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ICD↔CPT crosswalk

CPT G0269: ICD-10 codes that support medical necessity

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

These ICD-10-CM diagnoses support medical necessity for CPT G0269 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT G0269 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
A18.84Tuberculosis of heart
A39.50Meningococcal carditis, unspecified
A39.51Meningococcal endocarditis
A39.52Meningococcal myocarditis
A52.02Syphilitic aortitis
A52.03Syphilitic endocarditis
A52.06Other syphilitic heart involvement
A54.83Gonococcal heart infection
A78Q fever
B33.20Viral carditis, unspecified
B33.21Viral endocarditis
B33.22Viral myocarditis
B37.6Candidal endocarditis
B39.4Histoplasmosis capsulati, unspecified
B39.5Histoplasmosis duboisii
B57.0Acute Chagas' disease with heart involvement
B57.2Chagas' disease (chronic) with heart involvement
C38.0Malignant neoplasm of heart
C45.2Mesothelioma of pericardium
D15.1Benign neoplasm of heart
D86.0Sarcoidosis of lung
D86.1Sarcoidosis of lymph nodes
D86.2Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.3Sarcoidosis of skin
D86.81Sarcoid meningitis
D86.82Multiple cranial nerve palsies in sarcoidosis
D86.83Sarcoid iridocyclitis
D86.84Sarcoid pyelonephritis
D86.85Sarcoid myocarditis
D86.86Sarcoid arthropathy
D86.87Sarcoid myositis
D86.89Sarcoidosis of other sites
D86.9Sarcoidosis, unspecified
E51.11Dry beriberi
E51.12Wet beriberi
E61.9Deficiency of nutrient element, unspecified
E63.9Nutritional deficiency, unspecified
E64.9Sequelae of unspecified nutritional deficiency
E74.00Glycogen storage disease, unspecified
E74.01von Gierke disease
E74.02Pompe disease
E74.03Cori disease
E74.04McArdle disease
E74.05Lysosome-associated membrane protein 2 [LAMP2] deficiency
E74.09Other glycogen storage disease
E74.4Disorders of pyruvate metabolism and gluconeogenesis
E76.01Hurler's syndrome
E76.02Hurler-Scheie syndrome
E76.03Scheie's syndrome
E76.1Mucopolysaccharidosis, type II
E76.210Morquio A mucopolysaccharidoses
E76.211Morquio B mucopolysaccharidoses
E76.219Morquio mucopolysaccharidoses, unspecified
E76.22Sanfilippo mucopolysaccharidoses
E76.29Other mucopolysaccharidoses
E76.3Mucopolysaccharidosis, unspecified
E76.8Other disorders of glucosaminoglycan metabolism
E76.9Glucosaminoglycan metabolism disorder, unspecified
E84.0Cystic fibrosis with pulmonary manifestations
E85.1Neuropathic heredofamilial amyloidosis
E85.2Heredofamilial amyloidosis, unspecified
E85.3Secondary systemic amyloidosis
E85.4Organ-limited amyloidosis
E85.81Light chain (AL) amyloidosis
E85.82Wild-type transthyretin-related (ATTR) amyloidosis
E85.89Other amyloidosis
E85.9Amyloidosis, unspecified
E86.0Dehydration
E86.1Hypovolemia
E86.9Volume depletion, unspecified
E87.71Transfusion associated circulatory overload
E87.79Other fluid overload
E88.810Metabolic syndrome
E88.811Insulin resistance syndrome, Type A
E88.818Other insulin resistance
E88.819Insulin resistance, unspecified
E88.82Obesity due to disruption of MC4R pathway
E88.9Metabolic disorder, unspecified
G11.10Early-onset cerebellar ataxia, unspecified
G11.11Friedreich ataxia
G45.8Other transient cerebral ischemic attacks and related syndromes
G45.9Transient cerebral ischemic attack, 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
I01.0Acute rheumatic pericarditis
I01.1Acute rheumatic endocarditis
I01.2Acute rheumatic myocarditis
I01.8Other acute rheumatic heart disease
I01.9Acute rheumatic heart disease, unspecified
I05.0Rheumatic mitral stenosis
I05.1Rheumatic mitral insufficiency
I05.2Rheumatic mitral stenosis with insufficiency
I05.8Other rheumatic mitral valve diseases
I05.9Rheumatic mitral valve disease, unspecified
I06.0Rheumatic aortic stenosis
I06.1Rheumatic aortic insufficiency
I06.2Rheumatic aortic stenosis with insufficiency
I06.8Other rheumatic aortic valve diseases
I06.9Rheumatic aortic valve disease, unspecified
I07.0Rheumatic tricuspid stenosis
I07.1Rheumatic tricuspid insufficiency
I07.2Rheumatic tricuspid stenosis and insufficiency
I07.8Other rheumatic tricuspid valve diseases
I07.9Rheumatic tricuspid valve disease, unspecified
I08.0Rheumatic disorders of both mitral and aortic valves
I08.1Rheumatic disorders of both mitral and tricuspid valves
I08.2Rheumatic disorders of both aortic and tricuspid valves
I08.3Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8Other rheumatic multiple valve diseases
