RETIRED LCD Reference Article Billing and Coding Article

Billing and Coding: Pulmonary Function Testing

A57216

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Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
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General Information

Source Article ID
N/A
Article ID
A57216
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Pulmonary Function Testing
Article Type
Billing and Coding
Original Effective Date
10/01/2019
Revision Effective Date
10/01/2023
Revision Ending Date
11/04/2023
Retirement Date
11/04/2023
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2023 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2023 American Dental Association. All rights reserved.

Copyright © 2023, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Title XVIII of the Social Security Act (SSA), §1862(a)(1)(A), states that no Medicare payment shall be made for items or services that “are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.”

Title XVIII of the Social Security Act, §1862(a)(7) and 42 Code of Federal Regulations (CFR), §411.15, exclude routine physical examinations.

Title XVIII of the Social Security Act, §1833(e), prohibits Medicare payment for any claim lacking the necessary documentation to process the claim.

42 CFR §410.32 and §410.33, indicate that diagnostic tests are payable only when ordered by the physician who is treating the beneficiary for a specific medical problem and who uses the results in such treatment.

CMS Manual System, Publication 100-08, Medicare Program Integrity Manual, Chapter 3, §3.2.3.3, Third-party Additional Documentation Request.

CMS Manual System, Publication 100-08 , Medicare Program Integrity Manual, Chapter 15, Enrollment, §§15.5.19 - 15.5.19.7 Independent Diagnostic Testing Facilities Standards. See also 42 CFR 410.33.

CMS Manual System, Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, §§60 and 80, indicate that the technical component of diagnostic tests are not covered as "incident-to" physician healthcare services, but under a distinct coverage category and subject to supervision levels found in the Physician Fee Schedule database. See also 42 CFR §§410.32 and 410.33.

Ruling of the Administrator 95-1 (HCFA Ruling 95-1), binding on providers, contractors, and Administrative Law Judges, states that by virtue of their licensure and practice, providers are responsible for knowing norms of community practice.

CMS Manual System, Publication 100-08, Medicare Program Integrity Manual, Chapter 3, §3.4.1.3., Diagnosis Code Requirement.

Article Guidance

Article Text

The following coding and billing guidance is to be used with its associated Local Coverage Determination.

Pulmonary Function Testing codes:

CPT codes relative to Medicare’s standards of reasonable and necessary care are: 94070, 94200, 94640, 94726, 94727 and 94729.

  1. Spirometry - CPT codes for Spirometry include 94010, 94011, 94012, 94060, 94070, 94150, 94200, 94375, 94726 and 94727. Routine and/or repetitive billing for unnecessary batteries of tests is not clinically reasonable.
  2. Lung Volume - CPT codes for lung volume determination are 94013, 94726, 94727 and 94728.
  3. Diffusion Capacity - CPT codes for diffusion capacity include 94729.
  4. Pulmonary stress testing - CPT codes for pulmonary stress testing include 96417, 96418, 94619 and 96421.

CPT 94664 is intended for device “demonstration and/or evaluation" and will be usually paid for once per beneficiary for the same provider or group. (Occasional extenuating circumstances, new equipment, etc, may merit two sessions or other repeat training or evaluation. Simple follow-up observation during an E/M exam for pulmonary disease is not a stand-alone procedure, unless the E/M session is not billed).

Documentation Requirements

Supportive documentation evidencing the condition and treatment is expected to be documented in the medical record and be available upon request.

Contractors are explicitly authorized to request additional documentation from third parties (e.g. ordering physician) when needed to evaluate the medical necessity of the service and may consider care prior to or subsequent to the service in question.

Each claim must be submitted with ICD-10-CM codes that reflect the actual condition of the patient. The mere listing of an ICD-10-CM code alone does not justify the test if the overall context and condition of the patient do not support necessity of the test.

All providers of pulmonary function tests should have on file a referral (an order, a prescription) with clinical diagnoses and requested tests. Indications in the primary medical record must be available for review.

All equipment and studies should meet minimum standards as outlined by the American Thoracic Society.

Spirometry studies, in particular, require 3 attempts to be clinically acceptable.

All studies require an interpretation with a written report. Computerized reports must have a physician’s signature attesting to review and accuracy.

Documentation must be available to Medicare upon request and must be legible. The medical record must document the test results and usage in treatment.

American Thoracic Society and the American Lung Association and the American College of Chest Physicians have published guidelines for typical usage of pulmonary function tests which represent typical community norms.

Follow up testing which is weekly or monthly is appropriate only when clinically required, such as in periods of acute exacerbation of interstitial lung disease.

PFTs are diagnostic, not therapeutic. PFTs are not used to demonstrate breathing exercises.

Demonstration/observation of a nebulizer (94664) is usually used once or at rare intervals as a stand-alone procedure code. See Indications and Limitations.

Response To Comments

Number Comment Response
1
N/A

Coding Information

Bill Type Codes

Code Description
999x Not Applicable
N/A

Revenue Codes

Code Description
99999 Not Applicable
N/A

CPT/HCPCS Codes

Group 1

(23 Codes)
Group 1 Paragraph

N/A

Group 1 Codes
Code Description
94010 Breathing capacity test
94011 Spirometry up to 2 yrs old
94012 Spirmtry w/brnchdil inf-2 yr
94013 Meas lung vol thru 2 yrs
94060 Evaluation of wheezing
94070 Evaluation of wheezing
94150 Vital capacity test
94200 Lung function test (mbc/mvv)
94375 Respiratory flow volume loop
94450 Hypoxia response curve
94617 Exercise tst brncspsm w/ecg
94618 Pulmonary stress testing
94619 Exercise tst brncspsm wo ecg
94621 Cardiopulm exercise testing
94640 Airway inhalation treatment
94664 Evaluate pt use of inhaler
94680 Exhaled air analysis o2
94681 Exhaled air analysis o2/co2
94690 Exhaled air analysis
94726 Pulm funct tst plethysmograp
94727 Pulm function test by gas
94728 Airwy resist by oscillometry
94729 Co/membane diffuse capacity
N/A

CPT/HCPCS Modifiers

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(842 Codes)
Group 1 Paragraph

Section A - The following ICD-10-CM codes are covered for CPT codes 94010, 94011, 94012, 94013, 94060, 94150, 94200, 94375, 94450, 94640, 94664, 94680, 94681, 94690, 94726, 94727, 94728 and 94729.

For the utilization of CPT code 94664, see the Pulmonary Function Testing codes in the Article Text section above.

