R06.01: Orthopnea
R06.01, orthopnea, is listed as a covered diagnosis in 9 Medicare billing and coding articles that apply to 34 HCPCS Level II codes, including J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg), J1245 (Injection, dipyridamole, per 10 mg). The articles come from 4 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 R06.01 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 6 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 6 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 6 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 4 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 3 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 3 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 3 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 3 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 3 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 2 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 2 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | Carrier judgment | — | 2 |
| A9501 | Technetium tc-99m teboroxime, diagnostic, per study dose | Carrier judgment | — | 2 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 4 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 4 |
| Q9950 | Injection, sulfur hexafluoride lipid microspheres, per ml | Carrier judgment | — | 1 |
| A9512 | Technetium tc-99m pertechnetate, diagnostic, per millicurie | Carrier judgment | — | 1 |
| A9560 | Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries | Carrier judgment | — | 1 |
| A9538 | Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries | 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 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 2 |
| C8922 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8923 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography | Special coverage instructions apply | — | 2 |
9 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing R06.01
- A58503: Billing and Coding: Echocardiography for Myocardial Perfusion (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes). LCD with the same title: L38786
- A56494: Billing and Coding: Cardiovascular Nuclear Medicine (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 12 Level II codes). LCD with the same title: L33560, L33960
- A57183: Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L34324
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B); 13 Level II codes). LCD with the same title: L33457
- 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
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B); 17 Level II codes). LCD with the same title: L33577, L34338
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L37379
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 R06 diagnoses (Abnormalities of breathing)
- R06.00 — Dyspnea, unspecified
- R06.02 — Shortness of breath
- R06.03 — Acute respiratory distress
- R06.09 — Other forms of dyspnea
- R06.1 — Stridor
- R06.2 — Wheezing
- R06.3 — Periodic breathing
- R06.4 — Hyperventilation
- R06.81 — Apnea, not elsewhere classified
- R06.82 — Tachypnea, not elsewhere classified
- R06.83 — Snoring
- R06.89 — Other abnormalities of breathing
Frequently asked questions
Does Medicare cover R06.01 (Orthopnea)?
Medicare covers items and services, not diagnoses. 9 Medicare billing and coding articles list R06.01 as a covered diagnosis for 34 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 R06.01?
The Level II codes from the policies most specific to this diagnosis are J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 6 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 6 articles); J1245 (Injection, dipyridamole, per 10 mg, 6 articles); A9700 (Supply of injectable contrast material for use in…, 4 articles); J3490 (Unclassified drugs, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R06.01?
A58503 (Billing and Coding: Echocardiography for Myocardial Perfusion); A56494 (Billing and Coding: Cardiovascular Nuclear Medicine); A57183 (Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography), and 6 more articles.
What is ICD-10-CM code R06.01?
R06.01 is the ICD-10-CM code for orthopnea, in category R06 (Abnormalities of breathing), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under J0153
- Watch J0153 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0153
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