SUPERSEDED LCD Reference Article Billing and Coding Article

Billing and Coding: Flow Cytometry

A56464

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General Information

Source Article ID
N/A
Article ID
A56464
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Flow Cytometry
Article Type
Billing and Coding
Original Effective Date
10/03/2019
Revision Effective Date
10/01/2023
Revision Ending Date
11/15/2023
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim lacking the necessary documentation to process the claim.

CMS IOM Pub 100-04 Ch 16, §50.5 Jurisdiction of Laboratory Claims, §60.1.2 Independent Laboratory Specimen Drawing, §60.2. Travel Allowance

CMS IOM Pub 100-04 Medicare Claims Processing Manual, Ch 23, §10 Reporting ICD Diagnosis and Procedure Codes

Article Guidance

Article Text

This article gives guidance for billing, coding, and other guidelines in relation to local coverage policy for L34037-Flow Cytometry.

 

General Guidelines for Claims submitted to Part A or Part B MAC:

General Guidelines for claims submitted to Part A or Part B MAC:

Code 88182 applies to the physician professional and facility technical components of DNA ploidy and S-phase analysis of tumor by flow cytometric technique. Use codes 88184 (first marker) and 88185 (each additional marker, beyond the first) to report the facility technical component of flow cytometric immunophenotyping for the assessment of potential hematolymphoid neoplasia.

Flow cytometry interpretation should be reported using CPT codes 88187-88189. Only one code should be reported for all flow cytometry performed on a specimen. Since Medicare does not pay for duplicate testing, do not report flow cytometry on multiple specimens on the same date of service unless the morphology or other clinical factors suggest differing results on the different specimens. There is no CPT code for interpretation of one marker. The provider should not bill for interpretation of a single marker using another CPT code.

Quantitative cell counts performed by flow cytometry are billed using CPT codes 86355, 86356, 86357, 86359, 86360, 86361 and 86367. These codes should not be reported with the flow cytometry interpretation CPT codes 88187-88189 since there is no interpretative service for these quantitative cell counts. Do not report code 88184 or 88185 together with a code in the 86355-86367 series in conjunction with the same laboratory analysis.

Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare. For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim. A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act. The diagnosis code(s) must best describe the patient's condition for which the service was performed. For diagnostic tests, report the result of the test if known; otherwise the symptoms prompting the performance of the test should be reported.

 

Advance Beneficiary Notice of Non-coverage (ABN) Modifier Guidelines

An ABN may be used for services which are likely to be non-covered, whether for medical necessity or for other reasons. Refer to CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 30, for complete instructions.

Effective from April 1, 2010, non-covered services should be billed with modifier –GA, -GX, -GY, or –GZ, as appropriate.

The –GA modifier (“Waiver of Liability Statement Issued as Required by Payer Policy”) should be used when physicians, practitioners, or suppliers want to indicate that they anticipate that Medicare will deny a specific service as not reasonable and necessary and they do have an ABN signed by the beneficiary on file. Modifier GA applies only when services will be denied under reasonable and necessary provisions, sections 1862(a)(1), 1862(a)(9), 1879(e), or 1879(g) of the Social Security Act. Effective April 1, 2010, Part A MAC systems will automatically deny services billed with modifier GA. An ABN, Form CMS-R-131, should be signed by the beneficiary to indicate that ‎he/she accepts responsibility for payment.‎ The -GA modifier may also be used on assigned claims when a patient refuses to sign the ABN and the latter is properly witnessed. For claims submitted to the Part A MAC, occurrence code 32 and the date of the ABN is required.

 

Modifier GX (“Notice of Liability Issued, Voluntary Under Payer Policy”) should be used when the beneficiary has signed an ABN, and a denial is anticipated based on provisions other than medical necessity, such as statutory exclusions of coverage or technical issues. An ABN is not required for these denials, but if non-covered services are reported with modifier GX, will automatically be denied services.

 

The –GZ modifier should be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an item or service as not reasonable and necessary and they have not had an ABN signed by the beneficiary. ‎If the service is statutorily non-covered, or without a benefit category, submit the ‎appropriate CPT/HCPCS code with the -GY modifier. An ABN is not required for these denials, and the limitation of liability does not apply for beneficiaries. Services with modifier GY will automatically deny.

Documentation Requirements

The patient’s medical record should include but is not limited to:

  • The assessment of the patient by the ordering provider as it relates to the complaint of the patient for that visit,
  • Relevant medical history
  • Results of pertinent tests/procedures
  • Signed and dated office visit record/operative report (Please note that all services ordered or rendered to Medicare beneficiaries must be signed.)

 

For claims submitted to the Part B MAC:

All services/procedures performed on the same day for the same beneficiary by the physician/provider should be billed on the same claim.

Claims for Flow Cytometry services are payable under Medicare Part B in the following places of service:

For CPT codes 86355, 86356, 86357, 86359, 86360 and 86361: office (11), independent clinic (49), federally qualified health center (50), rural health clinic (72), and independent laboratory (81);

For CPT code 88182, (global service) office (11), independent clinic (49), and independent laboratory (81);

For CPT codes 88182-TC, 88184 and 88185 (technical services), office (11), independent clinic (49), federally qualified health center (50), rural health clinic (72), and independent laboratory (81);

For CPT codes 88182-26, 88187, 88188 and 88189 (professional services) office (11), inpatient hospital (21), outpatient hospital (22), independent clinic (49), and independent laboratory (81).

For CPT code 92025 (global/technical) POS 15 (mobile unit) is payable under Medicare Part B. 

 

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
014x Hospital - Laboratory Services Provided to Non-patients
018x Hospital - Swing Beds
021x Skilled Nursing - Inpatient (Including Medicare Part A)
022x Skilled Nursing - Inpatient (Medicare Part B only)
023x Skilled Nursing - Outpatient
071x Clinic - Rural Health
073x Clinic - Freestanding
077x Clinic - Federally Qualified Health Center (FQHC)
085x Critical Access Hospital
N/A

Revenue Codes

Code Description
0300 Laboratory - General Classification
0302 Laboratory - Immunology
0309 Laboratory - Other Laboratory
N/A

CPT/HCPCS Codes

Group 1

(6 Codes)
Group 1 Paragraph

N/A

Group 1 Codes
Code Description
88182 FLOW CYTOMETRY, CELL CYCLE OR DNA ANALYSIS
88184 FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; FIRST MARKER
88185 FLOW CYTOMETRY, CELL SURFACE, CYTOPLASMIC, OR NUCLEAR MARKER, TECHNICAL COMPONENT ONLY; EACH ADDITIONAL MARKER (LIST SEPARATELY IN ADDITION TO CODE FOR FIRST MARKER)
88187 FLOW CYTOMETRY, INTERPRETATION; 2 TO 8 MARKERS
88188 FLOW CYTOMETRY, INTERPRETATION; 9 TO 15 MARKERS
88189 FLOW CYTOMETRY, INTERPRETATION; 16 OR MORE MARKERS

Group 2

(7 Codes)
Group 2 Paragraph

Quantitative Codes in immunology section:

Group 2 Codes
Code Description
86355 B CELLS, TOTAL COUNT
86356 MONONUCLEAR CELL ANTIGEN, QUANTITATIVE (EG, FLOW CYTOMETRY), NOT OTHERWISE SPECIFIED, EACH ANTIGEN
86357 NATURAL KILLER (NK) CELLS, TOTAL COUNT
86359 T CELLS; TOTAL COUNT
86360 T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO
86361 T CELLS; ABSOLUTE CD4 COUNT
86367 STEM CELLS (IE, CD34), TOTAL COUNT
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(1,345 Codes)
Group 1 Paragraph

It is the responsibility of the provider to code to the highest level specified in the ICD-10-CM. The correct use of an ICD-10-CM code does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in this determination.