Group 1 Codes
Code Description
A15.0 Tuberculosis of lung
A15.4 Tuberculosis of intrathoracic lymph nodes
A15.5 Tuberculosis of larynx, trachea and bronchus
A15.6 Tuberculous pleurisy
A15.7 Primary respiratory tuberculosis
A15.8 Other respiratory tuberculosis
A18.01 Tuberculosis of spine
A19.0 Acute miliary tuberculosis of a single specified site
A19.1 Acute miliary tuberculosis of multiple sites
A19.8 Other miliary tuberculosis
A31.0 Pulmonary mycobacterial infection
A42.0 Pulmonary actinomycosis
A43.0 Pulmonary nocardiosis
A80.39 Other acute paralytic poliomyelitis
B38.0 Acute pulmonary coccidioidomycosis
B38.1 Chronic pulmonary coccidioidomycosis
B40.0 Acute pulmonary blastomycosis
B40.1 Chronic pulmonary blastomycosis
B40.7 Disseminated blastomycosis
B40.81 Blastomycotic meningoencephalitis
B40.89 Other forms of blastomycosis
B42.0 Pulmonary sporotrichosis
B42.7 Disseminated sporotrichosis
B42.81 Cerebral sporotrichosis
B42.82 Sporotrichosis arthritis
B42.89 Other forms of sporotrichosis
B44.81 Allergic bronchopulmonary aspergillosis
B45.0 Pulmonary cryptococcosis
B45.1 Cerebral cryptococcosis
B45.3 Osseous cryptococcosis
B45.7 Disseminated cryptococcosis
B45.8 Other forms of cryptococcosis
B58.3 Pulmonary toxoplasmosis
B91 Sequelae of poliomyelitis
C33 Malignant neoplasm of trachea
C34.01 Malignant neoplasm of right main bronchus
C34.02 Malignant neoplasm of left main bronchus
C34.11 Malignant neoplasm of upper lobe, right bronchus or lung
C34.12 Malignant neoplasm of upper lobe, left bronchus or lung
C34.2 Malignant neoplasm of middle lobe, bronchus or lung
C34.31 Malignant neoplasm of lower lobe, right bronchus or lung
C34.32 Malignant neoplasm of lower lobe, left bronchus or lung
C34.81 Malignant neoplasm of overlapping sites of right bronchus and lung
C34.82 Malignant neoplasm of overlapping sites of left bronchus and lung
C37 Malignant neoplasm of thymus
C38.0 Malignant neoplasm of heart
C38.1 Malignant neoplasm of anterior mediastinum
C38.2 Malignant neoplasm of posterior mediastinum
C38.4 Malignant neoplasm of pleura
C38.8 Malignant neoplasm of overlapping sites of heart, mediastinum and pleura
C45.0 Mesothelioma of pleura
C45.2 Mesothelioma of pericardium
C78.01 Secondary malignant neoplasm of right lung
C78.02 Secondary malignant neoplasm of left lung
C78.1 Secondary malignant neoplasm of mediastinum
C78.2 Secondary malignant neoplasm of pleura
C78.39 Secondary malignant neoplasm of other respiratory organs
C96.5 Multifocal and unisystemic Langerhans-cell histiocytosis
C96.6 Unifocal Langerhans-cell histiocytosis
D02.21 Carcinoma in situ of right bronchus and lung
D02.22 Carcinoma in situ of left bronchus and lung
D02.3 Carcinoma in situ of other parts of respiratory system
D14.31 Benign neoplasm of right bronchus and lung
D14.32 Benign neoplasm of left bronchus and lung
D15.2 Benign neoplasm of mediastinum
D18.1 Lymphangioma, any site
D19.0 Benign neoplasm of mesothelial tissue of pleura
D37.1 Neoplasm of uncertain behavior of stomach
D37.2 Neoplasm of uncertain behavior of small intestine
D37.3 Neoplasm of uncertain behavior of appendix
D37.4 Neoplasm of uncertain behavior of colon
D37.5 Neoplasm of uncertain behavior of rectum
D38.1 Neoplasm of uncertain behavior of trachea, bronchus and lung
D38.2 Neoplasm of uncertain behavior of pleura
D38.3 Neoplasm of uncertain behavior of mediastinum
D38.4 Neoplasm of uncertain behavior of thymus
D38.5 Neoplasm of uncertain behavior of other respiratory organs
D45 Polycythemia vera
D57.414 Sickle-cell thalassemia, unspecified, with dactylitis
D57.431 Sickle-cell thalassemia beta zero with acute chest syndrome
D57.434 Sickle-cell thalassemia beta zero with dactylitis
D57.451 Sickle-cell thalassemia beta plus with acute chest syndrome
D57.454 Sickle-cell thalassemia beta plus with dactylitis
D75.1 Secondary polycythemia
D86.0 Sarcoidosis of lung
D86.1 Sarcoidosis of lymph nodes
D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.81 Sarcoid meningitis
D86.82 Multiple cranial nerve palsies in sarcoidosis
D86.85 Sarcoid myocarditis
D86.86 Sarcoid arthropathy
D86.87 Sarcoid myositis
D86.89 Sarcoidosis of other sites
E84.0 Cystic fibrosis with pulmonary manifestations
E84.11 Meconium ileus in cystic fibrosis
E84.19 Cystic fibrosis with other intestinal manifestations
E84.8 Cystic fibrosis with other manifestations
E88.41 MELAS syndrome
E88.42 MERRF syndrome
E88.43 Disorders of mitochondrial tRNA synthetases
E88.49 Other mitochondrial metabolism disorders
E88.810 Metabolic syndrome
E88.811 Insulin resistance syndrome, Type A
E88.818 Other insulin resistance
E88.819 Insulin resistance, unspecified
E88.89 Other specified metabolic disorders
G12.21 Amyotrophic lateral sclerosis
G12.22 Progressive bulbar palsy
G14 Postpolio syndrome
G61.0 Guillain-Barre syndrome
G70.00 Myasthenia gravis without (acute) exacerbation
G70.01 Myasthenia gravis with (acute) exacerbation
G71.00 Muscular dystrophy, unspecified
G71.01 Duchenne or Becker muscular dystrophy
G71.02 Facioscapulohumeral muscular dystrophy
G71.09 Other specified muscular dystrophies
G71.11 Myotonic muscular dystrophy
G71.12 Myotonia congenita
G71.13 Myotonic chondrodystrophy
G71.14 Drug induced myotonia
G71.19 Other specified myotonic disorders
G72.41 Inclusion body myositis [IBM]
G72.49 Other inflammatory and immune myopathies, not elsewhere classified
G80.0 Spastic quadriplegic cerebral palsy
G80.1 Spastic diplegic cerebral palsy
G80.2 Spastic hemiplegic cerebral palsy
G80.4 Ataxic cerebral palsy
G80.8 Other cerebral palsy
G82.51 Quadriplegia, C1-C4 complete
G82.52 Quadriplegia, C1-C4 incomplete
G82.53 Quadriplegia, C5-C7 complete
G82.54 Quadriplegia, C5-C7 incomplete
G83.5 Locked-in state
G83.81 Brown-Sequard syndrome
G83.82 Anterior cord syndrome
G83.83 Posterior cord syndrome
G83.84 Todd's paralysis (postepileptic)
G83.89 Other specified paralytic syndromes
I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale
I26.09 Other pulmonary embolism with acute cor pulmonale
I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale
I26.93 Single subsegmental pulmonary embolism without acute cor pulmonale
I26.94 Multiple subsegmental pulmonary emboli without acute cor pulmonale
I26.99 Other pulmonary embolism without acute cor pulmonale
I27.0 Primary pulmonary hypertension
I27.1 Kyphoscoliotic heart disease
I27.20 Pulmonary hypertension, unspecified
I27.21 Secondary pulmonary arterial hypertension
I27.22 Pulmonary hypertension due to left heart disease
I27.23 Pulmonary hypertension due to lung diseases and hypoxia
I27.24 Chronic thromboembolic pulmonary hypertension
I27.29 Other secondary pulmonary hypertension
I27.81 Cor pulmonale (chronic)
I27.82 Chronic pulmonary embolism
I27.83 Eisenmenger's syndrome
I27.89 Other specified pulmonary heart diseases
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I69.010 Attention and concentration deficit following nontraumatic subarachnoid hemorrhage
I69.011 Memory deficit following nontraumatic subarachnoid hemorrhage
I69.012 Visuospatial deficit and spatial neglect following nontraumatic subarachnoid hemorrhage
I69.013 Psychomotor deficit following nontraumatic subarachnoid hemorrhage
I69.014 Frontal lobe and executive function deficit following nontraumatic subarachnoid hemorrhage
I69.015 Cognitive social or emotional deficit following nontraumatic subarachnoid hemorrhage
I69.018 Other symptoms and signs involving cognitive functions following nontraumatic subarachnoid hemorrhage
I69.051 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right dominant side
I69.052 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left dominant side
I69.053 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting right non-dominant side
I69.054 Hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side
I69.061 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right dominant side
I69.062 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left dominant side
I69.063 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting right non-dominant side
I69.064 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage affecting left non-dominant side
I69.065 Other paralytic syndrome following nontraumatic subarachnoid hemorrhage, bilateral
I69.090 Apraxia following nontraumatic subarachnoid hemorrhage
I69.091 Dysphagia following nontraumatic subarachnoid hemorrhage
