Is J99 a billable ICD-10-CM code?

Yes. J99 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J99 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 J99?

J99 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

J99

J99 — Respiratory disorders in diseases classified elsewhere

Billable / specific codeICD-10-CM

J99 is a billable, specific ICD-10-CM code for respiratory disorders in diseases classified elsewhere. It is valid for submission on a claim.

Excludes1 — 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.

underlying disease, such as:
amyloidosis (E85.-)
ankylosing spondylitis (M45.-)
congenital syphilis (A50.-)
cryoglobulinemia (D89.1)
early congenital syphilis (A50.0-)
plasminogen deficiency (E88.02)
schistosomiasis (B65.0-B65.9)

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.

Medicare coverage

J99 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

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

Questions about J99

Is J99 a billable ICD-10-CM code?: Yes. J99 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J99 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 J99?: J99 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.