R06.09: Other forms of dyspnea
R06.09, other forms of dyspnea, is listed as a covered diagnosis in 11 Medicare billing and coding articles that apply to 56 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 5 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 R06.09 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 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | Carrier judgment | — | 3 |
| A9502 | Technetium tc-99m tetrofosmin, diagnostic, per study dose | Carrier judgment | — | 3 |
| A9505 | Thallium tl-201 thallous chloride, diagnostic, per millicurie | Carrier judgment | — | 3 |
| A9501 | Technetium tc-99m teboroxime, diagnostic, per study dose | Carrier judgment | — | 3 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 3 |
| A9512 | Technetium tc-99m pertechnetate, diagnostic, per millicurie | Carrier judgment | — | 2 |
| A9560 | Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries | Carrier judgment | — | 2 |
| A9538 | Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries | Carrier judgment | — | 2 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 3 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 4 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 4 |
| 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 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| A9520 | Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries | Carrier judgment | — | 1 |
| C9176 | Tc-99m from domestically produced non-heu mo-99, [minimum 50 percent], full cost recovery add-on, per study dose | Special coverage instructions apply | — | 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 |
31 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing R06.09
- 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
- A56743: Billing and Coding: Cardiovascular Nuclear Medicine (Wellpoint Federal (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L33560, L33960
- A56505: Billing and Coding: Transesophageal Echocardiography (TEE) (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 6 Level II codes). LCD with the same title: L33579, L34337, L35016
- 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
- A56775: Billing and Coding: Magnetic Resonance Angiography (Palmetto GBA (MAC - Part A, MAC - Part B); 18 Level II codes). LCD with the same title: L34424
- 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
- R06.01 — Orthopnea
- R06.02 — Shortness of breath
- R06.03 — Acute respiratory distress
- 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 R06.09 (Other forms of dyspnea)?
Medicare covers items and services, not diagnoses. 11 Medicare billing and coding articles list R06.09 as a covered diagnosis for 56 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 R06.09?
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); A9500 (Technetium tc-99m sestamibi, diagnostic, per study dose, 3 articles); A9502 (Technetium tc-99m tetrofosmin, diagnostic, per study dose, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R06.09?
A56494 (Billing and Coding: Cardiovascular Nuclear Medicine); A56743 (Billing and Coding: Cardiovascular Nuclear Medicine); A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)), and 8 more articles.
What is ICD-10-CM code R06.09?
R06.09 is the ICD-10-CM code for other forms of dyspnea, 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