Group 1 Codes
Code Description
B20 Human immunodeficiency virus [HIV] disease
B97.33 Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere
B97.34 Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere
B97.35 Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
C07 Malignant neoplasm of parotid gland
C08.0 Malignant neoplasm of submandibular gland
C11.0 - C11.3 Malignant neoplasm of superior wall of nasopharynx - Malignant neoplasm of anterior wall of nasopharynx
C11.8 Malignant neoplasm of overlapping sites of nasopharynx
C11.9 Malignant neoplasm of nasopharynx, unspecified
C15.3 Malignant neoplasm of upper third of esophagus
C15.4 Malignant neoplasm of middle third of esophagus
C15.5 Malignant neoplasm of lower third of esophagus
C15.8 Malignant neoplasm of overlapping sites of esophagus
C16.0 - C16.9 Malignant neoplasm of cardia - Malignant neoplasm of stomach, unspecified
C17.0 - C17.2 Malignant neoplasm of duodenum - Malignant neoplasm of ileum
C17.8 Malignant neoplasm of overlapping sites of small intestine
C17.9 Malignant neoplasm of small intestine, unspecified
C18.0 Malignant neoplasm of cecum
C18.1 Malignant neoplasm of appendix
C18.2 Malignant neoplasm of ascending colon
C18.3 Malignant neoplasm of hepatic flexure
C18.4 Malignant neoplasm of transverse colon
C18.5 Malignant neoplasm of splenic flexure
C18.6 Malignant neoplasm of descending colon
C18.7 Malignant neoplasm of sigmoid colon
C18.8 Malignant neoplasm of overlapping sites of colon
C18.9 Malignant neoplasm of colon, unspecified
C19 Malignant neoplasm of rectosigmoid junction
C20 Malignant neoplasm of rectum
C21.0 - C21.2 Malignant neoplasm of anus, unspecified - Malignant neoplasm of cloacogenic zone
C21.8 Malignant neoplasm of overlapping sites of rectum, anus and anal canal
C22.0 Liver cell carcinoma
C22.2 Hepatoblastoma
C22.7 Other specified carcinomas of liver
C22.8 Malignant neoplasm of liver, primary, unspecified as to type
C22.9 Malignant neoplasm of liver, not specified as primary or secondary
C23 Malignant neoplasm of gallbladder
C24.0 Malignant neoplasm of extrahepatic bile duct
C24.1 Malignant neoplasm of ampulla of Vater
C25.0 - C25.2 Malignant neoplasm of head of pancreas - Malignant neoplasm of tail of pancreas
C25.7 - C25.9 Malignant neoplasm of other parts of pancreas - Malignant neoplasm of pancreas, unspecified
C26.0 Malignant neoplasm of intestinal tract, part unspecified
C26.1 Malignant neoplasm of spleen
C26.9 Malignant neoplasm of ill-defined sites within the digestive system
C30.0 Malignant neoplasm of nasal cavity
C30.1 Malignant neoplasm of middle ear
C31.0 Malignant neoplasm of maxillary sinus
C31.1 Malignant neoplasm of ethmoidal sinus
C31.2 Malignant neoplasm of frontal sinus
C31.3 Malignant neoplasm of sphenoid sinus
C31.8 Malignant neoplasm of overlapping sites of accessory sinuses
C31.9 Malignant neoplasm of accessory sinus, unspecified
C32.0 Malignant neoplasm of glottis
C32.1 Malignant neoplasm of supraglottis
C32.2 Malignant neoplasm of subglottis
C32.3 Malignant neoplasm of laryngeal cartilage
C32.8 Malignant neoplasm of overlapping sites of larynx
C32.9 Malignant neoplasm of larynx, unspecified
C33 Malignant neoplasm of trachea
C34.01 Malignant neoplasm of right main bronchus
C34.02 Malignant neoplasm of left main bronchus
C34.2 Malignant neoplasm of middle lobe, bronchus or lung
C34.80 Malignant neoplasm of overlapping sites of unspecified bronchus and 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
C37 Malignant neoplasm of thymus
C38.1 Malignant neoplasm of anterior mediastinum
C38.2 Malignant neoplasm of posterior mediastinum
C38.3 Malignant neoplasm of mediastinum, part unspecified
C38.4 Malignant neoplasm of pleura
C38.8 Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
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
C41.0 - C41.4 Malignant neoplasm of bones of skull and face - Malignant neoplasm of pelvic bones, sacrum and coccyx
C41.9 Malignant neoplasm of bone and articular cartilage, unspecified
C43.0 Malignant melanoma of lip
C43.111 Malignant melanoma of right upper eyelid, including canthus
C43.112 Malignant melanoma of right lower eyelid, including canthus
C43.121 Malignant melanoma of left upper eyelid, including canthus
C43.122 Malignant melanoma of left lower eyelid, including canthus
C43.21 Malignant melanoma of right ear and external auricular canal
C43.22 Malignant melanoma of left ear and external auricular canal
C43.31 Malignant melanoma of nose
C43.39 Malignant melanoma of other parts of face
C43.4 Malignant melanoma of scalp and neck
C44.00 Unspecified malignant neoplasm of skin of lip
C44.01 Basal cell carcinoma of skin of lip
C44.02 Squamous cell carcinoma of skin of lip
C44.09 Other specified malignant neoplasm of skin of lip
C44.1121 Basal cell carcinoma of skin of right upper eyelid, including canthus
C44.1122 Basal cell carcinoma of skin of right lower eyelid, including canthus
C44.1191 Basal cell carcinoma of skin of left upper eyelid, including canthus
C44.1192 Basal cell carcinoma of skin of left lower eyelid, including canthus
C44.1221 Squamous cell carcinoma of skin of right upper eyelid, including canthus
C44.1222 Squamous cell carcinoma of skin of right lower eyelid, including canthus
C44.1291 Squamous cell carcinoma of skin of left upper eyelid, including canthus
C44.1292 Squamous cell carcinoma of skin of left lower eyelid, including canthus
C44.1921 Other specified malignant neoplasm of skin of right upper eyelid, including canthus
C44.1922 Other specified malignant neoplasm of skin of right lower eyelid, including canthus
C44.311 Basal cell carcinoma of skin of nose
C44.319 Basal cell carcinoma of skin of other parts of face
C44.321 Squamous cell carcinoma of skin of nose
C44.391 Other specified malignant neoplasm of skin of nose
C44.399 Other specified malignant neoplasm of skin of other parts of face
C44.40 Unspecified malignant neoplasm of skin of scalp and neck
C44.41 Basal cell carcinoma of skin of scalp and neck
C44.42 Squamous cell carcinoma of skin of scalp and neck
C44.49 Other specified malignant neoplasm of skin of scalp and neck
C44.500 Unspecified malignant neoplasm of anal skin
C44.501 Unspecified malignant neoplasm of skin of breast
C44.509 Unspecified malignant neoplasm of skin of other part of trunk
C44.510 Basal cell carcinoma of anal skin
C44.511 Basal cell carcinoma of skin of breast
C44.519 Basal cell carcinoma of skin of other part of trunk
C44.520 Squamous cell carcinoma of anal skin
C44.521 Squamous cell carcinoma of skin of breast
C44.529 Squamous cell carcinoma of skin of other part of trunk
C44.590 Other specified malignant neoplasm of anal skin
C44.591 Other specified malignant neoplasm of skin of breast
C44.599 Other specified malignant neoplasm of skin of other part of trunk
C44.702 Unspecified malignant neoplasm of skin of right lower limb, including hip
C44.709 Unspecified malignant neoplasm of skin of left lower limb, including hip
C44.712 Basal cell carcinoma of skin of right lower limb, including hip
C44.719 Basal cell carcinoma of skin of left lower limb, including hip
C44.722 Squamous cell carcinoma of skin of right lower limb, including hip
C44.729 Squamous cell carcinoma of skin of left lower limb, including hip
C44.792 Other specified malignant neoplasm of skin of right lower limb, including hip
C44.799 Other specified malignant neoplasm of skin of left lower limb, including hip
C44.80 Unspecified malignant neoplasm of overlapping sites of skin
C44.81 Basal cell carcinoma of overlapping sites of skin
C44.82 Squamous cell carcinoma of overlapping sites of skin
C44.89 Other specified malignant neoplasm of overlapping sites of skin
C45.0 Mesothelioma of pleura
C45.1 Mesothelioma of peritoneum
C45.9 Mesothelioma, unspecified
C46.0 - C46.4 Kaposi's sarcoma of skin - Kaposi's sarcoma of gastrointestinal sites
C46.51 Kaposi's sarcoma of right lung
C46.52 Kaposi's sarcoma of left lung
C46.7 Kaposi's sarcoma of other sites
C47.0 Malignant neoplasm of peripheral nerves of head, face and neck
C47.21 Malignant neoplasm of peripheral nerves of right lower limb, including hip
C47.22 Malignant neoplasm of peripheral nerves of left lower limb, including hip
C47.3 Malignant neoplasm of peripheral nerves of thorax
C47.8 Malignant neoplasm of overlapping sites of peripheral nerves and autonomic nervous system
C48.0 - C48.2 Malignant neoplasm of retroperitoneum - Malignant neoplasm of peritoneum, unspecified
C48.8 Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum
C49.0 Malignant neoplasm of connective and soft tissue of head, face and neck
C49.21 Malignant neoplasm of connective and soft tissue of right lower limb, including hip
C49.22 Malignant neoplasm of connective and soft tissue of left lower limb, including hip
C49.3 - C49.6 Malignant neoplasm of connective and soft tissue of thorax - Malignant neoplasm of connective and soft tissue of trunk, unspecified
C49.8 Malignant neoplasm of overlapping sites of connective and soft tissue
C49.9 Malignant neoplasm of connective and soft tissue, unspecified
C50.011 Malignant neoplasm of nipple and areola, right female breast
C50.012 Malignant neoplasm of nipple and areola, left female breast
C50.021 Malignant neoplasm of nipple and areola, right male breast
C50.022 Malignant neoplasm of nipple and areola, left male breast
C50.111 Malignant neoplasm of central portion of right female breast
C50.112 Malignant neoplasm of central portion of left female breast
C50.121 Malignant neoplasm of central portion of right male breast
C50.122 Malignant neoplasm of central portion of left male 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
C50.221 Malignant neoplasm of upper-inner quadrant of right male breast
C50.222 Malignant neoplasm of upper-inner quadrant of left male 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
C50.321 Malignant neoplasm of lower-inner quadrant of right male breast
C50.322 Malignant neoplasm of lower-inner quadrant of left male 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
C50.421 Malignant neoplasm of upper-outer quadrant of right male breast
C50.422 Malignant neoplasm of upper-outer quadrant of left male 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
C50.521 Malignant neoplasm of lower-outer quadrant of right male breast
C50.522 Malignant neoplasm of lower-outer quadrant of left male breast
C50.611 Malignant neoplasm of axillary tail of right female breast
C50.612 Malignant neoplasm of axillary tail of left female breast
C50.621 Malignant neoplasm of axillary tail of right male breast
C50.622 Malignant neoplasm of axillary tail of left male breast
