Is J96.1 a billable ICD-10-CM code?

No. J96.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does J96.1 sit in the tabular list?

Diseases of the respiratory system (J00-J99), in the block Other diseases of the respiratory system (J96-J99).

J96.1

J96.1 — Chronic respiratory failure

Non-billable headerICD-10-CM

J96.1 is a non-billable header ICD-10-CM code for chronic respiratory failure. It cannot be billed on its own: choose one of the more specific child codes below.

Risk adjustment

J96.1 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 J96.1

3 child codes. Green means billable.

J96.10Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.11Chronic respiratory failure with hypoxia
J96.12Chronic respiratory failure with hypercapnia

Related codes at this level

Codes that share J96. If J96.1 is not quite right, the correct code is usually one of these.

J96.0Acute respiratory failure
J96.2Acute and chronic respiratory failure
J96.9Respiratory failure, unspecified

Questions about J96.1

Is J96.1 a billable ICD-10-CM code?: No. J96.1 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does J96.1 sit in the tabular list?: Diseases of the respiratory system (J00-J99), in the block Other diseases of the respiratory system (J96-J99).