ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 J44.81

Billable / Specific HCC v28: 111

Bronchiolitis obliterans and bronchiolitis obliterans syndrome

J44
Block
1
Synonyms
619
LCDs
10
Payer Policies
2
Linked CPTs

About ICD-10-CM J44.81

ICD-10-CM code J44.81 represents Bronchiolitis obliterans and bronchiolitis obliterans syndrome. This is a billable/specific code in the Respiratory System chapter (block J44). The 2026 edition of ICD-10-CM J44.81 became effective on October 1, 2025.

Coding Tips for J44.81

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

J44.81 is a CMS-HCC v28 risk-adjustment code (category 111). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under J44.81. Per CMS ICD-10-CM Tabular 2026.

  • Obliterative bronchiolitis

Coding Notes

Code Also

  • , if applicable, associated conditions, such as:
  • chronic graft-versus-host disease (D89.811)
  • chronic lung allograft dysfunction (J4A.-)
  • chronic respiratory conditions due to chemicals, gases, fumes and vapors (J68.4)

Code First

  • , if applicable:
  • complication of bone marrow transplant (T86.09)
  • complication of stem cell transplant (T86.5)
  • heart-lung transplant rejection (T86.31)
  • lung transplant rejection (T86.810)
  • other complications of heart-lung transplant (T86.39)
  • other complications of lung transplant (T86.818)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 111
ESRD-HCC
Category 111
RxHCC (Part D)
Category 111

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Medicare LCD Coverage for J44.81

Local Coverage Determinations (LCDs) from CMS MACs that list J44.81 as a covered diagnosis.

619 LCDs

Showing top 10 of 619 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94642 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT G0238 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94004 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94668 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94680 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing J44.81.

10 policies

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Billing and Coding: Pulmonary Rehabilitation Services
Policy ID: ART-56152
Billing and Coding: Allergy Skin Testing
Policy ID: ART-56559
Billing and Coding: Respiratory Therapy (Respiratory Care)
Policy ID: ART-56717
Billing and Coding: Noninvasive Ear or Pulse Oximetry For Oxygen Saturation
Policy ID: ART-57115

CPT Codes Commonly Billed with J44.81

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • 94626 CMS LCD: Billing and Coding: Pulmonary Rehabilitation Services CMS LCD
  • 94625 CMS LCD: Billing and Coding: Pulmonary Rehabilitation Services CMS LCD

ICD-10 J44.81, Billing FAQ

Is ICD-10 code J44.81 billable? +

Yes, J44.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to J44.81? +

ICD-10 J44.81 includes: Obliterative bronchiolitis.

Does J44.81 affect Medicare Advantage HCC risk adjustment? +

Yes. J44.81 maps to CMS-HCC v28 category 111. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with J44.81? +

Procedures frequently paired with J44.81 include: 94626, 94625.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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