CPT J3425: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT J3425 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT J3425 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 |
|---|---|
| D51.0 | Vitamin B12 deficiency anemia due to intrinsic factor deficiency |
| D51.1 | Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria |
| D51.2 | Transcobalamin II deficiency |
| D51.3 | Other dietary vitamin B12 deficiency anemia |
| D51.8 | Other vitamin B12 deficiency anemias |
| D51.9 | Vitamin B12 deficiency anemia, unspecified |
| D52.0 | Dietary folate deficiency anemia |
| D52.1 | Drug-induced folate deficiency anemia |
| D52.8 | Other folate deficiency anemias |
| D52.9 | Folate deficiency anemia, unspecified |
| D53.1 | Other megaloblastic anemias, not elsewhere classified |
| D53.9 | Nutritional anemia, unspecified |
| D81.818 | Other biotin-dependent carboxylase deficiency |
| D81.819 | Biotin-dependent carboxylase deficiency, unspecified |
| E40 | Kwashiorkor |
| E41 | Nutritional marasmus |
| E42 | Marasmic kwashiorkor |
| E44.1 | Mild protein-calorie malnutrition |
| E45 | Retarded development following protein-calorie malnutrition |
| E46 | Unspecified protein-calorie malnutrition |
| E53.8 | Deficiency of other specified B group vitamins |
| E64.0 | Sequelae of protein-calorie malnutrition |
| G32.0 | Subacute combined degeneration of spinal cord in diseases classified elsewhere |
| K29.30 | Chronic superficial gastritis without bleeding |
| K29.40 | Chronic atrophic gastritis without bleeding |
| K29.50 | Unspecified chronic gastritis without bleeding |
| K86.0 | Alcohol-induced chronic pancreatitis |
| K86.1 | Other chronic pancreatitis |
| K90.0 | Celiac disease |
| K90.1 | Tropical sprue |
| K90.2 | Blind loop syndrome, not elsewhere classified |
| K90.3 | Pancreatic steatorrhea |
| K90.41 | Non-celiac gluten sensitivity |
| K90.49 | Malabsorption due to intolerance, not elsewhere classified |
| K90.821 | Short bowel syndrome with colon in continuity |
| K90.822 | Short bowel syndrome without colon in continuity |
| K90.83 | Intestinal failure |
| K90.89 | Other intestinal malabsorption |
| K90.9 | Intestinal malabsorption, unspecified |
| K91.1 | Postgastric surgery syndromes |
| K91.2 | Postsurgical malabsorption, not elsewhere classified |
| 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 J3425?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 44 ICD-10 diagnosis codes that support medical necessity for CPT J3425. 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 J3425 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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