LCD Reference Article Billing and Coding Article

Billing and Coding: Routine Foot Care

A52996

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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General Information

Source Article ID
N/A
Article ID
A52996
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Routine Foot Care
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
01/01/2024
Revision Ending Date
N/A
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.

Copyright © 2024, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Social Security Act (Title XVIII) Standard References:

  • Title XVIII of the Social Security Act, Section 1833(e) states that no payment shall be made to any provider of services or other person under this part unless there has been furnished such information as may be necessary in order to determine the amounts due such provider or other person under this part for the period with respect to which the amounts are being paid or for any prior period.

Article Guidance

Article Text

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L35138 (Routine Foot Care). Please refer to the LCD for reasonable and necessary requirements.

Coverage Guidance

Notice: It is not appropriate to bill Medicare for services that are not covered (as described by the entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

It is not appropriate to report procedure codes 11305-11308 for the removal of corns and calluses of the feet. Removal of these lesions is considered to be routine foot care and must be reported with procedure codes 11055-11057, paring or cutting of benign hyperkeratotic lesion (e.g., corn or callus). Services must be reported using the procedure code that most accurately describes the procedure performed.

When reporting routine foot care services that needs to meet one of the exclusions, one of the following applicable Q modifiers identifying the class findings must be included on the claim.

  • Q7 – 1 Class A findings
  • Q8 – 2 Class B findings
  • Q9 – 1 Class B and 2 Class C findings


For all claims for foot-care services, report a foot/toe location modifier (when appropriate). The following are valid HCPCS modifiers:

  • Left foot - LT
  • First toe, left foot - TA
  • Second toe, left foot - T1
  • Third toe, left foot - T2
  • Fourth toe, left foot - T3
  • Fifth toe, left foot - T4
  • Right foot - RT
  • First toe, right foot - T5
  • Second toe, right foot - T6
  • Third toe, right foot - T7
  • Fourth toe, right foot - T8
  • Fifth toe, right foot - T9


If a significant separately identified evaluation and management service is provided on the same day as routine foot care, the -25 modifier should be appended.

Report only one of CPT codes 11055-11057 for each date of service. Total the number of keratotic lesions debrided and select the most appropriate CPT code. Example: if one lesion is debrided on the right foot and two lesions are debrided on the left foot, code 11056 (two to four lesions) would be the most appropriate CPT code.

When reporting one of the ICD-10-CM codes that fall under the "active care requirement", the date that the beneficiary was last seen by the M.D., D.O., or qualified NPP, responsible for treating the underlying condition must be reported in line 19 of the CMS-1500 claim form or the electronic equivalent. 

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
011x Hospital Inpatient (Including Medicare Part A)
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
028x Skilled Nursing - Swing Beds
071x Clinic - Rural Health
073x Clinic - Freestanding
075x Clinic - Comprehensive Outpatient Rehabilitation Facility (CORF)
077x Clinic - Federally Qualified Health Center (FQHC)
083x Ambulatory Surgery Center
085x Critical Access Hospital
N/A

Revenue Codes

Code Description
051X Clinic - General Classification
N/A

CPT/HCPCS Codes

Group 1

(7 Codes)
Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT codes in their CPT book.

Group 1 Codes
Code Description
11055 Paring/cutg b9 hyprker les 1
11056 Parng/cutg b9 hyprkr les 2-4
11057 Parng/cutg b9 hyprkr les >4
11719 Trim nail(s) any number
11720 Debride nail 1-5
11721 Debride nail 6 or more
G0127 Trim nail(s)
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

(746 Codes)
Group 1 Paragraph

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim(s) submitted.

The following ICD-10 codes support medical necessity and provide coverage for CPT/HCPCS codes: 11055, 11056, 11057, 11719, 11720, 11721 and G0127.