I69.092 Facial weakness following nontraumatic subarachnoid hemorrhage
I69.093 Ataxia following nontraumatic subarachnoid hemorrhage
I69.098 Other sequelae following nontraumatic subarachnoid hemorrhage
I69.110 Attention and concentration deficit following nontraumatic intracerebral hemorrhage
I69.111 Memory deficit following nontraumatic intracerebral hemorrhage
I69.112 Visuospatial deficit and spatial neglect following nontraumatic intracerebral hemorrhage
I69.113 Psychomotor deficit following nontraumatic intracerebral hemorrhage
I69.114 Frontal lobe and executive function deficit following nontraumatic intracerebral hemorrhage
I69.115 Cognitive social or emotional deficit following nontraumatic intracerebral hemorrhage
I69.118 Other symptoms and signs involving cognitive functions following nontraumatic intracerebral hemorrhage
I69.151 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right dominant side
I69.152 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left dominant side
I69.153 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting right non-dominant side
I69.154 Hemiplegia and hemiparesis following nontraumatic intracerebral hemorrhage affecting left non-dominant side
I69.161 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right dominant side
I69.162 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left dominant side
I69.163 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting right non-dominant side
I69.164 Other paralytic syndrome following nontraumatic intracerebral hemorrhage affecting left non-dominant side
I69.165 Other paralytic syndrome following nontraumatic intracerebral hemorrhage, bilateral
I69.190 Apraxia following nontraumatic intracerebral hemorrhage
I69.191 Dysphagia following nontraumatic intracerebral hemorrhage
I69.192 Facial weakness following nontraumatic intracerebral hemorrhage
I69.193 Ataxia following nontraumatic intracerebral hemorrhage
I69.198 Other sequelae of nontraumatic intracerebral hemorrhage
I69.210 Attention and concentration deficit following other nontraumatic intracranial hemorrhage
I69.211 Memory deficit following other nontraumatic intracranial hemorrhage
I69.212 Visuospatial deficit and spatial neglect following other nontraumatic intracranial hemorrhage
I69.213 Psychomotor deficit following other nontraumatic intracranial hemorrhage
I69.214 Frontal lobe and executive function deficit following other nontraumatic intracranial hemorrhage
I69.215 Cognitive social or emotional deficit following other nontraumatic intracranial hemorrhage
I69.218 Other symptoms and signs involving cognitive functions following other nontraumatic intracranial hemorrhage
I69.251 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right dominant side
I69.252 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left dominant side
I69.253 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting right non-dominant side
I69.254 Hemiplegia and hemiparesis following other nontraumatic intracranial hemorrhage affecting left non-dominant side
I69.261 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right dominant side
I69.262 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left dominant side
I69.263 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting right non-dominant side
I69.264 Other paralytic syndrome following other nontraumatic intracranial hemorrhage affecting left non-dominant side
I69.265 Other paralytic syndrome following other nontraumatic intracranial hemorrhage, bilateral
I69.290 Apraxia following other nontraumatic intracranial hemorrhage
I69.291 Dysphagia following other nontraumatic intracranial hemorrhage
I69.292 Facial weakness following other nontraumatic intracranial hemorrhage
I69.293 Ataxia following other nontraumatic intracranial hemorrhage
I69.298 Other sequelae of other nontraumatic intracranial hemorrhage
I69.310 Attention and concentration deficit following cerebral infarction
I69.311 Memory deficit following cerebral infarction
I69.312 Visuospatial deficit and spatial neglect following cerebral infarction
I69.313 Psychomotor deficit following cerebral infarction
I69.314 Frontal lobe and executive function deficit following cerebral infarction
I69.315 Cognitive social or emotional deficit following cerebral infarction
I69.318 Other symptoms and signs involving cognitive functions following cerebral infarction
I69.351 Hemiplegia and hemiparesis following cerebral infarction affecting right dominant side
I69.352 Hemiplegia and hemiparesis following cerebral infarction affecting left dominant side
I69.353 Hemiplegia and hemiparesis following cerebral infarction affecting right non-dominant side
I69.354 Hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side
I69.361 Other paralytic syndrome following cerebral infarction affecting right dominant side
I69.362 Other paralytic syndrome following cerebral infarction affecting left dominant side
I69.363 Other paralytic syndrome following cerebral infarction affecting right non-dominant side
I69.364 Other paralytic syndrome following cerebral infarction affecting left non-dominant side
I69.365 Other paralytic syndrome following cerebral infarction, bilateral
I69.390 Apraxia following cerebral infarction
I69.391 Dysphagia following cerebral infarction
I69.392 Facial weakness following cerebral infarction
I69.393 Ataxia following cerebral infarction
I69.398 Other sequelae of cerebral infarction
I69.810 Attention and concentration deficit following other cerebrovascular disease
I69.811 Memory deficit following other cerebrovascular disease
I69.812 Visuospatial deficit and spatial neglect following other cerebrovascular disease
I69.813 Psychomotor deficit following other cerebrovascular disease
I69.814 Frontal lobe and executive function deficit following other cerebrovascular disease
I69.815 Cognitive social or emotional deficit following other cerebrovascular disease
I69.818 Other symptoms and signs involving cognitive functions following other cerebrovascular disease
I69.851 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right dominant side
I69.852 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left dominant side
I69.853 Hemiplegia and hemiparesis following other cerebrovascular disease affecting right non-dominant side
I69.854 Hemiplegia and hemiparesis following other cerebrovascular disease affecting left non-dominant side
I69.861 Other paralytic syndrome following other cerebrovascular disease affecting right dominant side
I69.862 Other paralytic syndrome following other cerebrovascular disease affecting left dominant side
I69.863 Other paralytic syndrome following other cerebrovascular disease affecting right non-dominant side
I69.864 Other paralytic syndrome following other cerebrovascular disease affecting left non-dominant side
I69.865 Other paralytic syndrome following other cerebrovascular disease, bilateral
I69.890 Apraxia following other cerebrovascular disease
I69.891 Dysphagia following other cerebrovascular disease
I69.892 Facial weakness following other cerebrovascular disease
I69.893 Ataxia following other cerebrovascular disease
I69.898 Other sequelae of other cerebrovascular disease
J04.10 Acute tracheitis without obstruction
J04.11 Acute tracheitis with obstruction
J09.X1 Influenza due to identified novel influenza A virus with pneumonia
J09.X2 Influenza due to identified novel influenza A virus with other respiratory manifestations
J09.X3 Influenza due to identified novel influenza A virus with gastrointestinal manifestations
J09.X9 Influenza due to identified novel influenza A virus with other manifestations
J12.82 Pneumonia due to coronavirus disease 2019
J17 Pneumonia in diseases classified elsewhere
J20.0 Acute bronchitis due to Mycoplasma pneumoniae
J20.1 Acute bronchitis due to Hemophilus influenzae
J20.2 Acute bronchitis due to streptococcus
J20.3 Acute bronchitis due to coxsackievirus
J20.4 Acute bronchitis due to parainfluenza virus
J20.5 Acute bronchitis due to respiratory syncytial virus
J20.6 Acute bronchitis due to rhinovirus
J20.7 Acute bronchitis due to echovirus
J20.8 Acute bronchitis due to other specified organisms
J21.0 Acute bronchiolitis due to respiratory syncytial virus
J21.1 Acute bronchiolitis due to human metapneumovirus
J21.8 Acute bronchiolitis due to other specified organisms
