ICD↔CPT crosswalk
CPT Q5166: ICD-10 codes that support medical necessity
These ICD-10-CM diagnoses support medical necessity for CPT Q5166 under Medicare coverage policies (LCDs, NCDs, and Billing & Coding articles). Billing CPT Q5166 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 |
|---|---|
| C33 | Malignant neoplasm of trachea |
| C34.00 | Malignant neoplasm of unspecified main bronchus |
| C34.01 | Malignant neoplasm of right main bronchus |
| C34.02 | Malignant neoplasm of left main bronchus |
| C34.10 | Malignant neoplasm of upper lobe, unspecified bronchus or lung |
| C34.11 | Malignant neoplasm of upper lobe, right bronchus or lung |
| C34.12 | Malignant neoplasm of upper lobe, left bronchus or lung |
| C34.2 | Malignant neoplasm of middle lobe, bronchus or lung |
| C34.30 | Malignant neoplasm of lower lobe, unspecified bronchus or lung |
| C34.31 | Malignant neoplasm of lower lobe, right bronchus or lung |
| C34.32 | Malignant neoplasm of lower lobe, left bronchus or lung |
| C34.80 | Malignant neoplasm of overlapping sites of unspecified bronchus and lung |
| C34.81 | Malignant neoplasm of overlapping sites of right bronchus and lung |
| C34.82 | Malignant neoplasm of overlapping sites of left bronchus and lung |
| C34.90 | Malignant neoplasm of unspecified part of unspecified bronchus or lung |
| C34.91 | Malignant neoplasm of unspecified part of right bronchus or lung |
| C34.92 | Malignant neoplasm of unspecified part of left bronchus or lung |
| C40.01 | Malignant neoplasm of scapula and long bones of right upper limb |
| C40.02 | Malignant neoplasm of scapula and long bones of left upper limb |
| C40.11 | Malignant neoplasm of short bones of right upper limb |
| C40.12 | Malignant neoplasm of short bones of left upper limb |
| C40.21 | Malignant neoplasm of long bones of right lower limb |
| C40.22 | Malignant neoplasm of long bones of left lower limb |
| C40.31 | Malignant neoplasm of short bones of right lower limb |
| C40.32 | Malignant neoplasm of short bones of left lower limb |
| C40.81 | Malignant neoplasm of overlapping sites of bone and articular cartilage of right limb |
| C40.82 | Malignant neoplasm of overlapping sites of bone and articular cartilage of left limb |
| C40.91 | Malignant neoplasm of unspecified bones and articular cartilage of right limb |
| C40.92 | Malignant neoplasm of unspecified bones and articular cartilage of left limb |
| C41.9 | Malignant neoplasm of bone and articular cartilage, unspecified |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast |
| C50.111 | Malignant neoplasm of central portion of right female breast |
| C50.112 | Malignant neoplasm of central portion of left female breast |
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast |
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast |
| C50.311 | Malignant neoplasm of lower-inner quadrant of right female breast |
| C50.312 | Malignant neoplasm of lower-inner quadrant of left female breast |
| C50.411 | Malignant neoplasm of upper-outer quadrant of right female breast |
| C50.412 | Malignant neoplasm of upper-outer quadrant of left female breast |
| C50.511 | Malignant neoplasm of lower-outer quadrant of right female breast |
| C50.512 | Malignant neoplasm of lower-outer quadrant of left female breast |
| C50.611 | Malignant neoplasm of axillary tail of right female breast |
| C50.612 | Malignant neoplasm of axillary tail of left female breast |
| C50.811 | Malignant neoplasm of overlapping sites of right female breast |
| C50.812 | Malignant neoplasm of overlapping sites of left female breast |
| C50.911 | Malignant neoplasm of unspecified site of right female breast |
| C50.912 | Malignant neoplasm of unspecified site of left female breast |
| C50.A1 | Malignant inflammatory neoplasm of right breast |
| C50.A2 | Malignant inflammatory neoplasm of left breast |
| C61 | Malignant neoplasm of prostate |
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis |
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis |
| C64.9 | Malignant neoplasm of unspecified kidney, except renal pelvis |
| C65.1 | Malignant neoplasm of right renal pelvis |
| C65.2 | Malignant neoplasm of left renal pelvis |
| C65.9 | Malignant neoplasm of unspecified renal pelvis |
| C73 | Malignant neoplasm of thyroid gland |
| C79.51 | Secondary malignant neoplasm of bone |
| C90.00 | Multiple myeloma not having achieved remission |
| C90.01 | Multiple myeloma in remission |
| C90.02 | Multiple myeloma in relapse |
| C90.10 | Plasma cell leukemia not having achieved remission |
| C90.11 | Plasma cell leukemia in remission |
| C90.12 | Plasma cell leukemia in relapse |
| C90.20 | Extramedullary plasmacytoma not having achieved remission |
| C90.21 | Extramedullary plasmacytoma in remission |
| C90.22 | Extramedullary plasmacytoma in relapse |
| C90.30 | Solitary plasmacytoma not having achieved remission |
| C90.31 | Solitary plasmacytoma in remission |
| C90.32 | Solitary plasmacytoma in relapse |
