J45.40 ICD-10-CM Code: Moderate persistent asthma, uncomplicated
J45.40 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Chronic lower respiratory diseases (J40-J4A)
J45.40
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceModerate persistent asthma, uncomplicated
Moderate persistent asthma without any current complications or exacerbations.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 161_2
Code-level coefficient reference
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 229
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Moderate persistent asthma NOS
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from J00-J99, J40-J4A, J45
- certain infectious and parasitic diseases (A00-B99)Inherited from J00-J99, J40-J4A, J45
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from J00-J99, J40-J4A, J45
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from J00-J99, J40-J4A, J45
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from J00-J99, J40-J4A, J45
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from J00-J99, J40-J4A, J45
- neoplasms (C00-D49)Inherited from J00-J99, J40-J4A, J45
- smoke inhalation (T59.81-)Inherited from J00-J99, J40-J4A, J45
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from J00-J99, J40-J4A, J45
- cystic fibrosis (E84.-)Inherited from J00-J99, J40-J4A, J45
- asthma with chronic obstructive pulmonary disease (J44.89)Inherited from J00-J99, J40-J4A, J45
- chronic asthmatic (obstructive) bronchitis (J44.89)Inherited from J00-J99, J40-J4A, J45
- chronic obstructive asthma (J44.89)Inherited from J00-J99, J40-J4A, J45
- other specified chronic obstructive pulmonary disease (J44.89)Inherited from J00-J99, J40-J4A, J45
Related Codes
Includes
Official- allergic (predominantly) asthmaInherited from J45
- allergic bronchitis NOSInherited from J45
- allergic rhinitis with asthmaInherited from J45
- atopic asthmaInherited from J45
- extrinsic allergic asthmaInherited from J45
- hay fever with asthmaInherited from J45
- idiosyncratic asthmaInherited from J45
- intrinsic nonallergic asthmaInherited from J45
- nonallergic asthmaInherited from J45
Excludes 1
Official- bronchitis due to chemicals, gases, fumes and vapors (J68.0)Inherited from J40-J4A, J45
- detergent asthma (J69.8)Inherited from J40-J4A, J45
- miner's asthma (J60)Inherited from J40-J4A, J45
- wheezing NOS (R06.2)Inherited from J40-J4A, J45
- wood asthma (J67.8)Inherited from J40-J4A, J45
Code First
OfficialNo Code First sequencing instructions are included in this display for J45.40. Check the code and parent instructions in the Code Book.
Use Additional
Official- code, where applicable, to identify:Inherited from J00-J99, J45
- exposure to environmental tobacco smoke (Z77.22)Inherited from J00-J99, J45
- exposure to tobacco smoke in the perinatal period (P96.81)Inherited from J00-J99, J45
- history of tobacco dependence (Z87.891)Inherited from J00-J99, J45
- occupational exposure to environmental tobacco smoke (Z57.31)Inherited from J00-J99, J45
- tobacco dependence (F17.-)Inherited from J00-J99, J45
- tobacco use (Z72.0)Inherited from J00-J99, J45
- code to identify:Inherited from J00-J99, J45
- eosinophilic asthma (J82.83)Inherited from J00-J99, J45
Code Also
OfficialNo Code Also instructions are included in this display for J45.40. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is J45.40 an HCC code?
J45.40 has no mapping under the current CMS-HCC V28 community payment model. J45.40 has a separate mapping under the Part D RxHCC model (HCC 229 (Chronic Obstructive Pulmonary Disease, Bronchiectasis, and Other Asthma)); the applicable result needs member context. J45.40 also appears in the HHS-HCC commercial risk model (HCC 161_2 (HHS-HCC 161_2 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- J45.40
- Description
- Moderate persistent asthma, uncomplicated
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work J45.40 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for J45.40
For J45.40, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
J45.40 is the ICD-10-CM diagnosis code for moderate persistent asthma, uncomplicated. Moderate persistent asthma without any current complications or exacerbations. J45.40 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).
J45.40 has no mapping under the current CMS-HCC V28 community payment model. J45.40 has a separate mapping under the Part D RxHCC model (HCC 229 (Chronic Obstructive Pulmonary Disease, Bronchiectasis, and Other Asthma)); the applicable result needs member context. J45.40 also appears in the HHS-HCC commercial risk model (HCC 161_2 (HHS-HCC 161_2 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Use this code only when asthma is documented as moderate persistent and there is no acute exacerbation or status asthmaticus.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for J45.40 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when asthma is documented as moderate persistent and there is no acute exacerbation or status asthmaticus
- •Verify that the patient requires daily controller medications to distinguish moderate from mild persistent asthma
Documentation Requirements
- ✓Asthma diagnosis with severity explicitly classified as moderate persistent
- ✓Symptom frequency: daily symptoms, nighttime awakenings >1x/week but not nightly
- ✓Some limitation in normal activity documented
- ✓Daily controller medications: medium-dose inhaled corticosteroid ± long-acting beta-agonist
- ✓Lung function: FEV1 60-80% predicted if documented
- ✓Documentation of uncomplicated status (no current exacerbation)
Commonly Confused Codes
- •J45.30: Mild persistent asthma: symptoms >2 days/week but not daily; less severe
- •J45.50: Severe persistent asthma: symptoms throughout the day, extremely limited activity; more severe and maps to V28 HCC
- •J45.41: Moderate persistent asthma with acute exacerbation: use during acute worsening
- •J45.909: Unspecified asthma: always prefer severity-classified codes