J63.2: Berylliosis

Risk adjustment

J63.2 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

J63.2 is named in 19 Medicare coverage policies: 17 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
• A56416Billing and Coding: Assays for Vitamins and Metabolic Function