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

ICD-10 L12.1

Billable / Specific

Cicatricial pemphigoid

L12
Block
1
Synonyms
123
LCDs
17
Payer Policies
0
Linked CPTs

About ICD-10-CM L12.1

ICD-10-CM code L12.1 represents Cicatricial pemphigoid. This is a billable/specific code in the Skin and Subcutaneous Tissue chapter (block L12). The 2026 edition of ICD-10-CM L12.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under L12.1. Per CMS ICD-10-CM Tabular 2026.

  • Benign mucous membrane pemphigoid

Medicare LCD Coverage for L12.1

Local Coverage Determinations (LCDs) from CMS MACs that list L12.1 as a covered diagnosis.

123 LCDs

Showing top 10 of 123 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1459 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1573 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1552 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1566 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1557 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J0840 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1571 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT 90376 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1560 →
CMS LCD: Billing and Coding: Immune Globulins
Article ID: 57554, Effective: 2026-04-09 00:00:00, 1176 covered, 0 non-covered
CPT J1572 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing L12.1.

17 policies

5 Medicare

Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
Policy ID: ART-54641
Billing and Coding: Intravenous Immune Globulin (IVIg)-NCD 250.3
Policy ID: ART-54643
Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions
Policy ID: ART-55639
Billing and Coding: Rituximab
Policy ID: ART-56380
Billing and Coding: Intravenous Immunoglobulin (IVIG)
Policy ID: ART-56718

4 Aetna

Contact Lenses and Eyeglasses
Policy ID: CPB-0126
Parenteral Immunoglobulins
Policy ID: CPB-0206
Rituximab
Policy ID: CPB-0314
External Ocular Photography
Policy ID: CPB-0734

CPT Codes Commonly Billed with L12.1

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

No procedure linkages on file for L12.1

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert L12.1 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
L12.1 69460 10000
L12.1 69461 10000

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

ICD-10 L12.1, Billing FAQ

Is ICD-10 code L12.1 billable? +

Yes, L12.1 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 L12.1? +

ICD-10 L12.1 includes: Benign mucous membrane pemphigoid.

What ICD-9 codes does L12.1 map to? +

Per CMS GEMs, L12.1 maps to ICD-9 codes: 69460, 69461. 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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