Unspecified pneumoconiosis
In Lung diseases due to external agents (J60-J70), chapter 10: Diseases of the Respiratory System
- J64 is an unspecified code: use it only when the record doesn't document anything more specific. If the record has more detail, check the other codes under J60-J70 below.
- As a secondary diagnosis it is not a CC or MCC, so it doesn't raise the MS-DRG payment.
- Counts toward HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) in the Medicare Advantage risk model (CMS-HCC V28).
- AHRQ's Chronic Condition Indicator classes it as chronic: expected to last 12 months or longer and to limit daily life or need ongoing care.
- 33 US deaths in 2024 had an underlying cause in category J64, per the National Vital Statistics System on CDC WONDER. Death records use WHO ICD-10, so the count is for the whole category.
Also indexed as: Asthma, pneumoconiotic NEC; Fibrosis, lung, with, dust reticulation; Fibrosis, lung, with, pneumoconiosis NOS; Pneumoconiosis
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Instructional notes
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers COPD and asthma exacerbations, sequencing of acute respiratory failure, confirmed versus suspected identified influenza, ventilator associated pneumonia, and vaping-related disorders.
- Chronic Obstructive Pulmonary Disease [COPD] and Asthma (page 56)
- Acute Respiratory Failure (page 56)
- Influenza due to certain identified influenza viruses (page 57)
- Ventilator associated Pneumonia (page 57)
- Vaping-related disorders (page 58)
Other codes under J60-J70
Lung diseases due to external agents (J60-J70)
- J60Coalworker's pneumoconiosis
- J61Pneumoconiosis due to asbestos and other mineral fibers
- J62Pneumoconiosis due to dust containing silica
- J63Pneumoconiosis due to other inorganic dusts
- J64Unspecified pneumoconiosis(this code)
- J65Pneumoconiosis associated with tuberculosis
- J66Airway disease due to specific organic dust
- J67Hypersensitivity pneumonitis due to organic dust
- J68Respiratory conditions due to inhalation of chemicals, gases, fumes and vapors
- J69Pneumonitis due to solids and liquids
- J70Respiratory conditions due to other external agents
J64 MS-DRGs
As the principal diagnosis, J64 groups to MS-DRG 196, 197, or 198 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
J64 is in Lung disease due to external agents (RSP013, its default category), with 45 codes. Others in it:
Medicare coverage articles listing J64
These 7 Medicare billing and coding articles list J64 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
Other codes that refer to J64
Notes on these codes point to J64.
- J65 Includes: Any condition in J60-J64 with tuberculosis, any type in A15
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Interstitial Lung Diseases
Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and scarring make it hard to get enough oxygen. The scarring is called pulmonary fibrosis.
Read more about interstitial lung diseases on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 505 Pneumoconiosis, unspecified (approximate)