J42 — Unspecified chronic bronchitis
J42 is a billable, specific ICD-10-CM code for unspecified chronic bronchitis. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Chronic bronchitis NOS
- Chronic tracheitis
- Chronic tracheobronchitis
Other codes that can never be billed with J42
These codes carry an Excludes1 note pointing at J42. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J42 alone.
- J37.1Chronic laryngotracheitis
Risk adjustment
J42 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders0.319 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
J42 is named in 18 Medicare coverage policies — 16 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
How J42 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J42.
- Pharyngotracheitis, chronic
- Bronchitis›chronic
- Bronchitis›senile(chronic)
- Bronchorrhea›chronic(infective) (purulent)
- Infection, infected, infective›trachea, chronic
- Tracheitis›chronic
- Tracheopharyngitis›chronic
- Bronchitis›chemical›chronic
- Bronchitis›chemical›due to fumes or vapors
- Bronchitis›chronic›chemical(due to fumes or vapors)
- Bronchitis›chronic›due to›chemicals, gases, fumes or vapors(inhalation)
- Bronchitis›chronic›with›tracheitis(chronic)
Questions about J42
- Is J42 a billable ICD-10-CM code?
- Yes. J42 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J42 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Chronic lower respiratory diseases (J40-J4A).
- What cannot be coded together with J42?
- J42 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.