ICD↔CPT crosswalk
CPT 98942: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT 98942 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT 98942 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 |
|---|---|
| G43.009 | Migraine without aura, not intractable, without status migrainosus |
| G43.019 | Migraine without aura, intractable, without status migrainosus |
| G43.109 | Migraine with aura, not intractable, without status migrainosus |
| G43.119 | Migraine with aura, intractable, without status migrainosus |
| G43.909 | Migraine, unspecified, not intractable, without 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 |
| G44.1 | Vascular headache, not elsewhere classified |
| G44.209 | Tension-type headache, unspecified, not intractable |
| 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 |
| G54.8 | Other nerve root and plexus disorders |
| G55 | Nerve root and plexus compressions in diseases classified elsewhere |
| 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 |
| G57.21 | 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 |
| G57.91 | Unspecified mononeuropathy of right lower limb |
| G57.92 | Unspecified mononeuropathy of left lower limb |
| G57.93 | Unspecified mononeuropathy of bilateral lower limbs |
| M12.311 | Palindromic rheumatism, right shoulder |
| M12.312 | Palindromic rheumatism, left shoulder |
| M12.351 | Palindromic rheumatism, right hip |
| M12.352 | Palindromic rheumatism, left hip |
| M12.361 | Palindromic rheumatism, right knee |
| M12.362 | Palindromic rheumatism, left knee |
| M12.371 | Palindromic rheumatism, right ankle and foot |
| M12.372 | Palindromic rheumatism, left ankle and foot |
| M12.38 | Palindromic rheumatism, other specified site |
| M12.39 | Palindromic rheumatism, multiple sites |
| M12.411 | Intermittent hydrarthrosis, right shoulder |
| M12.412 | Intermittent hydrarthrosis, left shoulder |
| M12.451 | Intermittent hydrarthrosis, right hip |
| M12.452 | Intermittent hydrarthrosis, left hip |
| M12.461 | Intermittent hydrarthrosis, right knee |
| M12.462 | Intermittent hydrarthrosis, left knee |
| M12.471 | Intermittent hydrarthrosis, right ankle and foot |
| M12.472 | Intermittent hydrarthrosis, left ankle and foot |
| M12.48 | Intermittent hydrarthrosis, other site |
| M12.49 | Intermittent hydrarthrosis, multiple sites |
| M15.4 | Erosive (osteo)arthritis |
| M15.8 | Other polyosteoarthritis |
| M16.0 | Bilateral primary osteoarthritis of hip |
| M16.11 | Unilateral primary osteoarthritis, right hip |
| M16.12 | Unilateral primary osteoarthritis, left hip |
| M25.011 | Hemarthrosis, right shoulder |
| M25.012 | Hemarthrosis, left shoulder |
| M25.051 | Hemarthrosis, right hip |
| M25.052 | Hemarthrosis, left hip |
| M25.061 | Hemarthrosis, right knee |
| M25.062 | Hemarthrosis, left knee |
| M25.071 | Hemarthrosis, right ankle |
| M25.072 | Hemarthrosis, left ankle |
| M25.074 | Hemarthrosis, right foot |
| M25.075 | Hemarthrosis, left foot |
| M25.08 | Hemarthrosis, other specified site |
| M25.451 | Effusion, right hip |
| M25.452 | Effusion, left hip |
| M25.461 | Effusion, right knee |
| M25.462 | Effusion, left knee |
| M25.471 | Effusion, right ankle |
| M25.472 | Effusion, left ankle |
| M25.474 | Effusion, right foot |
| M25.475 | Effusion, left foot |
| M25.511 | Pain in right shoulder |
| M25.512 | Pain in left shoulder |
| M25.551 | Pain in right hip |
| M25.552 | Pain in left hip |
| M25.561 | Pain in right knee |
| M25.562 | Pain in left knee |
| M25.571 | Pain in right ankle and joints of right foot |
| M25.572 | Pain in left ankle and joints of left foot |
| M25.611 | Stiffness of right shoulder, not elsewhere classified |