Group 1 Codes
Code Description
A30.0 Indeterminate leprosy
A30.1 Tuberculoid leprosy
A30.2 Borderline tuberculoid leprosy
A30.3 Borderline leprosy
A30.4 Borderline lepromatous leprosy
A30.5 Lepromatous leprosy
A50.1 Early congenital syphilis, latent
A50.40 Late congenital neurosyphilis, unspecified
A50.41 Late congenital syphilitic meningitis
A50.42 Late congenital syphilitic encephalitis
A50.43 Late congenital syphilitic polyneuropathy
A50.45 Juvenile general paresis
A52.11 Tabes dorsalis
A52.13 Late syphilitic meningitis
A52.14 Late syphilitic encephalitis
A52.15 Late syphilitic neuropathy
A52.16 Charcot's arthropathy (tabetic)
A52.17 General paresis
A52.19 Other symptomatic neurosyphilis
A52.2 Asymptomatic neurosyphilis
B20 Human immunodeficiency virus [HIV] disease
B35.1 Tinea unguium
D51.0* Vitamin B12 deficiency anemia due to intrinsic factor deficiency
D81.818* Other biotin-dependent carboxylase deficiency
D81.819* Biotin-dependent carboxylase deficiency, unspecified
E08.00* Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E08.01* Diabetes mellitus due to underlying condition with hyperosmolarity with coma
E08.10* Diabetes mellitus due to underlying condition with ketoacidosis without coma
E08.11* Diabetes mellitus due to underlying condition with ketoacidosis with coma
E08.21* Diabetes mellitus due to underlying condition with diabetic nephropathy
E08.22* Diabetes mellitus due to underlying condition with diabetic chronic kidney disease
E08.29* Diabetes mellitus due to underlying condition with other diabetic kidney complication
E08.311* Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema
E08.319* Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema
E08.3211* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye
E08.3212* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, left eye
E08.3213* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3291* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, right eye
E08.3292* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, left eye
E08.3293* Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3311* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E08.3312* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E08.3313* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3391* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E08.3392* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E08.3393* Diabetes mellitus due to underlying condition with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3411* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, right eye
E08.3412* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, left eye
E08.3413* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E08.3491* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, right eye
E08.3492* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, left eye
E08.3493* Diabetes mellitus due to underlying condition with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E08.3511* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, right eye
E08.3512* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, left eye
E08.3513* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral
E08.3521* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E08.3522* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E08.3523* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E08.3531* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E08.3532* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E08.3533* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E08.3541* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E08.3542* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E08.3543* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E08.3551* Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, right eye
E08.3552* Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, left eye
E08.3553* Diabetes mellitus due to underlying condition with stable proliferative diabetic retinopathy, bilateral
E08.3591* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, right eye
E08.3592* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, left eye
E08.3593* Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy without macular edema, bilateral
E08.36* Diabetes mellitus due to underlying condition with diabetic cataract
E08.37X1* Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, right eye
E08.37X2* Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, left eye
E08.37X3* Diabetes mellitus due to underlying condition with diabetic macular edema, resolved following treatment, bilateral
E08.39* Diabetes mellitus due to underlying condition with other diabetic ophthalmic complication
E08.40* Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
E08.41* Diabetes mellitus due to underlying condition with diabetic mononeuropathy
E08.42* Diabetes mellitus due to underlying condition with diabetic polyneuropathy
E08.43* Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
E08.44* Diabetes mellitus due to underlying condition with diabetic amyotrophy
E08.49* Diabetes mellitus due to underlying condition with other diabetic neurological complication
E08.51* Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy without gangrene
E08.52* Diabetes mellitus due to underlying condition with diabetic peripheral angiopathy with gangrene
E08.59* Diabetes mellitus due to underlying condition with other circulatory complications
E08.610* Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy
E08.618* Diabetes mellitus due to underlying condition with other diabetic arthropathy
E08.620* Diabetes mellitus due to underlying condition with diabetic dermatitis
E08.621* Diabetes mellitus due to underlying condition with foot ulcer
E08.622* Diabetes mellitus due to underlying condition with other skin ulcer
E08.628* Diabetes mellitus due to underlying condition with other skin complications
E08.630* Diabetes mellitus due to underlying condition with periodontal disease
E08.638* Diabetes mellitus due to underlying condition with other oral complications
E08.641* Diabetes mellitus due to underlying condition with hypoglycemia with coma
E08.649* Diabetes mellitus due to underlying condition with hypoglycemia without coma
E08.65* Diabetes mellitus due to underlying condition with hyperglycemia
E08.69* Diabetes mellitus due to underlying condition with other specified complication
E08.8* Diabetes mellitus due to underlying condition with unspecified complications
E08.9* Diabetes mellitus due to underlying condition without complications
E09.00* Drug or chemical induced diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E09.01* Drug or chemical induced diabetes mellitus with hyperosmolarity with coma
E09.10* Drug or chemical induced diabetes mellitus with ketoacidosis without coma
E09.11* Drug or chemical induced diabetes mellitus with ketoacidosis with coma
E09.21* Drug or chemical induced diabetes mellitus with diabetic nephropathy
E09.22* Drug or chemical induced diabetes mellitus with diabetic chronic kidney disease
E09.29* Drug or chemical induced diabetes mellitus with other diabetic kidney complication
E09.311* Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy with macular edema
E09.319* Drug or chemical induced diabetes mellitus with unspecified diabetic retinopathy without macular edema
E09.3211* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E09.3212* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E09.3213* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3291* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E09.3292* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E09.3293* Drug or chemical induced diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3311* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E09.3312* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E09.3313* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3391* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E09.3392* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E09.3393* Drug or chemical induced diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3411* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E09.3412* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E09.3413* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E09.3491* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E09.3492* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E09.3493* Drug or chemical induced diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E09.3511* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E09.3512* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E09.3513* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E09.3521* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E09.3522* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E09.3523* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E09.3531* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E09.3532* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E09.3533* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E09.3541* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E09.3542* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E09.3543* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E09.3551* Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E09.3552* Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E09.3553* Drug or chemical induced diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E09.3591* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E09.3592* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E09.3593* Drug or chemical induced diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E09.36* Drug or chemical induced diabetes mellitus with diabetic cataract
