ICD-10 J84.114
Billable / Specific HCC v28: 112 CCAcute interstitial pneumonitis
About ICD-10-CM J84.114
ICD-10-CM code J84.114 represents Acute interstitial pneumonitis. This is a billable/specific code in the Respiratory System chapter (block J84). The 2026 edition of ICD-10-CM J84.114 became effective on October 1, 2025.
Coding Tips for J84.114
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J84.114 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.
J84.114 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under J84.114. Per CMS ICD-10-CM Tabular 2026.
- Hamman-Rich syndrome
Type 1 Excludes
Pure excludes, these codes can never be coded together with J84.114. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- pneumocystis pneumonia (B59)
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.
Inpatient DRG Impact, CC
codes Acute interstitial pneumonitis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for J84.114
Local Coverage Determinations (LCDs) from CMS MACs that list J84.114 as a covered diagnosis.
Showing top 10 of 665 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J84.114.
5 Medicare
CPT Codes Commonly Billed with J84.114
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 J84.114 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 |
|---|---|---|
| J84.114 | 51633 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J84.114
Other codes in section J80-J84 (Other respiratory diseases principally affecting the interstitium).
ICD-10 J84.114, Billing FAQ
Is ICD-10 code J84.114 billable? +
Yes, J84.114 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 J84.114? +
ICD-10 J84.114 includes: Hamman-Rich syndrome.
What codes are Type 1 Excludes for J84.114? +
Type 1 Excludes (never code together with J84.114): pneumocystis pneumonia (B59)
Does J84.114 affect Medicare Advantage HCC risk adjustment? +
Yes. J84.114 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is J84.114 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does J84.114 map to? +
Per CMS GEMs, J84.114 maps to ICD-9 codes: 51633. 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 July 16, 2026.
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