J96.01 — Acute respiratory failure with hypoxia
J96.01 is a billable, specific ICD-10-CM code for acute respiratory failure with hypoxia. It is valid for submission on a claim.
Risk adjustment
J96.01 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 213 Cardio-Respiratory Failure and Shock0.370 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.
Medicare coverage
J96.01 is named in 18 Medicare coverage policies — 17 listing it as supporting medical necessity, and 1 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52514Oxygen and Oxygen Equipment - Policy Articlenot covered
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56500Billing and Coding: Cardiac Catheterization and Coronary Angiography
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
How J96.01 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 J96.01.
- Failure, failed›respiration, respiratory›acute›with›hypoxia
Related codes at this level
Codes that share J96.0. If J96.01 is not quite right, the correct code is usually one of these.
Questions about J96.01
- Is J96.01 a billable ICD-10-CM code?
- Yes. J96.01 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J96.01 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of the respiratory system (J96-J99).