ICD-10 J84.843
Billable / Specific HCC v28: 112 MCCAlveolar capillary dysplasia with vein misalignment
About ICD-10-CM J84.843
ICD-10-CM code J84.843 represents Alveolar capillary dysplasia with vein misalignment. This is a billable/specific code in the Respiratory System chapter (block J84). The 2026 edition of ICD-10-CM J84.843 became effective on October 1, 2025.
Coding Tips for J84.843
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J84.843 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.
J84.843 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
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, MCC
codes Alveolar capillary dysplasia with vein misalignment. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for J84.843
Local Coverage Determinations (LCDs) from CMS MACs that list J84.843 as a covered diagnosis.
Showing top 10 of 80 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J84.843.
5 Medicare
CPT Codes Commonly Billed with J84.843
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 J84.843 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 |
|---|---|---|
| J84.843 | 51664 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J84.843
Other codes in section J80-J84 (Other respiratory diseases principally affecting the interstitium).
ICD-10 J84.843, Billing FAQ
Is ICD-10 code J84.843 billable? +
Yes, J84.843 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Does J84.843 affect Medicare Advantage HCC risk adjustment? +
Yes. J84.843 maps to CMS-HCC v28 category 112. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is J84.843 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does J84.843 map to? +
Per CMS GEMs, J84.843 maps to ICD-9 codes: 51664. 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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