| M25.612 | Stiffness of left shoulder, not elsewhere classified |
| M25.651 | Stiffness of right hip, not elsewhere classified |
| M25.652 | Stiffness of left hip, not elsewhere classified |
| M25.661 | Stiffness of right knee, not elsewhere classified |
| M25.662 | Stiffness of left knee, not elsewhere classified |
| M25.671 | Stiffness of right ankle, not elsewhere classified |
| M25.672 | Stiffness of left ankle, not elsewhere classified |
| M25.674 | Stiffness of right foot, not elsewhere classified |
| M25.675 | Stiffness of left foot, not elsewhere classified |
| M25.811 | Other specified joint disorders, right shoulder |
| M25.812 | Other specified joint disorders, left shoulder |
| M25.851 | Other specified joint disorders, right hip |
| M25.852 | Other specified joint disorders, left hip |
| M25.861 | Other specified joint disorders, right knee |
| M25.862 | Other specified joint disorders, left knee |
| M25.871 | Other specified joint disorders, right ankle and foot |
| M25.872 | Other specified joint disorders, left ankle and foot |
| M43.01 | Spondylolysis, occipito-atlanto-axial region |
| M43.02 | Spondylolysis, cervical region |
| M43.03 | Spondylolysis, cervicothoracic region |
| M43.04 | Spondylolysis, thoracic region |
| M43.05 | Spondylolysis, thoracolumbar region |
| M43.06 | Spondylolysis, lumbar region |
| M43.07 | Spondylolysis, lumbosacral region |
| M43.08 | Spondylolysis, sacral and sacrococcygeal region |
| M43.09 | Spondylolysis, multiple sites in spine |
| M43.11 | Spondylolisthesis, occipito-atlanto-axial region |
| M43.12 | Spondylolisthesis, cervical region |
| M43.13 | Spondylolisthesis, cervicothoracic region |
| M43.14 | Spondylolisthesis, thoracic region |
| M43.15 | Spondylolisthesis, thoracolumbar region |
| M43.16 | Spondylolisthesis, lumbar region |
| M43.17 | Spondylolisthesis, lumbosacral region |
| M43.18 | Spondylolisthesis, sacral and sacrococcygeal region |
| M43.19 | Spondylolisthesis, multiple sites in spine |
| M43.27 | Fusion of spine, lumbosacral region |
| M43.28 | Fusion of spine, sacral and sacrococcygeal region |
| M43.6 | Torticollis |
| M46.01 | Spinal enthesopathy, occipito-atlanto-axial region |
| M46.02 | Spinal enthesopathy, cervical region |
| M46.03 | Spinal enthesopathy, cervicothoracic region |
| M46.04 | Spinal enthesopathy, thoracic region |
| M46.05 | Spinal enthesopathy, thoracolumbar region |
| M46.06 | Spinal enthesopathy, lumbar region |
| M46.07 | Spinal enthesopathy, lumbosacral region |
| M46.08 | Spinal enthesopathy, sacral and sacrococcygeal region |
| M46.09 | Spinal enthesopathy, multiple sites in spine |
| M46.41 | Discitis, unspecified, occipito-atlanto-axial region |
| M46.42 | Discitis, unspecified, cervical region |
| M46.43 | Discitis, unspecified, cervicothoracic region |
| M46.44 | Discitis, unspecified, thoracic region |
| M46.45 | Discitis, unspecified, thoracolumbar region |
| M46.46 | Discitis, unspecified, lumbar region |
| M46.47 | Discitis, unspecified, lumbosacral region |
| M47.24 | Other spondylosis with radiculopathy, thoracic region |
| M47.25 | Other spondylosis with radiculopathy, thoracolumbar region |
| M47.26 | Other spondylosis with radiculopathy, lumbar region |
| M47.27 | Other spondylosis with radiculopathy, lumbosacral region |
| M47.28 | Other spondylosis with radiculopathy, sacral and sacrococcygeal region |
| M47.811 | Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region |
| M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region |
| M47.813 | Spondylosis without myelopathy or radiculopathy, cervicothoracic region |
| M47.814 | Spondylosis without myelopathy or radiculopathy, thoracic region |
| M47.815 | Spondylosis without myelopathy or radiculopathy, thoracolumbar region |
| M47.816 | Spondylosis without myelopathy or radiculopathy, lumbar region |
| M47.817 | Spondylosis without myelopathy or radiculopathy, lumbosacral region |
| M47.818 | Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region |
| M48.01 | Spinal stenosis, occipito-atlanto-axial region |
| M48.02 | Spinal stenosis, cervical region |
| M48.03 | Spinal stenosis, cervicothoracic region |
| M48.04 | Spinal stenosis, thoracic region |
| M48.05 | Spinal stenosis, thoracolumbar region |
| M48.061 | Spinal stenosis, lumbar region without neurogenic claudication |
| M48.062 | Spinal stenosis, lumbar region with neurogenic claudication |
| M48.07 | Spinal stenosis, lumbosacral region |
| M48.11 | Ankylosing hyperostosis [Forestier], occipito-atlanto-axial region |
| M48.12 | Ankylosing hyperostosis [Forestier], cervical region |
| M48.13 | Ankylosing hyperostosis [Forestier], cervicothoracic region |
| M48.14 | Ankylosing hyperostosis [Forestier], thoracic region |
| M48.15 | Ankylosing hyperostosis [Forestier], thoracolumbar region |
| M48.16 | Ankylosing hyperostosis [Forestier], lumbar region |
| M48.17 | Ankylosing hyperostosis [Forestier], lumbosacral region |
| M48.18 | Ankylosing hyperostosis [Forestier], sacral and sacrococcygeal region |
| M48.19 | Ankylosing hyperostosis [Forestier], multiple sites in spine |
| M48.31 | Traumatic spondylopathy, occipito-atlanto-axial region |
| M48.32 | Traumatic spondylopathy, cervical region |
| M48.33 | Traumatic spondylopathy, cervicothoracic region |
| M48.34 | Traumatic spondylopathy, thoracic region |
| M48.35 | Traumatic spondylopathy, thoracolumbar region |
| M48.36 | Traumatic spondylopathy, lumbar region |
| M48.37 | Traumatic spondylopathy, lumbosacral region |
| M48.38 | Traumatic spondylopathy, sacral and sacrococcygeal region |
| M50.11 | Cervical disc disorder with radiculopathy, high cervical region |
| M50.120 | Mid-cervical disc disorder, unspecified level |
| M50.121 | Cervical disc disorder at C4-C5 level with radiculopathy |
| M50.122 | Cervical disc disorder at C5-C6 level with radiculopathy |
| M50.123 | Cervical disc disorder at C6-C7 level with radiculopathy |
| M50.13 | Cervical disc disorder with radiculopathy, cervicothoracic region |
| M50.21 | Other cervical disc displacement, high cervical region |
| M50.220 | Other cervical disc displacement, mid-cervical region, unspecified level |
| M50.221 | Other cervical disc displacement at C4-C5 level |
| M50.222 | Other cervical disc displacement at C5-C6 level |
| M50.223 | Other cervical disc displacement at C6-C7 level |
| M50.23 | Other cervical disc displacement, cervicothoracic region |
| M50.31 | Other cervical disc degeneration, high cervical region |
| M50.320 | Other cervical disc degeneration, mid-cervical region, unspecified level |
| M50.321 | Other cervical disc degeneration at C4-C5 level |
| M50.322 | Other cervical disc degeneration at C5-C6 level |
| M50.323 | Other cervical disc degeneration at C6-C7 level |
| M50.33 | Other cervical disc degeneration, cervicothoracic region |
| M50.81 | Other cervical disc disorders, high cervical region |
| M50.820 | Other cervical disc disorders, mid-cervical region, unspecified level |
| M50.821 | Other cervical disc disorders at C4-C5 level |
| M50.822 | Other cervical disc disorders at C5-C6 level |
| M50.823 | Other cervical disc disorders at C6-C7 level |
| M50.83 | Other cervical disc disorders, cervicothoracic region |
| M50.91 | Cervical disc disorder, unspecified, high cervical region |
| M50.920 | Unspecified cervical disc disorder, mid-cervical region, unspecified level |
