CPT G2216: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT G2216 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT G2216 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 |
|---|---|
| F11.10 | Opioid abuse, uncomplicated |
| F11.11 | Opioid abuse, in remission |
| F11.120 | Opioid abuse with intoxication, uncomplicated |
| F11.121 | Opioid abuse with intoxication delirium |
| F11.122 | Opioid abuse with intoxication with perceptual disturbance |
| F11.13 | Opioid abuse with withdrawal |
| F11.14 | Opioid abuse with opioid-induced mood disorder |
| F11.150 | Opioid abuse with opioid-induced psychotic disorder with delusions |
| F11.151 | Opioid abuse with opioid-induced psychotic disorder with hallucinations |
| F11.181 | Opioid abuse with opioid-induced sexual dysfunction |
| F11.182 | Opioid abuse with opioid-induced sleep disorder |
| F11.188 | Opioid abuse with other opioid-induced disorder |
| F11.19 | Opioid abuse with unspecified opioid-induced disorder |
| F11.20 | Opioid dependence, uncomplicated |
| F11.21 | Opioid dependence, in remission |
| F11.220 | Opioid dependence with intoxication, uncomplicated |
| F11.221 | Opioid dependence with intoxication delirium |
| F11.222 | Opioid dependence with intoxication with perceptual disturbance |
| F11.23 | Opioid dependence with withdrawal |
| F11.24 | Opioid dependence with opioid-induced mood disorder |
| F11.250 | Opioid dependence with opioid-induced psychotic disorder with delusions |
| F11.251 | Opioid dependence with opioid-induced psychotic disorder with hallucinations |
| F11.281 | Opioid dependence with opioid-induced sexual dysfunction |
| F11.282 | Opioid dependence with opioid-induced sleep disorder |
| F11.288 | Opioid dependence with other opioid-induced disorder |
| F11.29 | Opioid dependence with unspecified opioid-induced disorder |
| F11.90 | Opioid use, unspecified, uncomplicated |
| F11.91 | Opioid use, unspecified, in remission |
| F11.920 | Opioid use, unspecified with intoxication, uncomplicated |
| F11.921 | Opioid use, unspecified with intoxication delirium |
| F11.922 | Opioid use, unspecified with intoxication with perceptual disturbance |
| F11.93 | Opioid use, unspecified with withdrawal |
| F11.94 | Opioid use, unspecified with opioid-induced mood disorder |
| F11.950 | Opioid use, unspecified with opioid-induced psychotic disorder with delusions |
| F11.951 | Opioid use, unspecified with opioid-induced psychotic disorder with hallucinations |
| F11.981 | Opioid use, unspecified with opioid-induced sexual dysfunction |
| F11.982 | Opioid use, unspecified with opioid-induced sleep disorder |
| F11.988 | Opioid use, unspecified with other opioid-induced disorder |
| F11.99 | Opioid use, unspecified with unspecified opioid-induced disorder |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT G2216?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 39 ICD-10 diagnosis codes that support medical necessity for CPT G2216. 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 G2216 view of that relationship.
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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