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

ICD-10 J68.2

Billable / Specific HCC v28: 112

Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified

J68
Block
0
Synonyms
123
LCDs
6
Payer Policies
0
Linked CPTs

About ICD-10-CM J68.2

ICD-10-CM code J68.2 represents Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified. This is a billable/specific code in the Respiratory System chapter (block J68). The 2026 edition of ICD-10-CM J68.2 became effective on October 1, 2025.

Coding Tips for J68.2

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

HCC capture: document with MEAT each year

J68.2 is a CMS-HCC v28 risk-adjustment code (category 112). 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.

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 112
ESRD-HCC
Category 112
RxHCC (Part D)
Category 112

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 J68.2

Local Coverage Determinations (LCDs) from CMS MACs that list J68.2 as a covered diagnosis.

123 LCDs

Showing top 10 of 123 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 J68.2.

6 policies

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Respiratory Therapy (Respiratory Care)
Policy ID: ART-56717
Billing and Coding: Oximetry Services
Policy ID: ART-57205
Billing and Coding: Respiratory Care
Policy ID: ART-57224

CPT Codes Commonly Billed with J68.2

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

No procedure linkages on file for J68.2

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.

Convert J68.2 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
J68.2 5062 00000

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

ICD-10 J68.2, Billing FAQ

Is ICD-10 code J68.2 billable? +

Yes, J68.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Does J68.2 affect Medicare Advantage HCC risk adjustment? +

Yes. J68.2 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What ICD-9 codes does J68.2 map to? +

Per CMS GEMs, J68.2 maps to ICD-9 codes: 5062. 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 June 1, 2026.

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