J81.0: Acute pulmonary edema

J81.0, acute pulmonary edema, is listed as a covered diagnosis in 6 Medicare billing and coding articles that apply to 24 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). The articles come from 4 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 J81.0 as a covered diagnosis

Code	Description	Medicare coverage	DMEPOS fee 2026 (state range)	Articles listing it
J0461	Injection, atropine sulfate, 0.01 mg	Special coverage instructions apply	—	3
J0153	Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)	Special coverage instructions apply	—	3
J1250	Injection, dobutamine hydrochloride, per 250 mg	Special coverage instructions apply	—	3
J0280	Injection, aminophyllin, up to 250 mg	Special coverage instructions apply	—	3
J1245	Injection, dipyridamole, per 10 mg	Special coverage instructions apply	—	3
A9700	Supply of injectable contrast material for use in echocardiography, per study	Special coverage instructions apply	—	3
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
J2785	Injection, regadenoson, 0.1 mg	Carrier judgment	—	2
Q9957	Injection, perflutren lipid microspheres, per ml	Carrier judgment	—	2
Q9956	Injection, octafluoropropane microspheres, per ml	Carrier judgment	—	2
C8921	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete	Special coverage instructions apply	—	2
C8922	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study	Special coverage instructions apply	—	2
C8923	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography	Special coverage instructions apply	—	2
C8924	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study	Special coverage instructions apply	—	2
C8928	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report	Special coverage instructions apply	—	2
C8929	Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography	Special coverage instructions apply	—	2
C8930	Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision	Special coverage instructions apply	—	2
Q9955	Injection, perflexane lipid microspheres, per ml	Carrier judgment	—	2
G0278	Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)	Carrier judgment	—	1
G0269	Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)	Special coverage instructions apply	—	1
J3490	Unclassified drugs	Special coverage instructions apply	—	1
C9399	Unclassified drugs or biologicals	Special coverage instructions apply	—	1

Medicare policy articles listing J81.0

A56500: Billing and Coding: Cardiac Catheterization and Coronary Angiography (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L33557, L33959
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
A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379

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 J81 diagnoses (Pulmonary edema)

J81.1 — Chronic pulmonary edema

Frequently asked questions

Does Medicare cover J81.0 (Acute pulmonary edema)?

Medicare covers items and services, not diagnoses. 6 Medicare billing and coding articles list J81.0 as a covered diagnosis for 24 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 J81.0?

The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 3 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 3 articles); J0280 (Injection, aminophyllin, up to 250 mg, 3 articles); J1245 (Injection, dipyridamole, per 10 mg, 3 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list J81.0?

A56500 (Billing and Coding: Cardiac Catheterization and Coronary Angiography); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A57224 (Billing and Coding: Respiratory Care), and 3 more articles.

What is ICD-10-CM code J81.0?

J81.0 is the ICD-10-CM code for acute pulmonary edema, in category J81 (Pulmonary edema), chapter 10: Diseases of the respiratory 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 10: Diseases of the respiratory system · All diagnoses · HCPCS lookup