PAYER READY CREDENTIALING & COMPLIANCE
ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 J98.6

Billable / Specific

Disorders of diaphragm

J98
Block
3
Synonyms
77
LCDs
8
Payer Policies
0
Linked CPTs

About ICD-10-CM J98.6

ICD-10-CM code J98.6 represents Disorders of diaphragm. This is a billable/specific code in the Respiratory System chapter (block J98). The 2026 edition of ICD-10-CM J98.6 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under J98.6. Per CMS ICD-10-CM Tabular 2026.

  • Diaphragmatitis
  • Paralysis of diaphragm
  • Relaxation of diaphragm

Type 1 Excludes

Pure excludes, these codes can never be coded together with J98.6. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • congenital malformation of diaphragm NEC (Q79.1)
  • congenital diaphragmatic hernia (Q79.0)

Type 2 Excludes

Not included here, the excluded code is not part of J98.6, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • diaphragmatic hernia (K44.-)

Medicare LCD Coverage for J98.6

Local Coverage Determinations (LCDs) from CMS MACs that list J98.6 as a covered diagnosis.

77 LCDs

Showing top 10 of 77 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 J98.6.

8 policies

2 Aetna

Chest Physiotherapy and Airway Clearance Devices - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0067
Pulse Oximetry and Capnography for Home Use
Policy ID: CPB-0339

5 Medicare

High Frequency Chest Wall Oscillation Devices - Policy Article
Policy ID: ART-52494
Mechanical In-exsufflation Devices - Policy Article
Policy ID: ART-52510
Billing and Coding: Respiratory Therapy (Respiratory Care)
Policy ID: ART-56717
Billing and Coding: Pulmonary Stress Testing
Policy ID: ART-56784
Billing and Coding: Oximetry Services
Policy ID: ART-57205

CPT Codes Commonly Billed with J98.6

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

No procedure linkages on file for J98.6

We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.

Convert J98.6 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
J98.6 5194 00000

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

ICD-10 J98.6, Billing FAQ

Is ICD-10 code J98.6 billable? +

Yes, J98.6 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 J98.6? +

ICD-10 J98.6 includes: Diaphragmatitis; Paralysis of diaphragm; Relaxation of diaphragm.

What codes are Type 1 Excludes for J98.6? +

Type 1 Excludes (never code together with J98.6): congenital malformation of diaphragm NEC (Q79.1); congenital diaphragmatic hernia (Q79.0)

What codes are Type 2 Excludes for J98.6? +

Type 2 Excludes (may be coded together when both conditions exist): diaphragmatic hernia (K44.-)

What ICD-9 codes does J98.6 map to? +

Per CMS GEMs, J98.6 maps to ICD-9 codes: 5194. Useful for legacy data review and historical claim analysis.

Get the full PayerReady toolkit

Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.

Start free →

Run this code through our claim audit tool

Check NCCI bundling, MUE limits, and modifier logic before submission.

Try the auditor →

Did this page help?

Quick signal so we know what to improve.

Thanks!

If you want a code reference page that doesn't exist yet, email coding@payerready.com.

Sorry to hear that.

Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.

Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team

Every month un-credentialed is revenue you never bill

Sign up free, add your first provider, and watch the pipeline start moving this week.

Ask CredBrain

Answers from your credentialing team's verified knowledge base

Hi, I'm CredBrain. I answer from your credentialing team's verified knowledge base: payer join paths, state rules, timelines, associate billing, and enrollment workflows. If I don't have a verified answer, I'll say so and point you to your team. What would you like to know?

Try asking