T59.2X1A: Toxic effect of formaldehyde, accidental (unintentional), initial encounter

T59.2X1A, toxic effect of formaldehyde, accidental (unintentional), initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 12 HCPCS Level II codes, including G0238 (Therapeutic procedures to improve respiratory function…), G0237 (Therapeutic procedures to increase strength or endurance…), G0239 (Therapeutic procedures to improve respiratory function or…). The articles come from 2 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 T59.2X1A as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0238Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)Carrier judgment—2
G0237Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)Carrier judgment—2
G0239Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)Carrier judgment—2
G2187Patients with clinical indications for imaging of the head: head traumaCarrier judgment—1
G2188Patients with clinical indications for imaging of the head: new or change in headache above 50 years of ageCarrier judgment—1
G2189Patients with clinical indications for imaging of the head: abnormal neurologic examCarrier judgment—1
G2190Patients with clinical indications for imaging of the head: headache radiating to the neckCarrier judgment—1
G2191Patients with clinical indications for imaging of the head: positional headachesCarrier judgment—1
G2192Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of ageCarrier judgment—1
G2193Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age)Carrier judgment—1
G2194Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behaviorCarrier judgment—1
G2195Patients with clinical indications for imaging of the head: occipital headache in childrenCarrier judgment—1

Medicare policy articles listing T59.2X1A

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 T59 diagnoses (Toxic effect of other gases, fumes and vapors)

Frequently asked questions

Does Medicare cover T59.2X1A (Toxic effect of formaldehyde, accidental (unintentional)…)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T59.2X1A as a covered diagnosis for 12 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 T59.2X1A?

The Level II codes from the policies most specific to this diagnosis are G0238 (Therapeutic procedures to improve respiratory function…, 2 articles); G0237 (Therapeutic procedures to increase strength or endurance…, 2 articles); G0239 (Therapeutic procedures to improve respiratory function or…, 2 articles); G2187 (Patients with clinical indications for imaging of the…, 1 article); G2188 (Patients with clinical indications for imaging of the…, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list T59.2X1A?

A56717 (Billing and Coding: Respiratory Therapy (Respiratory Care)); A57224 (Billing and Coding: Respiratory Care); A56612 (Billing and Coding: CT of the Head).

What is ICD-10-CM code T59.2X1A?

T59.2X1A is the ICD-10-CM code for toxic effect of formaldehyde, accidental (unintentional), initial encounter, in category T59 (Toxic effect of other gases, fumes and vapors), chapter 19: Injury, poisoning and other consequences of external causes.

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 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup