K76.81: Hepatopulmonary syndrome
K76.81, hepatopulmonary syndrome, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 6 HCPCS Level II codes, including G0299 (Direct skilled nursing services of a registered nurse (rn)…), G0300 (Direct skilled nursing services of a licensed practical…), G0238 (Therapeutic procedures to improve respiratory function…). 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 K76.81 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0299 | Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (lpn) in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 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 |
| J0585 | Injection, onabotulinumtoxina, 1 unit | Special coverage instructions apply | — | 1 |
Medicare policy articles listing K76.81
- A56669: Billing and Coding: Hospice - Liver Disease (Palmetto GBA (HHH MAC); 2 Level II codes). LCD with the same title: L34544
- A56389: Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34434
- 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 K76 diagnoses (Other diseases of liver)
- K76.7 — Hepatorenal syndrome
Frequently asked questions
Does Medicare cover K76.81 (Hepatopulmonary syndrome)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list K76.81 as a covered diagnosis for 6 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 K76.81?
The Level II codes from the policies most specific to this diagnosis are G0299 (Direct skilled nursing services of a registered nurse (rn)…, 1 article); G0300 (Direct skilled nursing services of a licensed practical…, 1 article); 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). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list K76.81?
A56669 (Billing and Coding: Hospice - Liver Disease); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)), and 1 more article.
What is ICD-10-CM code K76.81?
K76.81 is the ICD-10-CM code for hepatopulmonary syndrome, in category K76 (Other diseases of liver), chapter 11: Diseases of the digestive system.
Next steps
- Run a reimbursement report for a device billed under G0299
- Watch G0299 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0299
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 11: Diseases of the digestive system · All diagnoses · HCPCS lookup