I08.9Rheumatic multiple valve disease, unspecified
I09.0Rheumatic myocarditis
I09.1Rheumatic diseases of endocardium, valve unspecified
I09.2Chronic rheumatic pericarditis
I09.81Rheumatic heart failure
I09.89Other specified rheumatic heart diseases
I09.9Rheumatic heart disease, unspecified
I10Essential (primary) hypertension
I11.0Hypertensive heart disease with heart failure
I11.9Hypertensive heart disease without heart failure
I12.0Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
I12.9Hypertensive chronic kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.0Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.10Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.11Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I13.2Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I15.0Renovascular hypertension
I15.1Hypertension secondary to other renal disorders
I16.0Hypertensive urgency
I16.1Hypertensive emergency
I16.9Hypertensive crisis, unspecified
I20.0Unstable angina
I20.1Angina pectoris with documented spasm
I20.81Angina pectoris with coronary microvascular dysfunction
I20.89Other forms of angina pectoris
I20.9Angina pectoris, unspecified
I21.01ST elevation (STEMI) myocardial infarction involving left main coronary artery
I21.02ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29ST elevation (STEMI) myocardial infarction involving other sites
I21.3ST elevation (STEMI) myocardial infarction of unspecified site
I21.4Non-ST elevation (NSTEMI) myocardial infarction
I21.9Acute myocardial infarction, unspecified
I21.A1Myocardial infarction type 2
I21.A9Other myocardial infarction type
I22.0Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8Subsequent ST elevation (STEMI) myocardial infarction of other sites
I22.9Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
I23.0Hemopericardium as current complication following acute myocardial infarction
I23.1Atrial septal defect as current complication following acute myocardial infarction
I23.2Ventricular septal defect as current complication following acute myocardial infarction
I23.3Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
I23.4Rupture of chordae tendineae as current complication following acute myocardial infarction
I23.5Rupture of papillary muscle as current complication following acute myocardial infarction
I23.6Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
I23.7Postinfarction angina
I23.8Other current complications following acute myocardial infarction
I24.0Acute coronary thrombosis not resulting in myocardial infarction
I24.1Dressler's syndrome
I24.81Acute coronary microvascular dysfunction
I24.89Other forms of acute ischemic heart disease
I24.9Acute ischemic heart disease, unspecified
I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.112Atherosclerotic heart disease of native coronary artery with refractory angina pectoris
I25.118Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2Old myocardial infarction
I25.3Aneurysm of heart
I25.41Coronary artery aneurysm
I25.42Coronary artery dissection
I25.5Ischemic cardiomyopathy
I25.6Silent myocardial ischemia
I25.700Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.702Atherosclerosis of coronary artery bypass graft(s), unspecified, with refractory angina pectoris
I25.708Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.712Atherosclerosis of autologous vein coronary artery bypass graft(s) with refractory angina pectoris
I25.718Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.722Atherosclerosis of autologous artery coronary artery bypass graft(s) with refractory angina pectoris
I25.728Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.732Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with refractory angina pectoris
I25.738Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
I25.752Atherosclerosis of native coronary artery of transplanted heart with refractory angina pectoris
I25.758Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.762Atherosclerosis of bypass graft of coronary artery of transplanted heart with refractory angina pectoris
I25.768Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.792Atherosclerosis of other coronary artery bypass graft(s) with refractory angina pectoris
I25.798Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.810Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82Chronic total occlusion of coronary artery
