E24.3: Ectopic ACTH syndrome
E24.3, ectopic ACTH syndrome, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 10 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), G2187 (Patients with clinical indications for imaging of the…), G2188 (Patients with clinical indications for imaging of the…). The articles come from 2 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with E24.3 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children | Carrier judgment | — | 1 |
Medicare policy articles listing E24.3
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other E24 diagnoses (Cushing's syndrome)
- E24.0 — Pituitary-dependent Cushing's disease
- E24.2 — Drug-induced Cushing's syndrome
- E24.4 — Alcohol-induced pseudo-Cushing's syndrome
- E24.8 — Other Cushing's syndrome
- E24.9 — Cushing's syndrome, unspecified
Frequently asked questions
Does Medicare cover E24.3 (Ectopic ACTH syndrome)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list E24.3 as a covered diagnosis for 10 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 E24.3?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); G2187 (Patients with clinical indications for imaging of the…, 1 article); G2188 (Patients with clinical indications for imaging of the…, 1 article); G2189 (Patients with clinical indications for imaging of the…, 1 article); G2190 (Patients with clinical indications for imaging of the…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list E24.3?
A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement); A56612 (Billing and Coding: CT of the Head).
What is ICD-10-CM code E24.3?
E24.3 is the ICD-10-CM code for ectopic ACTH syndrome, in category E24 (Cushing's syndrome), chapter 4: Endocrine, nutritional and metabolic diseases.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 4: Endocrine, nutritional and metabolic diseases · All diagnoses · HCPCS lookup