J45.41 — Moderate persistent asthma with (acute) exacerbation
J45.41 is a billable, specific ICD-10-CM code for moderate persistent asthma with (acute) exacerbation. It is valid for submission on a claim.
Risk adjustment
J45.41 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
J45.41 is named in 54 Medicare coverage policies — 52 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A52448Billing and Coding: Omalizumab and biosimilar, OMLYCLO® (omalizumab-igec)
- A52466Nebulizers - Policy Article
How J45.41 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 J45.41.
- Asthma, asthmatic›moderate persistent›with›exacerbation(acute)
- Asthma, asthmatic›persistent›moderate›with›exacerbation(acute)
Related codes at this level
Codes that share J45.4. If J45.41 is not quite right, the correct code is usually one of these.
Questions about J45.41
- Is J45.41 a billable ICD-10-CM code?
- Yes. J45.41 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J45.41 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Chronic lower respiratory diseases (J40-J4A).