J39.8 Other specified diseases of upper respiratory tract
J40 Bronchitis, not specified as acute or chronic
J41.0 Simple chronic bronchitis
J41.1 Mucopurulent chronic bronchitis
J41.8 Mixed simple and mucopurulent chronic bronchitis
J43.0 Unilateral pulmonary emphysema [MacLeod's syndrome]
J43.1 Panlobular emphysema
J43.2 Centrilobular emphysema
J43.8 Other emphysema
J44.0 Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
J44.9 Chronic obstructive pulmonary disease, unspecified
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.909 Unspecified asthma, uncomplicated
J45.990 Exercise induced bronchospasm
J45.991 Cough variant asthma
J45.998 Other asthma
J47.0 Bronchiectasis with acute lower respiratory infection
J47.1 Bronchiectasis with (acute) exacerbation
J47.9 Bronchiectasis, uncomplicated
J60 Coalworker's pneumoconiosis
J61 Pneumoconiosis due to asbestos and other mineral fibers
J62.0 Pneumoconiosis due to talc dust
J62.8 Pneumoconiosis due to other dust containing silica
J63.0 Aluminosis (of lung)
J63.1 Bauxite fibrosis (of lung)
J63.2 Berylliosis
J63.3 Graphite fibrosis (of lung)
J63.4 Siderosis
J63.5 Stannosis
J63.6 Pneumoconiosis due to other specified inorganic dusts
J65 Pneumoconiosis associated with tuberculosis
J66.0 Byssinosis
J66.1 Flax-dressers' disease
J66.2 Cannabinosis
J66.8 Airway disease due to other specific organic dusts
J67.0 Farmer's lung
J67.1 Bagassosis
J67.2 Bird fancier's lung
J67.3 Suberosis
J67.4 Maltworker's lung
J67.5 Mushroom-worker's lung
J67.6 Maple-bark-stripper's lung
J67.7 Air conditioner and humidifier lung
J67.8 Hypersensitivity pneumonitis due to other organic dusts
J68.0 Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors
J68.1 Pulmonary edema due to chemicals, gases, fumes and vapors
J68.2 Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified
J68.3 Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapors
J68.4 Chronic respiratory conditions due to chemicals, gases, fumes and vapors
J68.8 Other respiratory conditions due to chemicals, gases, fumes and vapors
J69.0 Pneumonitis due to inhalation of food and vomit
J69.1 Pneumonitis due to inhalation of oils and essences
J69.8 Pneumonitis due to inhalation of other solids and liquids
J70.0 Acute pulmonary manifestations due to radiation
J70.1 Chronic and other pulmonary manifestations due to radiation
J70.2 Acute drug-induced interstitial lung disorders
J70.3 Chronic drug-induced interstitial lung disorders
J70.5 Respiratory conditions due to smoke inhalation
J70.8 Respiratory conditions due to other specified external agents
J80 Acute respiratory distress syndrome
J81.0 Acute pulmonary edema
J81.1 Chronic pulmonary edema
J82.81 Chronic eosinophilic pneumonia
J82.82 Acute eosinophilic pneumonia
J82.83 Eosinophilic asthma
J82.89 Other pulmonary eosinophilia, not elsewhere classified
J84.01 Alveolar proteinosis
J84.02 Pulmonary alveolar microlithiasis
J84.03 Idiopathic pulmonary hemosiderosis
J84.111 Idiopathic interstitial pneumonia, not otherwise specified
J84.112 Idiopathic pulmonary fibrosis
J84.113 Idiopathic non-specific interstitial pneumonitis
J84.114 Acute interstitial pneumonitis
J84.115 Respiratory bronchiolitis interstitial lung disease
J84.116 Cryptogenic organizing pneumonia
J84.117 Desquamative interstitial pneumonia
J84.170 Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
J84.178 Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere
J84.2 Lymphoid interstitial pneumonia
J84.81 Lymphangioleiomyomatosis
J84.82 Adult pulmonary Langerhans cell histiocytosis
J84.83 Surfactant mutations of the lung
J84.842 Pulmonary interstitial glycogenosis
J84.843 Alveolar capillary dysplasia with vein misalignment
J84.848 Other interstitial lung diseases of childhood
J84.89 Other specified interstitial pulmonary diseases
J86.0 Pyothorax with fistula
J86.9 Pyothorax without fistula
J90 Pleural effusion, not elsewhere classified
J91.0 Malignant pleural effusion
J91.8 Pleural effusion in other conditions classified elsewhere
J92.0 Pleural plaque with presence of asbestos
J92.9 Pleural plaque without asbestos
J94.0 Chylous effusion
J94.1 Fibrothorax
J94.2 Hemothorax
J94.8 Other specified pleural conditions
J95.1 Acute pulmonary insufficiency following thoracic surgery
J95.2 Acute pulmonary insufficiency following nonthoracic surgery
J95.3 Chronic pulmonary insufficiency following surgery
J95.821 Acute postprocedural respiratory failure
J95.822 Acute and chronic postprocedural respiratory failure
J95.87 Transfusion-associated dyspnea (TAD)
J96.01 Acute respiratory failure with hypoxia
J96.02 Acute respiratory failure with hypercapnia
J96.11 Chronic respiratory failure with hypoxia
J96.12 Chronic respiratory failure with hypercapnia
J96.21 Acute and chronic respiratory failure with hypoxia
J96.22 Acute and chronic respiratory failure with hypercapnia
J98.01 Acute bronchospasm
J98.09 Other diseases of bronchus, not elsewhere classified
J98.11 Atelectasis
J98.19 Other pulmonary collapse
J98.2 Interstitial emphysema
J98.3 Compensatory emphysema
J98.4 Other disorders of lung
J98.6 Disorders of diaphragm
J98.8 Other specified respiratory disorders
J99 Respiratory disorders in diseases classified elsewhere
K76.81 Hepatopulmonary syndrome
M05.011 Felty's syndrome, right shoulder
M05.012 Felty's syndrome, left shoulder
M05.021 Felty's syndrome, right elbow
M05.022 Felty's syndrome, left elbow
M05.031 Felty's syndrome, right wrist
M05.032 Felty's syndrome, left wrist
M05.041 Felty's syndrome, right hand
M05.042 Felty's syndrome, left hand
M05.051 Felty's syndrome, right hip
M05.052 Felty's syndrome, left hip
M05.061 Felty's syndrome, right knee
M05.062 Felty's syndrome, left knee
M05.071 Felty's syndrome, right ankle and foot
M05.072 Felty's syndrome, left ankle and foot
M05.09 Felty's syndrome, multiple sites
M05.111 Rheumatoid lung disease with rheumatoid arthritis of right shoulder
M05.112 Rheumatoid lung disease with rheumatoid arthritis of left shoulder
M05.121 Rheumatoid lung disease with rheumatoid arthritis of right elbow
M05.122 Rheumatoid lung disease with rheumatoid arthritis of left elbow
M05.131 Rheumatoid lung disease with rheumatoid arthritis of right wrist
M05.132 Rheumatoid lung disease with rheumatoid arthritis of left wrist
M05.141 Rheumatoid lung disease with rheumatoid arthritis of right hand
M05.142 Rheumatoid lung disease with rheumatoid arthritis of left hand
M05.151 Rheumatoid lung disease with rheumatoid arthritis of right hip
M05.152 Rheumatoid lung disease with rheumatoid arthritis of left hip
M05.161 Rheumatoid lung disease with rheumatoid arthritis of right knee
M05.162 Rheumatoid lung disease with rheumatoid arthritis of left knee
M05.171 Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot
M05.172 Rheumatoid lung disease with rheumatoid arthritis of left ankle and foot
M05.19 Rheumatoid lung disease with rheumatoid arthritis of multiple sites
M05.211 Rheumatoid vasculitis with rheumatoid arthritis of right shoulder
M05.212 Rheumatoid vasculitis with rheumatoid arthritis of left shoulder
M05.221 Rheumatoid vasculitis with rheumatoid arthritis of right elbow
M05.222 Rheumatoid vasculitis with rheumatoid arthritis of left elbow
M05.231 Rheumatoid vasculitis with rheumatoid arthritis of right wrist
M05.232 Rheumatoid vasculitis with rheumatoid arthritis of left wrist
M05.241 Rheumatoid vasculitis with rheumatoid arthritis of right hand
M05.242 Rheumatoid vasculitis with rheumatoid arthritis of left hand
M05.251 Rheumatoid vasculitis with rheumatoid arthritis of right hip
M05.252 Rheumatoid vasculitis with rheumatoid arthritis of left hip
M05.261 Rheumatoid vasculitis with rheumatoid arthritis of right knee
M05.262 Rheumatoid vasculitis with rheumatoid arthritis of left knee
M05.271 Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot
M05.272 Rheumatoid vasculitis with rheumatoid arthritis of left ankle and foot
M05.29 Rheumatoid vasculitis with rheumatoid arthritis of multiple sites
M05.311 Rheumatoid heart disease with rheumatoid arthritis of right shoulder
M05.312 Rheumatoid heart disease with rheumatoid arthritis of left shoulder
M05.321 Rheumatoid heart disease with rheumatoid arthritis of right elbow
M05.322 Rheumatoid heart disease with rheumatoid arthritis of left elbow
M05.331 Rheumatoid heart disease with rheumatoid arthritis of right wrist
