J99: Respiratory disorders in diseases classified elsewhere
J99 is a billable, specific ICD-10-CM code for respiratory disorders in diseases classified elsewhere. It is valid for submission on a claim.
Check J99 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.
- respiratory disorders in:
- amebiasis (A06.5)
- blastomycosis (B40.0-B40.2)
- candidiasis (B37.1)
- coccidioidomycosis (B38.0-B38.2)
- cystic fibrosis with pulmonary manifestations (E84.0)
- dermatomyositis (M33.01, M33.11)
- histoplasmosis (B39.0-B39.2)
- late syphilis (A52.72, A52.73)
- polymyositis (M33.21)
- Sjögren syndrome (M35.02)
- systemic lupus erythematosus (M32.13)
- systemic sclerosis (M34.81)
- Wegener's granulomatosis (M31.30-M31.31)
Code first
The underlying condition must be sequenced before this code.
Risk adjustment
J99 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
J99 is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56784Billing and Coding: Pulmonary Stress Testing
- A57205Billing and Coding: Oximetry Services
Code history
Unchanged in every release from FY2024 to FY2027.