Is J80 a billable ICD-10-CM code?

Yes. J80 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J80 sit in the tabular list?

Diseases of the respiratory system (J00-J99), in the block Other respiratory diseases principally affecting the interstitium (J80-J84).

What cannot be coded together with J80?

J80 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

J80

J80 — Acute respiratory distress syndrome

Billable / specific codeICD-10-CM

J80 is a billable, specific ICD-10-CM code for acute respiratory distress syndrome. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

respiratory distress syndrome in newborn (perinatal) (P22.0)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acute respiratory distress syndrome in adult or child
Adult hyaline membrane disease

Other codes that can never be billed with J80

These codes carry an Excludes1 note pointing at J80. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J80 alone.

R06Abnormalities of breathing
R09Other symptoms and signs involving the circulatory and respiratory system
J96Respiratory failure, not elsewhere classified
T71Asphyxiation

Risk adjustment

J80 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 213 Cardio-Respiratory Failure and Shock0.370 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.

Medicare coverage

J80 is named in 16 Medicare coverage policies — 16 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56476Billing and Coding: Cardiac Radionuclide Imaging
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax

How J80 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 J80.

Shock›lung
Syndrome›acute respiratory distress(adult) (child)
Syndrome›shock-lung
Distress›acute respiratory›syndrome(adult) (child)
Disease, diseased›hyaline›membrane›adult
Syndrome›respiratory›distress›acute
Syndrome›respiratory›distress›acute›adult
Syndrome›respiratory›distress›acute›child

Questions about J80

Is J80 a billable ICD-10-CM code?: Yes. J80 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J80 sit in the tabular list?: Diseases of the respiratory system (J00-J99), in the block Other respiratory diseases principally affecting the interstitium (J80-J84).
What cannot be coded together with J80?: J80 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.