M05.332 Rheumatoid heart disease with rheumatoid arthritis of left wrist
M05.341 Rheumatoid heart disease with rheumatoid arthritis of right hand
M05.342 Rheumatoid heart disease with rheumatoid arthritis of left hand
M05.351 Rheumatoid heart disease with rheumatoid arthritis of right hip
M05.352 Rheumatoid heart disease with rheumatoid arthritis of left hip
M05.361 Rheumatoid heart disease with rheumatoid arthritis of right knee
M05.362 Rheumatoid heart disease with rheumatoid arthritis of left knee
M05.371 Rheumatoid heart disease with rheumatoid arthritis of right ankle and foot
M05.372 Rheumatoid heart disease with rheumatoid arthritis of left ankle and foot
M05.39 Rheumatoid heart disease with rheumatoid arthritis of multiple sites
M05.411 Rheumatoid myopathy with rheumatoid arthritis of right shoulder
M05.412 Rheumatoid myopathy with rheumatoid arthritis of left shoulder
M05.421 Rheumatoid myopathy with rheumatoid arthritis of right elbow
M05.422 Rheumatoid myopathy with rheumatoid arthritis of left elbow
M05.431 Rheumatoid myopathy with rheumatoid arthritis of right wrist
M05.432 Rheumatoid myopathy with rheumatoid arthritis of left wrist
M05.441 Rheumatoid myopathy with rheumatoid arthritis of right hand
M05.442 Rheumatoid myopathy with rheumatoid arthritis of left hand
M05.451 Rheumatoid myopathy with rheumatoid arthritis of right hip
M05.452 Rheumatoid myopathy with rheumatoid arthritis of left hip
M05.461 Rheumatoid myopathy with rheumatoid arthritis of right knee
M05.462 Rheumatoid myopathy with rheumatoid arthritis of left knee
M05.471 Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot
M05.472 Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot
M05.49 Rheumatoid myopathy with rheumatoid arthritis of multiple sites
M05.511 Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder
M05.512 Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder
M05.521 Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow
M05.522 Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow
M05.531 Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist
M05.532 Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist
M05.541 Rheumatoid polyneuropathy with rheumatoid arthritis of right hand
M05.542 Rheumatoid polyneuropathy with rheumatoid arthritis of left hand
M05.551 Rheumatoid polyneuropathy with rheumatoid arthritis of right hip
M05.552 Rheumatoid polyneuropathy with rheumatoid arthritis of left hip
M05.561 Rheumatoid polyneuropathy with rheumatoid arthritis of right knee
M05.562 Rheumatoid polyneuropathy with rheumatoid arthritis of left knee
M05.571 Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot
M05.572 Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot
M05.59 Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites
M05.611 Rheumatoid arthritis of right shoulder with involvement of other organs and systems
M05.612 Rheumatoid arthritis of left shoulder with involvement of other organs and systems
M05.621 Rheumatoid arthritis of right elbow with involvement of other organs and systems
M05.622 Rheumatoid arthritis of left elbow with involvement of other organs and systems
M05.631 Rheumatoid arthritis of right wrist with involvement of other organs and systems
M05.632 Rheumatoid arthritis of left wrist with involvement of other organs and systems
M05.641 Rheumatoid arthritis of right hand with involvement of other organs and systems
M05.642 Rheumatoid arthritis of left hand with involvement of other organs and systems
M05.651 Rheumatoid arthritis of right hip with involvement of other organs and systems
M05.652 Rheumatoid arthritis of left hip with involvement of other organs and systems
M05.661 Rheumatoid arthritis of right knee with involvement of other organs and systems
M05.662 Rheumatoid arthritis of left knee with involvement of other organs and systems
M05.671 Rheumatoid arthritis of right ankle and foot with involvement of other organs and systems
M05.672 Rheumatoid arthritis of left ankle and foot with involvement of other organs and systems
M05.69 Rheumatoid arthritis of multiple sites with involvement of other organs and systems
M06.08 Rheumatoid arthritis without rheumatoid factor, vertebrae
M06.09 Rheumatoid arthritis without rheumatoid factor, multiple sites
M06.1 Adult-onset Still's disease
M08.211 Juvenile rheumatoid arthritis with systemic onset, right shoulder
M08.212 Juvenile rheumatoid arthritis with systemic onset, left shoulder
M08.221 Juvenile rheumatoid arthritis with systemic onset, right elbow
M08.222 Juvenile rheumatoid arthritis with systemic onset, left elbow
M08.231 Juvenile rheumatoid arthritis with systemic onset, right wrist
M08.232 Juvenile rheumatoid arthritis with systemic onset, left wrist
M08.241 Juvenile rheumatoid arthritis with systemic onset, right hand
M08.242 Juvenile rheumatoid arthritis with systemic onset, left hand
M08.251 Juvenile rheumatoid arthritis with systemic onset, right hip
M08.252 Juvenile rheumatoid arthritis with systemic onset, left hip
M08.261 Juvenile rheumatoid arthritis with systemic onset, right knee
M08.262 Juvenile rheumatoid arthritis with systemic onset, left knee
M08.271 Juvenile rheumatoid arthritis with systemic onset, right ankle and foot
M08.272 Juvenile rheumatoid arthritis with systemic onset, left ankle and foot
M08.28 Juvenile rheumatoid arthritis with systemic onset, vertebrae
M08.29 Juvenile rheumatoid arthritis with systemic onset, multiple sites
M08.3 Juvenile rheumatoid polyarthritis (seronegative)
M30.1 Polyarteritis with lung involvement [Churg-Strauss]
M31.0 Hypersensitivity angiitis
M31.30 Wegener's granulomatosis without renal involvement
M31.31 Wegener's granulomatosis with renal involvement
M32.0 Drug-induced systemic lupus erythematosus
M32.11 Endocarditis in systemic lupus erythematosus
M32.12 Pericarditis in systemic lupus erythematosus
M32.13 Lung involvement in systemic lupus erythematosus
M32.14 Glomerular disease in systemic lupus erythematosus
M32.15 Tubulo-interstitial nephropathy in systemic lupus erythematosus
M32.19 Other organ or system involvement in systemic lupus erythematosus
M32.8 Other forms of systemic lupus erythematosus
M33.01 Juvenile dermatomyositis with respiratory involvement
M33.02 Juvenile dermatomyositis with myopathy
M33.09 Juvenile dermatomyositis with other organ involvement
M33.11 Other dermatomyositis with respiratory involvement
M33.12 Other dermatomyositis with myopathy
M33.19 Other dermatomyositis with other organ involvement
M33.21 Polymyositis with respiratory involvement
M33.22 Polymyositis with myopathy
M33.29 Polymyositis with other organ involvement
M34.0 Progressive systemic sclerosis
M34.1 CR(E)ST syndrome
M34.2 Systemic sclerosis induced by drug and chemical
M34.81 Systemic sclerosis with lung involvement
M34.82 Systemic sclerosis with myopathy
M34.83 Systemic sclerosis with polyneuropathy
M34.89 Other systemic sclerosis
M35.02 Sjogren syndrome with lung involvement
M35.03 Sjogren syndrome with myopathy
M35.1 Other overlap syndromes
M35.5 Multifocal fibrosclerosis
M35.89 Other specified systemic involvement of connective tissue
M36.0 Dermato(poly)myositis in neoplastic disease
M36.8 Systemic disorders of connective tissue in other diseases classified elsewhere
M40.03 Postural kyphosis, cervicothoracic region
M40.04 Postural kyphosis, thoracic region
M40.05 Postural kyphosis, thoracolumbar region
M40.292 Other kyphosis, cervical region
M40.293 Other kyphosis, cervicothoracic region
M40.294 Other kyphosis, thoracic region
M40.295 Other kyphosis, thoracolumbar region
M41.03 Infantile idiopathic scoliosis, cervicothoracic region
M41.04 Infantile idiopathic scoliosis, thoracic region
M41.05 Infantile idiopathic scoliosis, thoracolumbar region
M41.113 Juvenile idiopathic scoliosis, cervicothoracic region
M41.114 Juvenile idiopathic scoliosis, thoracic region
M41.115 Juvenile idiopathic scoliosis, thoracolumbar region
M41.123 Adolescent idiopathic scoliosis, cervicothoracic region
M41.124 Adolescent idiopathic scoliosis, thoracic region
M41.125 Adolescent idiopathic scoliosis, thoracolumbar region
M41.23 Other idiopathic scoliosis, cervicothoracic region
M41.24 Other idiopathic scoliosis, thoracic region
M41.25 Other idiopathic scoliosis, thoracolumbar region
M41.34 Thoracogenic scoliosis, thoracic region
