A “crosswalk” or “link” refers to a medical necessity relationship between a Medical Procedure (CPT/HCPCS) Code and a Diagnosis (ICD10) Code

Search Both Ways

Lookup CPT or HCPCS Level II Codes and find supporting ICD10 Diagnosis Crosswalks in seconds.  Also perform reverse searches from ICD10 to CPT/HCPCS

Both Versions

Standard Version:  Access to over 16,000 CPT/HCPCS Codes and 94,000 ICD10 Codes and over 5.2 million crosswalks $249

Professional Version:  Same features as Standard but with full export privileges $999

Reports And Documentation

Print LCD (Local Coverage Determination) and LCA (Local Coverage Article) policies with detailed explanations of Medical Necessity with Indications and Limitations of Coverage.

Why CrossCoder?

Streamline Medical Claim Validation with CrossCoder

Medicare and private payers rely on crosswalks to validate the medical necessity of claims, often based on Local Coverage Determinations (LCDs) and Articles (LCAs). CrossCoder offers instant access to active and retired CMS policies and articles, enabling users to validate claims with confidence.

Our platform extracts procedure and diagnostic codes from these policies and combines them with our proprietary National Medicare Database (NMD) crosswalks, based on millions of validated claims. This ensures accurate crosswalks that help substantiate the medical necessity of services. CrossCoder includes policies detailing reasonable and necessary coverage conditions, along with coding and payment guidelines.

Our database also provides:

  • ICD10 diagnostic codes that support medical necessity
  • Lists of ICD10 codes that do not support medical necessity

Comprehensive Code Lookup

CrossCoder allows users to search over 16,000 medical service and procedure codes, including:

  • CPT Codes
  • HCPCS Level II
  • DMEPOS
  • J Codes
  • Anesthesia
  • Category II and III (F and T codes)

Additionally, we offer access to over 94,000 ICD10 diagnosis codes, including accident and injury codes. Exclusive to CrossCoder is the ability to perform reverse searches from diagnosis to procedure codes, resulting in over 5.2 million crosswalks.

Why Use CrossCoder?

Physicians are paid based on procedure or service codes, not diagnosis codes. To ensure proper claim submission, providers must link the diagnosis to the appropriate procedure, validating medical necessity. If a diagnosis does not support the medical service, claims may be rejected or audited.

Lower your audit exposure with CrossCoder, a tool that mirrors the links used by Medicare and private payers for claim validation. Trusted by healthcare providers, administrators, payers, managed care organizations, TPAs, billing services, researchers, and consultants, CrossCoder is your key to streamlined, accurate claim validation.

Pricing 

  • Standard Version: $249
  • Professional Version: $999 (with full exporting capabilities to CSV or MS Access)

For Windows PC 7/8/10/11

For additional information see our FAQ page.

CrossCoder is based on 3 sources.

Local Coverage Determinations (LCD):

In the absence of a national coverage policy, an item or service may be covered at the discretion of the Medicare Contractors based on a local coverage determination (LCD). Local Coverage Determination (LCD) crosswalks are Part B contractor developed coverage policies, pertaining to services or items not addressed in National Coverage Determinations (NCDs) or program manuals. LCDs contain CPT & ICD10 coding, guidelines and related policy information. LCDs are developed to define the appropriate use of new technologies, address services with an abuse history or potential and high volume and high dollar services.

Local Coverage Article (LCA):

A local policy may consist of two separate, though closely related documents: the LCD and an associated Article (LCA). The LCD only contains reasonable and necessary language. Any non-reasonable and necessary language a Medicare contractor wishes to communicate to providers may be done through the Article. 

National Medicare Database (NMD):

NMD Crosswalks are based on our independent analysis of over 40,000,000 validated claims.  This additional source of crosswalks information greatly helps locate and validate medical necessity for thousands of procedures and services codes not found in LCD and NCD policies.