I25.83Coronary atherosclerosis due to lipid rich plaque
I25.84Coronary atherosclerosis due to calcified coronary lesion
I25.85Chronic coronary microvascular dysfunction
I25.89Other forms of chronic ischemic heart disease
I25.9Chronic ischemic heart disease, unspecified
I26.01Septic pulmonary embolism with acute cor pulmonale
I26.02Saddle embolus of pulmonary artery with acute cor pulmonale
I26.03Cement embolism of pulmonary artery with acute cor pulmonale
I26.04Fat embolism of pulmonary artery with acute cor pulmonale
I26.09Other pulmonary embolism with acute cor pulmonale
I26.90Septic pulmonary embolism without acute cor pulmonale
I26.92Saddle embolus of pulmonary artery without acute cor pulmonale
I26.93Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale
I26.94Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale
I26.95Cement embolism of pulmonary artery without acute cor pulmonale
I26.96Fat embolism of pulmonary artery without acute cor pulmonale
I26.99Other pulmonary embolism without acute cor pulmonale
I27.0Primary pulmonary hypertension
I27.1Kyphoscoliotic heart disease
I27.20Pulmonary hypertension, unspecified
I27.21Secondary pulmonary arterial hypertension
I27.22Pulmonary hypertension due to left heart disease
I27.23Pulmonary hypertension due to lung diseases and hypoxia
I27.24Chronic thromboembolic pulmonary hypertension
I27.29Other secondary pulmonary hypertension
I27.81Cor pulmonale (chronic)
I27.82Chronic pulmonary embolism
I27.83Eisenmenger's syndrome
I27.840Fontan-associated liver disease [FALD]
I27.841Fontan-associated lymphatic dysfunction
I27.848Other Fontan-associated condition
I27.89Other specified pulmonary heart diseases
I27.9Pulmonary heart disease, unspecified
I28.0Arteriovenous fistula of pulmonary vessels
I28.1Aneurysm of pulmonary artery
I28.8Other diseases of pulmonary vessels
I28.9Disease of pulmonary vessels, unspecified
I30.0Acute nonspecific idiopathic pericarditis
I30.1Infective pericarditis
I30.8Other forms of acute pericarditis
I30.9Acute pericarditis, unspecified
I31.0Chronic adhesive pericarditis
I31.1Chronic constrictive pericarditis
I31.2Hemopericardium, not elsewhere classified
I31.31Malignant pericardial effusion in diseases classified elsewhere
I31.39Other pericardial effusion (noninflammatory)
I31.4Cardiac tamponade
I31.8Other specified diseases of pericardium
I31.9Disease of pericardium, unspecified
I32Pericarditis in diseases classified elsewhere
I33.0Acute and subacute infective endocarditis
I33.9Acute and subacute endocarditis, unspecified
I34.0Nonrheumatic mitral (valve) insufficiency
I34.1Nonrheumatic mitral (valve) prolapse
I34.2Nonrheumatic mitral (valve) stenosis
I34.81Nonrheumatic mitral (valve) annulus calcification
I34.89Other nonrheumatic mitral valve disorders
I34.9Nonrheumatic mitral valve disorder, unspecified
I35.0Nonrheumatic aortic (valve) stenosis
I35.1Nonrheumatic aortic (valve) insufficiency
I35.2Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8Other nonrheumatic aortic valve disorders
I35.9Nonrheumatic aortic valve disorder, unspecified
I36.0Nonrheumatic tricuspid (valve) stenosis
I36.1Nonrheumatic tricuspid (valve) insufficiency
I36.2Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.8Other nonrheumatic tricuspid valve disorders
I36.9Nonrheumatic tricuspid valve disorder, unspecified
I37.0Nonrheumatic pulmonary valve stenosis
I37.1Nonrheumatic pulmonary valve insufficiency
I37.2Nonrheumatic pulmonary valve stenosis with insufficiency
I37.8Other nonrheumatic pulmonary valve disorders
I37.9Nonrheumatic pulmonary valve disorder, unspecified
I38Endocarditis, valve unspecified
I39Endocarditis and heart valve disorders in diseases classified elsewhere
I40.0Infective myocarditis
I40.1Isolated myocarditis
I40.8Other acute myocarditis
I40.9Acute myocarditis, unspecified
I41Myocarditis in diseases classified elsewhere
I42.0Dilated cardiomyopathy
I42.1Obstructive hypertrophic cardiomyopathy
I42.2Other hypertrophic cardiomyopathy
I42.3Endomyocardial (eosinophilic) disease
I42.4Endocardial fibroelastosis
I42.5Other restrictive cardiomyopathy
I42.6Alcoholic cardiomyopathy
I42.7Cardiomyopathy due to drug and external agent
I42.8Other cardiomyopathies
I42.9Cardiomyopathy, unspecified
I43Cardiomyopathy in diseases classified elsewhere
I46.2Cardiac arrest due to underlying cardiac condition