E09.37X1* Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E09.37X2* Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E09.37X3* Drug or chemical induced diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E09.39* Drug or chemical induced diabetes mellitus with other diabetic ophthalmic complication
E09.40* Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified
E09.41* Drug or chemical induced diabetes mellitus with neurological complications with diabetic mononeuropathy
E09.42* Drug or chemical induced diabetes mellitus with neurological complications with diabetic polyneuropathy
E09.43* Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
E09.44* Drug or chemical induced diabetes mellitus with neurological complications with diabetic amyotrophy
E09.49* Drug or chemical induced diabetes mellitus with neurological complications with other diabetic neurological complication
E09.51* Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy without gangrene
E09.52* Drug or chemical induced diabetes mellitus with diabetic peripheral angiopathy with gangrene
E09.59* Drug or chemical induced diabetes mellitus with other circulatory complications
E09.610* Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy
E09.618* Drug or chemical induced diabetes mellitus with other diabetic arthropathy
E09.620* Drug or chemical induced diabetes mellitus with diabetic dermatitis
E09.621* Drug or chemical induced diabetes mellitus with foot ulcer
E09.622* Drug or chemical induced diabetes mellitus with other skin ulcer
E09.628* Drug or chemical induced diabetes mellitus with other skin complications
E09.630* Drug or chemical induced diabetes mellitus with periodontal disease
E09.638* Drug or chemical induced diabetes mellitus with other oral complications
E09.641* Drug or chemical induced diabetes mellitus with hypoglycemia with coma
E09.649* Drug or chemical induced diabetes mellitus with hypoglycemia without coma
E09.65* Drug or chemical induced diabetes mellitus with hyperglycemia
E09.69* Drug or chemical induced diabetes mellitus with other specified complication
E09.8* Drug or chemical induced diabetes mellitus with unspecified complications
E09.9* Drug or chemical induced diabetes mellitus without complications
E10.10* Type 1 diabetes mellitus with ketoacidosis without coma
E10.11* Type 1 diabetes mellitus with ketoacidosis with coma
E10.21* Type 1 diabetes mellitus with diabetic nephropathy
E10.22* Type 1 diabetes mellitus with diabetic chronic kidney disease
E10.29* Type 1 diabetes mellitus with other diabetic kidney complication
E10.311* Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E10.319* Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E10.3211* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E10.3212* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E10.3213* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3291* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E10.3292* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E10.3293* Type 1 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3311* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E10.3312* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E10.3313* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3391* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E10.3392* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E10.3393* Type 1 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3411* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E10.3412* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E10.3413* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E10.3491* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E10.3492* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E10.3493* Type 1 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E10.3511* Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E10.3512* Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E10.3513* Type 1 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E10.3521* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E10.3522* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E10.3523* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E10.3531* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E10.3532* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E10.3533* Type 1 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E10.3541* Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E10.3542* Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E10.3543* Type 1 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E10.3551* Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E10.3552* Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E10.3553* Type 1 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E10.3591* Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E10.3592* Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E10.3593* Type 1 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E10.36* Type 1 diabetes mellitus with diabetic cataract
E10.39* Type 1 diabetes mellitus with other diabetic ophthalmic complication
E10.40* Type 1 diabetes mellitus with diabetic neuropathy, unspecified
E10.41* Type 1 diabetes mellitus with diabetic mononeuropathy
E10.42* Type 1 diabetes mellitus with diabetic polyneuropathy
E10.43* Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
E10.44* Type 1 diabetes mellitus with diabetic amyotrophy
E10.49* Type 1 diabetes mellitus with other diabetic neurological complication
E10.51* Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E10.52* Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E10.59* Type 1 diabetes mellitus with other circulatory complications
E10.610* Type 1 diabetes mellitus with diabetic neuropathic arthropathy
E10.618* Type 1 diabetes mellitus with other diabetic arthropathy
E10.620* Type 1 diabetes mellitus with diabetic dermatitis
E10.621* Type 1 diabetes mellitus with foot ulcer
E10.622* Type 1 diabetes mellitus with other skin ulcer
E10.628* Type 1 diabetes mellitus with other skin complications
E10.630* Type 1 diabetes mellitus with periodontal disease
E10.638* Type 1 diabetes mellitus with other oral complications
E10.641* Type 1 diabetes mellitus with hypoglycemia with coma
E10.649* Type 1 diabetes mellitus with hypoglycemia without coma
E10.65* Type 1 diabetes mellitus with hyperglycemia
E10.69* Type 1 diabetes mellitus with other specified complication
E10.8* Type 1 diabetes mellitus with unspecified complications
E10.9* Type 1 diabetes mellitus without complications
E11.00* Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E11.01* Type 2 diabetes mellitus with hyperosmolarity with coma
E11.10* Type 2 diabetes mellitus with ketoacidosis without coma
E11.11* Type 2 diabetes mellitus with ketoacidosis with coma
E11.21* Type 2 diabetes mellitus with diabetic nephropathy
E11.22* Type 2 diabetes mellitus with diabetic chronic kidney disease
E11.29* Type 2 diabetes mellitus with other diabetic kidney complication
E11.311* Type 2 diabetes mellitus with unspecified diabetic retinopathy with macular edema
E11.319* Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema
E11.3211* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E11.3212* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E11.3213* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3291* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E11.3292* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E11.3293* Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3311* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E11.3312* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E11.3313* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3391* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E11.3392* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E11.3393* Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3411* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E11.3412* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E11.3413* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E11.3491* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E11.3492* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E11.3493* Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E11.3511* Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E11.3512* Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E11.3513* Type 2 diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E11.3521* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E11.3522* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E11.3523* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E11.3531* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E11.3532* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E11.3533* Type 2 diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E11.3541* Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E11.3542* Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E11.3543* Type 2 diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E11.3551* Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E11.3552* Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E11.3553* Type 2 diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E11.3591* Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E11.3592* Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E11.3593* Type 2 diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E11.36* Type 2 diabetes mellitus with diabetic cataract
E11.37X1* Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E11.37X2* Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E11.37X3* Type 2 diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E11.39* Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.40* Type 2 diabetes mellitus with diabetic neuropathy, unspecified
E11.41* Type 2 diabetes mellitus with diabetic mononeuropathy
E11.42* Type 2 diabetes mellitus with diabetic polyneuropathy
E11.43* Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
E11.44* Type 2 diabetes mellitus with diabetic amyotrophy
E11.49* Type 2 diabetes mellitus with other diabetic neurological complication
E11.51* Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
E11.52* Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
E11.59* Type 2 diabetes mellitus with other circulatory complications
E11.610* Type 2 diabetes mellitus with diabetic neuropathic arthropathy
E11.618* Type 2 diabetes mellitus with other diabetic arthropathy
E11.620* Type 2 diabetes mellitus with diabetic dermatitis
E11.621* Type 2 diabetes mellitus with foot ulcer
E11.622* Type 2 diabetes mellitus with other skin ulcer
E11.628* Type 2 diabetes mellitus with other skin complications
E11.630* Type 2 diabetes mellitus with periodontal disease
E11.638* Type 2 diabetes mellitus with other oral complications
E11.641* Type 2 diabetes mellitus with hypoglycemia with coma
E11.649* Type 2 diabetes mellitus with hypoglycemia without coma
E11.65* Type 2 diabetes mellitus with hyperglycemia
E11.69* Type 2 diabetes mellitus with other specified complication
E11.8* Type 2 diabetes mellitus with unspecified complications
E11.9* Type 2 diabetes mellitus without complications
E13.00* Other specified diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
E13.01* Other specified diabetes mellitus with hyperosmolarity with coma
E13.10* Other specified diabetes mellitus with ketoacidosis without coma
E13.11* Other specified diabetes mellitus with ketoacidosis with coma
E13.21* Other specified diabetes mellitus with diabetic nephropathy
E13.22* Other specified diabetes mellitus with diabetic chronic kidney disease
E13.29* Other specified diabetes mellitus with other diabetic kidney complication
E13.311* Other specified diabetes mellitus with unspecified diabetic retinopathy with macular edema
E13.319* Other specified diabetes mellitus with unspecified diabetic retinopathy without macular edema
E13.3211* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, right eye
E13.3212* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, left eye
E13.3213* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3291* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, right eye
E13.3292* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, left eye
E13.3293* Other specified diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3311* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, right eye
E13.3312* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, left eye
E13.3313* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3391* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, right eye
E13.3392* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, left eye
E13.3393* Other specified diabetes mellitus with moderate nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3411* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, right eye
E13.3412* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, left eye
E13.3413* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy with macular edema, bilateral
E13.3491* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, right eye
E13.3492* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, left eye
E13.3493* Other specified diabetes mellitus with severe nonproliferative diabetic retinopathy without macular edema, bilateral
E13.3511* Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, right eye
E13.3512* Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, left eye
E13.3513* Other specified diabetes mellitus with proliferative diabetic retinopathy with macular edema, bilateral
E13.3521* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, right eye
E13.3522* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, left eye
E13.3523* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment involving the macula, bilateral
E13.3531* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, right eye
E13.3532* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, left eye
E13.3533* Other specified diabetes mellitus with proliferative diabetic retinopathy with traction retinal detachment not involving the macula, bilateral
E13.3541* Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, right eye
E13.3542* Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, left eye
E13.3543* Other specified diabetes mellitus with proliferative diabetic retinopathy with combined traction retinal detachment and rhegmatogenous retinal detachment, bilateral
E13.3551* Other specified diabetes mellitus with stable proliferative diabetic retinopathy, right eye
E13.3552* Other specified diabetes mellitus with stable proliferative diabetic retinopathy, left eye
E13.3553* Other specified diabetes mellitus with stable proliferative diabetic retinopathy, bilateral
E13.3591* Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, right eye
E13.3592* Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, left eye
E13.3593* Other specified diabetes mellitus with proliferative diabetic retinopathy without macular edema, bilateral
E13.36* Other specified diabetes mellitus with diabetic cataract
E13.37X1* Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, right eye
E13.37X2* Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, left eye
E13.37X3* Other specified diabetes mellitus with diabetic macular edema, resolved following treatment, bilateral
E13.39* Other specified diabetes mellitus with other diabetic ophthalmic complication
E13.40* Other specified diabetes mellitus with diabetic neuropathy, unspecified
E13.41* Other specified diabetes mellitus with diabetic mononeuropathy
E13.42* Other specified diabetes mellitus with diabetic polyneuropathy
E13.43* Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
E13.44* Other specified diabetes mellitus with diabetic amyotrophy
E13.49* Other specified diabetes mellitus with other diabetic neurological complication
E13.51* Other specified diabetes mellitus with diabetic peripheral angiopathy without gangrene
E13.52* Other specified diabetes mellitus with diabetic peripheral angiopathy with gangrene
E13.59* Other specified diabetes mellitus with other circulatory complications
