J42: Unspecified chronic bronchitis
J42 is a billable, specific ICD-10-CM code for unspecified chronic bronchitis. It is valid for submission on a claim.
Check J42 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Use additional code
Add a secondary code to capture the detail described below.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, chronic respiratory conditions due to chemicals, gases, fumes and vapors (J68.4)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Chronic bronchitis NOS
- Chronic tracheitis
- Chronic tracheobronchitis
Other codes that can never be billed with J42
Their own Excludes1 notes name this code, so the conflict is not listed above.
- J37.1Chronic laryngotracheitis
Risk adjustment
J42 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders0.319 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
J42 is named in 11 Medicare coverage policies: 9 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which one applies depends on your Medicare contractor.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52466Nebulizers - Policy Article
- A53057Billing and Coding: Home Health Occupational Therapy
Alphabetic index entries that lead here
- Pharyngotracheitis, chronic
- Bronchitis›chronic
- Bronchitis›senile(chronic)
- Bronchorrhea›chronic(infective) (purulent)
- Infection, infected, infective›trachea, chronic
- Tracheitis›chronic
- Tracheopharyngitis›chronic
- Bronchitis›chronic›with›tracheitis(chronic)
- Bronchitis›with›tracheitis›chronic
- Tracheitis›chronic›with›bronchitis(chronic)
- Tracheitis›with›bronchitis›chronic
Code history
Unchanged in every release from FY2024 to FY2027.