J94.8 — Other specified pleural conditions
J94.8 is a billable, specific ICD-10-CM code for other specified pleural conditions. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Hydropneumothorax
- Hydrothorax
Excludes1 inherited from the categories above J94.8
These are not written on J94.8, but they bind it: a note on a category applies to every code beneath it. Billing J94.8 with anything listed here is a denial.
Other codes that can never be billed with J94.8
These codes carry an Excludes1 note pointing at J94.8. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J94.8 alone.
- R60Edema, not elsewhere classified
Risk adjustment
J94.8 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
J94.8 is named in 7 Medicare coverage policies — 7 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
- A57205Billing and Coding: Oximetry Services
How J94.8 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 J94.8.
- Hydropneumothorax
- Hydrothorax(double) (pleura)
- Adhesions, adhesive›pleura, pleuritic
- Adhesions, adhesive›pleuropericardial
- Calcification›pleura
- Congestion, congestive›pleural
- Cyst›pleura
- Fluid›chest
- Fluid›pleural cavity
- Calcification›pleura›postinfectional
- Disease, diseased›pleura›specified NEC
- Water›on›chest
Code history
J94.8 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share J94. If J94.8 is not quite right, the correct code is usually one of these.
Questions about J94.8
- Is J94.8 a billable ICD-10-CM code?
- Yes. J94.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J94.8 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of the pleura (J90-J94).
- What cannot be coded together with J94.8?
- J94.8 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J94.8 (J94) and apply to it just the same.