E13.610* Other specified diabetes mellitus with diabetic neuropathic arthropathy
E13.618* Other specified diabetes mellitus with other diabetic arthropathy
E13.620* Other specified diabetes mellitus with diabetic dermatitis
E13.621* Other specified diabetes mellitus with foot ulcer
E13.622* Other specified diabetes mellitus with other skin ulcer
E13.628* Other specified diabetes mellitus with other skin complications
E13.630* Other specified diabetes mellitus with periodontal disease
E13.638* Other specified diabetes mellitus with other oral complications
E13.641* Other specified diabetes mellitus with hypoglycemia with coma
E13.649* Other specified diabetes mellitus with hypoglycemia without coma
E13.65* Other specified diabetes mellitus with hyperglycemia
E13.69* Other specified diabetes mellitus with other specified complication
E13.8* Other specified diabetes mellitus with unspecified complications
E13.9* Other specified diabetes mellitus without complications
E52* Niacin deficiency [pellagra]
E53.0* Riboflavin deficiency
E53.1* Pyridoxine deficiency
E53.8* Deficiency of other specified B group vitamins
E53.9* Vitamin B deficiency, unspecified
E75.21 Fabry (-Anderson) disease
E75.22 Gaucher disease
E75.240 Niemann-Pick disease type A
E75.241 Niemann-Pick disease type B
E75.242 Niemann-Pick disease type C
E75.243 Niemann-Pick disease type D
E75.244 Niemann-Pick disease type A/B
E75.248 Other Niemann-Pick disease
E75.249 Niemann-Pick disease, unspecified
E75.3 Sphingolipidosis, unspecified
E77.0 Defects in post-translational modification of lysosomal enzymes
E77.1 Defects in glycoprotein degradation
E77.8 Other disorders of glycoprotein metabolism
E77.9 Disorder of glycoprotein metabolism, unspecified
E85.1 Neuropathic heredofamilial amyloidosis
E85.2 Heredofamilial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis
E85.4 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
G12.21 Amyotrophic lateral sclerosis
G12.25 Progressive spinal muscle atrophy
G13.0* Paraneoplastic neuromyopathy and neuropathy
G13.1* Other systemic atrophy primarily affecting central nervous system in neoplastic disease
G35* Multiple sclerosis
G60.0 Hereditary motor and sensory neuropathy
G60.1 Refsum's disease
G60.2 Neuropathy in association with hereditary ataxia
G60.3 Idiopathic progressive neuropathy
G60.8 Other hereditary and idiopathic neuropathies
G60.9 Hereditary and idiopathic neuropathy, unspecified
G61.0 Guillain-Barre syndrome
G61.1* Serum neuropathy
G61.81 Chronic inflammatory demyelinating polyneuritis
G61.89 Other inflammatory polyneuropathies
G61.9 Inflammatory polyneuropathy, unspecified
G62.0* Drug-induced polyneuropathy
G62.1* Alcoholic polyneuropathy
G62.2* Polyneuropathy due to other toxic agents
G62.81 Critical illness polyneuropathy
G62.82* Radiation-induced polyneuropathy
G62.89 Other specified polyneuropathies
G62.9 Polyneuropathy, unspecified
G63* Polyneuropathy in diseases classified elsewhere
G64 Other disorders of peripheral nervous system
G65.0* Sequelae of Guillain-Barre syndrome
G65.1* Sequelae of other inflammatory polyneuropathy
G65.2* Sequelae of toxic polyneuropathy
G90.09 Other idiopathic peripheral autonomic neuropathy
G99.0 Autonomic neuropathy in diseases classified elsewhere
I70.201 Unspecified atherosclerosis of native arteries of extremities, right leg
I70.202 Unspecified atherosclerosis of native arteries of extremities, left leg
I70.203 Unspecified atherosclerosis of native arteries of extremities, bilateral legs
I70.208 Unspecified atherosclerosis of native arteries of extremities, other extremity
I70.209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
I70.219 Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity
I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg
I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg
I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
I70.228 Atherosclerosis of native arteries of extremities with rest pain, other extremity
I70.229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
I70.231 Atherosclerosis of native arteries of right leg with ulceration of thigh
I70.232 Atherosclerosis of native arteries of right leg with ulceration of calf
I70.233 Atherosclerosis of native arteries of right leg with ulceration of ankle
I70.234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
I70.235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot
I70.238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
I70.239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site
I70.241 Atherosclerosis of native arteries of left leg with ulceration of thigh
I70.242 Atherosclerosis of native arteries of left leg with ulceration of calf
I70.243 Atherosclerosis of native arteries of left leg with ulceration of ankle
I70.244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot
I70.245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot
I70.248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg
I70.249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site
I70.25 Atherosclerosis of native arteries of other extremities with ulceration
I70.261 Atherosclerosis of native arteries of extremities with gangrene, right leg
I70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg
I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs
I70.268 Atherosclerosis of native arteries of extremities with gangrene, other extremity
I70.269 Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity
I70.291 Other atherosclerosis of native arteries of extremities, right leg
I70.292 Other atherosclerosis of native arteries of extremities, left leg
I70.293 Other atherosclerosis of native arteries of extremities, bilateral legs
I70.298 Other atherosclerosis of native arteries of extremities, other extremity
I70.299 Other atherosclerosis of native arteries of extremities, unspecified extremity
I70.90 Unspecified atherosclerosis
I70.91 Generalized atherosclerosis
I73.00 Raynaud's syndrome without gangrene
I73.01 Raynaud's syndrome with gangrene
I73.1 Thromboangiitis obliterans [Buerger's disease]
I73.81 Erythromelalgia
I73.89 Other specified peripheral vascular diseases
I73.9 Peripheral vascular disease, unspecified
I77.1 Stricture of artery
I77.6 Arteritis, unspecified
I79.1 Aortitis in diseases classified elsewhere
I79.8 Other disorders of arteries, arterioles and capillaries in diseases classified elsewhere
I80.00* Phlebitis and thrombophlebitis of superficial vessels of unspecified lower extremity
I80.01* Phlebitis and thrombophlebitis of superficial vessels of right lower extremity
I80.02* Phlebitis and thrombophlebitis of superficial vessels of left lower extremity
I80.03* Phlebitis and thrombophlebitis of superficial vessels of lower extremities, bilateral
I80.10* Phlebitis and thrombophlebitis of unspecified femoral vein
I80.11* Phlebitis and thrombophlebitis of right femoral vein
I80.12* Phlebitis and thrombophlebitis of left femoral vein
I80.13* Phlebitis and thrombophlebitis of femoral vein, bilateral
I80.201* Phlebitis and thrombophlebitis of unspecified deep vessels of right lower extremity
I80.202* Phlebitis and thrombophlebitis of unspecified deep vessels of left lower extremity
I80.203* Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities, bilateral
I80.209* Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity
I80.221* Phlebitis and thrombophlebitis of right popliteal vein
I80.222* Phlebitis and thrombophlebitis of left popliteal vein
I80.223* Phlebitis and thrombophlebitis of popliteal vein, bilateral
I80.229* Phlebitis and thrombophlebitis of unspecified popliteal vein
I80.231* Phlebitis and thrombophlebitis of right tibial vein
I80.232* Phlebitis and thrombophlebitis of left tibial vein
I80.233* Phlebitis and thrombophlebitis of tibial vein, bilateral
I80.239* Phlebitis and thrombophlebitis of unspecified tibial vein
I80.241* Phlebitis and thrombophlebitis of right peroneal vein
I80.242* Phlebitis and thrombophlebitis of left peroneal vein
I80.243* Phlebitis and thrombophlebitis of peroneal vein, bilateral
I80.251* Phlebitis and thrombophlebitis of right calf muscular vein
I80.252* Phlebitis and thrombophlebitis of left calf muscular vein
I80.253* Phlebitis and thrombophlebitis of calf muscular vein, bilateral
I80.291* Phlebitis and thrombophlebitis of other deep vessels of right lower extremity
I80.292* Phlebitis and thrombophlebitis of other deep vessels of left lower extremity
I80.293* Phlebitis and thrombophlebitis of other deep vessels of lower extremity, bilateral
I80.299* Phlebitis and thrombophlebitis of other deep vessels of unspecified lower extremity
