J95.860: Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure
J95.860, postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 21 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…). The articles come from 2 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 J95.860 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 |
| C8900 | Magnetic resonance angiography with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8901 | Magnetic resonance angiography without contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8902 | Magnetic resonance angiography without contrast followed by with contrast, abdomen | Special coverage instructions apply | — | 1 |
| C8909 | Magnetic resonance angiography with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8910 | Magnetic resonance angiography without contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8911 | Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium) | Special coverage instructions apply | — | 1 |
| C8912 | Magnetic resonance angiography with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8913 | Magnetic resonance angiography without contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8914 | Magnetic resonance angiography without contrast followed by with contrast, lower extremity | Special coverage instructions apply | — | 1 |
| C8918 | Magnetic resonance angiography with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8919 | Magnetic resonance angiography without contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8920 | Magnetic resonance angiography without contrast followed by with contrast, pelvis | Special coverage instructions apply | — | 1 |
| C8931 | Magnetic resonance angiography with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8932 | Magnetic resonance angiography without contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8933 | Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contents | Special coverage instructions apply | — | 1 |
| C8934 | Magnetic resonance angiography with contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8935 | Magnetic resonance angiography without contrast, upper extremity | Special coverage instructions apply | — | 1 |
| C8936 | Magnetic resonance angiography without contrast followed by with contrast, upper extremity | Special coverage instructions apply | — | 1 |
Medicare policy articles listing J95.860
- 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
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
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 J95 diagnoses (Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified)
- J95.861 — Postprocedural hematoma of a respiratory system organ or structure…
- J95.862 — Postprocedural seroma of a respiratory system organ or structure…
- J95.863 — Postprocedural seroma of a respiratory system organ or structure…
- J95.821 — Acute postprocedural respiratory failure
- J95.822 — Acute and chronic postprocedural respiratory failure
- J95.84 — Transfusion-related acute lung injury (TRALI)
- J95.00 — Unspecified tracheostomy complication
- J95.01 — Hemorrhage from tracheostomy stoma
- J95.02 — Infection of tracheostomy stoma
- J95.03 — Malfunction of tracheostomy stoma
- J95.04 — Tracheo-esophageal fistula following tracheostomy
- J95.09 — Other tracheostomy complication
- J95.1 — Acute pulmonary insufficiency following thoracic surgery
- J95.2 — Acute pulmonary insufficiency following nonthoracic surgery
- J95.3 — Chronic pulmonary insufficiency following surgery
Frequently asked questions
Does Medicare cover J95.860 (Postprocedural hematoma of a respiratory system organ or…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list J95.860 as a covered diagnosis for 21 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 J95.860?
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); C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article); C8901 (Magnetic resonance angiography without contrast, abdomen, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list J95.860?
A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A57224 (Billing and Coding: Respiratory Care); A56775 (Billing and Coding: Magnetic Resonance Angiography).
What is ICD-10-CM code J95.860?
J95.860 is the ICD-10-CM code for postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure, in category J95 (Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified), 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