R06.3: Periodic breathing
R06.3, periodic breathing, is listed as a covered diagnosis in 7 Medicare billing and coding articles that apply to 29 HCPCS Level II codes, including Q9957 (Injection, perflutren lipid microspheres, per ml), Q9956 (Injection, octafluoropropane microspheres, per ml), Q9955 (Injection, perflexane lipid microspheres, per ml). 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 R06.3 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| 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 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 3 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 3 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 3 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 3 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 3 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 3 |
| 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 |
| J2785 | Injection, regadenoson, 0.1 mg | 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 |
| C8924 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study | Special coverage instructions apply | — | 2 |
| C8928 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report | Special coverage instructions apply | — | 2 |
| C8929 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography | Special coverage instructions apply | — | 2 |
| C8930 | Transthoracic echocardiography, with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision | Special coverage instructions apply | — | 2 |
| C8925 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, real time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 1 |
| C8926 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report | Special coverage instructions apply | — | 1 |
| C8927 | Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basis | Special coverage instructions apply | — | 1 |
| J3490 | Unclassified drugs | Special coverage instructions apply | — | 1 |
| C9399 | Unclassified drugs or biologicals | Special coverage instructions apply | — | 1 |
4 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing R06.3
- 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
- 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
- A57130: Billing and Coding: Psychiatric Codes (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 4 Level II codes). LCD with the same title: L35101
- 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
- R06.09 — Other forms of dyspnea
- R06.1 — Stridor
- R06.2 — Wheezing
- 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 R06.3 (Periodic breathing)?
Medicare covers items and services, not diagnoses. 7 Medicare billing and coding articles list R06.3 as a covered diagnosis for 29 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 R06.3?
The Level II codes from the policies most specific to this diagnosis are Q9957 (Injection, perflutren lipid microspheres, per ml, 3 articles); Q9956 (Injection, octafluoropropane microspheres, per ml, 3 articles); Q9955 (Injection, perflexane lipid microspheres, per ml, 3 articles); J0461 (Injection, atropine sulfate, 0.01 mg, 3 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 3 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list R06.3?
A56505 (Billing and Coding: Transesophageal Echocardiography (TEE)); A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A57224 (Billing and Coding: Respiratory Care), and 4 more articles.
What is ICD-10-CM code R06.3?
R06.3 is the ICD-10-CM code for periodic breathing, in category R06 (Abnormalities of breathing), chapter 18: Symptoms, signs and abnormal findings.
Next steps
- Run a reimbursement report for a device billed under Q9957
- Watch Q9957 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q9957
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