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J45

Non-Billable (Header)

Asthma

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

J45 is the ICD-10-CM diagnosis code for asthma. J45 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).

Header codes like J45 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at J45's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for J45 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • allergic (predominantly) asthma
  • allergic bronchitis NOS
  • allergic rhinitis with asthma
  • atopic asthma
  • extrinsic allergic asthma
  • hay fever with asthma
  • idiosyncratic asthma
  • intrinsic nonallergic asthma
  • nonallergic asthma

Excludes 1 — Do NOT code together

Excludes 2 — Not included here, may code separately

  • asthma with chronic obstructive pulmonary disease (J44.89)
  • chronic asthmatic (obstructive) bronchitis (J44.89)
  • chronic obstructive asthma (J44.89)
  • other specified chronic obstructive pulmonary disease (J44.89)

Use Additional Code

  • code to identify:
  • eosinophilic asthma (J82.83)
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Child Codes

Code Hierarchy

J45Asthma
J45Asthma

More on J45

Referenced in blog posts

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