M30.3: Mucocutaneous lymph node syndrome [Kawasaki]

M30.3, mucocutaneous lymph node syndrome [Kawasaki], is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 47 HCPCS Level II codes, including J1569 (Injection, immune globulin, (gammagard liquid/gammagard…), J1561 (Injection, immune globulin, (gamunex-c/gammaked)…), J1459 (Injection, immune globulin (privigen), intravenous…). The articles come from 7 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 M30.3 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—7
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—7
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—7
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—7
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—7
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—7
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—7
J1552Injection, immune globulin (alyglo), 500 mgCarrier judgment—6
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—6
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—5
J1577Injection, immune globulin (qivigy), 100 mgCarrier judgment—5
J1572Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—4
J1553Injection, immune globulin (yimmugo), 100 mgCarrier judgment—3
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—4
J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulinCarrier judgment—3
J1559Injection, immune globulin (hizentra), 100 mgCarrier judgment—2
J1555Injection, immune globulin (cuvitru), 100 mgCarrier judgment—2
J1558Injection, immune globulin (xembify), 100 mgCarrier judgment—2
J1551Injection, immune globulin (cutaquig), 100 mgCarrier judgment—2
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—3

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

Medicare policy articles listing M30.3

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 M30 diagnoses (Polyarteritis nodosa and related conditions)

Frequently asked questions

Does Medicare cover M30.3 (Mucocutaneous lymph node syndrome [Kawasaki])?

Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list M30.3 as a covered diagnosis for 47 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 M30.3?

The Level II codes from the policies most specific to this diagnosis are J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 7 articles); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 7 articles); J1459 (Injection, immune globulin (privigen), intravenous…, 7 articles); J1557 (Injection, immune globulin, (gammaplex), intravenous…, 7 articles); J1556 (Injection, immune globulin (bivigam), 500 mg, 7 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list M30.3?

A57187 (Billing and Coding: Immune Globulin Intravenous (IVIg)); A56779 (Billing and Coding: Intravenous Immune Globulin); A56786 (Billing and Coding: Immune Globulin), and 7 more articles.

What is ICD-10-CM code M30.3?

M30.3 is the ICD-10-CM code for mucocutaneous lymph node syndrome [Kawasaki], in category M30 (Polyarteritis nodosa and related conditions), chapter 13: Diseases of the musculoskeletal system and connective tissue.

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 13: Diseases of the musculoskeletal system and connective tissue · All diagnoses · HCPCS lookup