J96-J99 — Other diseases of the respiratory system
ICD-10-CM codes J96-J99 cover other diseases of the respiratory system, within diseases of the respiratory system. The block holds 34 codes across 3 categories, of which 25 are billable and 9 are header codes that cannot be submitted on a claim.
Risk adjustment in J96-J99
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 213 Cardio-Respiratory Failure and Shock
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
What else to watch in J96-J99
- 24 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.