J70.5: Respiratory conditions due to smoke inhalation
J70.5, respiratory conditions due to smoke inhalation, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 56 HCPCS Level II codes, including G0238 (Therapeutic procedures to improve respiratory function…), G0237 (Therapeutic procedures to increase strength or endurance…), G0239 (Therapeutic procedures to improve respiratory function or…). 20 of these codes have a 2026 DMEPOS fee schedule amount; K0730 pays $245.69 (RR) depending on the state. The articles come from 3 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 J70.5 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | Carrier judgment | — | 2 |
| K0730 | Controlled dose inhalation drug delivery system | Carrier judgment | $245.69 (RR) | 1 |
| E1372 | Immersion external heater for nebulizer | Special coverage instructions apply | $136.61–$208.94 (NU) | 1 |
| A7017 | Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen | Special coverage instructions apply | $130.82–$194.58 (NU) | 1 |
| E0580 | Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter | Special coverage instructions apply | $164.65–$182.27 (NU) | 1 |
| E0575 | Nebulizer, ultrasonic, large volume | Special coverage instructions apply | $124.51–$159.48 (RR) | 1 |
| E0565 | Compressor, air power source for equipment which is not self-contained or cylinder driven | Carrier judgment | $42.74–$82.96 (RR) | 1 |
| E0574 | Ultrasonic/electronic aerosol generator with small volume nebulizer | Carrier judgment | $48.76–$67.63 (RR) | 1 |
| E0585 | Nebulizer, with compressor and heater | Special coverage instructions apply | $32.06–$60.76 (RR) | 1 |
| E0572 | Aerosol compressor, adjustable pressure, light duty for intermittent use | Carrier judgment | $29.16–$51.74 (RR) | 1 |
| A7005 | Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable | Carrier judgment | $11.77–$29.20 (NU) | 1 |
| A7008 | Large volume nebulizer, disposable, prefilled, used with aerosol compressor | Carrier judgment | $12.46–$18.09 (NU) | 1 |
| A7016 | Dome and mouthpiece, used with small volume ultrasonic nebulizer | Carrier judgment | $9.31–$17.75 (NU) | 1 |
| E0570 | Nebulizer, with compressor | Special coverage instructions apply | $6.09–$15.43 (RR) | 1 |
| A7006 | Administration set, with small volume filtered pneumatic nebulizer | Carrier judgment | $8.19–$14.94 (NU) | 1 |
| A7007 | Large volume nebulizer, disposable, unfilled, used with aerosol compressor | Carrier judgment | $3.47–$5.87 (NU) | 1 |
| A7012 | Water collection device, used with large volume nebulizer | Carrier judgment | $3.25–$5.03 (NU) | 1 |
| A4217 | Sterile water/saline, 500 ml | Special coverage instructions apply | $2.18–$4.93 | 1 |
| A7003 | Administration set, with small volume nonfiltered pneumatic nebulizer, disposable | Carrier judgment | $1.86–$3.26 (NU) | 1 |
| A7004 | Small volume nonfiltered pneumatic nebulizer, disposable | Carrier judgment | $1.51–$2.08 (NU) | 1 |
| A7018 | Water, distilled, used with large volume nebulizer, 1000 ml | Carrier judgment | $0.38–$0.59 | 1 |
| J7677 | Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram | Carrier judgment | — | 1 |
| J7613 | Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg | Special coverage instructions apply | — | 1 |
31 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing J70.5
- A52466: Nebulizers - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 53 Level II codes). LCD with the same title: L33370
- A56717: Billing and Coding: Respiratory Therapy (Respiratory Care) (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34430
- A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34149
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 J70 diagnoses (Respiratory conditions due to other external agents)
- 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
- J70.8 — Respiratory conditions due to other specified external agents
Frequently asked questions
Does Medicare cover J70.5 (Respiratory conditions due to smoke inhalation)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list J70.5 as a covered diagnosis for 56 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 J70.5?
The Level II codes from the policies most specific to this diagnosis are G0238 (Therapeutic procedures to improve respiratory function…, 2 articles); G0237 (Therapeutic procedures to increase strength or endurance…, 2 articles); G0239 (Therapeutic procedures to improve respiratory function or…, 2 articles); K0730 (Controlled dose inhalation drug delivery system, 1 article); E1372 (Immersion external heater for nebulizer, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with J70.5?
Under the 2026 DMEPOS fee schedule (non-rural state fees): K0730 $245.69 (RR); E1372 $136.61 to $208.94 (NU); A7017 $130.82 to $194.58 (NU); E0580 $164.65 to $182.27 (NU). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list J70.5?
A52466 (Nebulizers - Policy Article); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A57224 (Billing and Coding: Respiratory Care).
What is ICD-10-CM code J70.5?
J70.5 is the ICD-10-CM code for respiratory conditions due to smoke inhalation, in category J70 (Respiratory conditions due to other external agents), chapter 10: Diseases of the respiratory system.
Next steps
- Run a reimbursement report for a device billed under G0238
- Watch G0238 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0238
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 10: Diseases of the respiratory system · All diagnoses · HCPCS lookup