J45.51: Severe persistent asthma with (acute) exacerbation
J45.51 is a billable, specific ICD-10-CM code for severe persistent asthma with (acute) exacerbation. It is valid for submission on a claim.
Check J45.51 with the rest of the claim: free scrubberExcludes1 inherited from the categories above J45.51
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above J45.51
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with J45.51
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
J45.51 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 279 Severe Persistent Asthma0.818 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
J45.51 is named in 40 Medicare coverage policies: 38 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
- A52448Billing and Coding: Omalizumab and biosimilar, OMLYCLO® (omalizumab-igec)
- A52466Nebulizers - Policy Article
Alphabetic index entries that lead here
- Asthma, asthmatic›severe persistent›with›exacerbation(acute)
- Asthma, asthmatic›persistent›severe›with›exacerbation(acute)
Code history
Unchanged in every release from FY2024 to FY2027.