Pulmonology Coding Alert

Question: Code J44.89 was a new addition to the 2024 ICD-10-CM code set. One of the synonyms is chronic emphysematous bronchitis. If chronic bronchitis is a hierarchical condition category (HCC) code and emphysema is an HCC code, why isn’t J44.89 listed as an HCC code when it includes a combination of the two conditions?

Codify Subscriber

Answer: Code J44.89 (Other specified chronic obstructive pulmonary disease) took effect on Oct. 1, 2023, with the 2024 ICD-10-CM code set, but you are correct in thinking that the combination code status.

Due to the timing of the code set release and when the risk adjustment models are updated, there is typically a lag in mapping the ICD-10-CM codes to risk adjustment models. Therefore, J44.89 wasn’t included in the initial ICD-10 mappings. However, the 2024 Midyear/Final ICD-10 Mappings do include J44.89 under the HCC models.

Resource: Check out the 2024 Midyear/Final ICD-10 Mappings at www.cms.gov/medicare/health-plans/ medicareadvtgspecratestats/risk-adjustors/2024-model-software/icd-10-mappings.