J43
J43 — Emphysema
Non-billable headerICD-10-CM
J43 is a non-billable header ICD-10-CM code for emphysema. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Other codes that can never be billed with J43
These codes carry an Excludes1 note pointing at J43. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J43 alone.
- J98.2Interstitial emphysema
Risk adjustment
J43 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Code to one of these instead J43
5 child codes. Green means billable.
Questions about J43
- Is J43 a billable ICD-10-CM code?
- No. J43 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does J43 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 J43?
- J43 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.