I80.3* Phlebitis and thrombophlebitis of lower extremities, unspecified
I87.001 Postthrombotic syndrome without complications of right lower extremity
I87.002 Postthrombotic syndrome without complications of left lower extremity
I87.003 Postthrombotic syndrome without complications of bilateral lower extremity
I87.009* Postthrombotic syndrome without complications of unspecified extremity
I87.011* Postthrombotic syndrome with ulcer of right lower extremity
I87.012* Postthrombotic syndrome with ulcer of left lower extremity
I87.013* Postthrombotic syndrome with ulcer of bilateral lower extremity
I87.019* Postthrombotic syndrome with ulcer of unspecified lower extremity
I87.021* Postthrombotic syndrome with inflammation of right lower extremity
I87.022* Postthrombotic syndrome with inflammation of left lower extremity
I87.023* Postthrombotic syndrome with inflammation of bilateral lower extremity
I87.029* Postthrombotic syndrome with inflammation of unspecified lower extremity
I87.031* Postthrombotic syndrome with ulcer and inflammation of right lower extremity
I87.032* Postthrombotic syndrome with ulcer and inflammation of left lower extremity
I87.033* Postthrombotic syndrome with ulcer and inflammation of bilateral lower extremity
I87.039* Postthrombotic syndrome with ulcer and inflammation of unspecified lower extremity
I87.091* Postthrombotic syndrome with other complications of right lower extremity
I87.092* Postthrombotic syndrome with other complications of left lower extremity
I87.093* Postthrombotic syndrome with other complications of bilateral lower extremity
I87.099* Postthrombotic syndrome with other complications of unspecified lower extremity
I87.1 Compression of vein
I87.2 Venous insufficiency (chronic) (peripheral)
I87.301 Chronic venous hypertension (idiopathic) without complications of right lower extremity
I87.302 Chronic venous hypertension (idiopathic) without complications of left lower extremity
I87.303 Chronic venous hypertension (idiopathic) without complications of bilateral lower extremity
I87.309 Chronic venous hypertension (idiopathic) without complications of unspecified lower extremity
I87.311 Chronic venous hypertension (idiopathic) with ulcer of right lower extremity
I87.312 Chronic venous hypertension (idiopathic) with ulcer of left lower extremity
I87.313 Chronic venous hypertension (idiopathic) with ulcer of bilateral lower extremity
I87.319 Chronic venous hypertension (idiopathic) with ulcer of unspecified lower extremity
I87.321 Chronic venous hypertension (idiopathic) with inflammation of right lower extremity
I87.322 Chronic venous hypertension (idiopathic) with inflammation of left lower extremity
I87.323 Chronic venous hypertension (idiopathic) with inflammation of bilateral lower extremity
I87.329 Chronic venous hypertension (idiopathic) with inflammation of unspecified lower extremity
I87.331 Chronic venous hypertension (idiopathic) with ulcer and inflammation of right lower extremity
I87.332 Chronic venous hypertension (idiopathic) with ulcer and inflammation of left lower extremity
I87.333 Chronic venous hypertension (idiopathic) with ulcer and inflammation of bilateral lower extremity
I87.339 Chronic venous hypertension (idiopathic) with ulcer and inflammation of unspecified lower extremity
I87.391 Chronic venous hypertension (idiopathic) with other complications of right lower extremity
I87.392 Chronic venous hypertension (idiopathic) with other complications of left lower extremity
I87.393 Chronic venous hypertension (idiopathic) with other complications of bilateral lower extremity
I87.399 Chronic venous hypertension (idiopathic) with other complications of unspecified lower extremity
I87.9 Disorder of vein, unspecified
I89.0 Lymphedema, not elsewhere classified
I99.9 Unspecified disorder of circulatory system
K90.0* Celiac disease
K90.1* Tropical sprue
K90.9* Intestinal malabsorption, unspecified
L02.415 Cutaneous abscess of right lower limb
L02.416 Cutaneous abscess of left lower limb
L02.419 Cutaneous abscess of limb, unspecified
L02.611 Cutaneous abscess of right foot
L02.612 Cutaneous abscess of left foot
L02.619 Cutaneous abscess of unspecified foot
L02.91 Cutaneous abscess, unspecified
L03.031 Cellulitis of right toe
L03.032 Cellulitis of left toe
L03.039 Cellulitis of unspecified toe
L03.041 Acute lymphangitis of right toe
L03.042 Acute lymphangitis of left toe
L03.049 Acute lymphangitis of unspecified toe
L03.115 Cellulitis of right lower limb
L03.116 Cellulitis of left lower limb
L03.119 Cellulitis of unspecified part of limb
L03.125 Acute lymphangitis of right lower limb
L03.126 Acute lymphangitis of left lower limb
L03.129 Acute lymphangitis of unspecified part of limb
L03.90 Cellulitis, unspecified
L03.91 Acute lymphangitis, unspecified
L98.3 Eosinophilic cellulitis [Wells]
M05.50 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site
M05.511 Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder
M05.512 Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder
M05.519 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder
M05.521 Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow
M05.522 Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow
M05.529 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified elbow
M05.531 Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist
M05.532 Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist
M05.539 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified wrist
M05.541 Rheumatoid polyneuropathy with rheumatoid arthritis of right hand
M05.542 Rheumatoid polyneuropathy with rheumatoid arthritis of left hand
M05.549 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hand
M05.551 Rheumatoid polyneuropathy with rheumatoid arthritis of right hip
M05.552 Rheumatoid polyneuropathy with rheumatoid arthritis of left hip
M05.559 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip
M05.561 Rheumatoid polyneuropathy with rheumatoid arthritis of right knee
M05.562 Rheumatoid polyneuropathy with rheumatoid arthritis of left knee
M05.569 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified knee
M05.571 Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot
M05.572 Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot
M05.579 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot
M05.59 Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites
M34.83* Systemic sclerosis with polyneuropathy
N18.1* Chronic kidney disease, stage 1
N18.2* Chronic kidney disease, stage 2 (mild)
N18.31* Chronic kidney disease, stage 3a
N18.32* Chronic kidney disease, stage 3b
N18.4* Chronic kidney disease, stage 4 (severe)
N18.5* Chronic kidney disease, stage 5
N18.6* End stage renal disease
N18.9* Chronic kidney disease, unspecified
O24.011* Pre-existing type 1 diabetes mellitus, in pregnancy, first trimester
O24.012* Pre-existing type 1 diabetes mellitus, in pregnancy, second trimester
O24.013* Pre-existing type 1 diabetes mellitus, in pregnancy, third trimester
O24.019* Pre-existing type 1 diabetes mellitus, in pregnancy, unspecified trimester
O24.02* Pre-existing type 1 diabetes mellitus, in childbirth
O24.03* Pre-existing type 1 diabetes mellitus, in the puerperium
O24.111* Pre-existing type 2 diabetes mellitus, in pregnancy, first trimester
O24.112* Pre-existing type 2 diabetes mellitus, in pregnancy, second trimester
O24.113* Pre-existing type 2 diabetes mellitus, in pregnancy, third trimester
O24.119* Pre-existing type 2 diabetes mellitus, in pregnancy, unspecified trimester
O24.12* Pre-existing type 2 diabetes mellitus, in childbirth
O24.13* Pre-existing type 2 diabetes mellitus, in the puerperium
O24.311* Unspecified pre-existing diabetes mellitus in pregnancy, first trimester
O24.312* Unspecified pre-existing diabetes mellitus in pregnancy, second trimester
O24.313* Unspecified pre-existing diabetes mellitus in pregnancy, third trimester
O24.319* Unspecified pre-existing diabetes mellitus in pregnancy, unspecified trimester
O24.32* Unspecified pre-existing diabetes mellitus in childbirth
O24.33* Unspecified pre-existing diabetes mellitus in the puerperium
O24.811* Other pre-existing diabetes mellitus in pregnancy, first trimester
O24.812* Other pre-existing diabetes mellitus in pregnancy, second trimester
O24.813* Other pre-existing diabetes mellitus in pregnancy, third trimester
O24.819* Other pre-existing diabetes mellitus in pregnancy, unspecified trimester
O24.82* Other pre-existing diabetes mellitus in childbirth
O24.83* Other pre-existing diabetes mellitus in the puerperium
O24.911* Unspecified diabetes mellitus in pregnancy, first trimester
