J90-J94 — Other diseases of the pleura
ICD-10-CM codes J90-J94 cover other diseases of the pleura, within diseases of the respiratory system. The block holds 23 codes across 5 categories, of which 17 are billable and 6 are header codes that cannot be submitted on a claim.
Risk adjustment in J90-J94
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 17 Cancer Metastatic to Lung, Liver, Brain, and Other Organs; Acute Myeloid Leukemia Except Promyelocytic
What else to watch in J90-J94
- 17 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.