I46.8Cardiac arrest due to other underlying condition
I46.9Cardiac arrest, cause unspecified
I47.0Re-entry ventricular arrhythmia
I47.20Ventricular tachycardia, unspecified
I47.21Torsades de pointes
I47.29Other ventricular tachycardia
I47.9Paroxysmal tachycardia, unspecified
I49.01Ventricular fibrillation
I49.02Ventricular flutter
I50.1Left ventricular failure, unspecified
I50.20Unspecified systolic (congestive) heart failure
I50.21Acute systolic (congestive) heart failure
I50.22Chronic systolic (congestive) heart failure
I50.23Acute on chronic systolic (congestive) heart failure
I50.30Unspecified diastolic (congestive) heart failure
I50.31Acute diastolic (congestive) heart failure
I50.32Chronic diastolic (congestive) heart failure
I50.33Acute on chronic diastolic (congestive) heart failure
I50.40Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.810Right heart failure, unspecified
I50.811Acute right heart failure
I50.812Chronic right heart failure
I50.813Acute on chronic right heart failure
I50.814Right heart failure due to left heart failure
I50.82Biventricular heart failure
I50.83High output heart failure
I50.84End stage heart failure
I50.89Other heart failure
I50.9Heart failure, unspecified
I51.0Cardiac septal defect, acquired
I51.1Rupture of chordae tendineae, not elsewhere classified
I51.2Rupture of papillary muscle, not elsewhere classified
I51.3Intracardiac thrombosis, not elsewhere classified
I51.4Myocarditis, unspecified
I51.5Myocardial degeneration
I51.7Cardiomegaly
I51.81Takotsubo syndrome
I51.89Other ill-defined heart diseases
I63.031Cerebral infarction due to thrombosis of right carotid artery
I63.032Cerebral infarction due to thrombosis of left carotid artery
I63.039Cerebral infarction due to thrombosis of unspecified carotid artery
I63.131Cerebral infarction due to embolism of right carotid artery
I63.132Cerebral infarction due to embolism of left carotid artery
I63.139Cerebral infarction due to embolism of unspecified carotid artery
I63.231Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries
I63.232Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries
I63.59Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I65.21Occlusion and stenosis of right carotid artery
I65.22Occlusion and stenosis of left carotid artery
I65.23Occlusion and stenosis of bilateral carotid arteries
I65.8Occlusion and stenosis of other precerebral arteries
I67.0Dissection of cerebral arteries, nonruptured
I67.841Reversible cerebrovascular vasoconstriction syndrome
I67.848Other cerebrovascular vasospasm and vasoconstriction
I67.850Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
I67.858Other hereditary cerebrovascular disease
I70.0Atherosclerosis of aorta
I70.1Atherosclerosis of renal artery
I70.211Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
I70.212Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
I70.213Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
I70.218Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
I70.221Atherosclerosis of native arteries of extremities with rest pain, right leg
I70.222Atherosclerosis of native arteries of extremities with rest pain, left leg
I70.223Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
I70.228Atherosclerosis of native arteries of extremities with rest pain, other extremity
I70.231Atherosclerosis of native arteries of right leg with ulceration of thigh
I70.232Atherosclerosis of native arteries of right leg with ulceration of calf
I70.233Atherosclerosis of native arteries of right leg with ulceration of ankle
I70.234Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
I70.235Atherosclerosis of native arteries of right leg with ulceration of other part of foot
I70.238Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
I70.239Atherosclerosis of native arteries of right leg with ulceration of unspecified site
I70.241Atherosclerosis of native arteries of left leg with ulceration of thigh
I70.242Atherosclerosis of native arteries of left leg with ulceration of calf

Showing the first 400 of 813 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 G0269?

Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 813 ICD-10 diagnosis codes that support medical necessity for CPT G0269. 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 G0269 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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