ICD-10-CM category J43
Emphysema: every J43 code with its CMS-HCC V28 status
J43, Emphysema, holds 6 codes in the FY2026 ICD-10-CM set: 5 billable codes and 1 header code that needs a further character. Every one of them maps to a CMS-HCC V28 payment category (HCC 280) for payment year 2026.
CMS-HCC V28 categories in J43 (1)
Coefficients are the code-level reference values from the CMS V28 factor file (community, non-dual, aged), not a member's score. Hierarchy, interactions, and enrollment segment decide what a documented condition contributes.
All 6 J43 codes (FY2026)
Descriptors are the FY2026 order-file text. Header codes need a further character and cannot be reported; open any billable code for its tabular notes, MEAT guidance, and mapping detail.
| Code | Description | FY2026 | CMS-HCC V28 |
|---|---|---|---|
| J43 | Emphysema | Header | Header code, not reportable |
| J43.0 | Unilateral pulmonary emphysema [MacLeod's syndrome] | Billable | HCC 280 |
| J43.1 | Panlobular emphysema | Billable | HCC 280 |
| J43.2 | Centrilobular emphysema | Billable | HCC 280 |
| J43.8 | Other emphysema | Billable | HCC 280 |
| J43.9 | Emphysema, unspecified | Billable | HCC 280 |
Documentation guides for J43
Frequently asked questions
How many J43 codes are there?
The J43 category (Emphysema) has 6 codes in the FY2026 ICD-10-CM order file: 5 billable and 1 header codes, counting the category itself. Only a billable code can be reported on a claim.
Which J43 codes map to an HCC under CMS-HCC V28?
5 billable codes in J43 map to HCC 280 in the CMS-HCC V28 model for payment year 2026. HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) carries the most, with 5 codes.
Source: FY2026 ICD-10-CM order file (FY 2026 Apr update) for codes, billability, and descriptors; CMS-HCC V28 PY2026 final ICD-10-CM mappings and relative factors for payment status. Table generated 2026-09-10.