M41.35 Thoracogenic scoliosis, thoracolumbar region
M46.51 Other infective spondylopathies, occipito-atlanto-axial region
M46.52 Other infective spondylopathies, cervical region
M46.53 Other infective spondylopathies, cervicothoracic region
M46.54 Other infective spondylopathies, thoracic region
M46.55 Other infective spondylopathies, thoracolumbar region
M46.59 Other infective spondylopathies, multiple sites in spine
M46.81 Other specified inflammatory spondylopathies, occipito-atlanto-axial region
M46.82 Other specified inflammatory spondylopathies, cervical region
M46.83 Other specified inflammatory spondylopathies, cervicothoracic region
M46.84 Other specified inflammatory spondylopathies, thoracic region
M46.85 Other specified inflammatory spondylopathies, thoracolumbar region
M46.89 Other specified inflammatory spondylopathies, multiple sites in spine
M95.4 Acquired deformity of chest and rib
M96.2 Postradiation kyphosis
M96.3 Postlaminectomy kyphosis
M96.5 Postradiation scoliosis
M99.82 Other biomechanical lesions of thoracic region
M99.88 Other biomechanical lesions of rib cage
Q67.6 Pectus excavatum
Q67.7 Pectus carinatum
R05.1 Acute cough
R05.2 Subacute cough
R05.3 Chronic cough
R05.4 Cough syncope
R05.8 Other specified cough
R06.01 Orthopnea
R06.02 Shortness of breath
R06.09 Other forms of dyspnea
R06.1 Stridor
R06.2 Wheezing
R06.3 Periodic breathing
R06.4 Hyperventilation
R06.81 Apnea, not elsewhere classified
R06.82 Tachypnea, not elsewhere classified
R06.83 Snoring
R06.89 Other abnormalities of breathing
R09.01 Asphyxia
R09.02 Hypoxemia
R09.1 Pleurisy
R23.0 Cyanosis
R79.81 Abnormal blood-gas level
R91.1 Solitary pulmonary nodule
R91.8 Other nonspecific abnormal finding of lung field
R94.2 Abnormal results of pulmonary function studies
T53.5X1A Toxic effect of chlorofluorocarbons, accidental (unintentional), initial encounter
T53.5X1D Toxic effect of chlorofluorocarbons, accidental (unintentional), subsequent encounter
T53.5X1S Toxic effect of chlorofluorocarbons, accidental (unintentional), sequela
T53.5X2A Toxic effect of chlorofluorocarbons, intentional self-harm, initial encounter
T53.5X2D Toxic effect of chlorofluorocarbons, intentional self-harm, subsequent encounter
T53.5X2S Toxic effect of chlorofluorocarbons, intentional self-harm, sequela
T53.5X3A Toxic effect of chlorofluorocarbons, assault, initial encounter
T53.5X3D Toxic effect of chlorofluorocarbons, assault, subsequent encounter
T53.5X3S Toxic effect of chlorofluorocarbons, assault, sequela
T53.5X4A Toxic effect of chlorofluorocarbons, undetermined, initial encounter
T53.5X4D Toxic effect of chlorofluorocarbons, undetermined, subsequent encounter
T53.5X4S Toxic effect of chlorofluorocarbons, undetermined, sequela
T57.3X1A Toxic effect of hydrogen cyanide, accidental (unintentional), initial encounter
T57.3X1D Toxic effect of hydrogen cyanide, accidental (unintentional), subsequent encounter
T57.3X1S Toxic effect of hydrogen cyanide, accidental (unintentional), sequela
T57.3X2A Toxic effect of hydrogen cyanide, intentional self-harm, initial encounter
T57.3X2D Toxic effect of hydrogen cyanide, intentional self-harm, subsequent encounter
T57.3X2S Toxic effect of hydrogen cyanide, intentional self-harm, sequela
T57.3X3A Toxic effect of hydrogen cyanide, assault, initial encounter
T57.3X3D Toxic effect of hydrogen cyanide, assault, subsequent encounter
T57.3X3S Toxic effect of hydrogen cyanide, assault, sequela
T57.3X4A Toxic effect of hydrogen cyanide, undetermined, initial encounter
T57.3X4D Toxic effect of hydrogen cyanide, undetermined, subsequent encounter
T57.3X4S Toxic effect of hydrogen cyanide, undetermined, sequela
T59.0X1A Toxic effect of nitrogen oxides, accidental (unintentional), initial encounter
T59.0X1D Toxic effect of nitrogen oxides, accidental (unintentional), subsequent encounter
T59.0X1S Toxic effect of nitrogen oxides, accidental (unintentional), sequela
T59.0X2A Toxic effect of nitrogen oxides, intentional self-harm, initial encounter
T59.0X2D Toxic effect of nitrogen oxides, intentional self-harm, subsequent encounter
T59.0X2S Toxic effect of nitrogen oxides, intentional self-harm, sequela
T59.0X3A Toxic effect of nitrogen oxides, assault, initial encounter
T59.0X3D Toxic effect of nitrogen oxides, assault, subsequent encounter
T59.0X3S Toxic effect of nitrogen oxides, assault, sequela
T59.0X4A Toxic effect of nitrogen oxides, undetermined, initial encounter
T59.0X4D Toxic effect of nitrogen oxides, undetermined, subsequent encounter
T59.0X4S Toxic effect of nitrogen oxides, undetermined, sequela
T59.1X1A Toxic effect of sulfur dioxide, accidental (unintentional), initial encounter
T59.1X1D Toxic effect of sulfur dioxide, accidental (unintentional), subsequent encounter
T59.1X1S Toxic effect of sulfur dioxide, accidental (unintentional), sequela
T59.1X2A Toxic effect of sulfur dioxide, intentional self-harm, initial encounter
T59.1X2D Toxic effect of sulfur dioxide, intentional self-harm, subsequent encounter
T59.1X2S Toxic effect of sulfur dioxide, intentional self-harm, sequela
T59.1X3A Toxic effect of sulfur dioxide, assault, initial encounter
T59.1X3D Toxic effect of sulfur dioxide, assault, subsequent encounter
T59.1X3S Toxic effect of sulfur dioxide, assault, sequela
T59.1X4A Toxic effect of sulfur dioxide, undetermined, initial encounter
T59.1X4D Toxic effect of sulfur dioxide, undetermined, subsequent encounter
T59.1X4S Toxic effect of sulfur dioxide, undetermined, sequela
T59.2X1A Toxic effect of formaldehyde, accidental (unintentional), initial encounter
T59.2X1D Toxic effect of formaldehyde, accidental (unintentional), subsequent encounter
T59.2X1S Toxic effect of formaldehyde, accidental (unintentional), sequela
T59.2X2A Toxic effect of formaldehyde, intentional self-harm, initial encounter
T59.2X2D Toxic effect of formaldehyde, intentional self-harm, subsequent encounter
T59.2X2S Toxic effect of formaldehyde, intentional self-harm, sequela
T59.2X3A Toxic effect of formaldehyde, assault, initial encounter
T59.2X3D Toxic effect of formaldehyde, assault, subsequent encounter
T59.2X3S Toxic effect of formaldehyde, assault, sequela
T59.2X4A Toxic effect of formaldehyde, undetermined, initial encounter
T59.2X4D Toxic effect of formaldehyde, undetermined, subsequent encounter
T59.2X4S Toxic effect of formaldehyde, undetermined, sequela
T59.3X1A Toxic effect of lacrimogenic gas, accidental (unintentional), initial encounter
T59.3X1D Toxic effect of lacrimogenic gas, accidental (unintentional), subsequent encounter
T59.3X1S Toxic effect of lacrimogenic gas, accidental (unintentional), sequela
T59.3X2A Toxic effect of lacrimogenic gas, intentional self-harm, initial encounter
T59.3X2D Toxic effect of lacrimogenic gas, intentional self-harm, subsequent encounter
T59.3X2S Toxic effect of lacrimogenic gas, intentional self-harm, sequela
T59.3X3A Toxic effect of lacrimogenic gas, assault, initial encounter
T59.3X3D Toxic effect of lacrimogenic gas, assault, subsequent encounter
T59.3X3S Toxic effect of lacrimogenic gas, assault, sequela
T59.3X4A Toxic effect of lacrimogenic gas, undetermined, initial encounter
T59.3X4D Toxic effect of lacrimogenic gas, undetermined, subsequent encounter
T59.3X4S Toxic effect of lacrimogenic gas, undetermined, sequela
T59.4X1A Toxic effect of chlorine gas, accidental (unintentional), initial encounter
T59.4X1D Toxic effect of chlorine gas, accidental (unintentional), subsequent encounter
T59.4X1S Toxic effect of chlorine gas, accidental (unintentional), sequela
T59.4X2A Toxic effect of chlorine gas, intentional self-harm, initial encounter
T59.4X2D Toxic effect of chlorine gas, intentional self-harm, subsequent encounter
T59.4X2S Toxic effect of chlorine gas, intentional self-harm, sequela
T59.4X3A Toxic effect of chlorine gas, assault, initial encounter
T59.4X3D Toxic effect of chlorine gas, assault, subsequent encounter
T59.4X3S Toxic effect of chlorine gas, assault, sequela
T59.4X4A Toxic effect of chlorine gas, undetermined, initial encounter
T59.4X4D Toxic effect of chlorine gas, undetermined, subsequent encounter
T59.4X4S Toxic effect of chlorine gas, undetermined, sequela
T59.5X1A Toxic effect of fluorine gas and hydrogen fluoride, accidental (unintentional), initial encounter
T59.5X1D Toxic effect of fluorine gas and hydrogen fluoride, accidental (unintentional), subsequent encounter
T59.5X1S Toxic effect of fluorine gas and hydrogen fluoride, accidental (unintentional), sequela
T59.5X2A Toxic effect of fluorine gas and hydrogen fluoride, intentional self-harm, initial encounter
T59.5X2D Toxic effect of fluorine gas and hydrogen fluoride, intentional self-harm, subsequent encounter
T59.5X2S Toxic effect of fluorine gas and hydrogen fluoride, intentional self-harm, sequela
T59.5X3A Toxic effect of fluorine gas and hydrogen fluoride, assault, initial encounter
T59.5X3D Toxic effect of fluorine gas and hydrogen fluoride, assault, subsequent encounter
T59.5X3S Toxic effect of fluorine gas and hydrogen fluoride, assault, sequela
T59.5X4A Toxic effect of fluorine gas and hydrogen fluoride, undetermined, initial encounter
T59.5X4D Toxic effect of fluorine gas and hydrogen fluoride, undetermined, subsequent encounter
T59.5X4S Toxic effect of fluorine gas and hydrogen fluoride, undetermined, sequela
T59.6X1A Toxic effect of hydrogen sulfide, accidental (unintentional), initial encounter
T59.6X1D Toxic effect of hydrogen sulfide, accidental (unintentional), subsequent encounter
T59.6X1S Toxic effect of hydrogen sulfide, accidental (unintentional), sequela
T59.6X2A Toxic effect of hydrogen sulfide, intentional self-harm, initial encounter
T59.6X2D Toxic effect of hydrogen sulfide, intentional self-harm, subsequent encounter
T59.6X2S Toxic effect of hydrogen sulfide, intentional self-harm, sequela
T59.6X3A Toxic effect of hydrogen sulfide, assault, initial encounter
T59.6X3D Toxic effect of hydrogen sulfide, assault, subsequent encounter
T59.6X3S Toxic effect of hydrogen sulfide, assault, sequela
T59.6X4A Toxic effect of hydrogen sulfide, undetermined, initial encounter
T59.6X4D Toxic effect of hydrogen sulfide, undetermined, subsequent encounter
T59.6X4S Toxic effect of hydrogen sulfide, undetermined, sequela
T59.7X1A Toxic effect of carbon dioxide, accidental (unintentional), initial encounter
T59.7X1D Toxic effect of carbon dioxide, accidental (unintentional), subsequent encounter
T59.7X1S Toxic effect of carbon dioxide, accidental (unintentional), sequela
T59.7X2A Toxic effect of carbon dioxide, intentional self-harm, initial encounter
T59.7X2D Toxic effect of carbon dioxide, intentional self-harm, subsequent encounter
T59.7X2S Toxic effect of carbon dioxide, intentional self-harm, sequela
T59.7X3A Toxic effect of carbon dioxide, assault, initial encounter
T59.7X3D Toxic effect of carbon dioxide, assault, subsequent encounter
T59.7X3S Toxic effect of carbon dioxide, assault, sequela
T59.7X4A Toxic effect of carbon dioxide, undetermined, initial encounter
T59.7X4D Toxic effect of carbon dioxide, undetermined, subsequent encounter
T59.7X4S Toxic effect of carbon dioxide, undetermined, sequela
T59.811A Toxic effect of smoke, accidental (unintentional), initial encounter
T59.811D Toxic effect of smoke, accidental (unintentional), subsequent encounter
T59.811S Toxic effect of smoke, accidental (unintentional), sequela
T59.812A Toxic effect of smoke, intentional self-harm, initial encounter
T59.812D Toxic effect of smoke, intentional self-harm, subsequent encounter
T59.812S Toxic effect of smoke, intentional self-harm, sequela
T59.813A Toxic effect of smoke, assault, initial encounter
T59.813D Toxic effect of smoke, assault, subsequent encounter
T59.813S Toxic effect of smoke, assault, sequela
T59.814A Toxic effect of smoke, undetermined, initial encounter
T59.814D Toxic effect of smoke, undetermined, subsequent encounter
T59.814S Toxic effect of smoke, undetermined, sequela
T59.891A Toxic effect of other specified gases, fumes and vapors, accidental (unintentional), initial encounter
T59.891D Toxic effect of other specified gases, fumes and vapors, accidental (unintentional), subsequent encounter
T59.891S Toxic effect of other specified gases, fumes and vapors, accidental (unintentional), sequela
T59.892A Toxic effect of other specified gases, fumes and vapors, intentional self-harm, initial encounter
T59.892D Toxic effect of other specified gases, fumes and vapors, intentional self-harm, subsequent encounter
T59.892S Toxic effect of other specified gases, fumes and vapors, intentional self-harm, sequela
T59.893A Toxic effect of other specified gases, fumes and vapors, assault, initial encounter
T59.893D Toxic effect of other specified gases, fumes and vapors, assault, subsequent encounter
T59.893S Toxic effect of other specified gases, fumes and vapors, assault, sequela
T59.894A Toxic effect of other specified gases, fumes and vapors, undetermined, initial encounter
T59.894D Toxic effect of other specified gases, fumes and vapors, undetermined, subsequent encounter
T59.894S Toxic effect of other specified gases, fumes and vapors, undetermined, sequela
T65.211A Toxic effect of chewing tobacco, accidental (unintentional), initial encounter
T65.211D Toxic effect of chewing tobacco, accidental (unintentional), subsequent encounter
T65.211S Toxic effect of chewing tobacco, accidental (unintentional), sequela
T65.212A Toxic effect of chewing tobacco, intentional self-harm, initial encounter
T65.212D Toxic effect of chewing tobacco, intentional self-harm, subsequent encounter
T65.212S Toxic effect of chewing tobacco, intentional self-harm, sequela
T65.213A Toxic effect of chewing tobacco, assault, initial encounter
T65.213D Toxic effect of chewing tobacco, assault, subsequent encounter
T65.213S Toxic effect of chewing tobacco, assault, sequela
T65.214A Toxic effect of chewing tobacco, undetermined, initial encounter
T65.214D Toxic effect of chewing tobacco, undetermined, subsequent encounter
T65.214S Toxic effect of chewing tobacco, undetermined, sequela
T65.221A Toxic effect of tobacco cigarettes, accidental (unintentional), initial encounter
T65.221D Toxic effect of tobacco cigarettes, accidental (unintentional), subsequent encounter
T65.221S Toxic effect of tobacco cigarettes, accidental (unintentional), sequela
T65.222A Toxic effect of tobacco cigarettes, intentional self-harm, initial encounter
T65.222D Toxic effect of tobacco cigarettes, intentional self-harm, subsequent encounter
T65.222S Toxic effect of tobacco cigarettes, intentional self-harm, sequela
T65.223A Toxic effect of tobacco cigarettes, assault, initial encounter
T65.223D Toxic effect of tobacco cigarettes, assault, subsequent encounter
T65.223S Toxic effect of tobacco cigarettes, assault, sequela
T65.224A Toxic effect of tobacco cigarettes, undetermined, initial encounter
T65.224D Toxic effect of tobacco cigarettes, undetermined, subsequent encounter
T65.224S Toxic effect of tobacco cigarettes, undetermined, sequela
T65.291A Toxic effect of other tobacco and nicotine, accidental (unintentional), initial encounter
T65.291D Toxic effect of other tobacco and nicotine, accidental (unintentional), subsequent encounter
T65.291S Toxic effect of other tobacco and nicotine, accidental (unintentional), sequela
T65.292A Toxic effect of other tobacco and nicotine, intentional self-harm, initial encounter
T65.292D Toxic effect of other tobacco and nicotine, intentional self-harm, subsequent encounter
T65.292S Toxic effect of other tobacco and nicotine, intentional self-harm, sequela
T65.293A Toxic effect of other tobacco and nicotine, assault, initial encounter
T65.293D Toxic effect of other tobacco and nicotine, assault, subsequent encounter
T65.293S Toxic effect of other tobacco and nicotine, assault, sequela
T65.294A Toxic effect of other tobacco and nicotine, undetermined, initial encounter
T65.294D Toxic effect of other tobacco and nicotine, undetermined, subsequent encounter
T65.294S Toxic effect of other tobacco and nicotine, undetermined, sequela
Z48.21 Encounter for aftercare following heart transplant
Z48.24 Encounter for aftercare following lung transplant
Z48.280 Encounter for aftercare following heart-lung transplant
Z79.899 Other long term (current) drug therapy
Z86.11 Personal history of tuberculosis
Z86.12 Personal history of poliomyelitis
Z86.15 Personal history of latent tuberculosis infection
Z86.16 Personal history of COVID-19
Z87.01 Personal history of pneumonia (recurrent)
Z87.09 Personal history of other diseases of the respiratory system
Z94.1 Heart transplant status
Z94.2 Lung transplant status
Z94.3 Heart and lungs transplant status

