy, unspecified, intractable, with status epilepticus
G40.919Epilepsy, unspecified, intractable, without status epilepticus
G40.A01Absence epileptic syndrome, not intractable, with status epilepticus
G40.A09Absence epileptic syndrome, not intractable, without status epilepticus
G40.A11Absence epileptic syndrome, intractable, with status epilepticus
G40.A19Absence epileptic syndrome, intractable, without status epilepticus
G40.B01Juvenile myoclonic epilepsy, not intractable, with status epilepticus
G40.B09Juvenile myoclonic epilepsy, not intractable, without status epilepticus
G40.B11Juvenile myoclonic epilepsy, intractable, with status epilepticus
G40.B19Juvenile myoclonic epilepsy, intractable, without status epilepticus
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
G51.0Bell's palsy
G51.1Geniculate ganglionitis
G51.2Melkersson's syndrome
G51.4Facial myokymia
G51.8Other disorders of facial nerve
G51.9Disorder of facial nerve, unspecified
G52.1Disorders of glossopharyngeal nerve
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
G60.0Hereditary motor and sensory neuropathy
G60.1Refsum's disease
G60.2Neuropathy in association with hereditary ataxia
G60.3Idiopathic progressive neuropathy
G60.8Other hereditary and idiopathic neuropathies
G60.9Hereditary and idiopathic neuropathy, unspecified
G61.0Guillain-Barre syndrome
G61.82Multifocal motor neuropathy
G62.0Drug-induced polyneuropathy
G62.1Alcoholic polyneuropathy
G62.2Polyneuropathy due to other toxic agents
G62.81Critical illness polyneuropathy
G70.00Myasthenia gravis without (acute) exacerbation
G70.01Myasthenia gravis with (acute) exacerbation
G70.1Toxic myoneural disorders
G70.2Congenital and developmental myasthenia
G70.80Lambert-Eaton syndrome, unspecified
G70.81Lambert-Eaton syndrome in disease classified elsewhere
G70.89Other specified myoneural disorders
G70.9Myoneural disorder, unspecified
G71.00Muscular dystrophy, unspecified
G71.01Duchenne or Becker muscular dystrophy
G71.02Facioscapulohumeral muscular dystrophy
G71.031Autosomal dominant limb girdle muscular dystrophy
G71.032Autosomal recessive limb girdle muscular dystrophy due to calpain-3 dysfunction
G71.033Limb girdle muscular dystrophy due to dysferlin dysfunction
G71.0340Limb girdle muscular dystrophy due to sarcoglycan dysfunction, unspecified
G71.0341Limb girdle muscular dystrophy due to alpha sarcoglycan dysfunction
G71.0342Limb girdle muscular dystrophy due to beta sarcoglycan dysfunction
G71.0349Limb girdle muscular dystrophy due to other sarcoglycan dysfunction
G71.035Limb girdle muscular dystrophy due to anoctamin-5 dysfunction
G71.036Limb girdle muscular dystrophy due to fukutin related protein dysfunction
G71.038Other limb girdle muscular dystrophy
G71.09Other specified muscular dystrophies
G71.11Myotonic muscular dystrophy
G71.12Myotonia congenita
G71.13Myotonic chondrodystrophy
G71.14Drug induced myotonia
G71.19Other specified myotonic disorders
G71.20Congenital myopathy, unspecified
G71.21Nemaline myopathy
G71.220X-linked myotubular myopathy
G71.228Other centronuclear myopathy
G71.29Other congenital myopathy
G72.0Drug-induced myopathy
G72.1Alcoholic myopathy
G72.2Myopathy due to other toxic agents
G72.3Periodic paralysis
G72.41Inclusion body myositis [IBM]
G72.49Other inflammatory and immune myopathies, not elsewhere classified
G72.81Critical illness myopathy
G73.1Lambert-Eaton syndrome in neoplastic disease
G80.0Spastic quadriplegic cerebral palsy
G80.1Spastic diplegic cerebral palsy
G80.2Spastic hemiplegic cerebral palsy
G80.3Athetoid cerebral palsy
G80.4Ataxic cerebral palsy
G80.8Other cerebral palsy
G80.9Cerebral palsy, unspecified
G81.01Flaccid hemiplegia affecting right dominant side

Showing the first 400 of 24447 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 97550?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 24447 ICD-10 diagnosis codes that support medical necessity for CPT 97550. 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 97550 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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