CPT J2353: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT J2353 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT J2353 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 |
|---|---|
| C25.4 | Malignant neoplasm of endocrine pancreas |
| C26.0 | Malignant neoplasm of intestinal tract, part unspecified |
| C37 | Malignant neoplasm of thymus |
| C7A.010 | Malignant carcinoid tumor of the duodenum |
| C7A.011 | Malignant carcinoid tumor of the jejunum |
| C7A.012 | Malignant carcinoid tumor of the ileum |
| C7A.019 | Malignant carcinoid tumor of the small intestine, unspecified portion |
| C7A.020 | Malignant carcinoid tumor of the appendix |
| C7A.021 | Malignant carcinoid tumor of the cecum |
| C7A.022 | Malignant carcinoid tumor of the ascending colon |
| C7A.023 | Malignant carcinoid tumor of the transverse colon |
| C7A.024 | Malignant carcinoid tumor of the descending colon |
| C7A.025 | Malignant carcinoid tumor of the sigmoid colon |
| C7A.026 | Malignant carcinoid tumor of the rectum |
| C7A.029 | Malignant carcinoid tumor of the large intestine, unspecified portion |
| C7A.090 | Malignant carcinoid tumor of the bronchus and lung |
| C7A.091 | Malignant carcinoid tumor of the thymus |
| C7A.092 | Malignant carcinoid tumor of the stomach |
| C7A.093 | Malignant carcinoid tumor of the kidney |
| C7A.094 | Malignant carcinoid tumor of the foregut, unspecified |
| C7A.095 | Malignant carcinoid tumor of the midgut, unspecified |
| C7A.096 | Malignant carcinoid tumor of the hindgut, unspecified |
| C7A.098 | Malignant carcinoid tumors of other sites |
| C7A.1 | Malignant poorly differentiated neuroendocrine tumors |
| C7A.8 | Other malignant neuroendocrine tumors |
| D13.7 | Benign neoplasm of endocrine pancreas |
| D13.91 | Familial adenomatous polyposis |
| D13.99 | Benign neoplasm of ill-defined sites within the digestive system |
| E13.641 | Other specified diabetes mellitus with hypoglycemia with coma |
| E13.649 | Other specified diabetes mellitus with hypoglycemia without coma |
| E22.0 | Acromegaly and pituitary gigantism |
| E34.00 | Carcinoid syndrome, unspecified |
| E34.01 | Carcinoid heart syndrome |
| E34.09 | Other carcinoid syndrome |
| I85.00 | Esophageal varices without bleeding |
| I85.01 | Esophageal varices with bleeding |
| I85.10 | Secondary esophageal varices without bleeding |
| I85.11 | Secondary esophageal varices with bleeding |
| K52.1 | Toxic gastroenteritis and colitis |
| K52.89 | Other specified noninfective gastroenteritis and colitis |
| K76.7 | Hepatorenal syndrome |
| K91.82 | Postprocedural hepatic failure |
| K91.83 | Postprocedural hepatorenal syndrome |
| O90.41 | Hepatorenal syndrome following labor and delivery |
| O90.49 | Other postpartum acute kidney failure |
| R19.7 | Diarrhea, unspecified |
| R79.89 | Other specified abnormal findings of blood chemistry |
| R94.7 | Abnormal results of other endocrine function studies |
| T38.895A | Adverse effect of other hormones and synthetic substitutes, initial encounter |
| T38.895D | Adverse effect of other hormones and synthetic substitutes, subsequent encounter |
| T38.895S | Adverse effect of other hormones and synthetic substitutes, sequela |
| T43.215A | Adverse effect of selective serotonin and norepinephrine reuptake inhibitors, initial encounter |
| T43.215D | Adverse effect of selective serotonin and norepinephrine reuptake inhibitors, subsequent encounter |
| T43.215S | Adverse effect of selective serotonin and norepinephrine reuptake inhibitors, sequela |
| T43.225A | Adverse effect of selective serotonin reuptake inhibitors, initial encounter |
| T43.225D | Adverse effect of selective serotonin reuptake inhibitors, subsequent encounter |
| T43.225S | Adverse effect of selective serotonin reuptake inhibitors, sequela |
| T43.641A | Poisoning by ecstasy, accidental (unintentional), initial encounter |
| T43.641D | Poisoning by ecstasy, accidental (unintentional), subsequent encounter |
| T43.641S | Poisoning by ecstasy, accidental (unintentional), sequela |
| T43.642A | Poisoning by ecstasy, intentional self-harm, initial encounter |
| T43.642D | Poisoning by ecstasy, intentional self-harm, subsequent encounter |
| T43.642S | Poisoning by ecstasy, intentional self-harm, sequela |
| T43.643A | Poisoning by ecstasy, assault, initial encounter |
| T43.643D | Poisoning by ecstasy, assault, subsequent encounter |
| T43.643S | Poisoning by ecstasy, assault, sequela |
| T43.644A | Poisoning by ecstasy, undetermined, initial encounter |
| T43.644D | Poisoning by ecstasy, undetermined, subsequent encounter |
| T43.644S | Poisoning by ecstasy, undetermined, sequela |
| T50.995A | Adverse effect of other drugs, medicaments and biological substances, initial encounter |
| T50.995D | Adverse effect of other drugs, medicaments and biological substances, subsequent encounter |
| T50.995S | Adverse effect of other drugs, medicaments and biological substances, sequela |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT J2353?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 72 ICD-10 diagnosis codes that support medical necessity for CPT J2353. 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 J2353 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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