ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 B35.1

Billable / Specific

Tinea unguium

B35
Block
4
Synonyms
595
LCDs
16
Payer Policies
9
Linked CPTs

About ICD-10-CM B35.1

ICD-10-CM code B35.1 represents Tinea unguium. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B35). The 2026 edition of ICD-10-CM B35.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under B35.1. Per CMS ICD-10-CM Tabular 2026.

  • Dermatophytic onychia
  • Dermatophytosis of nail
  • Onychomycosis
  • Ringworm of nails

Medicare LCD Coverage for B35.1

Local Coverage Determinations (LCDs) from CMS MACs that list B35.1 as a covered diagnosis.

595 LCDs

Showing top 10 of 595 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Surgical Treatment of Nails
Article ID: 57666, Effective: 2026-01-01 00:00:00, 392 covered, 1 non-covered
CPT 11750 →
CMS LCD: Billing and Coding: Surgical Treatment of Nails
Article ID: 57666, Effective: 2026-01-01 00:00:00, 392 covered, 1 non-covered
CPT 11765 →
CMS LCD: Billing and Coding: Surgical Treatment of Nails
Article ID: 57666, Effective: 2026-01-01 00:00:00, 392 covered, 1 non-covered
CPT 11730 →
CMS LCD: Billing and Coding: Surgical Treatment of Nails
Article ID: 57666, Effective: 2026-01-01 00:00:00, 392 covered, 1 non-covered
CPT 11732 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11719 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11721 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11057 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11720 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT G0127 →
CMS LCD: Billing and Coding: Routine Foot Care
Article ID: 56680, Effective: 2025-11-01 00:00:00, 1041 covered, 0 non-covered
CPT 11055 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B35.1.

16 policies

1 Aetna

Routine Foot Care - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0046

5 Medicare

Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: Surgical Treatment of Nails
Policy ID: ART-52998
Billing and Coding: Foot Care
Policy ID: ART-56232
Billing and Coding: Debridement of Mycotic Nails
Policy ID: ART-56640
Billing and Coding: Routine Foot Care
Policy ID: ART-56680

CPT Codes Commonly Billed with B35.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

9 linkages
  • 11721 Debridement nails 6+ — ingrown nail, onycholysis, onychogryphosis, nail disorder, onychomycosis, diabetic foot, corn/callosity Podiatry
  • 11720 Debridement nails 1-5 — same as 11721 Podiatry
  • 11730 Nail avulsion — ingrown nail, onychogryphosis, onycholysis, nail disorder, onychomycosis, cellulitis of toe Podiatry
  • 11719 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • G0127 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • 11056 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
  • 11732 CMS LCD: Billing and Coding: Surgical Treatment of Nails CMS LCD
  • 11765 CMS LCD: Billing and Coding: Surgical Treatment of Nails CMS LCD
  • 11750 CMS LCD: Billing and Coding: Surgical Treatment of Nails CMS LCD

Convert B35.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
B35.1 1101 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 B35.1, Billing FAQ

Is ICD-10 code B35.1 billable? +

Yes, B35.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to B35.1? +

ICD-10 B35.1 includes: Dermatophytic onychia; Dermatophytosis of nail; Onychomycosis, and 1 more clinical synonyms.

What CPT codes are commonly billed with B35.1? +

Procedures frequently paired with B35.1 include: 11721, 11720, 11730, 11719, G0127.

What ICD-9 codes does B35.1 map to? +

Per CMS GEMs, B35.1 maps to ICD-9 codes: 1101. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 2, 2026.

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