N80.512: Deep endometriosis of the rectum
N80.512, deep endometriosis of the rectum, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 13 HCPCS Level II codes, including J9217 (Leuprolide acetate (for depot suspension), 7.5 mg), J1952 (Leuprolide injectable, camcevi, 1 mg), J3315 (Injection, triptorelin pamoate, 3.75 mg). 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 N80.512 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | Special coverage instructions apply | — | 2 |
| J1952 | Leuprolide injectable, camcevi, 1 mg | Carrier judgment | — | 2 |
| J3315 | Injection, triptorelin pamoate, 3.75 mg | Special coverage instructions apply | — | 2 |
| J1954 | Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg | Carrier judgment | — | 2 |
| J9202 | Goserelin acetate implant, per 3.6 mg | Special coverage instructions apply | — | 2 |
| J1950 | Injection, leuprolide acetate (for depot suspension), per 3.75 mg | Special coverage instructions apply | — | 2 |
| J9219 | Leuprolide acetate implant, 65 mg | Special coverage instructions apply | — | 2 |
| J9225 | Histrelin implant (vantas), 50 mg | Special coverage instructions apply | — | 2 |
| J3316 | Injection, triptorelin, extended-release, 3.75 mg | Special coverage instructions apply | — | 1 |
| J9218 | Leuprolide acetate, per 1 mg | Special coverage instructions apply | — | 1 |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | Special coverage instructions apply | — | 1 |
| G9998 | Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes]) | Carrier judgment | — | 1 |
| G9999 | Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete) | Carrier judgment | — | 1 |
Medicare policy articles listing N80.512
- A59160: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Palmetto GBA (MAC - Part A, MAC - Part B); 8 Level II codes). LCD with the same title: L39387
- A52453: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Wellpoint Federal (MAC - Part A, MAC - Part B); 10 Level II codes). LCD with the same title: L39387
- A56632: Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy (Palmetto GBA (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34005, L34454
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 N80 diagnoses (Endometriosis)
- N80.522 — Deep endometriosis of the sigmoid colon
- N80.532 — Deep endometriosis of the cecum
- N80.542 — Deep endometriosis of the appendix
- N80.552 — Deep endometriosis of other parts of the colon
- N80.562 — Deep endometriosis of the small intestine
Frequently asked questions
Does Medicare cover N80.512 (Deep endometriosis of the rectum)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list N80.512 as a covered diagnosis for 13 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 N80.512?
The Level II codes from the policies most specific to this diagnosis are J9217 (Leuprolide acetate (for depot suspension), 7.5 mg, 2 articles); J1952 (Leuprolide injectable, camcevi, 1 mg, 2 articles); J3315 (Injection, triptorelin pamoate, 3.75 mg, 2 articles); J1954 (Injection, leuprolide acetate for depot suspension…, 2 articles); J9202 (Goserelin acetate implant, per 3.6 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list N80.512?
A59160 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs); A52453 (Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs); A56632 (Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy).
What is ICD-10-CM code N80.512?
N80.512 is the ICD-10-CM code for deep endometriosis of the rectum, in category N80 (Endometriosis), chapter 14: Diseases of the genitourinary system.
Next steps
- Run a reimbursement report for a device billed under J9217
- Watch J9217 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9217
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 14: Diseases of the genitourinary system · All diagnoses · HCPCS lookup