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

ICD-10 J44.9

Billable / Specific HCC v28: 111

Chronic obstructive pulmonary disease, unspecified

J44
Block
2
Synonyms
925
LCDs
25
Payer Policies
2
Linked CPTs

About ICD-10-CM J44.9

ICD-10-CM code J44.9 represents Chronic obstructive pulmonary disease, unspecified. This is a billable/specific code in the Respiratory System chapter (block J44). The 2026 edition of ICD-10-CM J44.9 became effective on October 1, 2025.

Coding Tips for J44.9

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

HCC capture: document with MEAT each year

J44.9 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 J44.9. Per CMS ICD-10-CM Tabular 2026.

  • Chronic obstructive airway disease NOS
  • Chronic obstructive lung disease NOS

Type 2 Excludes

Not included here, the excluded code is not part of J44.9, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.

  • lung diseases due to external agents (J60-J70)

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 J44.9

Local Coverage Determinations (LCDs) from CMS MACs that list J44.9 as a covered diagnosis.

925 LCDs

Showing top 10 of 925 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 J44.9.

25 policies

2 Aetna

Oxygen - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0002
Obstructive Sleep Apnea in Adults - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0004

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Billing and Coding: Home Health Occupational Therapy
Policy ID: ART-53057
Billing and Coding: Outpatient Occupational Therapy
Policy ID: ART-53064
Billing and Coding: Outpatient Physical Therapy
Policy ID: ART-53065
Billing and Coding: Pulmonary Rehabilitation Services
Policy ID: ART-56152

CPT Codes Commonly Billed with J44.9

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

Convert J44.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
J44.9 49120 10000
J44.9 49320 10000
J44.9 496 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 J44.9, Billing FAQ

Is ICD-10 code J44.9 billable? +

Yes, J44.9 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 J44.9? +

ICD-10 J44.9 includes: Chronic obstructive airway disease NOS; Chronic obstructive lung disease NOS.

What codes are Type 2 Excludes for J44.9? +

Type 2 Excludes (may be coded together when both conditions exist): lung diseases due to external agents (J60-J70)

Does J44.9 affect Medicare Advantage HCC risk adjustment? +

Yes. J44.9 maps to CMS-HCC v28 category 111. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with J44.9? +

Procedures frequently paired with J44.9 include: 94626, 94625.

What ICD-9 codes does J44.9 map to? +

Per CMS GEMs, J44.9 maps to ICD-9 codes: 49120, 49320, 496. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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