Respiratory failure, not elsewhere classified
In Other diseases of the respiratory system (J96-J99), chapter 10: Diseases of the Respiratory System
12 billable codes under J96: 9 are an MCC, 3 are a CC; all map to HCC 213 (Cardio-Respiratory Failure and Shock).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Excludes1: not coded here, use a different code
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)
All codes under J96
J96 can't be used on a claim. Pick a billable code below; grey headings group them.
- J96.0Acute respiratory failure
- J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
- J96.01Acute respiratory failure with hypoxia
- J96.02Acute respiratory failure with hypercapnia
- J96.1Chronic respiratory failure
- J96.10Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
- J96.11Chronic respiratory failure with hypoxia
- J96.12Chronic respiratory failure with hypercapnia
- J96.2Acute and chronic respiratory failure
- J96.20Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
- J96.21Acute and chronic respiratory failure with hypoxia
- J96.22Acute and chronic respiratory failure with hypercapnia
- J96.9Respiratory failure, unspecified
- J96.90Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia
- J96.91Respiratory failure, unspecified with hypoxia
- J96.92Respiratory failure, unspecified with hypercapnia
J96 MS-DRGs
As the principal diagnosis, the billable codes under J96 group to MS-DRG 189, 202, or 203 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 189 Pulmonary Edema and Respiratory Failure (12 of 12 codes)
- DRG 202 Bronchitis and Asthma with CC/MCC (1 of 12 codes)
- DRG 203 Bronchitis and Asthma without CC/MCC (1 of 12 codes)
Other codes that refer to J96
Notes on these codes point to J96.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Respiratory Failure
Respiratory failure is a condition in which your blood doesn't have enough oxygen or has too much carbon dioxide. Sometimes you can have both problems.
Read more about respiratory failure on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.