| M50.921 | Unspecified cervical disc disorder at C4-C5 level |
| M50.922 | Unspecified cervical disc disorder at C5-C6 level |
| M50.923 | Unspecified cervical disc disorder at C6-C7 level |
| M50.93 | Cervical disc disorder, unspecified, cervicothoracic region |
| M51.14 | Intervertebral disc disorders with radiculopathy, thoracic region |
| M51.15 | Intervertebral disc disorders with radiculopathy, thoracolumbar region |
| M51.16 | Intervertebral disc disorders with radiculopathy, lumbar region |
| M51.17 | Intervertebral disc disorders with radiculopathy, lumbosacral region |
| M51.24 | Other intervertebral disc displacement, thoracic region |
| M51.25 | Other intervertebral disc displacement, thoracolumbar region |
| M51.26 | Other intervertebral disc displacement, lumbar region |
| M51.27 | Other intervertebral disc displacement, lumbosacral region |
| M51.34 | Other intervertebral disc degeneration, thoracic region |
| M51.35 | Other intervertebral disc degeneration, thoracolumbar region |
| M51.360 | Other intervertebral disc degeneration, lumbar region with discogenic back pain only |
| M51.361 | Other intervertebral disc degeneration, lumbar region with lower extremity pain only |
| M51.362 | Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain |
| M51.370 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only |
| M51.371 | Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only |
| M51.372 | Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain |
| M51.84 | Other intervertebral disc disorders, thoracic region |
| M51.85 | Other intervertebral disc disorders, thoracolumbar region |
| M51.86 | Other intervertebral disc disorders, lumbar region |
| M51.87 | Other intervertebral disc disorders, lumbosacral region |
| M53.0 | Cervicocranial syndrome |
| M53.1 | Cervicobrachial syndrome |
| M53.2X7 | Spinal instabilities, lumbosacral region |
| M53.2X8 | Spinal instabilities, sacral and sacrococcygeal region |
| M53.86 | Other specified dorsopathies, lumbar region |
| M53.87 | Other specified dorsopathies, lumbosacral region |
| M53.88 | Other specified dorsopathies, sacral and sacrococcygeal region |
| M54.11 | Radiculopathy, occipito-atlanto-axial region |
| M54.12 | Radiculopathy, cervical region |
| M54.13 | Radiculopathy, cervicothoracic region |
| M54.14 | Radiculopathy, thoracic region |
| M54.15 | Radiculopathy, thoracolumbar region |
| M54.16 | Radiculopathy, lumbar region |
| M54.17 | Radiculopathy, lumbosacral region |
| M54.2 | Cervicalgia |
| M54.31 | Sciatica, right side |
| M54.32 | Sciatica, left side |
| M54.41 | Lumbago with sciatica, right side |
| M54.42 | Lumbago with sciatica, left side |
| M54.50 | Low back pain, unspecified |
| M54.51 | Vertebrogenic low back pain |
| M54.59 | Other low back pain |
| M54.6 | Pain in thoracic spine |
| M60.811 | Other myositis, right shoulder |
| M60.812 | Other myositis, left shoulder |
| M60.851 | Other myositis, right thigh |
| M60.852 | Other myositis, left thigh |
| M60.861 | Other myositis, right lower leg |
| M60.862 | Other myositis, left lower leg |
| M60.871 | Other myositis, right ankle and foot |
| M60.872 | Other myositis, left ankle and foot |
| M60.88 | Other myositis, other site |
| M60.89 | Other myositis, multiple sites |
| M62.49 | Contracture of muscle, multiple sites |
| M62.830 | Muscle spasm of back |
| M62.838 | Other muscle spasm |
| M62.85 | Dysfunction of the multifidus muscles, lumbar region |
| M79.11 | Myalgia of mastication muscle |
| M79.12 | Myalgia of auxiliary muscles, head and neck |
| M79.18 | Myalgia, other site |
| M79.7 | Fibromyalgia |
| M96.1 | Postlaminectomy syndrome, not elsewhere classified |