C50.811 Malignant neoplasm of overlapping sites of right female breast
C50.812 Malignant neoplasm of overlapping sites of left female breast
C50.821 Malignant neoplasm of overlapping sites of right male breast
C50.822 Malignant neoplasm of overlapping sites of left male breast
C50.911 Malignant neoplasm of unspecified site of right female breast
C50.912 Malignant neoplasm of unspecified site of left female breast
C50.921 Malignant neoplasm of unspecified site of right male breast
C50.922 Malignant neoplasm of unspecified site of left male breast
C51.0 - C51.2 Malignant neoplasm of labium majus - Malignant neoplasm of clitoris
C51.9 Malignant neoplasm of vulva, unspecified
C52 Malignant neoplasm of vagina
C53.0 Malignant neoplasm of endocervix
C53.1 Malignant neoplasm of exocervix
C53.8 Malignant neoplasm of overlapping sites of cervix uteri
C53.9 Malignant neoplasm of cervix uteri, unspecified
C54.0 Malignant neoplasm of isthmus uteri
C54.1 Malignant neoplasm of endometrium
C54.2 Malignant neoplasm of myometrium
C54.3 Malignant neoplasm of fundus uteri
C54.8 Malignant neoplasm of overlapping sites of corpus uteri
C55 Malignant neoplasm of uterus, part unspecified
C56.1 Malignant neoplasm of right ovary
C56.2 Malignant neoplasm of left ovary
C57.01 Malignant neoplasm of right fallopian tube
C57.02 Malignant neoplasm of left fallopian tube
C57.11 Malignant neoplasm of right broad ligament
C57.12 Malignant neoplasm of left broad ligament
C57.21 Malignant neoplasm of right round ligament
C57.22 Malignant neoplasm of left round ligament
C57.3 Malignant neoplasm of parametrium
C57.4 Malignant neoplasm of uterine adnexa, unspecified
C57.7 Malignant neoplasm of other specified female genital organs
C57.8 Malignant neoplasm of overlapping sites of female genital organs
C57.9 Malignant neoplasm of female genital organ, unspecified
C58 Malignant neoplasm of placenta
C60.1 - C60.2 Malignant neoplasm of glans penis - Malignant neoplasm of body of penis
C60.8 Malignant neoplasm of overlapping sites of penis
C60.9 Malignant neoplasm of penis, unspecified
C61 Malignant neoplasm of prostate
C63.00 Malignant neoplasm of unspecified epididymis
C63.10 Malignant neoplasm of unspecified spermatic cord
C63.2 Malignant neoplasm of scrotum
C63.7 - C63.9 Malignant neoplasm of other specified male genital organs - Malignant neoplasm of male genital organ, unspecified
C64.1 Malignant neoplasm of right kidney, except renal pelvis
C64.2 Malignant neoplasm of left kidney, except renal pelvis
C65.1 Malignant neoplasm of right renal pelvis
C65.2 Malignant neoplasm of left renal pelvis
C66.1 Malignant neoplasm of right ureter
C66.2 Malignant neoplasm of left ureter
C67.0 Malignant neoplasm of trigone of bladder
C67.1 Malignant neoplasm of dome of bladder
C67.2 Malignant neoplasm of lateral wall of bladder
C67.3 Malignant neoplasm of anterior wall of bladder
C67.4 Malignant neoplasm of posterior wall of bladder
C67.5 Malignant neoplasm of bladder neck
C67.6 Malignant neoplasm of ureteric orifice
C67.7 Malignant neoplasm of urachus
C67.8 Malignant neoplasm of overlapping sites of bladder
C67.9 Malignant neoplasm of bladder, unspecified
C68.0 Malignant neoplasm of urethra
C68.1 Malignant neoplasm of paraurethral glands
C68.8 Malignant neoplasm of overlapping sites of urinary organs
C69.01 Malignant neoplasm of right conjunctiva
C69.02 Malignant neoplasm of left conjunctiva
C69.11 Malignant neoplasm of right cornea
C69.12 Malignant neoplasm of left cornea
C69.21 Malignant neoplasm of right retina
C69.22 Malignant neoplasm of left retina
C69.31 Malignant neoplasm of right choroid
C69.32 Malignant neoplasm of left choroid
C69.41 Malignant neoplasm of right ciliary body
C69.42 Malignant neoplasm of left ciliary body
C69.51 Malignant neoplasm of right lacrimal gland and duct
C69.52 Malignant neoplasm of left lacrimal gland and duct
C69.61 Malignant neoplasm of right orbit
C69.62 Malignant neoplasm of left orbit
C69.81 Malignant neoplasm of overlapping sites of right eye and adnexa
C69.82 Malignant neoplasm of overlapping sites of left eye and adnexa
C70.0 Malignant neoplasm of cerebral meninges
C70.1 Malignant neoplasm of spinal meninges
C70.9 Malignant neoplasm of meninges, unspecified
C71.0 Malignant neoplasm of cerebrum, except lobes and ventricles
C71.1 Malignant neoplasm of frontal lobe
C71.2 Malignant neoplasm of temporal lobe
C71.3 Malignant neoplasm of parietal lobe
C71.4 Malignant neoplasm of occipital lobe
C71.5 Malignant neoplasm of cerebral ventricle
C71.6 Malignant neoplasm of cerebellum
C71.7 Malignant neoplasm of brain stem
C71.8 Malignant neoplasm of overlapping sites of brain
C72.0 Malignant neoplasm of spinal cord
C72.1 Malignant neoplasm of cauda equina
C72.21 Malignant neoplasm of right olfactory nerve
C72.22 Malignant neoplasm of left olfactory nerve
C72.31 Malignant neoplasm of right optic nerve
C72.32 Malignant neoplasm of left optic nerve
C72.41 Malignant neoplasm of right acoustic nerve
C72.42 Malignant neoplasm of left acoustic nerve
C72.50 Malignant neoplasm of unspecified cranial nerve
C72.9 Malignant neoplasm of central nervous system, unspecified
C73 Malignant neoplasm of thyroid gland
C74.01 Malignant neoplasm of cortex of right adrenal gland
C74.02 Malignant neoplasm of cortex of left adrenal gland
C74.11 Malignant neoplasm of medulla of right adrenal gland
C74.12 Malignant neoplasm of medulla of left adrenal gland
C75.0 - C75.5 Malignant neoplasm of parathyroid gland - Malignant neoplasm of aortic body and other paraganglia
C75.8 Malignant neoplasm with pluriglandular involvement, unspecified
C75.9 Malignant neoplasm of endocrine gland, unspecified
C76.0 - C76.3 Malignant neoplasm of head, face and neck - Malignant neoplasm of pelvis
C76.41 Malignant neoplasm of right upper limb
C76.42 Malignant neoplasm of left upper limb
C76.51 Malignant neoplasm of right lower limb
C76.52 Malignant neoplasm of left lower limb
C76.8 Malignant neoplasm of other specified ill-defined sites
C77.0 - C77.5 Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck - Secondary and unspecified malignant neoplasm of intrapelvic lymph nodes
C77.8 Secondary and unspecified malignant neoplasm of lymph nodes of multiple regions
C77.9 Secondary and unspecified malignant neoplasm of lymph node, unspecified
C78.01 - C78.02 Secondary malignant neoplasm of right lung - Secondary malignant neoplasm of left lung
C78.1 Secondary malignant neoplasm of mediastinum
C78.2 Secondary malignant neoplasm of pleura
C78.39 Secondary malignant neoplasm of other respiratory organs
C78.4 - C78.7 Secondary malignant neoplasm of small intestine - Secondary malignant neoplasm of liver and intrahepatic bile duct
C78.89 Secondary malignant neoplasm of other digestive organs
C79.01 - C79.02 Secondary malignant neoplasm of right kidney and renal pelvis - Secondary malignant neoplasm of left kidney and renal pelvis
C79.11 Secondary malignant neoplasm of bladder
C79.19 Secondary malignant neoplasm of other urinary organs
C79.2 Secondary malignant neoplasm of skin
C79.31 Secondary malignant neoplasm of brain
C79.32 Secondary malignant neoplasm of cerebral meninges
C79.49 Secondary malignant neoplasm of other parts of nervous system
C79.51 Secondary malignant neoplasm of bone
C79.52 Secondary malignant neoplasm of bone marrow
C79.61 Secondary malignant neoplasm of right ovary
C79.62 Secondary malignant neoplasm of left ovary
C79.63 Secondary malignant neoplasm of bilateral ovaries
C79.71 Secondary malignant neoplasm of right adrenal gland
C79.72 Secondary malignant neoplasm of left adrenal gland
C79.81 Secondary malignant neoplasm of breast
C79.82 Secondary malignant neoplasm of genital organs
C79.89 Secondary malignant neoplasm of other specified sites
C80.1 Malignant (primary) neoplasm, unspecified
C80.2 Malignant neoplasm associated with transplanted organ
C81.01 - C81.09 Nodular lymphocyte predominant Hodgkin lymphoma, lymph nodes of head, face, and neck - Nodular lymphocyte predominant Hodgkin lymphoma, extranodal and solid organ sites
C81.11 - C81.19 Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck - Nodular sclerosis Hodgkin lymphoma, extranodal and solid organ sites
C81.21 - C81.29 Mixed cellularity Hodgkin lymphoma, lymph nodes of head, face, and neck - Mixed cellularity Hodgkin lymphoma, extranodal and solid organ sites
C81.31 - C81.39 Lymphocyte depleted Hodgkin lymphoma, lymph nodes of head, face, and neck - Lymphocyte depleted Hodgkin lymphoma, extranodal and solid organ sites
C81.41 - C81.49 Lymphocyte-rich Hodgkin lymphoma, lymph nodes of head, face, and neck - Lymphocyte-rich Hodgkin lymphoma, extranodal and solid organ sites
C81.71 - C81.79 Other Hodgkin lymphoma, lymph nodes of head, face, and neck - Other Hodgkin lymphoma, extranodal and solid organ sites
C81.91 - C81.99 Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck - Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C82.01 - C82.09 Follicular lymphoma grade I, lymph nodes of head, face, and neck - Follicular lymphoma grade I, extranodal and solid organ sites
C82.11 - C82.19 Follicular lymphoma grade II, lymph nodes of head, face, and neck - Follicular lymphoma grade II, extranodal and solid organ sites
C82.21 - C82.29 Follicular lymphoma grade III, unspecified, lymph nodes of head, face, and neck - Follicular lymphoma grade III, unspecified, extranodal and solid organ sites
C82.31 - C82.39 Follicular lymphoma grade IIIa, lymph nodes of head, face, and neck - Follicular lymphoma grade IIIa, extranodal and solid organ sites
C82.41 - C82.49 Follicular lymphoma grade IIIb, lymph nodes of head, face, and neck - Follicular lymphoma grade IIIb, extranodal and solid organ sites
C82.51 - C82.59 Diffuse follicle center lymphoma, lymph nodes of head, face, and neck - Diffuse follicle center lymphoma, extranodal and solid organ sites
C82.61 - C82.69 Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck - Cutaneous follicle center lymphoma, extranodal and solid organ sites
C82.81 - C82.89 Other types of follicular lymphoma, lymph nodes of head, face, and neck - Other types of follicular lymphoma, extranodal and solid organ sites
C82.91 - C82.99 Follicular lymphoma, unspecified, lymph nodes of head, face, and neck - Follicular lymphoma, unspecified, extranodal and solid organ sites
C83.01 - C83.09 Small cell B-cell lymphoma, lymph nodes of head, face, and neck - Small cell B-cell lymphoma, extranodal and solid organ sites
C83.11 - C83.19 Mantle cell lymphoma, lymph nodes of head, face, and neck - Mantle cell lymphoma, extranodal and solid organ sites
C83.31 - C83.39 Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck - Diffuse large B-cell lymphoma, extranodal and solid organ sites
