ICD-10 J4A.0
Billable / Specific HCC v28: 186Restrictive allograft syndrome
About ICD-10-CM J4A.0
ICD-10-CM code J4A.0 represents Restrictive allograft syndrome. This is a billable/specific code in the Respiratory System chapter (block J4A). The 2026 edition of ICD-10-CM J4A.0 became effective on October 1, 2025.
Coding Tips for J4A.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J4A.0 is a CMS-HCC v28 risk-adjustment code (category 186). 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.
Coding Notes
Code Also
- , if applicable, for mixed chronic lung allograft dysfunction, bronchiolitis obliterans syndrome (J44.81)
Medicare Advantage HCC Impact
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 J4A.0
Local Coverage Determinations (LCDs) from CMS MACs that list J4A.0 as a covered diagnosis.
Showing top 3. Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J4A.0.
1 Medicare
CPT Codes Commonly Billed with J4A.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To J4A.0
Other codes in section J40-J4A (Chronic lower respiratory diseases).
ICD-10 J4A.0, Billing FAQ
Is ICD-10 code J4A.0 billable? +
Yes, J4A.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does J4A.0 affect Medicare Advantage HCC risk adjustment? +
Yes. J4A.0 maps to CMS-HCC v28 category 186. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team