J68.4: Chronic respiratory conditions due to chemicals, gases, fumes and vapors
J68.4 is a billable, specific ICD-10-CM code for chronic respiratory conditions due to chemicals, gases, fumes and vapors. It is valid for submission on a claim.
Check J68.4 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.
- chronic pulmonary edema due to chemicals, gases, fumes and vapors (J68.1)
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Risk adjustment
J68.4 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
J68.4 is named in 7 Medicare coverage policies: 7 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
Alphabetic index entries that lead here
- Bronchiolitis›chemical(chronic)
- Bronchitis›chemical›chronic
- Bronchitis›chemical›due to fumes or vapors
- Bronchitis›chronic›chemical(due to fumes or vapors)
- Bronchitis›chemical›due to fumes or vapors›chronic
- Bronchitis›chronic›due to›chemicals, gases, fumes or vapors(inhalation)
- Disease, diseased›respiratory›chronic NOS›due to›chemicals, gases, fumes or vapors
- Disease, diseased›respiratory›due to›chemicals, gases, fumes or vapors›chronic
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under J68
- J68.0Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors
- J68.1Pulmonary edema due to chemicals, gases, fumes and vapors
- J68.2Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified
- J68.3Other acute and subacute respiratory conditions due to chemicals, gases, fumes and vapors
- J68.8Other respiratory conditions due to chemicals, gases, fumes and vapors
- J68.9Unspecified respiratory condition due to chemicals, gases, fumes and vapors