G70.81: Lambert-Eaton syndrome in disease classified elsewhere

G70.81, lambert-Eaton syndrome in disease classified elsewhere, is listed as a covered diagnosis in 16 Medicare billing and coding articles that apply to 35 HCPCS Level II codes, including J1569 (Injection, immune globulin, (gammagard liquid/gammagard…), J1561 (Injection, immune globulin, (gamunex-c/gammaked)…), J1459 (Injection, immune globulin (privigen), intravenous…). The articles come from 7 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 G70.81 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—5
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—5
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—5
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—5
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—5
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—5
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—5
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—5
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—5
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—4
J1577Injection, immune globulin (qivigy), 100 mgCarrier judgment—4
J1553Injection, immune globulin (yimmugo), 100 mgCarrier judgment—3
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—3
J1559Injection, immune globulin (hizentra), 100 mgCarrier judgment—2
J1555Injection, immune globulin (cuvitru), 100 mgCarrier judgment—2
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—2
J1558Injection, immune globulin (xembify), 100 mgCarrier judgment—2
J1551Injection, immune globulin (cutaquig), 100 mgCarrier judgment—2
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—2
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iuSpecial coverage instructions apply—1
J2792Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iuSpecial coverage instructions apply—1
G0238Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)Carrier judgment—2
G0237Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)Carrier judgment—2
G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)Carrier judgment—2
G0153Services performed by a qualified speech-language pathologist in the home health or hospice setting, each 15 minutesCarrier judgment—1

10 more codes are listed. See every code with payment by region in Caduvo.

Medicare policy articles listing G70.81

1 more articles list G70.81.

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 G70 diagnoses (Myasthenia gravis and other myoneural disorders)

Frequently asked questions

Does Medicare cover G70.81 (Lambert-Eaton syndrome in disease classified elsewhere)?

Medicare covers items and services, not diagnoses. 16 Medicare billing and coding articles list G70.81 as a covered diagnosis for 35 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 G70.81?

The Level II codes from the policies most specific to this diagnosis are J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 5 articles); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 5 articles); J1459 (Injection, immune globulin (privigen), intravenous…, 5 articles); J1576 (Injection, immune globulin (panzyga), intravenous…, 5 articles); J1557 (Injection, immune globulin, (gammaplex), intravenous…, 5 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list G70.81?

A57187 (Billing and Coding: Immune Globulin Intravenous (IVIg)); A56786 (Billing and Coding: Immune Globulin); A57778 (Billing and Coding: Immune Globulin), and 13 more articles.

What is ICD-10-CM code G70.81?

G70.81 is the ICD-10-CM code for lambert-Eaton syndrome in disease classified elsewhere, in category G70 (Myasthenia gravis and other myoneural disorders), chapter 6: Diseases of the nervous system.

Next steps

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 6: Diseases of the nervous system · All diagnoses · HCPCS lookup