J95.3

J95.3: Chronic 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.

Check J95.3 with the rest of the claim: free scrubber

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-)

Excludes2 inherited from the categories above J95.3

Not part of this code, but both may be coded when both are present.

Written on J95: Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified

aspiration pneumonia (J69.-)
emphysema (subcutaneous) resulting from a procedure (T81.82)
hypostatic pneumonia (J18.2)
pulmonary manifestations due to radiation (J70.0-J70.1)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

J95.3 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56625Billing and Coding: Echocardiography
A56717Billing and Coding: Respiratory Therapy (Respiratory Care)

Alphabetic index entries that lead here

Insufficiency, insufficient›pulmonary›chronic, following surgery
Complication›surgical procedure›pulmonary insufficiency›chronic
Complication›respiratory system›postoperative›pulmonary insufficiency›chronic

Code history

Unchanged in every release from FY2024 to FY2027.