J21.0 — Acute bronchiolitis due to respiratory syncytial virus
J21.0 is a billable, specific ICD-10-CM code for acute bronchiolitis 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 bronchiolitis due to RSV
Other codes that can never be billed with J21.0
These codes carry an Excludes1 note pointing at J21.0. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J21.0 alone.
- B97.4Respiratory syncytial virus as the cause of diseases classified elsewhere
Risk adjustment
J21.0 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
J21.0 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A54111Billing and Coding: Speech Language Pathology (SLP) Services: Communication Disorders
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
- A57205Billing and Coding: Oximetry Services
How J21.0 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 J21.0.
- Bronchiolitis›due to›respiratory syncytial virus(RSV)
- Virus, viral›respiratory syncytial›bronchiolitis
- Infection, infected, infective›virus, viral NOS›respiratory syncytial›bronchiolitis
Related codes at this level
Codes that share J21. If J21.0 is not quite right, the correct code is usually one of these.
Questions about J21.0
- Is J21.0 a billable ICD-10-CM code?
- Yes. J21.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J21.0 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other acute lower respiratory infections (J20-J22).