T75.00XA: Unspecified effects of lightning, initial encounter
T75.00XA, unspecified effects of lightning, initial encounter, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 26 HCPCS Level II codes, including J0461 (Injection, atropine sulfate, 0.01 mg), J0153 (Injection, adenosine, 1 mg (not to be used to report any…), J1250 (Injection, dobutamine hydrochloride, per 250 mg). 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 T75.00XA as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 2 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 2 |
| J1250 | Injection, dobutamine hydrochloride, per 250 mg | Special coverage instructions apply | — | 2 |
| J0280 | Injection, aminophyllin, up to 250 mg | Special coverage instructions apply | — | 2 |
| J1245 | Injection, dipyridamole, per 10 mg | Special coverage instructions apply | — | 2 |
| A9700 | Supply of injectable contrast material for use in echocardiography, per study | Special coverage instructions apply | — | 2 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 1 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 1 |
| Q9956 | Injection, octafluoropropane microspheres, per ml | Carrier judgment | — | 1 |
| C8921 | Transthoracic echocardiography with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; complete | Special coverage instructions apply | — | 1 |
| 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 | — | 1 |
| 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 | — | 1 |
| 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 | — | 1 |
| 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 | — | 1 |
| 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 | — | 1 |
| 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 | — | 1 |
| Q9955 | Injection, perflexane lipid microspheres, per ml | Carrier judgment | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients 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 behavior | Carrier judgment | — | 1 |
1 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing T75.00XA
- 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
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
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 T75 diagnoses (Other and unspecified effects of other external causes)
- T75.01XA — Shock due to being struck by lightning, initial encounter
- T75.09XA — Other effects of lightning, initial encounter
- T75.4XXA — Electrocution, initial encounter
Frequently asked questions
Does Medicare cover T75.00XA (Unspecified effects of lightning, initial encounter)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list T75.00XA as a covered diagnosis for 26 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 T75.00XA?
The Level II codes from the policies most specific to this diagnosis are J0461 (Injection, atropine sulfate, 0.01 mg, 2 articles); J0153 (Injection, adenosine, 1 mg (not to be used to report any…, 2 articles); J1250 (Injection, dobutamine hydrochloride, per 250 mg, 2 articles); J0280 (Injection, aminophyllin, up to 250 mg, 2 articles); J1245 (Injection, dipyridamole, per 10 mg, 2 articles). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list T75.00XA?
A56781 (Billing and Coding: Transthoracic Echocardiography (TTE)); A56625 (Billing and Coding: Echocardiography); A56612 (Billing and Coding: CT of the Head).
What is ICD-10-CM code T75.00XA?
T75.00XA is the ICD-10-CM code for unspecified effects of lightning, initial encounter, in category T75 (Other and unspecified effects of other external causes), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under J0461
- Watch J0461 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0461
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