CPT J7191: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT J7191 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT J7191 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 |
|---|---|
| D66 | Hereditary factor VIII deficiency |
| D67 | Hereditary factor IX deficiency |
| D68.01 | Von Willebrand disease, type 1 |
| D68.020 | Von Willebrand disease, type 2A |
| D68.021 | Von Willebrand disease, type 2B |
| D68.022 | Von Willebrand disease, type 2M |
| D68.023 | Von Willebrand disease, type 2N |
| D68.03 | Von Willebrand disease, type 3 |
| D68.04 | Acquired von Willebrand disease |
| D68.09 | Other von Willebrand disease |
| D68.2 | Hereditary deficiency of other clotting factors |
| D68.311 | Acquired hemophilia |
| D68.318 | Other hemorrhagic disorder due to intrinsic circulating anticoagulants, antibodies, or inhibitors |
| D68.59 | Other primary thrombophilia |
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT J7191?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 14 ICD-10 diagnosis codes that support medical necessity for CPT J7191. 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 J7191 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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