Group 2

(31 Codes)
Group 2 Paragraph

Section B - The following ICD-10-CM codes are covered for CPT code 94013, 94070, 94450, 94640, 94664, 94680, 94681, 94690, 94726, 94727, 94728 and 94729.

For the utilization of CPT code 94664, see the Pulmonary Function Testing codes in the Article Text section above.

Group 2 Codes
Code Description
J12.82 Pneumonia due to coronavirus disease 2019
J15.61 Pneumonia due to Acinetobacter baumannii
J15.69 Pneumonia due to other Gram-negative bacteria
J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome
J44.89 Other specified chronic obstructive pulmonary disease
J44.9 Chronic obstructive pulmonary disease, unspecified
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute) exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
J45.909 Unspecified asthma, uncomplicated
J45.991 Cough variant asthma
J45.998 Other asthma
J95.87 Transfusion-associated dyspnea (TAD)
J98.4 Other disorders of lung
R05.1 Acute cough
R05.2 Subacute cough
R05.3 Chronic cough
R05.4 Cough syncope
R05.8 Other specified cough
Z86.16 Personal history of COVID-19

Group 3

(16 Codes)
Group 3 Paragraph

Section C - The following ICD-10-CM codes are covered for CPT codes 94013, 94450, 94617, 94618, 94619, 94621, 94640, 94664, 94680, 94681, 94690, 94726, 94727, 94728 and 94729.

For the utilization of CPT code 94664, see the Pulmonary Function Testing codes in the Article Text section above.

Group 3 Codes
Code Description
E66.2 Morbid (severe) obesity with alveolar hypoventilation
J12.82 Pneumonia due to coronavirus disease 2019
J15.61 Pneumonia due to Acinetobacter baumannii
J15.69 Pneumonia due to other Gram-negative bacteria
J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome
J44.89 Other specified chronic obstructive pulmonary disease
J45.990 Exercise induced bronchospasm
J95.87 Transfusion-associated dyspnea (TAD)
R06.02 Shortness of breath
R06.09 Other forms of dyspnea
R06.2 Wheezing
R06.82 Tachypnea, not elsewhere classified
R06.83 Snoring
R06.89 Other abnormalities of breathing
Z79.899 Other long term (current) drug therapy
Z86.16 Personal history of COVID-19
N/A

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

Group 1 Paragraph

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Group 1 Codes

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N/A

ICD-10-PCS Codes

Group 1

Group 1 Paragraph

N/A

Group 1 Codes

N/A

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description
999x Not Applicable
N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

Code Description
99999 Not Applicable
N/A

Other Coding Information

Group 1

Group 1 Paragraph

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Group 1 Codes

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A N/A
N/A
Non-Excluded CPT/HCPCS Ended Codes - Table Format
Code Descriptor Generic Name Descriptor Brand Name Exclusion Effective Date Exclusion End Date Reason for Exclusion
N/A

Revision History Information

Revision History Date Revision History Number Revision History Explanation
11/04/2023 R7

Due to being combined with the Respiratory Care policy for ease of access and consolidation of policies and standardization of coverage between jurisdictions, this policy is being retired effective 11/04/2023.

10/01/2023 R6

Per Annual ICD-10 Updates:

The following codes were added to Group 1: D57.414, D57.434, D57.454, E88.43, E88.810, E88.811, E88.818, E88.819

The following codes were added to Group 2: J15.61, J15.69, J44.81, J44.89

The following codes were added to Group 3: J15.61, J15.69, J44.81, J44.89

10/01/2022 R5

Effective 10/01/2022 - Annual ICD-10 Updates:

The following ICD-10 codes were added to Group 1, Group 2 and Group 3 of the ICD-10 Codes That Support Medical Necessity:

J95.87

10/01/2021 R4

The Code Description for M35.02 changed from Sicca syndrome with lung involvement to Sjogren syndrome with lung involvement and N35.03 changed from Sicca syndrome with myopathy to Sjogren syndrome with myopathy. Also added the following ICD-10-CM codes to replace the deleted code R05 – cough to Groups 1 and 2 effective 10/01/2021 per the Annual ICD-10-CM Update.

  • R05.1 - Acute cough
  • R05.2 - Subacute cough
  • R05.3 - Chronic cough
  • R05.4 - Cough syncope
  • R05.8 - Other specified cough
01/01/2021 R3

Deleted 94250, 94400 and 94750 Group 1, 2 and 3 Paragraphs of the ICD-10 Codes that Support Medical Necessity and added 94619 to the Group 3 Paragraph of this section and Article Text per the 2021 CPT/HCPCS Annual Update.

Code description for 94617 changed from Exercise tst brncspsm to Exercise tst brncspsm w ecg and added 94619 in  Group 1 CPT/HCPCS Codes section per the 2021 CPT/HCPCS Annual Update.

Added ICD-10-CM codes M35.89 and deleted M35.8 in Group 1 and added J12.82 and Z86.16 to Groups 1- 3 Codes of the ICD-10 Codes that Support Medical Necessity section per 2021 first quarter I-10 updates.

10/01/2020 R2

Effective 10/01/2020, added D57.431, D57.451, J82.81, J82.82, J82.83, J82.89, J84.170 and J84.178 and deleted J82 and J84.17 under Group 1. All updates made are per the ICD-10 Annual Updates.

01/01/2020 R1

The code description for 94728 changed per the 2020 CPT/HCPCS Annual Update.

N/A

Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L34247 - Pulmonary Function Testing
Related National Coverage Documents
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SAD Process URL 1
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SAD Process URL 2
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Statutory Requirements URLs
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Rules and Regulations URLs
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CMS Manual Explanations URLs
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Other URLs
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Public Versions
Updated On Effective Dates Status
11/04/2023 10/01/2023 - 11/04/2023 Retired You are here
08/24/2023 10/01/2023 - N/A Superseded View
09/02/2022 10/01/2022 - 09/30/2023 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Pulmonary
  • Function