J96.00: Acute respiratory failure, unspecified whether with hypoxia or hypercapnia

J96.00, acute respiratory failure, unspecified whether with hypoxia or hypercapnia, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 38 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 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 J96.00 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—2
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—2
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—2
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—2
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—2
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—2
G0238Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)Carrier judgment—1
G0237Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)Carrier judgment—1
G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)Carrier judgment—1
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—1
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—1
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—1
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—1
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—1
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—1
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—1
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—1
C8920Magnetic resonance angiography without contrast followed by with contrast, pelvisSpecial coverage instructions apply—1
C8931Magnetic resonance angiography with contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8932Magnetic resonance angiography without contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8933Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8934Magnetic resonance angiography with contrast, upper extremitySpecial coverage instructions apply—1

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

Medicare policy articles listing J96.00

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 J96 diagnoses (Respiratory failure, not elsewhere classified)

Frequently asked questions

Does Medicare cover J96.00 (Acute respiratory failure, unspecified whether with…)?

Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list J96.00 as a covered diagnosis for 38 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 J96.00?

The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 2 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 2 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 2 articles); J0280 (Injection, aminophyllin, up to 250 mg, 2 articles); J1245 (Injection, dipyridamole, per 10 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list J96.00?

A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A56775 (Billing and Coding: Magnetic Resonance Angiography); A56781 (Billing and Coding: Transthoracic Echocardiography (TTE)), and 1 more article.

What is ICD-10-CM code J96.00?

J96.00 is the ICD-10-CM code for acute respiratory failure, unspecified whether with hypoxia or hypercapnia, in category J96 (Respiratory failure, not elsewhere classified), 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