| D05.01 | Lobular carcinoma in situ of right breast |
| D05.02 | Lobular carcinoma in situ of left breast |
| D05.11 | Intraductal carcinoma in situ of right breast |
| D05.12 | Intraductal carcinoma in situ of left breast |
| D05.81 | Other specified type of carcinoma in situ of right breast |
| D05.82 | Other specified type of carcinoma in situ of left breast |
| D05.91 | Unspecified type of carcinoma in situ of right breast |
| D05.92 | Unspecified type of carcinoma in situ of left breast |
| D48.0 | Neoplasm of uncertain behavior of bone and articular cartilage |
| E83.52 | Hypercalcemia |
| M80.011A | Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture |
| M80.011D | Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing |
| M80.011G | Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing |
| M80.011K | Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion |
| M80.011P | Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion |
| M80.011S | Age-related osteoporosis with current pathological fracture, right shoulder, sequela |
| M80.012A | Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture |
| M80.012D | Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing |
| M80.012G | Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing |
| M80.012K | Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion |
| M80.012P | Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion |
| M80.012S | Age-related osteoporosis with current pathological fracture, left shoulder, sequela |
| M80.021A | Age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture |
| M80.021D | Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing |
| M80.021G | Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing |
| M80.021K | Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion |
| M80.021P | Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion |
| M80.021S | Age-related osteoporosis with current pathological fracture, right humerus, sequela |
| M80.022A | Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture |
| M80.022D | Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing |
| M80.022G | Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing |
| M80.022K | Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion |
| M80.022P | Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion |
| M80.022S | Age-related osteoporosis with current pathological fracture, left humerus, sequela |
| M80.031A | Age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture |
| M80.031D | Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing |
| M80.031G | Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing |
| M80.031K | Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion |
| M80.031P | Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion |
| M80.031S | Age-related osteoporosis with current pathological fracture, right forearm, sequela |
| M80.032A | Age-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture |
| M80.032D | Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing |
| M80.032G | Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing |
| M80.032K | Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion |
| M80.032P | Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion |
| M80.032S | Age-related osteoporosis with current pathological fracture, left forearm, sequela |
| M80.041A | Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture |
| M80.041D | Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing |
| M80.041G | Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing |
| M80.041K | Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion |
| M80.041P | Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion |
| M80.041S | Age-related osteoporosis with current pathological fracture, right hand, sequela |
| M80.042A | Age-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture |
| M80.042D | Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing |
| M80.042G | Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing |
| M80.042K | Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion |
| M80.042P | Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion |
| M80.042S | Age-related osteoporosis with current pathological fracture, left hand, sequela |
| M80.051A | Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture |
| M80.051D | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing |
| M80.051G | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing |
| M80.051K | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion |
| M80.051P | Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion |
| M80.051S | Age-related osteoporosis with current pathological fracture, right femur, sequela |
| M80.052A | Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture |
| M80.052D | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing |
| M80.052G | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing |
| M80.052K | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion |
| M80.052P | Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion |
| M80.052S | Age-related osteoporosis with current pathological fracture, left femur, sequela |
| M80.061A | Age-related osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture |
| M80.061D | Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing |
| M80.061G | Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing |
| M80.061K | Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion |
| M80.061P | Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion |
| M80.061S | Age-related osteoporosis with current pathological fracture, right lower leg, sequela |
| M80.062A | Age-related osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture |
| M80.062D | Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing |
| M80.062G | Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing |
| M80.062K | Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion |
| M80.062P | Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion |
| M80.062S | Age-related osteoporosis with current pathological fracture, left lower leg, sequela |
| M80.071A | Age-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture |
| M80.071D | Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing |
| M80.071G | Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing |
| M80.071K | Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion |
| M80.071P | Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion |
| M80.071S | Age-related osteoporosis with current pathological fracture, right ankle and foot, sequela |
| M80.072A | Age-related osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture |
| M80.072D | Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing |
| M80.072G | Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing |
| M80.072K | Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion |
| M80.072P | Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion |
| M80.072S | Age-related osteoporosis with current pathological fracture, left ankle and foot, sequela |
| M80.08XA | Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture |
| M80.08XD | Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing |
| M80.08XG | Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing |
| M80.08XK | Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion |
| M80.08XP | Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion |
| M80.08XS | Age-related osteoporosis with current pathological fracture, vertebra(e), sequela |
| M80.0AXA | Age-related osteoporosis with current pathological fracture, other site, initial encounter for fracture |
| M80.0AXD | Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing |
| M80.0AXG | Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healing |
| M80.0AXK | Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion |
| M80.0AXP | Age-related osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with malunion |
| M80.0AXS | Age-related osteoporosis with current pathological fracture, other site, sequela |
| M80.0B1A | Age-related osteoporosis with current pathological fracture, right pelvis, initial encounter for fracture |
| M80.0B1D | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with routine healing |
| M80.0B1G | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with delayed healing |
| M80.0B1K | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with nonunion |
| M80.0B1P | Age-related osteoporosis with current pathological fracture, right pelvis, subsequent encounter for fracture with malunion |
| M80.0B1S | Age-related osteoporosis with current pathological fracture, right pelvis, sequela |
| M80.0B2A | Age-related osteoporosis with current pathological fracture, left pelvis, initial encounter for fracture |
| M80.0B2D | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with routine healing |
| M80.0B2G | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with delayed healing |
| M80.0B2K | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with nonunion |
| M80.0B2P | Age-related osteoporosis with current pathological fracture, left pelvis, subsequent encounter for fracture with malunion |
| M80.0B2S | Age-related osteoporosis with current pathological fracture, left pelvis, sequela |
| M80.811A | Other osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture |
| M80.811D | Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing |
| M80.811G | Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing |
| M80.811K | Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion |
| M80.811P | Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion |
| M80.811S | Other osteoporosis with current pathological fracture, right shoulder, sequela |
| M80.812A | Other osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture |
| M80.812D | Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing |
| M80.812G | Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing |
| M80.812K | Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion |
| M80.812P | Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion |
| M80.812S | Other osteoporosis with current pathological fracture, left shoulder, sequela |
| M80.821A | Other osteoporosis with current pathological fracture, right humerus, initial encounter for fracture |
| M80.821D | Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing |
| M80.821G | Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing |
| M80.821K | Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion |
| M80.821P | Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion |
| M80.821S | Other osteoporosis with current pathological fracture, right humerus, sequela |
| M80.822A | Other osteoporosis with current pathological fracture, left humerus, initial encounter for fracture |
| M80.822D | Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing |
| M80.822G | Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing |
| M80.822K | Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion |
| M80.822P | Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion |
| M80.822S | Other osteoporosis with current pathological fracture, left humerus, sequela |
| M80.831A | Other osteoporosis with current pathological fracture, right forearm, initial encounter for fracture |
| M80.831D | Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing |
| M80.831G | Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing |
| M80.831K | Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion |
| M80.831P | Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion |
| M80.831S | Other osteoporosis with current pathological fracture, right forearm, sequela |
| M80.832A | Other osteoporosis with current pathological fracture, left forearm, initial encounter for fracture |
| M80.832D | Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing |
| M80.832G | Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing |
| M80.832K | Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion |
| M80.832P | Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion |
| M80.832S | Other osteoporosis with current pathological fracture, left forearm, sequela |
| M80.841A | Other osteoporosis with current pathological fracture, right hand, initial encounter for fracture |
| M80.841D | Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing |
| M80.841G | Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing |
| M80.841K | Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion |
| M80.841P | Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion |
| M80.841S | Other osteoporosis with current pathological fracture, right hand, sequela |
| M80.842A | Other osteoporosis with current pathological fracture, left hand, initial encounter for fracture |
| M80.842D | Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing |
| M80.842G | Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing |
| M80.842K | Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion |
| M80.842P | Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion |
| M80.842S | Other osteoporosis with current pathological fracture, left hand, sequela |
| M80.851A | Other osteoporosis with current pathological fracture, right femur, initial encounter for fracture |
| M80.851D | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing |
| M80.851G | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing |
| M80.851K | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion |
| M80.851P | Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion |
| M80.851S | Other osteoporosis with current pathological fracture, right femur, sequela |
| M80.852A | Other osteoporosis with current pathological fracture, left femur, initial encounter for fracture |
| M80.852D | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing |
| M80.852G | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing |
| M80.852K | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion |
| M80.852P | Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion |
| M80.852S | Other osteoporosis with current pathological fracture, left femur, sequela |
| M80.861A | Other osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture |
| M80.861D | Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing |
| M80.861G | Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing |
| M80.861K | Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion |
| M80.861P | Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion |
| M80.861S | Other osteoporosis with current pathological fracture, right lower leg, sequela |
| M80.862A | Other osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture |
| M80.862D | Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing |
| M80.862G | Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing |
| M80.862K | Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion |
| M80.862P | Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion |
| M80.862S | Other osteoporosis with current pathological fracture, left lower leg, sequela |
| M80.871A | Other osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture |
