Is J20.5 a billable ICD-10-CM code?

Yes. J20.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J20.5 sit in the tabular list?

Diseases of the respiratory system (J00-J99), in the block Other acute lower respiratory infections (J20-J22).

J20.5

J20.5 — Acute bronchitis due to respiratory syncytial virus

Billable / specific codeICD-10-CM

J20.5 is a billable, specific ICD-10-CM code for acute bronchitis due to respiratory syncytial virus. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acute bronchitis due to RSV

Other codes that can never be billed with J20.5

These codes carry an Excludes1 note pointing at J20.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J20.5 alone.

B97.4Respiratory syncytial virus as the cause of diseases classified elsewhere

Risk adjustment

J20.5 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.

Medicare coverage

J20.5 is named in 10 Medicare coverage policies — 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
A56730Billing and Coding: Respiratory Therapy and Oximetry Services
A57205Billing and Coding: Oximetry Services
A57224Billing and Coding: Respiratory Care

How J20.5 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 J20.5.

Virus, viral›respiratory syncytial›bronchitis
Infection, infected, infective›virus, viral NOS›respiratory syncytial›bronchitis
Bronchitis›acute or subacute›due to›virus›respiratory syncytial(RSV)

Related codes at this level

Codes that share J20. If J20.5 is not quite right, the correct code is usually one of these.

Questions about J20.5

Is J20.5 a billable ICD-10-CM code?: Yes. J20.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J20.5 sit in the tabular list?: Diseases of the respiratory system (J00-J99), in the block Other acute lower respiratory infections (J20-J22).