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The following list of ICD-10-CM codes represents diagnoses that, alone or together, support the medical necessity of either MRIs or CTs. These diagnoses must be supported by appropriate documentation of medical necessity in the medical record. These are the only covered diagnoses:

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Dovetail joints often hold two boards together in a box or drawer, almost like interlocking the fingertips of your hands. As the dovetail joint evolved through the last one hundred thirty years, it becomes a clue for the age and authenticity of antique furniture. The type of dovetailed joint, especially in drawers, reveals much about furniture construction and dating. With just a little study of these examples, it is easy to spot true hand made construction vs. machine made furniture.

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Added: C81.0A, C81.1A, C81.2A, C81.3A, C81.4A, C81.7A, C81.9A, C82.0A C82.1A, C82.2A, C82.3A, C82.4A, C82.5A, C82.6A, C82.8A, C82.9A, C83.0A, C83.1A, C83.390, C83.398, C83.3A, C83.5A, C83.7A, C83.8A, C83.9A, C84.0A, C84.1A, C84.4A, C84.6A, C84.7B, C84.9A, C84.AA, C84.ZA, C85.1A, C85.2A, C85.8A, C85.9A, E34.00, E34.01, E34.09, G40.841, G40.842, G40.843, G48.844, G93.45, R41.85, Z86.0100, Z86.0101, Z86.0102, Z86.0109

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European cabinetmakers continued to produce hand-cut dovetails through the 1930’s. Electric power tools, like routers and various types of saws were put into widespread use after World War II in the 1940’s. There was resistance – in England, carpenters unions went on strike over the use of electric saws, fearing the end of their livelihoods. Nevertheless, by the 1950’s, power tools were used in almost all furniture construction across Great Britain.

Hand cut dovetails were used to hold the sides of drawers together, but also to join the structural members of case furniture. Hand made screws and nails were relatively expensive and could rust and expand, sometimes cracking the wood they secured. Glues of the period sometimes weakened. Dovetails have great strength, holding pieces of wood in perfect alignment over long periods of time. This lavishly hand-carved cabinet from about 1890 shows structural dovetail joints on the back side.

* Effective 8/11/15 K04.8, M26.02, M26.04, M26.12, M26.69, S02.5XXA, S02.5XXB, S02.5XXD, S02.5XXG, S02.5XXK, S02.5XXS, S03.2XXA S03.2XXD and S03.2XXS may be considered routine dental services. Providers must have documentation available for review to support these services are reasonable and necessary and not routine dental services.*The asterisked ICD-10-CM codes that are NOT any of the asterisked codes listed directly above should only be coded when they involve conditions of the head or neck/spine (C1-C7).

For the most part, codes are no longer included in the LCD (policy). You will find them in the Billing & Coding Articles. Try using the MCD Search to find what you're looking for. Enter the code you're looking for in the "Enter keyword, code, or document ID" box. The list of results will include documents which contain the code you entered.

Effective 10/01/2020, added A84.81, A84.89, B60.01, B60.02, B60.03, B60.09, D57.03, D57.09, D57.213, D57.218, D57.413, D57.42, D57.431, D57.432, D57.433, D57.438, D57.44, D57.451, D57.452, D57.453, D57.458, D57.813, D57.818, F10.131, F10.132, F10.930, F10.931, F10.932, F11.13, F12.13, F13.131, F13.132, F14.13, F14.93, F15.13, F19.131, F19.132, G11.10, G11.11, G11.19, G40.42, G40.833, G40.834, G71.21, G71.220, G71.228, G71.29, G96.00, G96.01, G96.02, G96.08, G96.09, G96.191, G96.198, G96.810, G96.811, G96.819, G96.89, G97.83, G97.84, H55.82, M26.641, M26.642, M26.643, M26.651, M26.652, M26.653, P91.821, P91.822, P91.823, R51.0, R51.9, T86.8401, T86.8402, T86.8403, T86.8411, T86.8412, T86.8413, T86.8421, T86.8422, T86.8423, T86.8481, T86.8482, T86.8483, T86.8491, T86.8492 and T86.8493; deleted A84.8, G11.1, G96.0, G96.19, G96.8 and R51 and code description changed for H55.81. All these updates are per the ICD-10 Annual Updates.

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Added ICD-10 codes F78.A1, F78.A9, G92.00, G92.01, G92.02, G92.03, G92.04, G92.05, G92.8, M31.11 and M31.19 to replace the deleted codes F78, G92 & M31.1 and added the new ICD-10 codes C84.7A, E75.244, G04.82, G44.86, S06.A0XA, S06.A0XD, S06.A0XS, S06.A1XA, S06.A1XD and S06.A1XS effective 10/01/2021 per the Annual ICD-10 Update.

Billing and Coding article updated to include E85.0 - E85.4 and E85.81 - E85.89 per the ICD-10 rules indicating for amyloid angiopathy, E85.XX must be coded first when billing I68.0, which is a covered services.

9/12/2024 - At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

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Title XVIII of the Social Security Act, Section 1862(a)(7) excludes routine physical examinations. This provision excludes screening examinations.Title XVIII of the Social Security Act, Section 1862(a)(1)(A) allows coverage and payment for only those services that are considered reasonable and necessary.Title XVIII of the Social Security Act, Section 1833(e) prohibits Medicare payment for any claim, which lacks the necessary information to process the claim.Title XVIII of the Social Security Act, Section 1862(a)(1)(D) prohibits Medicare payment for services and items that are experimental or investigational.CMS publication 100-3, Medicare National Coverage Determinations, Sections 220.1 “Computerized Tomography”, and 220.2-220.2.B.2d and Section 220.2.C-220.2.D “Magnetic Resonance Imaging”.