| M80.871D | Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing |
| M80.871G | Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing |
| M80.871K | Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion |
| M80.871P | Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion |
| M80.871S | Other osteoporosis with current pathological fracture, right ankle and foot, sequela |
| M80.872A | Other osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture |
| M80.872D | Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing |
| M80.872G | Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing |
| M80.872K | Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion |
| M80.872P | Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion |
| M80.872S | Other osteoporosis with current pathological fracture, left ankle and foot, sequela |
| M80.88XA | Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture |
| M80.88XD | Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing |
| M80.88XG | Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing |
| M80.88XK | Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion |
| M80.88XP | Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion |
| M80.88XS | Other osteoporosis with current pathological fracture, vertebra(e), sequela |
| M80.8AXA | Other osteoporosis with current pathological fracture, other site, initial encounter for fracture |
| M80.8AXD | Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with routine healing |
| M80.8AXG | Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with delayed healing |
| M80.8AXK | Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with nonunion |
| M80.8AXP | Other osteoporosis with current pathological fracture, other site, subsequent encounter for fracture with malunion |
| M80.8AXS | Other osteoporosis with current pathological fracture, other site, sequela |
| M81.0 | Age-related osteoporosis without current pathological fracture |
| M81.8 | Other osteoporosis without current pathological fracture |
| M84.511A | Pathological fracture in neoplastic disease, right shoulder, initial encounter for fracture |
| M84.511D | Pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with routine healing |
| M84.511G | Pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with delayed healing |
| M84.511K | Pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with nonunion |
| M84.511P | Pathological fracture in neoplastic disease, right shoulder, subsequent encounter for fracture with malunion |
| M84.511S | Pathological fracture in neoplastic disease, right shoulder, sequela |
| M84.512A | Pathological fracture in neoplastic disease, left shoulder, initial encounter for fracture |
| M84.512D | Pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with routine healing |
| M84.512G | Pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with delayed healing |
| M84.512K | Pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with nonunion |
| M84.512P | Pathological fracture in neoplastic disease, left shoulder, subsequent encounter for fracture with malunion |
| M84.512S | Pathological fracture in neoplastic disease, left shoulder, sequela |
| M84.521A | Pathological fracture in neoplastic disease, right humerus, initial encounter for fracture |
| M84.521D | Pathological fracture in neoplastic disease, right humerus, subsequent encounter for fracture with routine healing |
| M84.521G | Pathological fracture in neoplastic disease, right humerus, subsequent encounter for fracture with delayed healing |
| M84.521K | Pathological fracture in neoplastic disease, right humerus, subsequent encounter for fracture with nonunion |
| M84.521P | Pathological fracture in neoplastic disease, right humerus, subsequent encounter for fracture with malunion |
| M84.521S | Pathological fracture in neoplastic disease, right humerus, sequela |
| M84.522A | Pathological fracture in neoplastic disease, left humerus, initial encounter for fracture |
| M84.522D | Pathological fracture in neoplastic disease, left humerus, subsequent encounter for fracture with routine healing |
| M84.522G | Pathological fracture in neoplastic disease, left humerus, subsequent encounter for fracture with delayed healing |
| M84.522K | Pathological fracture in neoplastic disease, left humerus, subsequent encounter for fracture with nonunion |
| M84.522P | Pathological fracture in neoplastic disease, left humerus, subsequent encounter for fracture with malunion |
| M84.522S | Pathological fracture in neoplastic disease, left humerus, sequela |
| M84.531A | Pathological fracture in neoplastic disease, right ulna, initial encounter for fracture |
| M84.531D | Pathological fracture in neoplastic disease, right ulna, subsequent encounter for fracture with routine healing |
| M84.531G | Pathological fracture in neoplastic disease, right ulna, subsequent encounter for fracture with delayed healing |
| M84.531K | Pathological fracture in neoplastic disease, right ulna, subsequent encounter for fracture with nonunion |
