ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 A15.4

Billable / Specific CC

Tuberculosis of intrathoracic lymph nodes

A15
Block
3
Synonyms
59
LCDs
9
Payer Policies
11
Linked CPTs

About ICD-10-CM A15.4

ICD-10-CM code A15.4 represents Tuberculosis of intrathoracic lymph nodes. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A15). The 2026 edition of ICD-10-CM A15.4 became effective on October 1, 2025.

Coding Tips for A15.4

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

A15.4 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under A15.4. Per CMS ICD-10-CM Tabular 2026.

  • Tuberculosis of hilar lymph nodes
  • Tuberculosis of mediastinal lymph nodes
  • Tuberculosis of tracheobronchial lymph nodes

Type 1 Excludes

Pure excludes, these codes can never be coded together with A15.4. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • tuberculosis specified as primary (A15.7)

Inpatient DRG Impact, CC

codes Tuberculosis of intrathoracic lymph nodes. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for A15.4

Local Coverage Determinations (LCDs) from CMS MACs that list A15.4 as a covered diagnosis.

59 LCDs

Showing top 10 of 59 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94642 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT G0238 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94004 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94668 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94680 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing A15.4.

9 policies

1 Cigna

Vitamin D Testing - (0526) ---- future effective policy
Policy ID: MM_0526

5 Medicare

Billing and Coding: Assays for Vitamins and Metabolic Function
Policy ID: ART-56416
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed
Policy ID: ART-56841
Billing and Coding: Respiratory Care
Policy ID: ART-57224
Billing and Coding: Vitamin D Assay Testing
Policy ID: ART-57484

CPT Codes Commonly Billed with A15.4

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

11 linkages
  • 82306 CMS LCD: Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed CMS LCD
  • 94680 CMS LCD: Billing and Coding: Respiratory Care CMS LCD
  • 94690 CMS LCD: Billing and Coding: Respiratory Care CMS LCD
  • 94681 CMS LCD: Billing and Coding: Respiratory Care CMS LCD
  • 82379 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD
  • 86352 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD
  • 82652 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD
  • 84207 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD
  • 85385 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD
  • 82746 CMS LCD: Billing and Coding: Assays for Vitamins and Metabolic Function CMS LCD

Convert A15.4 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
A15.4 01210 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 A15.4, Billing FAQ

Is ICD-10 code A15.4 billable? +

Yes, A15.4 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to A15.4? +

ICD-10 A15.4 includes: Tuberculosis of hilar lymph nodes; Tuberculosis of mediastinal lymph nodes; Tuberculosis of tracheobronchial lymph nodes.

What codes are Type 1 Excludes for A15.4? +

Type 1 Excludes (never code together with A15.4): tuberculosis specified as primary (A15.7)

Is A15.4 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with A15.4? +

Procedures frequently paired with A15.4 include: 82306, 94680, 94690, 94681, 82379.

What ICD-9 codes does A15.4 map to? +

Per CMS GEMs, A15.4 maps to ICD-9 codes: 01210. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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