MEDICARE APPROVED DIAGNOSIS CODES FOR SIX MINUTE WALK TESTING

ICD-10 Codes that Support Medical Necessity

Group 1 Codes:

ICD-10 CODE DESCRIPTION

B44.81 Allergic bronchopulmonary aspergillosis

C33 Malignant neoplasm of

C34.00 Malignant neoplasm of unspecified main

C34.01 Malignant neoplasm of right main bronchus

C34.02 Malignant neoplasm of left main bronchus

C34.10 Malignant neoplasm of upper lobe, unspecified bronchus or

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

C34.30 Malignant neoplasm of lower lobe, unspecified 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

C34.80 Malignant neoplasm of overlapping sites of unspecified bronchus and 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

C34.90 Malignant neoplasm of unspecified part of unspecified bronchus or lung

C34.91 Malignant neoplasm of unspecified part of right bronchus or lung

C34.92 Malignant neoplasm of unspecified part of left bronchus or lung

C78.00 Secondary malignant neoplasm of unspecified lung

C78.01 Secondary malignant neoplasm of right lung

C78.02 Secondary malignant neoplasm of left lung

C78.30 Secondary malignant neoplasm of unspecified respiratory organ

C78.39 Secondary malignant neoplasm of other respiratory organs

D14.2 Benign neoplasm of trachea

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D14.30 Benign neoplasm of unspecified bronchus and lung

D14.31 Benign neoplasm of right bronchus and lung

D14.32 Benign neoplasm of left bronchus and lung

D57.01 Hb-SS disease with

D57.211 Sickle-cell/Hb-C disease with acute chest syndrome

D57.411 Sickle-cell thalassemia with acute chest syndrome

D57.811 Other sickle-cell disorders with acute chest syndrome

D86.0 of lung

D86.1 Sarcoidosis of lymph nodes

D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes

D86.3 Sarcoidosis of skin

D86.81 Sarcoid meningitis

D86.82 Multiple cranial nerve palsies in sarcoidosis

D86.83 Sarcoid iridocyclitis

D86.84 Sarcoid pyelonephritis

D86.85 Sarcoid myocarditis

D86.86 Sarcoid arthropathy

D86.87 Sarcoid myositis

D86.89 Sarcoidosis of other sites

D86.9 Sarcoidosis, unspecified

E84.0 with pulmonary manifestations

E84.19 Cystic fibrosis with other intestinal manifestations

G02 Meningitis in other infectious and parasitic diseases classified elsewhere

G47.30 Sleep apnea, unspecified

126.01 Septic with acute cor pulmonale

126.02 Saddle embolus of pulmonary artery with acute cor pulmonale

126.09 Other pulmonary embolism with acute cor pulmonale

126.90 Septic pulmonary embolism without acute cor pulmonale

126.92 Saddle embolus of pulmonary artery without acute cor pulmonale

126.93 Single subsegmental pulmonary embolism without acute cor pulmonale

126.94 Multiple subsegmental pulmonary emboli without acute cor pulmonale

126.99 Other pulmonary embolism without acute cor pulmonale

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]17 in diseases classified elsewhere

]18.8 Other pneumonia, unspecified organism

J18.9 Pneumonia, unspecified organism

]20.0 Acute due to pneumoniae

]20.1 due to Hemophilus influenzae

]20.2 Acute bronchitis due to streptococcus

]20.3 Acute bronchitis due to coxsackievirus

]20.4 Acute bronchitis due to parainfluenza virus

]20.5 Acute bronchitis due to respiratory syncytial virus

]20.6 Acute bronchitis due to rhinovirus

]20.7 Acute bronchitis due to echovirus

]20.8 Acute bronchitis due to other specified organisms

]20.9 Acute bronchitis, unspecified

]21.0 Acute due to respiratory syncytial virus

]21.1 Acute bronchiolitis due to human metapneumovirus

]21.8 Acute bronchiolitis due to other specified organisms

]21.9 Acute bronchiolitis, unspecified

]22 Unspecified acute lower respiratory infection

J39.8 Other specified diseases of upper

]40 Bronchitis, not specified as acute or chronic

]41.0 Simple chronic bronchitis

]41.1 Mucopurulent chronic bronchitis

]41.8 Mixed simple and mucopurulent chronic bronchitis

]42 Unspecified chronic bronchitis

]43.0 Unilateral pulmonary emphysema [Macleod's syndrome]

]43.1 Panlobular emphysema

]43.2 Centrilobular emphysema

]43.8 Other emphysema

]43.9 Emphysema, unspecified

]44.0 Chronic obstructive pulmonary disease with (acute) lower respiratory infection

]44.1 Chronic obstructive pulmonary disease with (acute) exacerbation

]44.9 Chronic obstructive pulmonary disease, unspecified

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J45.20 Mild intermittent , uncomplicated