| M84.531P | Pathological fracture in neoplastic disease, right ulna, subsequent encounter for fracture with malunion |
| M84.531S | Pathological fracture in neoplastic disease, right ulna, sequela |
| M84.532A | Pathological fracture in neoplastic disease, left ulna, initial encounter for fracture |
| M84.532D | Pathological fracture in neoplastic disease, left ulna, subsequent encounter for fracture with routine healing |
| M84.532G | Pathological fracture in neoplastic disease, left ulna, subsequent encounter for fracture with delayed healing |
| M84.532K | Pathological fracture in neoplastic disease, left ulna, subsequent encounter for fracture with nonunion |
| M84.532P | Pathological fracture in neoplastic disease, left ulna, subsequent encounter for fracture with malunion |
| M84.532S | Pathological fracture in neoplastic disease, left ulna, sequela |
| M84.533A | Pathological fracture in neoplastic disease, right radius, initial encounter for fracture |
| M84.533D | Pathological fracture in neoplastic disease, right radius, subsequent encounter for fracture with routine healing |
| M84.533G | Pathological fracture in neoplastic disease, right radius, subsequent encounter for fracture with delayed healing |
| M84.533K | Pathological fracture in neoplastic disease, right radius, subsequent encounter for fracture with nonunion |
| M84.533P | Pathological fracture in neoplastic disease, right radius, subsequent encounter for fracture with malunion |
| M84.533S | Pathological fracture in neoplastic disease, right radius, sequela |
| M84.534A | Pathological fracture in neoplastic disease, left radius, initial encounter for fracture |
| M84.534D | Pathological fracture in neoplastic disease, left radius, subsequent encounter for fracture with routine healing |
| M84.534G | Pathological fracture in neoplastic disease, left radius, subsequent encounter for fracture with delayed healing |
| M84.534K | Pathological fracture in neoplastic disease, left radius, subsequent encounter for fracture with nonunion |
| M84.534P | Pathological fracture in neoplastic disease, left radius, subsequent encounter for fracture with malunion |
| M84.534S | Pathological fracture in neoplastic disease, left radius, sequela |
| M84.541A | Pathological fracture in neoplastic disease, right hand, initial encounter for fracture |
| M84.541D | Pathological fracture in neoplastic disease, right hand, subsequent encounter for fracture with routine healing |
| M84.541G | Pathological fracture in neoplastic disease, right hand, subsequent encounter for fracture with delayed healing |
| M84.541K | Pathological fracture in neoplastic disease, right hand, subsequent encounter for fracture with nonunion |
| M84.541P | Pathological fracture in neoplastic disease, right hand, subsequent encounter for fracture with malunion |
| M84.541S | Pathological fracture in neoplastic disease, right hand, sequela |
| M84.542A | Pathological fracture in neoplastic disease, left hand, initial encounter for fracture |
| M84.542D | Pathological fracture in neoplastic disease, left hand, subsequent encounter for fracture with routine healing |
| M84.542G | Pathological fracture in neoplastic disease, left hand, subsequent encounter for fracture with delayed healing |
| M84.542K | Pathological fracture in neoplastic disease, left hand, subsequent encounter for fracture with nonunion |
| M84.542P | Pathological fracture in neoplastic disease, left hand, subsequent encounter for fracture with malunion |
| M84.542S | Pathological fracture in neoplastic disease, left hand, sequela |
| M84.550A | Pathological fracture in neoplastic disease, pelvis, initial encounter for fracture |
| M84.550D | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with routine healing |
| M84.550G | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with delayed healing |
| M84.550K | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with nonunion |
| M84.550P | Pathological fracture in neoplastic disease, pelvis, subsequent encounter for fracture with malunion |
| M84.550S | Pathological fracture in neoplastic disease, pelvis, sequela |
| M84.551A | Pathological fracture in neoplastic disease, right femur, initial encounter for fracture |
| M84.551D | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with routine healing |
| M84.551G | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with delayed healing |
| M84.551K | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with nonunion |
| M84.551P | Pathological fracture in neoplastic disease, right femur, subsequent encounter for fracture with malunion |
| M84.551S | Pathological fracture in neoplastic disease, right femur, sequela |
| M84.552A | Pathological fracture in neoplastic disease, left femur, initial encounter for fracture |
| M84.552D | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with routine healing |
| M84.552G | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with delayed healing |
