R78.81: Bacteremia

R78.81, bacteremia, is listed as a covered diagnosis in 13 Medicare billing and coding articles that apply to 40 HCPCS Level II codes, including C8925 (Transesophageal echocardiography (tee) with contrast, or…), C8926 (Transesophageal echocardiography (tee) with contrast, or…), C8927 (Transesophageal echocardiography (tee) with contrast, or…). The articles come from 7 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 R78.81 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
C8925Transesophageal 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 reportSpecial coverage instructions apply—4
C8926Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and reportSpecial coverage instructions apply—4
C8927Transesophageal 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 basisSpecial coverage instructions apply—4
U00022019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdcCarrier judgment—4
U0001Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panelCarrier judgment—4
Q9957Injection, perflutren lipid microspheres, per mlCarrier judgment—3
Q9956Injection, octafluoropropane microspheres, per mlCarrier judgment—3
Q9955Injection, perflexane lipid microspheres, per mlCarrier judgment—3
J0461Injection, atropine sulfate, 0.01 mgSpecial coverage instructions apply—3
J0153Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)Special coverage instructions apply—3
J1250Injection, dobutamine hydrochloride, per 250 mgSpecial coverage instructions apply—3
J0280Injection, aminophyllin, up to 250 mgSpecial coverage instructions apply—3
J1245Injection, dipyridamole, per 10 mgSpecial coverage instructions apply—3
A9700Supply of injectable contrast material for use in echocardiography, per studySpecial coverage instructions apply—3
J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mgSpecial coverage instructions apply—1
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1459Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mgSpecial coverage instructions apply—1
J1557Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1556Injection, immune globulin (bivigam), 500 mgCarrier judgment—1
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mgCarrier judgment—1
J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mgSpecial coverage instructions apply—1
J1554Injection, immune globulin (asceniv), 500 mgCarrier judgment—1
J1599Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mgCarrier judgment—1
J2791Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iuSpecial coverage instructions apply—1

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

Medicare policy articles listing R78.81

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 R78.81 (Bacteremia)?

Medicare covers items and services, not diagnoses. 13 Medicare billing and coding articles list R78.81 as a covered diagnosis for 40 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 R78.81?

The Level II codes from the policies most specific to this diagnosis are C8925 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); C8926 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); C8927 (Transesophageal echocardiography (tee) with contrast, or…, 4 articles); U0002 (2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19)…, 4 articles); U0001 (Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr…, 4 articles). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list R78.81?

A56718 (Billing and Coding: Intravenous Immunoglobulin (IVIG)); A57179 (Billing and Coding: Transesophageal Echocardiogram); A56809 (Billing and Coding: Transesophageal Echocardiography (TEE)), and 10 more articles.

What is ICD-10-CM code R78.81?

R78.81 is the ICD-10-CM code for bacteremia, in category R78 (Findings of drugs and other substances, not normally found in blood), 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