CPT J1072: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT J1072 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT J1072 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 |
|---|---|
| D35.2 | Benign neoplasm of pituitary gland |
| D44.3 | Neoplasm of uncertain behavior of pituitary gland |
| E23.0 | Hypopituitarism |
| E23.1 | Drug-induced hypopituitarism |
| E23.3 | Hypothalamic dysfunction, not elsewhere classified |
| E23.6 | Other disorders of pituitary gland |
| E23.7 | Disorder of pituitary gland, unspecified |
| E29.1 | Testicular hypofunction |
| E29.8 | Other testicular dysfunction |
| E30.0 | Delayed puberty |
| E89.5 | Postprocedural testicular hypofunction |
| F64.0 | Transsexualism |
| F64.1 | Dual role transvestism |
| F64.2 | Gender identity disorder of childhood |
| F64.8 | Other gender identity disorders |
| F64.9 | Gender identity disorder, unspecified |
| N44.00 | Torsion of testis, unspecified |
| N44.01 | Extravaginal torsion of spermatic cord |
| N44.02 | Intravaginal torsion of spermatic cord |
| N44.03 | Torsion of appendix testis |
| N44.04 | Torsion of appendix epididymis |
| N45.2 | Orchitis |
| N50.89 | Other specified disorders of the male genital organs |
| Q53.00 | Ectopic testis, unspecified |
| Q53.01 | Ectopic testis, unilateral |
| Q53.02 | Ectopic testes, bilateral |
| Q53.10 | Unspecified undescended testicle, unilateral |
| Q53.111 | Unilateral intraabdominal testis |
| Q53.112 | Unilateral inguinal testis |
| Q53.12 | Ectopic perineal testis, unilateral |
| Q53.20 | Undescended testicle, unspecified, bilateral |
| Q53.211 | Bilateral intraabdominal testes |
| Q53.212 | Bilateral inguinal testes |
| Q53.22 | Ectopic perineal testis, bilateral |
| Q53.9 | Undescended testicle, unspecified |
| Q55.0 | Absence and aplasia of testis |
| Z79.890 | Hormone replacement therapy |
| Z87.8904 | Personal history of intersex surgery |
| Z90.79 | Acquired absence of other genital organ(s) |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT J1072?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 39 ICD-10 diagnosis codes that support medical necessity for CPT J1072. 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 J1072 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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