What is ICD-10 code J44.0?

J44.0 is the ICD-10-CM diagnosis code for Chronic obstructive pulmonary disease with (acute) lower respiratory infection. A chronic lung disease (COPD) that is currently worsened by an acute infection in the lower airways such as bronchitis or pneumonia. J44.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. J44.0 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. J44.0 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. J44.0 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for J44.0?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For J44.0, V28 maps to Chronic Obstructive Pulmonary Disease at RAF 0.334 while V24 mapped to Chronic Obstructive Pulmonary Disease at RAF 0.334. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting J44.0?

This code requires documentation of both COPD and an acute lower respiratory infection; identify the specific infection organism if documented Do not use this code if the infection is only in the upper respiratory tract Because J44.0 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

J44.0 ICD-10 Code: Chronic obstructive pulmonary

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupJ44.0Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Chronic lower respiratory diseases (J40-J4A)

J44.0

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Chronic obstructive pulmonary disease with (acute) lower respiratory infection

A chronic lung disease (COPD) that is currently worsened by an acute infection in the lower airways such as bronchitis or pneumonia.

Buddy Insight

Chronic obstructive pulmonary disease with acute lower respiratory infection represents a COPD patient experiencing a concurrent acute infection such as pneumonia or acute bronchitis.

CMS-HCC V28

Mapped

HCC 280

Chronic Obstructive Pulmonary...

RAF 0.334

CMS-HCC V24

Mapped

HCC 111

Chronic Obstructive Pulmonary...

RAF 0.334

ACA/HHS

Not risk-adjusted for this model/period.

RAF 0

ESRD/PACE

Not risk-adjusted for this model/period.

RAF 0

RXHCC

Mapped

HCC 229

COPD and Chronic Bronchitis

RAF 0.0

Code Trumping

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Code Book Path

Official

J44Other chronic obstructive pulmonary disease

J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J44.0 in this effective period.

Excludes 2

Official

bronchiectasis (J47.-)
chronic bronchitis NOS (J42)
chronic simple and mucopurulent bronchitis (J41.-)
chronic tracheitis (J42)
chronic tracheobronchitis (J42)

Related Child Codes

Official

J44.1Chronic obstructive pulmonary disease with (acute) exacerbation

J44.8Other specified chronic obstructive pulmonary disease

J44.9Chronic obstructive pulmonary disease, unspecified

Includes

Official

asthma with chronic obstructive pulmonary disease
chronic asthmatic (obstructive) bronchitis
chronic bronchitis with airway obstruction
chronic bronchitis with emphysema
chronic emphysematous bronchitis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for J44.0 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J44.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J44.0 in this effective period.

Code Also

Official

to identify the infection

Buddy Documentation Tip

HCC Buddy guidance

Established diagnosis of COPD (chronic obstructive pulmonary disease)

Documentation of an acute lower respiratory infection (pneumonia, acute bronchitis) occurring concurrently

The specific acute infection should be identified and coded separately (e.g., J13-J18 for pneumonia, J20.x for acute bronchitis)

Clinical presentation: increased dyspnea, fever, purulent sputum, new infiltrate on imaging

MEAT Support

HCC Buddy guidance

Established diagnosis of COPD (chronic obstructive pulmonary disease)

Documentation of an acute lower respiratory infection (pneumonia, acute bronchitis) occurring concurrently

The specific acute infection should be identified and coded separately (e.g., J13-J18 for pneumonia, J20.x for acute bronchitis)

Clinical presentation: increased dyspnea, fever, purulent sputum, new infiltrate on imaging

Audit Caution

HCC Buddy guidance

Failing to code both J44.0 AND the specific infection code — you need both to fully capture the clinical picture

Confusing J44.0 (COPD with infection) with J44.1 (COPD with exacerbation) — an infection is not the same as an exacerbation, though both may coexist

Not coding J44.1 additionally when the patient has both an acute infection AND an exacerbation of COPD

Using J44.0 for upper respiratory infections — this code is specifically for lower respiratory infections

Common Mistakes

HCC Buddy guidance

J44.1 — COPD with acute exacerbation: use when COPD worsens without a documented infection; J44.0 requires documented infection

J44.9 — COPD, unspecified: does not capture the acute component; never use when an acute infection is documented

J18.9 — Pneumonia, unspecified: code additionally to identify the infection; J44.0 alone does not specify the type

J20.9 — Acute bronchitis, unspecified: code additionally if this is the acute lower respiratory infection

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is J44.0 an HCC code?

Yes. J44.0 maps to Chronic Obstructive Pulmonary Disease under the CMS-HCC V28 risk adjustment model (and Chronic Obstructive Pulmonary Disease under V24).

HCC Category Mapping

V28HCC 280, Chronic Obstructive Pulmonary Disease

0.334

V24HCC 111, Chronic Obstructive Pulmonary Disease

0.334

RxHCCHCC 229, COPD and Chronic Bronchitis

0.000

RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

MEAT Criteria for J44.0

For J44.0to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed J44.0 during that encounter, not just copy-forwarded from a problem list.

What This Code Means

J44.0 is the ICD-10-CM diagnosis code for chronic obstructive pulmonary disease with (acute) lower respiratory infection. A chronic lung disease (COPD) that is currently worsened by an acute infection in the lower airways such as bronchitis or pneumonia. J44.0 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering chronic lower respiratory diseases (j40-j4a).

Under the CMS-HCC V28 risk adjustment model, J44.0 maps to Chronic Obstructive Pulmonary Disease (HCC 280) with a community, non-dual, aged base RAF weight of 0.334. The V24 model used during the PY2024–PY2025 transition mapped J44.0 the same way and at the same RAF weight. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

This code requires documentation of both COPD and an acute lower respiratory infection; identify the specific infection organism if documented. Because J44.0 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for J44.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code requires documentation of both COPD and an acute lower respiratory infection; identify the specific infection organism if documented
•Do not use this code if the infection is only in the upper respiratory tract

Clinical Significance

Chronic obstructive pulmonary disease with acute lower respiratory infection represents a COPD patient experiencing a concurrent acute infection such as pneumonia or acute bronchitis. This combination significantly increases morbidity, hospitalization risk, and mortality, making accurate capture critical for reflecting true patient acuity in risk adjustment.

Documentation Requirements

✓Established diagnosis of COPD (chronic obstructive pulmonary disease)
✓Documentation of an acute lower respiratory infection (pneumonia, acute bronchitis) occurring concurrently
✓The specific acute infection should be identified and coded separately (e.g., J13-J18 for pneumonia, J20.x for acute bronchitis)
✓Clinical presentation: increased dyspnea, fever, purulent sputum, new infiltrate on imaging
✓Treatment plan for both the underlying COPD and the acute infection
✓Severity indicators: oxygen requirements, hospitalization, respiratory failure

Code Also

to identify the infection

Commonly Confused Codes

•J44.1: COPD with acute exacerbation: use when COPD worsens without a documented infection; J44.0 requires documented infection
•J44.9: COPD, unspecified: does not capture the acute component; never use when an acute infection is documented
•J18.9: Pneumonia, unspecified: code additionally to identify the infection; J44.0 alone does not specify the type
•J20.9: Acute bronchitis, unspecified: code additionally if this is the acute lower respiratory infection