ICD-10 J84.113
Billable / Specific HCC v28: 112Idiopathic non-specific interstitial pneumonitis
About ICD-10-CM J84.113
ICD-10-CM code J84.113 represents Idiopathic non-specific interstitial pneumonitis. This is a billable/specific code in the Respiratory System chapter (block J84). The 2026 edition of ICD-10-CM J84.113 became effective on October 1, 2025.
Coding Tips for J84.113
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J84.113 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.
Type 1 Excludes
Pure excludes, these codes can never be coded together with J84.113. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- non-specific interstitial pneumonia NOS, or due to known underlying cause (J84.89)
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 J84.113
Local Coverage Determinations (LCDs) from CMS MACs that list J84.113 as a covered diagnosis.
Showing top 10 of 136 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J84.113.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with J84.113
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.
Convert J84.113 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| J84.113 | 51632 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J84.113
Other codes in section J80-J84 (Other respiratory diseases principally affecting the interstitium).
ICD-10 J84.113, Billing FAQ
Is ICD-10 code J84.113 billable? +
Yes, J84.113 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for J84.113? +
Type 1 Excludes (never code together with J84.113): non-specific interstitial pneumonia NOS, or due to known underlying cause (J84.89)
Does J84.113 affect Medicare Advantage HCC risk adjustment? +
Yes. J84.113 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does J84.113 map to? +
Per CMS GEMs, J84.113 maps to ICD-9 codes: 51632. 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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