ICD-10 J98.2
Billable / Specific HCC v28: 111Interstitial emphysema
About ICD-10-CM J98.2
ICD-10-CM code J98.2 represents Interstitial emphysema. This is a billable/specific code in the Respiratory System chapter (block J98). The 2026 edition of ICD-10-CM J98.2 became effective on October 1, 2025.
Coding Tips for J98.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J98.2 is a CMS-HCC v28 risk-adjustment code (category 111). 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 J98.2. Per CMS ICD-10-CM Tabular 2026.
- Mediastinal emphysema
Type 1 Excludes
Pure excludes, these codes can never be coded together with J98.2. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- emphysema NOS (J43.9)
- emphysema in newborn (P25.0)
- surgical emphysema (subcutaneous) (T81.82)
- traumatic subcutaneous emphysema (T79.7)
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 J98.2
Local Coverage Determinations (LCDs) from CMS MACs that list J98.2 as a covered diagnosis.
Showing top 10 of 131 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J98.2.
5 Medicare
CPT Codes Commonly Billed with J98.2
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 J98.2 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 |
|---|---|---|
| J98.2 | 5181 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J98.2
Other codes in section J96-J99 (Other diseases of the respiratory system).
ICD-10 J98.2, Billing FAQ
Is ICD-10 code J98.2 billable? +
Yes, J98.2 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 J98.2? +
ICD-10 J98.2 includes: Mediastinal emphysema.
What codes are Type 1 Excludes for J98.2? +
Type 1 Excludes (never code together with J98.2): emphysema NOS (J43.9); emphysema in newborn (P25.0); surgical emphysema (subcutaneous) (T81.82)
Does J98.2 affect Medicare Advantage HCC risk adjustment? +
Yes. J98.2 maps to CMS-HCC v28 category 111. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does J98.2 map to? +
Per CMS GEMs, J98.2 maps to ICD-9 codes: 5181. 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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