C83.51 - C83.59 Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck - Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites
C83.71 - C83.79 Burkitt lymphoma, lymph nodes of head, face, and neck - Burkitt lymphoma, extranodal and solid organ sites
C83.81 - C83.89 Other non-follicular lymphoma, lymph nodes of head, face, and neck - Other non-follicular lymphoma, extranodal and solid organ sites
C83.91 - C83.99 Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of head, face, and neck - Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites
C84.01 - C84.09 Mycosis fungoides, lymph nodes of head, face, and neck - Mycosis fungoides, extranodal and solid organ sites
C84.11 - C84.19 Sezary disease, lymph nodes of head, face, and neck - Sezary disease, extranodal and solid organ sites
C84.41 - C84.49 Peripheral T-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck - Peripheral T-cell lymphoma, not elsewhere classified, extranodal and solid organ sites
C84.61 - C84.69 Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck - Anaplastic large cell lymphoma, ALK-positive, extranodal and solid organ sites
C84.71 - C84.79 Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck - Anaplastic large cell lymphoma, ALK-negative, extranodal and solid organ sites
C84.7A Anaplastic large cell lymphoma, ALK-negative, breast
C84.A1 Cutaneous T-cell lymphoma, unspecified lymph nodes of head, face, and neck
C84.A2 Cutaneous T-cell lymphoma, unspecified, intrathoracic lymph nodes
C84.A3 Cutaneous T-cell lymphoma, unspecified, intra-abdominal lymph nodes
C84.A4 Cutaneous T-cell lymphoma, unspecified, lymph nodes of axilla and upper limb
C84.A5 Cutaneous T-cell lymphoma, unspecified, lymph nodes of inguinal region and lower limb
C84.A6 Cutaneous T-cell lymphoma, unspecified, intrapelvic lymph nodes
C84.A7 Cutaneous T-cell lymphoma, unspecified, spleen
C84.A8 Cutaneous T-cell lymphoma, unspecified, lymph nodes of multiple sites
C84.A9 Cutaneous T-cell lymphoma, unspecified, extranodal and solid organ sites
C84.Z1 Other mature T/NK-cell lymphomas, lymph nodes of head, face, and neck
C84.Z2 Other mature T/NK-cell lymphomas, intrathoracic lymph nodes
C84.Z3 Other mature T/NK-cell lymphomas, intra-abdominal lymph nodes
C84.Z4 Other mature T/NK-cell lymphomas, lymph nodes of axilla and upper limb
C84.Z5 Other mature T/NK-cell lymphomas, lymph nodes of inguinal region and lower limb
C84.Z6 Other mature T/NK-cell lymphomas, intrapelvic lymph nodes
C84.Z7 Other mature T/NK-cell lymphomas, spleen
C84.Z8 Other mature T/NK-cell lymphomas, lymph nodes of multiple sites
C84.Z9 Other mature T/NK-cell lymphomas, extranodal and solid organ sites
C84.91 - C84.99 Mature T/NK-cell lymphomas, unspecified, lymph nodes of head, face, and neck - Mature T/NK-cell lymphomas, unspecified, extranodal and solid organ sites
C85.11 - C85.19 Unspecified B-cell lymphoma, lymph nodes of head, face, and neck - Unspecified B-cell lymphoma, extranodal and solid organ sites
C85.21 - C85.29 Mediastinal (thymic) large B-cell lymphoma, lymph nodes of head, face, and neck - Mediastinal (thymic) large B-cell lymphoma, extranodal and solid organ sites
C85.81 - C85.89 Other specified types of non-Hodgkin lymphoma, lymph nodes of head, face, and neck - Other specified types of non-Hodgkin lymphoma, extranodal and solid organ sites
C85.91 - C85.99 Non-Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck - Non-Hodgkin lymphoma, unspecified, extranodal and solid organ sites
C86.0 Extranodal NK/T-cell lymphoma, nasal type
C86.1 Hepatosplenic T-cell lymphoma
C86.2 Enteropathy-type (intestinal) T-cell lymphoma
C86.3 Subcutaneous panniculitis-like T-cell lymphoma
C86.4 Blastic NK-cell lymphoma
C86.5 Angioimmunoblastic T-cell lymphoma
C86.6 Primary cutaneous CD30-positive T-cell proliferations
C88.0 Waldenstrom macroglobulinemia
C88.2 Heavy chain disease
C88.3 Immunoproliferative small intestinal disease
C88.4 Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma]
C88.8 Other malignant immunoproliferative diseases
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
C91.00 Acute lymphoblastic leukemia not having achieved remission
C91.01 Acute lymphoblastic leukemia, in remission
C91.02 Acute lymphoblastic leukemia, in relapse
C91.10 Chronic lymphocytic leukemia of B-cell type not having achieved remission
C91.11 Chronic lymphocytic leukemia of B-cell type in remission
C91.12 Chronic lymphocytic leukemia of B-cell type in relapse
C91.30 Prolymphocytic leukemia of B-cell type not having achieved remission
C91.31 Prolymphocytic leukemia of B-cell type, in remission
C91.32 Prolymphocytic leukemia of B-cell type, in relapse
C91.40 Hairy cell leukemia not having achieved remission
C91.41 Hairy cell leukemia, in remission
C91.42 Hairy cell leukemia, in relapse
C91.50 Adult T-cell lymphoma/leukemia (HTLV-1-associated) not having achieved remission
C91.51 Adult T-cell lymphoma/leukemia (HTLV-1-associated), in remission
C91.52 Adult T-cell lymphoma/leukemia (HTLV-1-associated), in relapse
C91.60 Prolymphocytic leukemia of T-cell type not having achieved remission
C91.61 Prolymphocytic leukemia of T-cell type, in remission
C91.62 Prolymphocytic leukemia of T-cell type, in relapse
C91.A0 Mature B-cell leukemia Burkitt-type not having achieved remission
C91.A1 Mature B-cell leukemia Burkitt-type, in remission
C91.A2 Mature B-cell leukemia Burkitt-type, in relapse
C91.Z0 Other lymphoid leukemia not having achieved remission
C91.Z1 Other lymphoid leukemia, in remission
C91.Z2 Other lymphoid leukemia, in relapse
C91.90 Lymphoid leukemia, unspecified not having achieved remission
C91.91 Lymphoid leukemia, unspecified, in remission
C91.92 Lymphoid leukemia, unspecified, in relapse
C92.00 Acute myeloblastic leukemia, not having achieved remission
C92.01 Acute myeloblastic leukemia, in remission
C92.02 Acute myeloblastic leukemia, in relapse
C92.10 Chronic myeloid leukemia, BCR/ABL-positive, not having achieved remission
C92.11 Chronic myeloid leukemia, BCR/ABL-positive, in remission
C92.12 Chronic myeloid leukemia, BCR/ABL-positive, in relapse
C92.20 Atypical chronic myeloid leukemia, BCR/ABL-negative, not having achieved remission
C92.21 Atypical chronic myeloid leukemia, BCR/ABL-negative, in remission
C92.22 Atypical chronic myeloid leukemia, BCR/ABL-negative, in relapse
C92.30 Myeloid sarcoma, not having achieved remission
C92.31 Myeloid sarcoma, in remission
C92.32 Myeloid sarcoma, in relapse
C92.40 Acute promyelocytic leukemia, not having achieved remission
C92.41 Acute promyelocytic leukemia, in remission
C92.42 Acute promyelocytic leukemia, in relapse
C92.50 Acute myelomonocytic leukemia, not having achieved remission
C92.51 Acute myelomonocytic leukemia, in remission
C92.52 Acute myelomonocytic leukemia, in relapse
C92.60 Acute myeloid leukemia with 11q23-abnormality not having achieved remission
C92.61 Acute myeloid leukemia with 11q23-abnormality in remission
C92.62 Acute myeloid leukemia with 11q23-abnormality in relapse
C92.A0 Acute myeloid leukemia with multilineage dysplasia, not having achieved remission
C92.A1 Acute myeloid leukemia with multilineage dysplasia, in remission
C92.A2 Acute myeloid leukemia with multilineage dysplasia, in relapse
C92.Z0 Other myeloid leukemia not having achieved remission
C92.Z1 Other myeloid leukemia, in remission
C92.Z2 Other myeloid leukemia, in relapse
C92.90 Myeloid leukemia, unspecified, not having achieved remission
C92.91 Myeloid leukemia, unspecified in remission
C92.92 Myeloid leukemia, unspecified in relapse
C93.00 Acute monoblastic/monocytic leukemia, not having achieved remission
C93.01 Acute monoblastic/monocytic leukemia, in remission
C93.02 Acute monoblastic/monocytic leukemia, in relapse
C93.10 Chronic myelomonocytic leukemia not having achieved remission
C93.11 Chronic myelomonocytic leukemia, in remission
C93.12 Chronic myelomonocytic leukemia, in relapse
C93.30 Juvenile myelomonocytic leukemia, not having achieved remission
C93.31 Juvenile myelomonocytic leukemia, in remission
C93.32 Juvenile myelomonocytic leukemia, in relapse
C93.Z0 Other monocytic leukemia, not having achieved remission
C93.Z1 Other monocytic leukemia, in remission
C93.Z2 Other monocytic leukemia, in relapse
C93.90 Monocytic leukemia, unspecified, not having achieved remission
C93.91 Monocytic leukemia, unspecified in remission
C93.92 Monocytic leukemia, unspecified in relapse
C94.00 Acute erythroid leukemia, not having achieved remission
C94.01 Acute erythroid leukemia, in remission
C94.02 Acute erythroid leukemia, in relapse
C94.20 Acute megakaryoblastic leukemia not having achieved remission
C94.21 Acute megakaryoblastic leukemia, in remission
C94.22 Acute megakaryoblastic leukemia, in relapse
C94.30 Mast cell leukemia not having achieved remission
C94.31 Mast cell leukemia, in remission
C94.32 Mast cell leukemia, in relapse
C94.40 Acute panmyelosis with myelofibrosis not having achieved remission
C94.41 Acute panmyelosis with myelofibrosis, in remission
C94.42 Acute panmyelosis with myelofibrosis, in relapse
C94.6 Myelodysplastic disease, not elsewhere classified
C94.80 Other specified leukemias not having achieved remission
C94.81 Other specified leukemias, in remission
C94.82 Other specified leukemias, in relapse
C95.00 Acute leukemia of unspecified cell type not having achieved remission
C95.01 Acute leukemia of unspecified cell type, in remission
C95.02 Acute leukemia of unspecified cell type, in relapse
C95.10 Chronic leukemia of unspecified cell type not having achieved remission
C95.11 Chronic leukemia of unspecified cell type, in remission
C95.12 Chronic leukemia of unspecified cell type, in relapse
C95.90 Leukemia, unspecified not having achieved remission
C95.91 Leukemia, unspecified, in remission
C95.92 Leukemia, unspecified, in relapse
C96.0 Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis
C96.20 Malignant mast cell neoplasm, unspecified
C96.21 Aggressive systemic mastocytosis
C96.22 Mast cell sarcoma
C96.29 Other malignant mast cell neoplasm
C96.4 Sarcoma of dendritic cells (accessory cells)
C96.A Histiocytic sarcoma
C96.Z Other specified malignant neoplasms of lymphoid, hematopoietic and related tissue
C96.9 Malignant neoplasm of lymphoid, hematopoietic and related tissue, unspecified
D02.0 Carcinoma in situ of larynx
D02.1 Carcinoma in situ of trachea
D03.0 Melanoma in situ of lip
D03.111 Melanoma in situ of right upper eyelid, including canthus
D03.112 Melanoma in situ of right lower eyelid, including canthus
D03.121 Melanoma in situ of left upper eyelid, including canthus
