J95.859
J95.859: Other complication of respirator [ventilator]
Billable / specific codeICD-10-CM
J95.859 is a billable, specific ICD-10-CM code for other complication of respirator [ventilator]. It is valid for submission on a claim.
Check J95.859 with the rest of the claim: free scrubberExcludes2 inherited from the categories above J95.859
Not part of this code, but both may be coded when both are present.
Risk adjustment
J95.859 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
J95.859 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A57205Billing and Coding: Oximetry Services
Alphabetic index entries that lead here
- Breakdown›respirator›specified NEC
- Breakdown›ventilator›specified NEC
- Complication›respirator›mechancial›specified NEC
- Complication›ventilator›mechanical›specified NEC
Code history
Unchanged in every release from FY2024 to FY2027.