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The use of hand tools and hand-cut dovetails is now the province of hobbyists and a few small shops creating authentic replicas of antique furniture. This over-view of the dovetailing techniques should easily help identification and dating of most furniture from the last 200 years.

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Here is an example of an Eastlake chest of drawers with characteristic “spoon” carving and “pin and cove” dovetails from the 1880’s:

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Diagnostic evaluation of the head and neck (head/neck scans) performed by computerized tomography (CT) scanners is covered when the documentation supports that the scan is reasonable and necessary. Accurate coding information must be provided with claims to differentiate CT and/or MRI scans from other radiology services and to make coverage determinations. Sufficient documentation such as, history and physical notes, laboratory results, signs and symptoms of the disease to warrant the diagnostic test and to support the claim of reasonable and necessary must be included in the medical records. This information must be available to Medicare upon request.

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The name “dovetail” comes from the appearance of the joint, resembling the triangle shape of a bird’s tail. The earliest examples are from furniture placed with mummies in Egypt thousands of years ago, and also in the burials of ancient Chinese emperors.

The HCPCS/CPT code(s) may be subject to Correct Coding Initiative (CCI) edits in addition to guidance in this LCD. Please refer to the CCI for correct coding guidelines and specific applicable code combinations prior to billing Medicare. Whichever guidance is more restrictive should be adhered to.

Genuine hand made dovetails like these were the standard of good furniture craftsmanship until about 1870, when American ingenuity developed the “pin and cove” or round style dovetail, often seen on late Victorian and Eastlake furniture. These were cut with a jig or pattern, and an apprentice could create a very well fitting and attractive joint. Popular here into the 1890’s, these joints never gained acceptance outside of the U.S. and Canada. European cabinetmakers continued their hand-cut dovetails well into the 1900’s.

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Simpler country furniture often had larger dovetails, or even a single tail and pin. This country pine cupboard from the 1890’s has big country dovetails:

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The next technological development in joinery was again American. In the 1890’s, American furniture began to be mass produced, with interchangeable parts and speedy production for the growing and affluent middle class. The slow and laborious crafting and carving, one piece at a time, by a master woodworker was not suited to the new mass market. Steam power, transferred by pulleys and leather belts, operated saws, carving machines and routers that could copy an original pattern exactly.

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Please Note: For Durable Medical Equipment (DME) MACs only, CPT/HCPCS codes remain located in LCDs. All other Codes (ICD-10, Bill Type, and Revenue) have moved to Articles for DME MACs, as they have for the other Local Coverage MAC types.

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Other drawer joints include sliding keyhole or French dovetails that were have been used since the 1890’s. Here is an oak cylinder roll desk from about 1895 with keyhole dovetailed drawers.

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For thousands of years, a dovetail joint was created by a skilled cabinetmaker using small, precision saws and wood chisels. Tiny angled saw cuts were followed by careful cutting by a sharpened chisel on both sides to avoid splintering. One board had tiny “tails,” and the other had the larger “pins,” carefully measured to match and fit together exactly. When the joint is expertly executed, it is a thing of beauty, and a secure joining of two boards that can last for centuries. A little glue cements the connection, and a good dovetail joint has great strength and durability.

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Annual ICD-10 Update - the following codes were added to Group 1: G20.A1, G20.A2, G20.B1, G20.B2, G20.C, G37.81, G37.89, Q75.001, Q75.002, Q75.009, Q75.01, Q75.021, Q75.022, Q75.029, Q75.03, Q75.041, Q75.042, Q75.049, Q75.051, Q75.052, Q75.058, Q75.08

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The following diagnosis codes were accidentally deleted with the previous update and are being added back in effective 10/01/2020: A02.21, A06.6, A17.0, A17.1, A17.81*, A17.82*, A17.83*, A17.89*, A18.01, A18.03*, A18.51, A18.52, A18.53, A18.54, A18.59, A18.6, A27.81, A32.11, A32.12, A32.7, A32.81, A32.89*, A39.0, A39.1, A39.2, A39.3, A39.81, A39.82, A39.83*, A39.84*, A39.89, A41.9, A50.32, A50.39, A50.40, A50.41, A50.42, A50.43, A50.44, A50.45, A50.49, A50.59, A51.41, A52.11, A52.12, A52.13, A52.14, A52.15, A52.19, A54.81, A80.0. The asterisked ICD-10-CM codes listed above should only be coded when they involve conditions of the head or neck/spine (C1-C7).

These routers were ancestors of the electric precision tools of today, and could be used to rapidly cut a machined dovetail joint. Each cut is exactly like the others, each “tail” and “pin” are exactly matched. A close inspection shows no irregular saw cuts or variation from a skilled craftsman, but rather a precise and identical manufactured machined joint. These machine-cut dovetails are as strong and long lasting as the hand-made joints, and became the standard of better American furniture ever since the late 1890’s. Here is an early example of machine-cut dovetails on a 1920’s sideboard from a dining set:

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This secretary desk from about 1780 was built by a good country carpenter, notice the dovetails on the side of the drawer, and holding the top and side planks together as well.

In the ICD-10-CM Codes that Support Medical Necessity section, added DX code E34.30 inadvertently missed with the ICD-10 updates effective 10/01/2022.

NCDs do not contain claims processing information like diagnosis or procedure codes nor do they give instructions to the provider on how to bill Medicare for the service or item. For this supplementary claims processing information we rely on other CMS publications, namely Change Requests (CR) Transmittals and inclusions in the Medicare Fee-For-Service Claims Processing Manual (CPM).