D03.122 Melanoma in situ of left lower eyelid, including canthus
D03.21 Melanoma in situ of right ear and external auricular canal
D03.22 Melanoma in situ of left ear and external auricular canal
D03.30 Melanoma in situ of unspecified part of face
D03.39 Melanoma in situ of other parts of face
D03.4 Melanoma in situ of scalp and neck
D04.0 Carcinoma in situ of skin of lip
D04.111 Carcinoma in situ of skin of right upper eyelid, including canthus
D04.112 Carcinoma in situ of skin of right lower eyelid, including canthus
D04.121 Carcinoma in situ of skin of left upper eyelid, including canthus
D04.122 Carcinoma in situ of skin of left lower eyelid, including canthus
D04.21 Carcinoma in situ of skin of right ear and external auricular canal
D04.22 Carcinoma in situ of skin of left ear and external auricular canal
D04.39 Carcinoma in situ of skin of other parts of face
D07.0 Carcinoma in situ of endometrium
D10.0 - D10.2 Benign neoplasm of lip - Benign neoplasm of floor of mouth
D10.39 Benign neoplasm of other parts of mouth
D10.4 - D10.7 Benign neoplasm of tonsil - Benign neoplasm of hypopharynx
D11.0 Benign neoplasm of parotid gland
D11.7 Benign neoplasm of other major salivary glands
D12.0 - D12.5 Benign neoplasm of cecum - Benign neoplasm of sigmoid colon
D14.0 - D14.2 Benign neoplasm of middle ear, nasal cavity and accessory sinuses - Benign neoplasm of trachea
D14.31 Benign neoplasm of right bronchus and lung
D14.32 Benign neoplasm of left bronchus and lung
D16.4 Benign neoplasm of bones of skull and face
D16.5 Benign neoplasm of lower jaw bone
D21.0 Benign neoplasm of connective and other soft tissue of head, face and neck
D22.0 Melanocytic nevi of lip
D22.111 Melanocytic nevi of right upper eyelid, including canthus
D22.112 Melanocytic nevi of right lower eyelid, including canthus
D22.121 Melanocytic nevi of left upper eyelid, including canthus
D22.122 Melanocytic nevi of left lower eyelid, including canthus
D22.21 Melanocytic nevi of right ear and external auricular canal
D22.22 Melanocytic nevi of left ear and external auricular canal
D22.30 Melanocytic nevi of unspecified part of face
D22.39 Melanocytic nevi of other parts of face
D22.4 Melanocytic nevi of scalp and neck
D23.0 Other benign neoplasm of skin of lip
D23.111 Other benign neoplasm of skin of right upper eyelid, including canthus
D23.112 Other benign neoplasm of skin of right lower eyelid, including canthus
D23.121 Other benign neoplasm of skin of left upper eyelid, including canthus
D23.122 Other benign neoplasm of skin of left lower eyelid, including canthus
D23.21 Other benign neoplasm of skin of right ear and external auricular canal
D23.22 Other benign neoplasm of skin of left ear and external auricular canal
D23.4 Other benign neoplasm of skin of scalp and neck
D31.01 Benign neoplasm of right conjunctiva
D31.02 Benign neoplasm of left conjunctiva
D31.11 Benign neoplasm of right cornea
D31.12 Benign neoplasm of left cornea
D31.21 Benign neoplasm of right retina
D31.22 Benign neoplasm of left retina
D31.31 Benign neoplasm of right choroid
D31.32 Benign neoplasm of left choroid
D31.41 Benign neoplasm of right ciliary body
D31.42 Benign neoplasm of left ciliary body
D31.51 Benign neoplasm of right lacrimal gland and duct
D31.52 Benign neoplasm of left lacrimal gland and duct
D31.61 Benign neoplasm of unspecified site of right orbit
D31.62 Benign neoplasm of unspecified site of left orbit
D31.91 Benign neoplasm of unspecified part of right eye
D31.92 Benign neoplasm of unspecified part of left eye
D32.0 Benign neoplasm of cerebral meninges
D33.0 Benign neoplasm of brain, supratentorial
D33.1 Benign neoplasm of brain, infratentorial
D33.3 Benign neoplasm of cranial nerves
D34 Benign neoplasm of thyroid gland
D35.01 Benign neoplasm of right adrenal gland
D35.02 Benign neoplasm of left adrenal gland
D35.1 - D35.5 Benign neoplasm of parathyroid gland - Benign neoplasm of carotid body
D36.0 Benign neoplasm of lymph nodes
D37.01 Neoplasm of uncertain behavior of lip
D37.02 Neoplasm of uncertain behavior of tongue
D37.030 Neoplasm of uncertain behavior of the parotid salivary glands
D37.031 Neoplasm of uncertain behavior of the sublingual salivary glands
D37.032 Neoplasm of uncertain behavior of the submandibular salivary glands
D37.04 Neoplasm of uncertain behavior of the minor salivary glands
D37.05 Neoplasm of uncertain behavior of pharynx
D37.1 Neoplasm of uncertain behavior of stomach
D37.2 Neoplasm of uncertain behavior of small intestine
D37.4 Neoplasm of uncertain behavior of colon
D37.5 Neoplasm of uncertain behavior of rectum
D37.6 Neoplasm of uncertain behavior of liver, gallbladder and bile ducts
D38.0 Neoplasm of uncertain behavior of larynx
D38.1 Neoplasm of uncertain behavior of trachea, bronchus and lung
D38.2 Neoplasm of uncertain behavior of pleura
D38.3 Neoplasm of uncertain behavior of mediastinum
D38.4 Neoplasm of uncertain behavior of thymus
D38.5 Neoplasm of uncertain behavior of other respiratory organs
D39.0 Neoplasm of uncertain behavior of uterus
D39.11 Neoplasm of uncertain behavior of right ovary
D39.12 Neoplasm of uncertain behavior of left ovary
D39.2 Neoplasm of uncertain behavior of placenta
D40.0 Neoplasm of uncertain behavior of prostate
D40.8 Neoplasm of uncertain behavior of other specified male genital organs
D41.4 Neoplasm of uncertain behavior of bladder
D44.3 - D44.5 Neoplasm of uncertain behavior of pituitary gland - Neoplasm of uncertain behavior of pineal gland
D45 Polycythemia vera
D46.0 Refractory anemia without ring sideroblasts, so stated
D46.1 Refractory anemia with ring sideroblasts
D46.20 Refractory anemia with excess of blasts, unspecified
D46.21 Refractory anemia with excess of blasts 1
D46.22 Refractory anemia with excess of blasts 2
D46.A Refractory cytopenia with multilineage dysplasia
D46.B Refractory cytopenia with multilineage dysplasia and ring sideroblasts
D46.C Myelodysplastic syndrome with isolated del(5q) chromosomal abnormality
D46.9 Myelodysplastic syndrome, unspecified
D47.01 Cutaneous mastocytosis
D47.02 Systemic mastocytosis
D47.09 Other mast cell neoplasms of uncertain behavior
D47.1 Chronic myeloproliferative disease
D47.2 Monoclonal gammopathy
D47.3 Essential (hemorrhagic) thrombocythemia
D47.4 Osteomyelofibrosis
D47.Z1 Post-transplant lymphoproliferative disorder (PTLD)
D47.Z2 Castleman disease
D48.0 - D48.5 Neoplasm of uncertain behavior of bone and articular cartilage - Neoplasm of uncertain behavior of skin
D48.7 Neoplasm of uncertain behavior of other specified sites
D49.6 Neoplasm of unspecified behavior of brain
D49.81 Neoplasm of unspecified behavior of retina and choroid
D49.89 Neoplasm of unspecified behavior of other specified sites
D50.9 Iron deficiency anemia, unspecified
D51.0 - D51.2 Vitamin B12 deficiency anemia due to intrinsic factor deficiency - Transcobalamin II deficiency
D51.8 Other vitamin B12 deficiency anemias
D52.0 Dietary folate deficiency anemia
D52.1 Drug-induced folate deficiency anemia
D52.8 Other folate deficiency anemias
D53.0 - D53.2 Protein deficiency anemia - Scorbutic anemia
D53.9 Nutritional anemia, unspecified
D56.0 - D56.5 Alpha thalassemia - Hemoglobin E-beta thalassemia
D57.02 Hb-SS disease with splenic sequestration
D57.03 Hb-SS disease with cerebral vascular involvement
D57.09 Hb-SS disease with crisis with other specified complication
D57.1 Sickle-cell disease without crisis
D57.20 Sickle-cell/Hb-C disease without crisis
D57.212 Sickle-cell/Hb-C disease with splenic sequestration
D57.213 Sickle-cell/Hb-C disease with cerebral vascular involvement
D57.218 Sickle-cell/Hb-C disease with crisis with other specified complication
D57.3 Sickle-cell trait
D57.412 Sickle-cell thalassemia, unspecified, with splenic sequestration
D57.42 Sickle-cell thalassemia beta zero without crisis
D57.431 - D57.433 Sickle-cell thalassemia beta zero with acute chest syndrome - Sickle-cell thalassemia beta zero with cerebral vascular involvement
D57.438 Sickle-cell thalassemia beta zero with crisis with other specified complication
D57.439 Sickle-cell thalassemia beta zero with crisis, unspecified
D57.44 Sickle-cell thalassemia beta plus without crisis
D57.451 - D57.453 Sickle-cell thalassemia beta plus with acute chest syndrome - Sickle-cell thalassemia beta plus with cerebral vascular involvement
D57.458 Sickle-cell thalassemia beta plus with crisis with other specified complication
D57.459 Sickle-cell thalassemia beta plus with crisis, unspecified
D57.80 Other sickle-cell disorders without crisis
D57.813 Other sickle-cell disorders with cerebral vascular involvement
D57.818 Other sickle-cell disorders with crisis with other specified complication
D57.819 Other sickle-cell disorders with crisis, unspecified
D58.0 - D58.2 Hereditary spherocytosis - Other hemoglobinopathies
D59.0 Drug-induced autoimmune hemolytic anemia
D59.11 Warm autoimmune hemolytic anemia
D59.12 Cold autoimmune hemolytic anemia
D59.13 Mixed type autoimmune hemolytic anemia
D59.19 Other autoimmune hemolytic anemia
D59.5 Paroxysmal nocturnal hemoglobinuria [Marchiafava-Micheli]
D59.6 Hemoglobinuria due to hemolysis from other external causes
D60.0 Chronic acquired pure red cell aplasia
D60.1 Transient acquired pure red cell aplasia
D60.8 Other acquired pure red cell aplasias
D61.01 Constitutional (pure) red blood cell aplasia
D61.09 Other constitutional aplastic anemia
D61.1 Drug-induced aplastic anemia
D61.2 Aplastic anemia due to other external agents
D61.3 Idiopathic aplastic anemia
D61.810 Antineoplastic chemotherapy induced pancytopenia
D61.811 Other drug-induced pancytopenia
D61.818 Other pancytopenia
D61.82 Myelophthisis
D61.89 Other specified aplastic anemias and other bone marrow failure syndromes
D61.9 Aplastic anemia, unspecified
D63.0 Anemia in neoplastic disease
D64.0 Hereditary sideroblastic anemia
D64.1 Secondary sideroblastic anemia due to disease
D64.2 Secondary sideroblastic anemia due to drugs and toxins
D64.3 Other sideroblastic anemias
D64.4 Congenital dyserythropoietic anemia
D64.81 Anemia due to antineoplastic chemotherapy
D64.89 Other specified anemias
D68.51 Activated protein C resistance
D68.52 Prothrombin gene mutation
D68.61 Antiphospholipid syndrome
D68.62 Lupus anticoagulant syndrome
D68.69 Other thrombophilia
D69.1 Qualitative platelet defects
D69.3 Immune thrombocytopenic purpura
D69.41 Evans syndrome
D69.42 Congenital and hereditary thrombocytopenia purpura
D69.49 Other primary thrombocytopenia
D69.51 Posttransfusion purpura
D69.59 Other secondary thrombocytopenia
D69.6 Thrombocytopenia, unspecified
D70.0 Congenital agranulocytosis
D70.1 Agranulocytosis secondary to cancer chemotherapy
