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

ICD-10 J84.10

Billable / Specific HCC v28: 112

Pulmonary fibrosis, unspecified

J84
Block
5
Synonyms
632
LCDs
22
Payer Policies
2
Linked CPTs

About ICD-10-CM J84.10

ICD-10-CM code J84.10 represents Pulmonary fibrosis, unspecified. This is a billable/specific code in the Respiratory System chapter (block J84). The 2026 edition of ICD-10-CM J84.10 became effective on October 1, 2025.

Coding Tips for J84.10

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

HCC capture: document with MEAT each year

J84.10 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under J84.10. Per CMS ICD-10-CM Tabular 2026.

  • Capillary fibrosis of lung
  • Cirrhosis of lung (chronic) NOS
  • Fibrosis of lung (atrophic) (chronic) (confluent) (massive) (perialveolar) (peribronchial) NOS
  • Induration of lung (chronic) NOS
  • Postinflammatory pulmonary fibrosis

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 J84.10

Local Coverage Determinations (LCDs) from CMS MACs that list J84.10 as a covered diagnosis.

632 LCDs

Showing top 10 of 632 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94617 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94619 →
CMS LCD: Billing and Coding: Pulmonary Stress Testing
Article ID: 56784, Effective: 2024-10-01 00:00:00, 199 covered, 0 non-covered
CPT 94621 →
CMS LCD: Billing and Coding: MolDX: Envisia�, Veracyte�, Idiopathic Pulmonary Fibrosis Diagnostic Test
Article ID: 57568, Effective: 2023-04-27 00:00:00, 6 covered, 0 non-covered
CPT 81554 →
CMS LCD: Billing and Coding: MolDX: Envisia�, Veracyte�, Idiopathic Pulmonary Fibrosis Diagnostic Test
Article ID: 56985, Effective: 2023-11-16 00:00:00, 6 covered, 0 non-covered
CPT 81554 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87555 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87653 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87486 →
CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing
Article ID: 58761, Effective: 2026-03-12 00:00:00, 851 covered, 0 non-covered
CPT 87626 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing J84.10.

22 policies

3 Aetna

Oxygen - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0002
Pulse Oximetry and Capnography for Home Use
Policy ID: CPB-0339
Tuberculosis Testing
Policy ID: CPB-0471

5 Medicare

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: Respiratory Therapy and Oximetry Services
Policy ID: ART-56730
Billing and Coding: Pulmonary Stress Testing
Policy ID: ART-56784
Billing and Coding: MolDX: Envisia�, Veracyte�, Idiopathic Pulmonary Fibrosis Diagnostic Test
Policy ID: ART-56898

CPT Codes Commonly Billed with J84.10

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

2 linkages
  • 94010 Spirometry — asthma all severity, COPD, COPD with exacerbation, dyspnea, wheezing, chronic cough, pulmonary disease, pulmonary fibrosis Pulmonology
  • 94729 DLCO — COPD, pulmonary fibrosis, emphysema, dyspnea, chronic respiratory failure, acute respiratory failure Pulmonology

Convert J84.10 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
J84.10 515 10000

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

ICD-10 J84.10, Billing FAQ

Is ICD-10 code J84.10 billable? +

Yes, J84.10 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 J84.10? +

ICD-10 J84.10 includes: Capillary fibrosis of lung; Cirrhosis of lung (chronic) NOS; Fibrosis of lung (atrophic) (chronic) (confluent) (massive) (perialveolar) (peribronchial) NOS, and 2 more clinical synonyms.

Does J84.10 affect Medicare Advantage HCC risk adjustment? +

Yes. J84.10 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.

What CPT codes are commonly billed with J84.10? +

Procedures frequently paired with J84.10 include: 94010, 94729.

What ICD-9 codes does J84.10 map to? +

Per CMS GEMs, J84.10 maps to ICD-9 codes: 515. 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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