O24.912* Unspecified diabetes mellitus in pregnancy, second trimester
O24.913* Unspecified diabetes mellitus in pregnancy, third trimester
O24.919* Unspecified diabetes mellitus in pregnancy, unspecified trimester
O24.92* Unspecified diabetes mellitus in childbirth
O24.93* Unspecified diabetes mellitus in the puerperium
Q82.0 Hereditary lymphedema
R60.0 Localized edema
R60.1 Generalized edema
R60.9 Edema, unspecified
S86.001A Unspecified injury of right Achilles tendon, initial encounter
S86.002A Unspecified injury of left Achilles tendon, initial encounter
S86.009A Unspecified injury of unspecified Achilles tendon, initial encounter
S86.091A Other specified injury of right Achilles tendon, initial encounter
S86.092A Other specified injury of left Achilles tendon, initial encounter
S86.099A Other specified injury of unspecified Achilles tendon, initial encounter
S86.101A Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, right leg, initial encounter
S86.102A Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, left leg, initial encounter
S86.109A Unspecified injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, initial encounter
S86.191A Other injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, right leg, initial encounter
S86.192A Other injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, left leg, initial encounter
S86.199A Other injury of other muscle(s) and tendon(s) of posterior muscle group at lower leg level, unspecified leg, initial encounter
S86.201A Unspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, right leg, initial encounter
S86.202A Unspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, left leg, initial encounter
S86.209A Unspecified injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, unspecified leg, initial encounter
S86.291A Other injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, right leg, initial encounter
S86.292A Other injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, left leg, initial encounter
S86.299A Other injury of muscle(s) and tendon(s) of anterior muscle group at lower leg level, unspecified leg, initial encounter
S86.301A Unspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, right leg, initial encounter
S86.302A Unspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter
S86.309A Unspecified injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, unspecified leg, initial encounter
S86.391A Other injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, right leg, initial encounter
S86.392A Other injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, left leg, initial encounter
S86.399A Other injury of muscle(s) and tendon(s) of peroneal muscle group at lower leg level, unspecified leg, initial encounter
S86.801A Unspecified injury of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter
S86.802A Unspecified injury of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
S86.809A Unspecified injury of other muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
S86.891A Other injury of other muscle(s) and tendon(s) at lower leg level, right leg, initial encounter
S86.892A Other injury of other muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
S86.899A Other injury of other muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
S86.901A Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter
S86.902A Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
S86.909A Unspecified injury of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
S86.991A Other injury of unspecified muscle(s) and tendon(s) at lower leg level, right leg, initial encounter
S86.992A Other injury of unspecified muscle(s) and tendon(s) at lower leg level, left leg, initial encounter
S86.999A Other injury of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter
S89.80XA Other specified injuries of unspecified lower leg, initial encounter
S89.81XA Other specified injuries of right lower leg, initial encounter
S89.82XA Other specified injuries of left lower leg, initial encounter
S89.90XA Unspecified injury of unspecified lower leg, initial encounter
S89.91XA Unspecified injury of right lower leg, initial encounter
S89.92XA Unspecified injury of left lower leg, initial encounter
S96.001A Unspecified injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, right foot, initial encounter
S96.002A Unspecified injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter
S96.009A Unspecified injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, unspecified foot, initial encounter
S96.091A Other injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, right foot, initial encounter
S96.092A Other injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, left foot, initial encounter
S96.099A Other injury of muscle and tendon of long flexor muscle of toe at ankle and foot level, unspecified foot, initial encounter
S96.101A Unspecified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, right foot, initial encounter
S96.102A Unspecified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, left foot, initial encounter
S96.109A Unspecified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, unspecified foot, initial encounter
S96.191A Other specified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, right foot, initial encounter
S96.192A Other specified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, left foot, initial encounter
S96.199A Other specified injury of muscle and tendon of long extensor muscle of toe at ankle and foot level, unspecified foot, initial encounter
S96.201A Unspecified injury of intrinsic muscle and tendon at ankle and foot level, right foot, initial encounter
S96.202A Unspecified injury of intrinsic muscle and tendon at ankle and foot level, left foot, initial encounter
S96.209A Unspecified injury of intrinsic muscle and tendon at ankle and foot level, unspecified foot, initial encounter
S96.291A Other specified injury of intrinsic muscle and tendon at ankle and foot level, right foot, initial encounter
S96.292A Other specified injury of intrinsic muscle and tendon at ankle and foot level, left foot, initial encounter
S96.299A Other specified injury of intrinsic muscle and tendon at ankle and foot level, unspecified foot, initial encounter
S96.801A Unspecified injury of other specified muscles and tendons at ankle and foot level, right foot, initial encounter
S96.802A Unspecified injury of other specified muscles and tendons at ankle and foot level, left foot, initial encounter
S96.809A Unspecified injury of other specified muscles and tendons at ankle and foot level, unspecified foot, initial encounter
S96.891A Other specified injury of other specified muscles and tendons at ankle and foot level, right foot, initial encounter
S96.892A Other specified injury of other specified muscles and tendons at ankle and foot level, left foot, initial encounter
S96.899A Other specified injury of other specified muscles and tendons at ankle and foot level, unspecified foot, initial encounter
S96.901A Unspecified injury of unspecified muscle and tendon at ankle and foot level, right foot, initial encounter
S96.902A Unspecified injury of unspecified muscle and tendon at ankle and foot level, left foot, initial encounter
S96.909A Unspecified injury of unspecified muscle and tendon at ankle and foot level, unspecified foot, initial encounter
S96.991A Other specified injury of unspecified muscle and tendon at ankle and foot level, right foot, initial encounter
S96.992A Other specified injury of unspecified muscle and tendon at ankle and foot level, left foot, initial encounter
S96.999A Other specified injury of unspecified muscle and tendon at ankle and foot level, unspecified foot, initial encounter
S99.811A Other specified injuries of right ankle, initial encounter
S99.812A Other specified injuries of left ankle, initial encounter
S99.819A Other specified injuries of unspecified ankle, initial encounter
S99.821A Other specified injuries of right foot, initial encounter
S99.822A Other specified injuries of left foot, initial encounter
S99.829A Other specified injuries of unspecified foot, initial encounter
S99.911A Unspecified injury of right ankle, initial encounter
S99.912A Unspecified injury of left ankle, initial encounter
S99.919A Unspecified injury of unspecified ankle, initial encounter
S99.921A Unspecified injury of right foot, initial encounter
S99.922A Unspecified injury of left foot, initial encounter
S99.929A Unspecified injury of unspecified foot, initial encounter
Z79.01* Long term (current) use of anticoagulants
Group 1 Medical Necessity ICD-10-CM Codes Asterisk Explanation