D70.2 Other drug-induced agranulocytosis
D70.3 Neutropenia due to infection
D70.4 Cyclic neutropenia
D70.8 Other neutropenia
D70.9 Neutropenia, unspecified
D71 Functional disorders of polymorphonuclear neutrophils
D72.0 Genetic anomalies of leukocytes
D72.110 Idiopathic hypereosinophilic syndrome [IHES]
D72.111 Lymphocytic Variant Hypereosinophilic Syndrome [LHES]
D72.118 Other hypereosinophilic syndrome
D72.119 Hypereosinophilic syndrome [HES], unspecified
D72.12 Drug rash with eosinophilia and systemic symptoms syndrome
D72.810 Lymphocytopenia
D72.818 Other decreased white blood cell count
D72.819 Decreased white blood cell count, unspecified
D72.820 Lymphocytosis (symptomatic)
D72.821 Monocytosis (symptomatic)
D72.822 Plasmacytosis
D72.823 Leukemoid reaction
D72.824 Basophilia
D72.828 Other elevated white blood cell count
D72.829 Elevated white blood cell count, unspecified
D72.89 Other specified disorders of white blood cells
D73.0 Hyposplenism
D73.1 - D73.5 Hypersplenism - Infarction of spleen
D73.81 Neutropenic splenomegaly
D73.89 Other diseases of spleen
D73.9 Disease of spleen, unspecified
D75.81 Myelofibrosis
D75.821 Non-immune heparin-induced thrombocytopenia
D75.822 Immune-mediated heparin-induced thrombocytopenia
D75.828 Other heparin-induced thrombocytopenia syndrome
D75.829 Heparin-induced thrombocytopenia, unspecified
D75.838 Other thrombocytosis
D75.84 Other platelet-activating anti-PF4 disorders
D75.89 Other specified diseases of blood and blood-forming organs
D75.9 Disease of blood and blood-forming organs, unspecified
D76.1 Hemophagocytic lymphohistiocytosis
D76.2 Hemophagocytic syndrome, infection-associated
D76.3 Other histiocytosis syndromes
D80.0 - D80.8 Hereditary hypogammaglobulinemia - Other immunodeficiencies with predominantly antibody defects
D81.0 Severe combined immunodeficiency [SCID] with reticular dysgenesis
D81.1 Severe combined immunodeficiency [SCID] with low T- and B-cell numbers
D81.2 Severe combined immunodeficiency [SCID] with low or normal B-cell numbers
D81.4 Nezelof's syndrome
D81.6 Major histocompatibility complex class I deficiency
D81.7 Major histocompatibility complex class II deficiency
D81.82 Activated Phosphoinositide 3-kinase Delta Syndrome [APDS]
D81.89 Other combined immunodeficiencies
D82.0 Wiskott-Aldrich syndrome
D82.1 Di George's syndrome
D83.0 Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function
D83.1 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
D83.2 Common variable immunodeficiency with autoantibodies to B- or T-cells
D83.8 Other common variable immunodeficiencies
D84.1 Defects in the complement system
D84.81 Immunodeficiency due to conditions classified elsewhere
D84.821 Immunodeficiency due to drugs
D84.822 Immunodeficiency due to external causes
D84.89 Other immunodeficiencies
D89.1 - D89.3 Cryoglobulinemia - Immune reconstitution syndrome
D89.810 Acute graft-versus-host disease
D89.811 Chronic graft-versus-host disease
D89.812 Acute on chronic graft-versus-host disease
D89.813 Graft-versus-host disease, unspecified
D89.82 Autoimmune lymphoproliferative syndrome [ALPS]
D89.831 - D89.835 Cytokine release syndrome, grade 1 - Cytokine release syndrome, grade 5
D89.839 Cytokine release syndrome, grade unspecified
D89.89 Other specified disorders involving the immune mechanism, not elsewhere classified
D89.9 Disorder involving the immune mechanism, unspecified
E34.0 Carcinoid syndrome
E85.0 - E85.4 Non-neuropathic heredofamilial amyloidosis - Organ-limited amyloidosis
E85.81 Light chain (AL) amyloidosis
E85.82 Wild-type transthyretin-related (ATTR) amyloidosis
E85.89 Other amyloidosis
E85.9 Amyloidosis, unspecified
E88.09 Other disorders of plasma-protein metabolism, not elsewhere classified
H20.9 Unspecified iridocyclitis
I31.8 Other specified diseases of pericardium
I81 Portal vein thrombosis
I82.91 Chronic embolism and thrombosis of unspecified vein
I88.0 Nonspecific mesenteric lymphadenitis
I88.1 Chronic lymphadenitis, except mesenteric
I88.9 Nonspecific lymphadenitis, unspecified
J34.0 Abscess, furuncle and carbuncle of nose
J34.81 Nasal mucositis (ulcerative)
J34.89 Other specified disorders of nose and nasal sinuses
J35.8 Other chronic diseases of tonsils and adenoids
J90 Pleural effusion, not elsewhere classified
J91.0 Malignant pleural effusion
J91.8 Pleural effusion in other conditions classified elsewhere
J94.0 Chylous effusion
J94.2 Hemothorax
K50.00 Crohn's disease of small intestine without complications
K50.10 Crohn's disease of large intestine without complications
K50.80 Crohn's disease of both small and large intestine without complications
K50.90 Crohn's disease, unspecified, without complications
K51.00 Ulcerative (chronic) pancolitis without complications
K51.20 Ulcerative (chronic) proctitis without complications
K51.30 Ulcerative (chronic) rectosigmoiditis without complications
K51.40 Inflammatory polyps of colon without complications
K51.50 Left sided colitis without complications
K51.80 Other ulcerative colitis without complications
K51.90 Ulcerative colitis, unspecified, without complications
K63.5 Polyp of colon
L40.54 Psoriatic juvenile arthropathy
L40.59 Other psoriatic arthropathy
M32.0 Drug-induced systemic lupus erythematosus
M32.10 - M32.15 Systemic lupus erythematosus, organ or system involvement unspecified - Tubulo-interstitial nephropathy in systemic lupus erythematosus
M32.8 Other forms of systemic lupus erythematosus
M32.9 Systemic lupus erythematosus, unspecified
M46.00 Spinal enthesopathy, site unspecified
M46.1 Sacroiliitis, not elsewhere classified
M46.80 Other specified inflammatory spondylopathies, site unspecified
M46.90 Unspecified inflammatory spondylopathy, site unspecified
M49.80 Spondylopathy in diseases classified elsewhere, site unspecified
O01.9 Hydatidiform mole, unspecified
Q85.01 - Q85.03 Neurofibromatosis, type 1 - Schwannomatosis
Q85.09 Other neurofibromatosis
R09.81 Nasal congestion
R16.1 Splenomegaly, not elsewhere classified
R16.2 Hepatomegaly with splenomegaly, not elsewhere classified
R18.0 Malignant ascites
R18.8 Other ascites
R19.00 - R19.07 Intra-abdominal and pelvic swelling, mass and lump, unspecified site - Generalized intra-abdominal and pelvic swelling, mass and lump
R19.09 Other intra-abdominal and pelvic swelling, mass and lump
R22.0 - R22.2 Localized swelling, mass and lump, head - Localized swelling, mass and lump, trunk
R22.31 - R22.33 Localized swelling, mass and lump, right upper limb - Localized swelling, mass and lump, upper limb, bilateral
R22.41 - R22.43 Localized swelling, mass and lump, right lower limb - Localized swelling, mass and lump, lower limb, bilateral
R59.0 Localized enlarged lymph nodes
R59.1 Generalized enlarged lymph nodes
R59.9 Enlarged lymph nodes, unspecified
R80.0 Isolated proteinuria
R80.1 Persistent proteinuria, unspecified
R80.3 Bence Jones proteinuria
R80.8 Other proteinuria
R80.9 Proteinuria, unspecified
R89.7 Abnormal histological findings in specimens from other organs, systems and tissues
R90.0 Intracranial space-occupying lesion found on diagnostic imaging of central nervous system
T86.01 Bone marrow transplant rejection
T86.02 Bone marrow transplant failure
T86.03 Bone marrow transplant infection
T86.09 Other complications of bone marrow transplant
T86.11 Kidney transplant rejection
T86.12 Kidney transplant failure
T86.13 Kidney transplant infection
T86.19 Other complication of kidney transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
T86.41 Liver transplant rejection
T86.42 Liver transplant failure
T86.43 Liver transplant infection
T86.49 Other complications of liver transplant
T86.5 Complications of stem cell transplant
T86.810 Lung transplant rejection
T86.811 Lung transplant failure
T86.812 Lung transplant infection
T86.818 Other complications of lung transplant
T86.830 - T86.832 Bone graft rejection - Bone graft infection
T86.838 Other complications of bone graft
T86.8401 - T86.8403 Corneal transplant rejection, right eye - Corneal transplant rejection, bilateral
T86.8411 - T86.8413 Corneal transplant failure, right eye - Corneal transplant failure, bilateral
T86.8421 - T86.8423 Corneal transplant infection, right eye - Corneal transplant infection, bilateral
T86.8481 - T86.8483 Other complications of corneal transplant, right eye - Other complications of corneal transplant, bilateral
T86.8491 - T86.8493 Unspecified complication of corneal transplant, right eye - Unspecified complication of corneal transplant, bilateral
T86.850 Intestine transplant rejection
T86.851 Intestine transplant failure
T86.852 Intestine transplant infection
T86.858 Other complications of intestine transplant
T86.890 Other transplanted tissue rejection
T86.891 Other transplanted tissue failure
T86.892 Other transplanted tissue infection
T86.898 Other complications of other transplanted tissue
T86.90 Unspecified complication of unspecified transplanted organ and tissue
T86.91 Unspecified transplanted organ and tissue rejection
T86.92 Unspecified transplanted organ and tissue failure
T86.93 Unspecified transplanted organ and tissue infection
Z03.89 Encounter for observation for other suspected diseases and conditions ruled out
Z21 Asymptomatic human immunodeficiency virus [HIV] infection status
Z48.21 Encounter for aftercare following heart transplant
Z48.22 Encounter for aftercare following kidney transplant
Z48.23 Encounter for aftercare following liver transplant
Z48.24 Encounter for aftercare following lung transplant
Z48.280 Encounter for aftercare following heart-lung transplant
Z48.288 Encounter for aftercare following multiple organ transplant
Z48.290 Encounter for aftercare following bone marrow transplant
Z48.298 Encounter for aftercare following other organ transplant
Z52.001 Unspecified donor, stem cells
Z52.011 Autologous donor, stem cells
Z52.091 Other blood donor, stem cells
Z52.3 Bone marrow donor
Z76.82 Awaiting organ transplant status
Z85.6 Personal history of leukemia
Z85.72 Personal history of non-Hodgkin lymphomas
Z85.79 Personal history of other malignant neoplasms of lymphoid, hematopoietic and related tissues
Z94.0 Kidney transplant status
Z94.1 Heart transplant status
Z94.2 Lung transplant status
Z94.3 Heart and lungs transplant status
Z94.4 Liver transplant status
Z94.5 Skin transplant status
Z94.6 Bone transplant status
Z94.7 Corneal transplant status
Z94.81 Bone marrow transplant status
Z94.82 Intestine transplant status
Z94.83 Pancreas transplant status
Z94.84 Stem cells transplant status
Z95.3 Presence of xenogenic heart valve
Z95.4 Presence of other heart-valve replacement
N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

