R04.0: Epistaxis
R04.0, epistaxis, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 4 HCPCS Level II codes, including Q2028 (Injection, sculptra, 0.5 mg), G0429 (Dermal filler injection(s) for the treatment of facial…), Q2026 (Injection, radiesse, 0.1 ml). 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 R04.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| Q2028 | Injection, sculptra, 0.5 mg | Special coverage instructions apply | — | 2 |
| G0429 | Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy) | Carrier judgment | — | 2 |
| Q2026 | Injection, radiesse, 0.1 ml | Special coverage instructions apply | — | 2 |
| G0278 | Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure) | Carrier judgment | — | 1 |
Medicare policy articles listing R04.0
- A59299: Billing and Coding: Cosmetic and Reconstructive Surgery (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A58774: Billing and Coding: Cosmetic and Reconstructive Surgery (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33428, L35090, L38914, L39051
- A57056: Billing and Coding: Aortography and Peripheral Angiography (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36767
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 R04 diagnoses (Hemorrhage from respiratory passages)
- R04.2 — Hemoptysis
- R04.81 — Acute idiopathic pulmonary hemorrhage in infants
- R04.89 — Hemorrhage from other sites in respiratory passages
Frequently asked questions
Does Medicare cover R04.0 (Epistaxis)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list R04.0 as a covered diagnosis for 4 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 R04.0?
The Level II codes from the policies most specific to this diagnosis are Q2028 (Injection, sculptra, 0.5 mg, 2 articles); G0429 (Dermal filler injection(s) for the treatment of facial…, 2 articles); Q2026 (Injection, radiesse, 0.1 ml, 2 articles); G0278 (Iliac and/or femoral artery angiography, non-selective…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R04.0?
A59299 (Billing and Coding: Cosmetic and Reconstructive Surgery); A58774 (Billing and Coding: Cosmetic and Reconstructive Surgery); A57056 (Billing and Coding: Aortography and Peripheral Angiography).
What is ICD-10-CM code R04.0?
R04.0 is the ICD-10-CM code for epistaxis, in category R04 (Hemorrhage from respiratory passages), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under Q2028
- Watch Q2028 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q2028
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 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup