J98.3 — Compensatory emphysema
J98.3 is a billable, specific ICD-10-CM code for compensatory emphysema. It is valid for submission on a claim.
Excludes1 inherited from the categories above J98.3
These are not written on J98.3, but they bind it: a note on a category applies to every code beneath it. Billing J98.3 with anything listed here is a denial.
Excludes2 inherited from the categories above J98.3
Also inherited, and the opposite of Excludes1: these conditions are not part of J98.3, but a patient can have both, so you may code both.
Other codes that can never be billed with J98.3
These codes carry an Excludes1 note pointing at J98.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J98.3 alone.
- J43Emphysema
Risk adjustment
J98.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders0.319 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
J98.3 is named in 9 Medicare coverage policies — 7 listing it as supporting medical necessity, and 2 listing it as NOT covered. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56566Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A57067Billing and Coding: Outpatient Physical and Occupational Therapy Servicesnot covered
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
How J98.3 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 J98.3.
- Emphysema›compensatory
Code history
J98.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share J98. If J98.3 is not quite right, the correct code is usually one of these.
Questions about J98.3
- Is J98.3 a billable ICD-10-CM code?
- Yes. J98.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J98.3 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Other diseases of the respiratory system (J96-J99).
- What cannot be coded together with J98.3?
- J98.3 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J98.3 (J98) and apply to it just the same.