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Group 1 Codes

N/A

N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
012x Hospital Inpatient (Medicare Part B only)
013x Hospital Outpatient
014x Hospital - Laboratory Services Provided to Non-patients
018x Hospital - Swing Beds
021x Skilled Nursing - Inpatient (Including Medicare Part A)
022x Skilled Nursing - Inpatient (Medicare Part B only)
023x Skilled Nursing - Outpatient
071x Clinic - Rural Health
073x Clinic - Freestanding
077x Clinic - Federally Qualified Health Center (FQHC)
085x Critical Access Hospital
N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Revenue codes only apply to providers who bill these services to the Part A MAC. Revenue codes do not apply to physicians, other professionals and suppliers who bill these services to the carrier or Part B MAC.

Please note that not all revenue codes apply to every type of bill code. Providers are encouraged to refer to the FISS revenue code file for allowable bill types. Similarly, not all revenue codes apply to each CPT/HCPCS code. Providers are encouraged to refer to the FISS HCPCS file for allowable revenue codes.

All revenue codes billed on the inpatient claim for the dates of service in question may be subject to review.


Code Description
0300 Laboratory - General Classification
0302 Laboratory - Immunology
0309 Laboratory - Other Laboratory
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Other Coding Information

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
10/01/2023 R12

Revision Effective: 10/01/2023
Revision Explanation: Annual ICD -inserted Support Medical Necessity, the following code changes   D48.110 in D48.0 - D48.5 D48.111 in D48.0 - D48.5 D48.112 in D48.0 - D48.5 D48.113 in D48.0 - D48.5 D48.114 in D48.0 - D48.5 D48.115 in D48.0 - D48.5 D48.116 in D48.0 - D48.5 D48.117 in D48.0 - D48.5 D48.118 in D48.0 - D48.5 and D48.19 in D48.0 - D48.5 added to Support Medical Necessity, Group 1. Code Expansion for Group 1:  D57.04, D57.214, D57.434, D57.454 and D57.814 

03/09/2023 R11

Revision Effective: 03/09/2023
Revision Explanation: Annual review, no changes 

10/01/2022 R10

Revision Effective: 10/01/2022
Revision Explanation: Annual ICD-10 Update, added the following codes: D75.829

10/01/2022 R9

Revision Effective: 10/01/2022
Revision Explanation: Annual ICD-10 Update, added the following codes: D75.821, D75.822, D75.828, D75.84, and D81.82.

02/10/2022 R8

Revision Effective: 02/10/2022
Revision Explanation: Annual review, no changes were made.

10/01/2021 R7

Revision Effective: 10/01/2021
Revision Explanation: Annual ICD-10 update. Under ICD-10-CM Codes that Support Medical Necessity Group 1: C79.63, C84.74, and D75.838.

03/04/2021 R6

Revision Effective: 03/04/2021
Revision Explanation: Annual review, no changes were made.

10/01/2020 R5

Revision Effective: 10/01/2020
Revision Explanation: During revision 3 there were codes added and deleted in error. This revision is to make corrections to add back the deleted codes and remove codes that were added in error.

