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J95.3

J95.3Chronic pulmonary insufficiency following surgery

Billable / specific codeICD-10-CM

J95.3 is a billable, specific ICD-10-CM code for chronic pulmonary insufficiency following surgery. It is valid for submission on a claim.

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

  • Functional disturbances following cardiac surgery (I97.0, I97.1-)

Risk adjustment

J95.3 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

J95.3 is named in 14 Medicare coverage policies 14 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

  • A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
  • A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
  • A56625Billing and Coding: Echocardiography
  • A56625Billing and Coding: Echocardiography

How J95.3 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 J95.3.

  • Insufficiency, insufficientpulmonarychronic, following surgery
  • Complicationsurgical procedurepulmonary insufficiencychronic
  • Complicationrespiratory systempostoperativepulmonary insufficiencychronic

Related codes at this level

Codes that share J95. If J95.3 is not quite right, the correct code is usually one of these.

Questions about J95.3

Is J95.3 a billable ICD-10-CM code?
Yes. J95.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J95.3 sit in the tabular list?
Diseases of the respiratory system (J00-J99), in the block Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified (J95).
ICD-10-CMFY2026-Apr· effective April 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release — see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.