*NOTE: When the patient's condition is one of those designated by an asterisk (*), routine procedures are covered only if the patient is under the active care of a doctor of medicine or osteopathy who documents the condition.

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

Group 1

Group 1 Paragraph

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

Group 1 Codes

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ICD-10-PCS Codes

Group 1

Group 1 Paragraph

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Group 1 Codes

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Additional ICD-10 Information

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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
011x Hospital Inpatient (Including Medicare Part A)
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
028x Skilled Nursing - Swing Beds
071x Clinic - Rural Health
073x Clinic - Freestanding
075x Clinic - Comprehensive Outpatient Rehabilitation Facility (CORF)
077x Clinic - Federally Qualified Health Center (FQHC)
083x Ambulatory Surgery Center
085x Critical Access Hospital
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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.

Note: The contractor has identified the Bill Type and Revenue Codes applicable for use with the CPT/HCPCS codes included in this article. Providers are reminded that not all CPT/HCPCS codes listed can be billed with all Bill Type and/or Revenue Codes listed. CPT/HCPCS codes are required to be billed with specific Bill Type and Revenue Codes. Providers are encouraged to refer to the CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, for further guidance.


Code Description
051X Clinic - General Classification
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Other Coding Information

Group 1

Group 1 Paragraph

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Group 1 Codes

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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
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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
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
01/01/2024 R6

Article revised and published on 01/25/2024 effective for dates of service on and after 01/01/2024 to reflect the Annual HCPCS/CPT Code Update. The following codes have a short descriptor change: 11055, 11056, and 11057.

10/01/2021 R5

Article revised and published on 10/14/2021 effective for dates of service on and after 10/01/2021 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10-CM code has been added to the Article: E75.244 to Group 1 Codes, along with minor formatting changes made throughout the article.

10/01/2020 R4

Article revised and published on 10/01/2020 effective for dates of service on and after 10/01/2020 to reflect the Annual ICD-10-CM Code Updates. The following ICD-10 codes have been added to the article: N18.31 and N18.32. The following ICD-10 code has been deleted and therefore has been removed from the article: N18.3. Minor formatting changes made through the coding section.

10/01/2019 R3

Article revised and published on 10/17/2019 effective for dates of service on or after 10/01/2019 to reflect the annual ICD-10 code updates. The following ICD-10 codes have been added to the Group 1 codes: I80.241, I80.242, I80.243, I80.251, I80.252, I80.253. The following codes have descriptor changes: I70.238 and I70.248. All codes with an asterisk listed in the Group 1 paragraph have been removed and an asterisk has been placed next to the code in the Group 1 code table. A Group 1 Medical Necessity ICD-10 Codes Asterisk Explanation has been added to the bottom of the Group 1 codes table.

System changes have been made to our articles in response to CMS Change Request 10901. The Coding Section has been reordered and new sections for CPT/HCPCS Modifiers and Other Coding Information have been added.

04/11/2019 R2

Article revised and published on 04/11/2019 to add the CPT and ICD-10 codes from the related LCD, L35138 Routine Foot Care, in response to CMS Change Request 10901. Please note that due to system limitations ICD-10 codes with asterisks are listed in the ICD-10 Codes that are Covered Group 1 Paragraph.

10/01/2015 R1 Article revised for JL states (Pennsylvania, Maryland, Delaware, New Jersey, and the district of Columbia) to provide information regarding the reporting of appropriate modifiers, clarification on the correct reporting of CPT codes 11055-11057, and the requirement to report the date that the beneficiary was last seen by their treating provider. Article is new for JH states (Texas, Colorado, New Mexico, Louisiana, Mississippi, Oklahoma, and Arkansas).
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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
L35138 - Routine Foot Care
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
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
01/19/2024 01/01/2024 - N/A Currently in Effect You are here
10/08/2021 10/01/2021 - 12/31/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

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