J85-J86 — Suppurative and necrotic conditions of the lower respiratory tract
ICD-10-CM codes J85-J86 cover suppurative and necrotic conditions of the lower respiratory tract, within diseases of the respiratory system. The block holds 8 codes across 2 categories, of which 6 are billable and 2 are header codes that cannot be submitted on a claim.
Risk adjustment in J85-J86
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 283 Empyema, Lung Abscess
What else to watch in J85-J86
- 6 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.