R55: Syncope and collapse

R55, syncope and collapse, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 55 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 R55 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—5
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—5
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—5
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—4
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—4
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—3
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—3
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—3
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—3
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—3
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—3
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—3
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—3
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—3
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—3
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—3
C8920Magnetic resonance angiography without contrast followed by with contrast, pelvisSpecial coverage instructions apply—3
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—3
J3490Unclassified drugsSpecial coverage instructions apply—2
C8931Magnetic resonance angiography with contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8932Magnetic resonance angiography without contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8933Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contentsSpecial coverage instructions apply—2
C8934Magnetic resonance angiography with contrast, upper extremitySpecial coverage instructions apply—2
C8935Magnetic resonance angiography without contrast, upper extremitySpecial coverage instructions apply—2
C8936Magnetic resonance angiography without contrast followed by with contrast, upper extremitySpecial coverage instructions apply—2

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

Medicare policy articles listing R55

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.

Frequently asked questions

Does Medicare cover R55 (Syncope and collapse)?

Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list R55 as a covered diagnosis for 55 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 R55?

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…, 5 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 5 articles); J1245 (Injection, dipyridamole, per 10 mg, 5 articles); J0461 (Injection, atropine sulfate, 0.01 mg, 4 articles); J0280 (Injection, aminophyllin, up to 250 mg, 4 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list R55?

A57183 (Billing and Coding: Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography); A56476 (Billing and Coding: Cardiac Radionuclide Imaging); A56805 (Billing and Coding: Magnetic Resonance Angiography (MRA)), and 7 more articles.

What is ICD-10-CM code R55?

R55 is the ICD-10-CM code for syncope and collapse, in category R55 (Syncope and collapse), chapter 18: Symptoms, signs and abnormal findings.

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 18: Symptoms, signs and abnormal findings · All diagnoses · HCPCS lookup