I89.0: Lymphedema, not elsewhere classified
I89.0, lymphedema, not elsewhere classified, is listed as a covered diagnosis in 8 Medicare billing and coding articles that apply to 30 HCPCS Level II codes, including G0127 (Trimming of dystrophic nails, any number), G0283 (Electrical stimulation (unattended), to one or more areas…), C8900 (Magnetic resonance angiography with contrast, abdomen). The articles come from 5 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 I89.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0127 | Trimming of dystrophic nails, any number | Special coverage instructions apply | — | 4 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 3 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8931 | Magnetic resonance angiography with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8932 | Magnetic resonance angiography without contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8933 | Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8934 | Magnetic resonance angiography with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8935 | Magnetic resonance angiography without contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8936 | Magnetic resonance angiography without contrast followed by with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
5 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing I89.0
- A57759: Billing and Coding: Routine Foot Care and Debridement of Nails (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A52996: Billing and Coding: Routine Foot Care (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
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.
Frequently asked questions
Does Medicare cover I89.0 (Lymphedema, not elsewhere classified)?
Medicare covers items and services, not diagnoses. 8 Medicare billing and coding articles list I89.0 as a covered diagnosis for 30 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 I89.0?
The Level II codes from the policies most specific to this diagnosis are G0127 (Trimming of dystrophic nails, any number, 4 articles); G0283 (Electrical stimulation (unattended), to one or more areas…, 3 articles); C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article); C8901 (Magnetic resonance angiography without contrast, abdomen, 1 article); C8902 (Magnetic resonance angiography without contrast followed…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list I89.0?
A57759 (Billing and Coding: Routine Foot Care and Debridement of Nails); A57954 (Billing and Coding: Routine Foot Care); A57193 (Billing and Coding: Routine Foot Care and Debridement of Nails), and 5 more articles.
What is ICD-10-CM code I89.0?
I89.0 is the ICD-10-CM code for lymphedema, not elsewhere classified, in category I89 (Other noninfective disorders of lymphatic vessels and lymph nodes), chapter 9: Diseases of the circulatory system.
Next steps
- Run a reimbursement report for a device billed under G0127
- Watch G0127 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0127
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 9: Diseases of the circulatory system · All diagnoses · HCPCS lookup