J98.6: Disorders of diaphragm
J98.6, disorders of diaphragm, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 7 HCPCS Level II codes, including A7020 (Interface for cough stimulating device, includes all…), E0483 (High frequency chest wall oscillation system, with full…), A7025 (High frequency chest wall oscillation system vest…). 4 of these codes have a 2026 DMEPOS fee schedule amount; A7020 pays $19.87 to $23.81 (NU) 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 J98.6 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| A7020 | Interface for cough stimulating device, includes all components, replacement only | Carrier judgment | $19.87–$23.81 (NU) | 1 |
| E0483 | High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each | Carrier judgment | $1,515.12–$1,818.13 (RR) | 1 |
| A7025 | High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each | Carrier judgment | $61.99–$74.42 (RR) | 1 |
| A7026 | High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each | Carrier judgment | $40.96–$49.15 (NU) | 1 |
| 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 |
Medicare policy articles listing J98.6
- A52510: Mechanical In-exsufflation Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 1 Level II codes). LCD with the same title: L33795
- A52494: High Frequency Chest Wall Oscillation Devices - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 3 Level II codes). LCD with the same title: L33785
- 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 J98 diagnoses (Other respiratory disorders)
- J98.09 — Other diseases of bronchus, not elsewhere classified
- J98.51 — Mediastinitis
- J98.59 — Other diseases of mediastinum, not elsewhere classified
Frequently asked questions
Does Medicare cover J98.6 (Disorders of diaphragm)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list J98.6 as a covered diagnosis for 7 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 J98.6?
The Level II codes from the policies most specific to this diagnosis are A7020 (Interface for cough stimulating device, includes all…, 1 article); E0483 (High frequency chest wall oscillation system, with full…, 1 article); A7025 (High frequency chest wall oscillation system vest…, 1 article); A7026 (High frequency chest wall oscillation system hose…, 1 article); G0238 (Therapeutic procedures to improve respiratory function…, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with J98.6?
Under the 2026 DMEPOS fee schedule (non-rural state fees): A7020 $19.87 to $23.81 (NU); E0483 $1,515.12 to $1,818.13 (RR); A7025 $61.99 to $74.42 (RR); A7026 $40.96 to $49.15 (NU). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list J98.6?
A52510 (Mechanical In-exsufflation Devices - Policy Article); A52494 (High Frequency Chest Wall Oscillation Devices - Policy Article); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)), and 1 more article.
What is ICD-10-CM code J98.6?
J98.6 is the ICD-10-CM code for disorders of diaphragm, in category J98 (Other respiratory disorders), chapter 10: Diseases of the respiratory system.
Next steps
- Run a reimbursement report for a device billed under A7020
- Watch A7020 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7020
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