J80: Acute respiratory distress syndrome
J80 is a billable, specific ICD-10-CM code for acute respiratory distress syndrome. It is valid for submission on a claim.
Check J80 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.
- 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
Their own Excludes1 notes name this code, so the conflict is not listed above.
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
J80 is named in 13 Medicare coverage policies: 13 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56476Billing and Coding: Cardiac Radionuclide Imaging
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56625Billing and Coding: Echocardiography
Alphabetic index entries that lead here
- 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
Code history
Unchanged in every release from FY2024 to FY2027.