| M84.552K | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with nonunion |
| M84.552P | Pathological fracture in neoplastic disease, left femur, subsequent encounter for fracture with malunion |
| M84.552S | Pathological fracture in neoplastic disease, left femur, sequela |
| M84.561A | Pathological fracture in neoplastic disease, right tibia, initial encounter for fracture |
| M84.561D | Pathological fracture in neoplastic disease, right tibia, subsequent encounter for fracture with routine healing |
| M84.561G | Pathological fracture in neoplastic disease, right tibia, subsequent encounter for fracture with delayed healing |
| M84.561K | Pathological fracture in neoplastic disease, right tibia, subsequent encounter for fracture with nonunion |
| M84.561P | Pathological fracture in neoplastic disease, right tibia, subsequent encounter for fracture with malunion |
| M84.561S | Pathological fracture in neoplastic disease, right tibia, sequela |
| M84.562A | Pathological fracture in neoplastic disease, left tibia, initial encounter for fracture |
| M84.562D | Pathological fracture in neoplastic disease, left tibia, subsequent encounter for fracture with routine healing |
| M84.562G | Pathological fracture in neoplastic disease, left tibia, subsequent encounter for fracture with delayed healing |
| M84.562K | Pathological fracture in neoplastic disease, left tibia, subsequent encounter for fracture with nonunion |
| M84.562P | Pathological fracture in neoplastic disease, left tibia, subsequent encounter for fracture with malunion |
| M84.562S | Pathological fracture in neoplastic disease, left tibia, sequela |
| M84.563A | Pathological fracture in neoplastic disease, right fibula, initial encounter for fracture |
| M84.563D | Pathological fracture in neoplastic disease, right fibula, subsequent encounter for fracture with routine healing |
| M84.563G | Pathological fracture in neoplastic disease, right fibula, subsequent encounter for fracture with delayed healing |
| M84.563K | Pathological fracture in neoplastic disease, right fibula, subsequent encounter for fracture with nonunion |
| M84.563P | Pathological fracture in neoplastic disease, right fibula, subsequent encounter for fracture with malunion |
| M84.563S | Pathological fracture in neoplastic disease, right fibula, sequela |
| M84.564A | Pathological fracture in neoplastic disease, left fibula, initial encounter for fracture |
| M84.564D | Pathological fracture in neoplastic disease, left fibula, subsequent encounter for fracture with routine healing |
| M84.564G | Pathological fracture in neoplastic disease, left fibula, subsequent encounter for fracture with delayed healing |
| M84.564K | Pathological fracture in neoplastic disease, left fibula, subsequent encounter for fracture with nonunion |
| M84.564P | Pathological fracture in neoplastic disease, left fibula, subsequent encounter for fracture with malunion |
| M84.564S | Pathological fracture in neoplastic disease, left fibula, sequela |
| M84.569A | Pathological fracture in neoplastic disease, unspecified tibia and fibula, initial encounter for fracture |
| M84.571A | Pathological fracture in neoplastic disease, right ankle, initial encounter for fracture |
| M84.571D | Pathological fracture in neoplastic disease, right ankle, subsequent encounter for fracture with routine healing |
| M84.571G | Pathological fracture in neoplastic disease, right ankle, subsequent encounter for fracture with delayed healing |
| M84.571K | Pathological fracture in neoplastic disease, right ankle, subsequent encounter for fracture with nonunion |
| M84.571P | Pathological fracture in neoplastic disease, right ankle, subsequent encounter for fracture with malunion |
| M84.571S | Pathological fracture in neoplastic disease, right ankle, sequela |
| M84.572A | Pathological fracture in neoplastic disease, left ankle, initial encounter for fracture |
| M84.572D | Pathological fracture in neoplastic disease, left ankle, subsequent encounter for fracture with routine healing |
| M84.572G | Pathological fracture in neoplastic disease, left ankle, subsequent encounter for fracture with delayed healing |
| M84.572K | Pathological fracture in neoplastic disease, left ankle, subsequent encounter for fracture with nonunion |
Showing the first 400 of 434 covered codes — this procedure has a large covered-diagnosis set; see the governing LCD/article for the complete list.
Frequently asked questions
Which ICD-10 codes support medical necessity for CPT Q5166?
Medicare coverage policies (LCDs/NCDs and Billing & Coding articles) list 434 ICD-10 diagnosis codes that support medical necessity for CPT Q5166. 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 Q5166 view of that relationship.
Catch medical-necessity denials before you bill. CareNiva scrubs claims against LCD/NCD coverage and flags unsupported diagnoses — in the same platform you run visits and billing.
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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