J95.850: Mechanical complication of respirator
J95.850 is a billable, specific ICD-10-CM code for mechanical complication of respirator. It is valid for submission on a claim.
Check J95.850 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.
- encounter for respirator [ventilator] dependence during power failure (Z99.12)
Excludes2 inherited from the categories above J95.850
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with J95.850
Their own Excludes1 notes name this code, so the conflict is not listed above.
- Z99.12Encounter for respirator [ventilator] dependence during power failure
Risk adjustment
J95.850 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 211 Respirator Dependence/Tracheostomy Status/Complications0.879 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
J95.850 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A57224Billing and Coding: Respiratory Care
Alphabetic index entries that lead here
- Breakdown›respirator
- Breakdown›ventilator
- Complication›respirator›mechancial
- Complication›ventilator›mechanical
Code history
Unchanged in every release from FY2024 to FY2027.