| M99.00 | Segmental and somatic dysfunction of head region |
| M99.01 | Segmental and somatic dysfunction of cervical region |
| M99.02 | Segmental and somatic dysfunction of thoracic region |
| M99.03 | Segmental and somatic dysfunction of lumbar region |
| M99.04 | Segmental and somatic dysfunction of sacral region |
| M99.05 | Segmental and somatic dysfunction of pelvic region |
| M99.20 | Subluxation stenosis of neural canal of head region |
| M99.21 | Subluxation stenosis of neural canal of cervical region |
| M99.22 | Subluxation stenosis of neural canal of thoracic region |
| M99.23 | Subluxation stenosis of neural canal of lumbar region |
| M99.30 | Osseous stenosis of neural canal of head region |
| M99.31 | Osseous stenosis of neural canal of cervical region |
| M99.32 | Osseous stenosis of neural canal of thoracic region |
| M99.33 | Osseous stenosis of neural canal of lumbar region |
| M99.40 | Connective tissue stenosis of neural canal of head region |
| M99.41 | Connective tissue stenosis of neural canal of cervical region |
| M99.42 | Connective tissue stenosis of neural canal of thoracic region |
| M99.43 | Connective tissue stenosis of neural canal of lumbar region |
| M99.50 | Intervertebral disc stenosis of neural canal of head region |
| M99.51 | Intervertebral disc stenosis of neural canal of cervical region |
| M99.52 | Intervertebral disc stenosis of neural canal of thoracic region |
| M99.53 | Intervertebral disc stenosis of neural canal of lumbar region |
| M99.60 | Osseous and subluxation stenosis of intervertebral foramina of head region |
| M99.61 | Osseous and subluxation stenosis of intervertebral foramina of cervical region |
| M99.62 | Osseous and subluxation stenosis of intervertebral foramina of thoracic region |
| M99.63 | Osseous and subluxation stenosis of intervertebral foramina of lumbar region |
| M99.70 | Connective tissue and disc stenosis of intervertebral foramina of head region |
| M99.71 | Connective tissue and disc stenosis of intervertebral foramina of cervical region |
| M99.72 | Connective tissue and disc stenosis of intervertebral foramina of thoracic region |
| M99.73 | Connective tissue and disc stenosis of intervertebral foramina of lumbar region |
| Q76.2 | Congenital spondylolisthesis |
| R26.2 | Difficulty in walking, not elsewhere classified |
| R29.4 | Clicking hip |
| R51.0 | Headache with orthostatic component, not elsewhere classified |
| R51.9 | Headache, unspecified |
| S13.4XXA | Sprain of ligaments of cervical spine, initial encounter |
| S13.8XXA | Sprain of joints and ligaments of other parts of neck, initial encounter |
| S16.1XXA | Strain of muscle, fascia and tendon at neck level, initial encounter |
| S23.3XXA | Sprain of ligaments of thoracic spine, initial encounter |
| S23.8XXA | Sprain of other specified parts of thorax, initial encounter |
| S29.012A | Strain of muscle and tendon of back wall of thorax, initial encounter |
| S33.5XXA | Sprain of ligaments of lumbar spine, initial encounter |
| S33.6XXA | Sprain of sacroiliac joint, initial encounter |
| S33.8XXA | Sprain of other parts of lumbar spine and pelvis, initial encounter |
| S39.012A | Strain of muscle, fascia and tendon of lower back, initial encounter |
| S39.013A | Strain of muscle, fascia and tendon of pelvis, initial encounter |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT 98942?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 315 ICD-10 diagnosis codes that support medical necessity for CPT 98942. 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 98942 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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