The following codes were deleted in error and added back: C07, C08.0, C11.0-c11.3, C11.8, C11.9, C21.2, C34.01, C34.02, C34.91, C34.92, C40.81, C40.82, C40.91, C40.92, C41.1, C43.0, C43.111, C43.112, C43.121,  C43.122, C43.21, C43.22, C43.31, C43.39, C43.4, C44.702, C44.709, C44.712, C44.719, C44.722, c44.729, C44.792, C44.799, C45.0, C45.1, C45.9, C47.0, C47.21, C47.22, C47.3, C49.21, C49.22, C50.011, C50.012, C50.021, C50.022, C50.111, C50.112, C50.121, C50.122, C50.211, C50.212, c50.221, c50.222, C50.311, C50.312, C50.321, C50.322, C50.411, C50.412, C50.421, C50.422, c50.511, C50.512, C50.521, C50.522, C0.611, C50.612, C50.621, C50.622, C50.811, C50.812, c50.821, C50.822, C50.911, C50.912, C50.921, C50.922, C56.1, C56.2, C57.01, C57.02, C57.11, C57.12, C57.21, C57.22, C57.3, C64.1, C64.2, C65.1, C65.2, C66.1, C66.2, C69.01, C69.02, C69.11, C69.12, C69.21, C69.22, C69.31, C69.32, C69.41, C69.42, C69.51, C69.52, C69.61, C69.62, C69.81, C69.82, C72.21, C72.22, C72.31, C72.32, C72.41, C72.42, C74.01, C74.02, C74.11, C74.12, C78.7, C78.89, C80.2, D02.0, D02.1, D03.0, D03.111, D03.112, D03.121, D03.122, D03.21, D03.22, D03.30, D03.39, D03.4, D04.0, D04.111, D04.112, D04.121, D04.122, D04.21, D04.22, D04.39, D07.0., D10.0-d10.2, D10.39, D10.4-D10.7, D11.0, D11.7, D12.0-d12.5, D14.0-d14.2, D14.31, D14.32, D16.4, d16.5, D21.0, D22.0, D22.111, D22.112, D22.121, D22.122, d22.21, d22.22, D22.30, D22.39, D22.4, D23.0, D53.111, d23.112, D23.121, D23.122, D23.21, d23.22, D23.4, D31.01, D31.02, D31.11, d31.12, D31.21, D31.22, D31.31, d31.32, D31.41, D31.42, D31.51, D31.52, D31.61, D31.62, D31.91, D31.92, D32.0, d33.0, D33.1, d33.3, D34, D35.01, D35.02, D35.1-d35.5, D36.0, D39.11, D39.12, d39.2, D44.3-d44.5, D47.09, D47.4, D48.0, D48.2, D49.6, D49.81, D49.89, d50.9, D51.0-d51.2, D51.8, D52.0, D52.1, D52.8, D53.0-d53.2, D53.9, D59.0, D59.1,D64.81, D68.51-D68.52, D68.61-d68.62, D68.69, D69.51, D69..59, D72.1, D73.0, D75.82, D75.89, D84.8, D89.2, 

Codes D59.1, D72.1, and D84.8 were deleted during the ICd-10 annual review and replaced with the following codes D59.11-D59.13, D59.19, D721.110, D72.111, D72.119, D72.119. D7212, D84.81, D84.821, D84.822, and D84.89. Codes D59.10 and D84.9 were added in error as there are more specific codes in these series that are more appropriate and have been removed.

The following unspecified codes were added in error and removed as there are codes from the related series that have a higher specificity: C34.00, C34.90, C44.701, C44.711, C44.721, C44.791, C49.20, C50.019, C50.029, C50.119, C50.219, C50.319, C50.419, C50.519, C50.619, C50.819, C50.919, C50.929, C54.9, C56.9, C64.9, C65.9, C66.9, C68.9, C69.00, C69.10, C69.20, C69.30, C69.40, C69.50, C69.60, C69.80, C69.90, C71.9, C8.0, C81.00, C81.10, C81.20, C81.30, C81.40, C81.70, C81.90, C82.00, C82.10, C82.20, C82.30, C82.40, C82.50, C82.60, C82.80, c82.90, C83.00, C83.10, C83.30, C83.50, C83.70, C83.80, C83.90, C84.00, C84.10, C84.40, C84.60, C84.70. C84.A0, C84.Z0, C84.90, C85.10, C85.20, C85.80, C85.90, C88.9, D35.00, D37.039, D37.8, D37.9, D38.6, D39.10, D39.8, D39.9, D46.4, D46.Z, D47.Z9, D47.9, D59.10, D59.8, D60.9, D64.9, D72.9, D81.9, D83.9, D84.9, T86.00, T86.10, T86.20, T86.30, T86.40, T86.819, T86.859, T86.899, T86.99, Z94.89, and Z94.9

The following unspecified code were added in  error and have been removed: C15.9,  C34.10, C34.30, C39.0, C39.9, C40.00, C40.10, C40.20, C40.30, C44.101, C44.1021-c44.1022, C44.1091-C44.1092, C44.111, C44.121, C44.191, C44.201, C44.211, C44.221, C44.291, C44.300-C44.301, C44.309, C44.310, C44.320, C44.329, C44.390, C44.601, C44.611, C44.621, C44.691, C44.90-C44.92, C44.99, C46.50,  C46.9, C49.10, C57.9, C62.00, C62.10, C62.90, C74.90, C76.40, C76.50, C78.00, C79.00, C79.60, C79.70, D05.90, D40.10, D40.9, D48.60, D56.9, D57.00, D57.219, D57.4113, D57.418, M02.30, M08.00, M35.9,  M45.9, T86.8409, T86.8419, T86.8429, T86.8489 and T86.8499.

The following codes were added effective 10/01/2020: C15.4, C15.5, C15.8, C16.0-C16.8, C17.0-C17.2, C17.8, C22.0, C22.2, C22.7-C22.8, C23, C24.0-c24.1, C34.2, C34.80, C37, C25.0-C25.2, C25.7, C25.8. C26.0, C26.9, C41.2-C41.4, C41.9, C44.1121-c44.1122, c44.1191-C44.1192. C44.1221-C44.1222, C44.1291-C44.1292, C44.311, C44.319, C44.321, C44.391, C44.399, C46.0-C46.4, C46.51-c46.52, C46.7, C47.8, C48.0, C48.2, C49.4-C496, C49.8, C49.9, C51.0-C51.2, C51.9, C52, C53.0, C53.1, C53.8, C53.9,  C57.7-C57.9, C58, C60.0-C60.2, C60.8, C60.9, C63.00, C63.10, C63.2, C63.7-C63.9, C70.1, C70.9, C72.0-C72.1, C72.50, C72.9, C75.5, C75.8, C75.9, C76.1-C76.3, C76.41-c76.42, C76.8, C77.1-C77.5, C77.8, c77.9, C78.01-C78.02, C78.39, C78.4, C78.5, C79.01-C79.02, C79.11, C79.19, C79.2, C79.32, C79.49, C79.51-C79.52, C79.61-C79.62, C79.71-c79.72, D40.0, D40.8, D48.3-D48.5, D48.7, D56.0- D56.5, D57.03, D57.09, D57.1, D57.20, D57.213, D57.218, D57.3, D57.42, D57.431-D57.433, D57.438, D57.439, D57.44, D57.451-D57.453, D57.458-D57.459, D57.80, D57.813, D57.818-D57.819, D58.0-D58.2, D61.89, D63.0, D73.89, D75.9,  D80.6, D80.8,  D81.4, D82.0-D82.1, D84.1, D89.3, D89.831-D89.835, D89.839, D89.9, E34.0, E88.09, H20.9, I81, I82.91, K50.00, K50.10, K50.80, K50.90, K51.00, K51.20, K51.30, K51.40, K51.50, K51.80, K51.90, L40.54, L40.59, M46.00, M46.1, M46.80, M46.90, M49.80, O01.9, R19.01-R19.07, R19.09, R80.0, R80.1, R80.3, R80.8, R80.9, R89.7, T86.8401-T86.8403, T86.8411-T86.8413, T86.8421-T86.8423, T86.8481-T86.8483, T86.8491-T86.8493, Z48.288, Z48.298, and Z76.82

10/01/2020 R4

Revision Effective: 10/01/2020
Revision Explanation: Added D59.12 as this was left off in error from previous review. Codes D72.1, D84.8 were deleted during annual ICD-10 review and replaced with the following code: D72.110, D72.111, D72.118, D72.119, D72.12, D84.81

D84.821, D84.822,  and D84.89.

10/01/2020 R3

Revision Effective: 10/01/2020

Revision Explanation: Under ICD-10 Codes that Support Medical Necessity – Group 1: Codes added codes D57.03, D57.09, D57.213, D57.218, D57.413, D57.418, D57.42, D57.431, D57.432, D57.433, D57.438, D57.439, D57.44, D57.451, D57.452, D57.453, D57.458, D57.459, D57.813, D57.818, D59.10, D59.11, D59.13, D59.19, D89.831, D89.832, D89.833, D89.834, D89.835, D89.839, T86.8401, T86.8402, T86.8403, T86.8409, T86.8411, T86.8412, T86.8413, T86.8419, T86.8421, T86.8422, T86.8423, T86.8429, T86.8481, T86.8482, T86.8483, T86.8489, T86.8491, T86.8492, T86.8493, and T86.8499. The description was revised for code D57.412 and code D72.1 was deleted. This revision is due to the Annual ICD-10 Code Update and is effective on 10/1/2020.

10/31/2019 R2

Revision Effective: N/A

Revision Explanation: Annual Review, no changes made.

10/31/2019 R1

R1

Revision Effective: 10/31/2019

Revision Explanation: Created group 2 CPT codes in CPT/HCPCS section as these codes are for quantitative codes in immunology. Regulations regarding billing and coding were removed from the CMS National Coverage Policy section of the related Lab: Flow Cytometry LCD and placed in this article.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L34037 - Flow Cytometry
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
11/07/2023 11/16/2023 - N/A Currently in Effect View
09/29/2023 10/01/2023 - 11/15/2023 Superseded You are here
02/28/2023 03/09/2023 - 09/30/2023 Superseded View
09/20/2022 10/01/2022 - 03/08/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

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