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

ICD-10 I89.0

Billable / Specific

Lymphedema, not elsewhere classified

I89
Block
5
Synonyms
400
LCDs
16
Payer Policies
1
Linked CPTs

About ICD-10-CM I89.0

ICD-10-CM code I89.0 represents Lymphedema, not elsewhere classified. This is a billable/specific code in the Circulatory System chapter (block I89). The 2026 edition of ICD-10-CM I89.0 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under I89.0. Per CMS ICD-10-CM Tabular 2026.

  • Elephantiasis (nonfilarial) NOS
  • Lymphangiectasis
  • Obliteration, lymphatic vessel
  • Praecox lymphedema
  • Secondary lymphedema

Type 1 Excludes

Pure excludes, these codes can never be coded together with I89.0. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • postmastectomy lymphedema (I97.2)

Medicare LCD Coverage for I89.0

Local Coverage Determinations (LCDs) from CMS MACs that list I89.0 as a covered diagnosis.

400 LCDs

Showing top 10 of 400 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Magnetic Resonance Angiography
Article ID: 56775, Effective: 2025-10-01 00:00:00, 1311 covered, 0 non-covered
CPT C8918 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I89.0.

16 policies

2 Aetna

Routine Foot Care - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0046
Compression Garments for the Legs
Policy ID: CPB-0482

5 Medicare

Billing and Coding: Peripheral Venous Ultrasound
Policy ID: ART-52993
Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Home Health Physical Therapy
Policy ID: ART-53058
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064

CPT Codes Commonly Billed with I89.0

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

1 linkages
  • 91299 CMS LCD: Billing and Coding: Endoscopy by Capsule CMS LCD

Convert I89.0 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
I89.0 4571 00000

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

Codes Adjacent To I89.0

Other codes in section I80-I89 (Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified).

I80 Phlebitis and thrombophlebitis (non-billable) I80.0 Phlebitis and thrombophlebitis of superficial vessels of lower extremities (non-billable) 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 I80.1 Phlebitis and thrombophlebitis of femoral vein (non-billable) 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 I80.2 Phlebitis and thrombophlebitis of other and unspecified deep vessels of lower extremities (non-billable) I80.20 Phlebitis and thrombophlebitis of unspecified deep vessels of lower extremities (non-billable) 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 I80.21 Phlebitis and thrombophlebitis of iliac vein (non-billable) I80.211 Phlebitis and thrombophlebitis of right iliac vein I80.212 Phlebitis and thrombophlebitis of left iliac vein

ICD-10 I89.0, Billing FAQ

Is ICD-10 code I89.0 billable? +

Yes, I89.0 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 I89.0? +

ICD-10 I89.0 includes: Elephantiasis (nonfilarial) NOS; Lymphangiectasis; Obliteration, lymphatic vessel, and 2 more clinical synonyms.

What codes are Type 1 Excludes for I89.0? +

Type 1 Excludes (never code together with I89.0): postmastectomy lymphedema (I97.2)

What CPT codes are commonly billed with I89.0? +

Procedures frequently paired with I89.0 include: 91299.

What ICD-9 codes does I89.0 map to? +

Per CMS GEMs, I89.0 maps to ICD-9 codes: 4571. 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 May 31, 2026.

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