]45.21 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

]45.52 Severe persistent asthma with status asthmaticus

]45.901 Unspecified asthma with (acute) exacerbation

ICD-10 CODE DESCRIPTION

]45.902 Unspecified asthma with status asthmaticus

]45.909 Unspecified asthma, uncomplicated

]45.990 Exercise induced bronchospasm

]45.991 Cough variant asthma

J45. 998 Other asthma

J47.0 with acute lower respiratory infection

J47.1 Bronchiectasis with (acute) exacerbation

J47.9 Bronchiectasis, uncomplicated

J60 Coalworker's

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 (of lung)

J63.1 (of lung)

J63.2

J63.3 Graphite fibrosis (of lung)

J63.4

J63.5 Stannosis

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J63.6 Pneumoconiosis due to other specified inorganic dusts

J64 Unspecified pneumoconiosis

J65 Pneumoconiosis associated with tuberculosis

J66.0

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

J67.2 Bird fancier's lung

J67.3

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 due to other organic dusts

J67.9 Hypersensitivity pneumonitis due to unspecified organic dust

J68.4 Chronic respiratory conditions due to chemicals, gases, fumes and vapors

J68.8 Other respiratory conditions due to chemicals, gases, fumes and vapors

J68.9 Unspecified respiratory condition due to chemicals, gases, fumes and vapors

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

J70.4 Drug-induced interstitial lung disorders, unspecified

J70.5 Respiratory conditions due to smoke inhalation

J70.8 Respiratory conditions due to other specified external agents

J70.9 Respiratory conditions due to unspecified external agent

J80 Acute respiratory distress syndrome

J81.0 Acute

J82 Pulmonary eosinophilia, not elsewhere classified

]84.01 Alveolar proteinosis

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J84.02 Pulmonary alveolar microlithiasis

J84.09 Other alveolar and parieto-alveolar conditions

J84.10 , unspecified

J84.111 Idiopathic interstitial pneumonia, not otherwise specified

J84. l 12 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

J84.17 Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere

J84.2 Lymphoid interstitial pneumonia

J84.81 Lymphangioleiomyomatosis

]84.82 Adult pulmonary Langerhans cell histiocytosis

]84.89 Other specified interstitial pulmonary diseases

J84.9 Interstitial pulmonary disease, unspecified

]95.1 Acute pulmonary insufficiency following thoracic surgery

]95.2 Acute pulmonary insufficiency following nonthoracic surgery

]95.3 Chronic pulmonary insufficiency following surgery

J95.821 Acute postprocedural

J95.822 Acute and chronic postprocedural respiratory failure

J95.84 Transfusion-related acute lung injury (TRALI)

]96.00 Acute respiratory failure, unspecified whether with or hypercapnia

]96.01 Acute respiratory failure with hypoxia

]96.02 Acute respiratory failure with hypercapnia

J96.10 Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia

J96.11 Chronic respiratory failure with hypoxia

]96.12 Chronic respiratory failure with hypercapnia

J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia

]96.21 Acute and chronic respiratory failure with hypoxia

]96.22 Acute and chronic respiratory failure with hypercapnia

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J96. 90 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia

J96.91 Respiratory failure, unspecified with hypoxia

J96.92 Respiratory failure, unspecified with hypercapnia

J98.01 Acute bronchospasm

J98.09 Other diseases of bronchus, not elsewhere classified

J98.11

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

M31.0 Hypersensitivity angiitis

M32.13 Lung involvement in systemic lupus erythematosus

M33.0l Juvenile dermatomyositis with respiratory involvement

M33.11 Other dermatomyositis with respiratory involvement

M33.21 Polymyositis with respiratory involvement

M33.91 Dermatopolymyositis, unspecified with respiratory involvement ICD-10 CODE DESCRIPTION

M34.81 Systemic sclerosis with lung involvement

M35.02 Sicca syndrome with lung involvement

R04.2 Hemoptysis

R04.89 Hemorrhage from other sites in respiratory passages

R04.9 Hemorrhage from respiratory passages, unspecified

ROS Cough

R06.00 Dyspnea, unspecified

R06.01 Orthopnea

R06.02

R06.03 Acute respiratory distress

R06.09 Other forms of dyspnea

R06.2 Wheezing

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R06.3 Periodic breathing

R06.81 Apnea, not elsewhere classified

R06.82 Tachypnea, not elsewhere classified

R06.83 Snoring

R06.89 Other abnormalities of breathing

R09.2 Respiratory arrest

R91.1 Solitary pulmonary nodule

R91.8 Other nonspecific abnormal finding of lung field

Z0l.811 Encounter for preprocedural respiratory examination

ZSl.81 Encounter for therapeutic drug level monitoring

ICD-10 Codes that DO NOT Support Medical Necessity

Group 1 Paragraph:

All those not listed under the "ICD-10 Codes that Support Medical Necessity" section of this article.

Group 1 Codes:

ICD-10 CODE DESCRIPTION

xxooo Not Applicable

Additional ICD-10 Information I N/A 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 policy does not apply to that Bill Type.Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.

I DESCRlPTION

Not Applicable 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 policy, services

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