FY2027 ICD-10-CM reference
J45.41: Moderate persistent asthma with (acute) exacerbation
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Moderate persistent asthma with (acute) exacerbation. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Source: J00-J99 (chapter, inherited).
Instructional note
code, where applicable, to identify:
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to environmental tobacco smoke (Z77.22)
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to tobacco smoke in the perinatal period (P96.81)
Source: J00-J99 (chapter, inherited).
Instructional note
history of tobacco dependence (Z87.891)
Source: J00-J99 (chapter, inherited).
Instructional note
occupational exposure to environmental tobacco smoke (Z57.31)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco dependence (F17.-)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco use (Z72.0)
Source: J00-J99 (chapter, inherited).
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: J00-J99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: J00-J99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: J00-J99 (chapter, inherited).
Excludes2
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Source: J00-J99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: J00-J99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: J00-J99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: J00-J99 (chapter, inherited).
Excludes2
smoke inhalation (T59.81-)
Source: J00-J99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: J00-J99 (chapter, inherited).
Excludes1
bronchitis due to chemicals, gases, fumes and vapors (J68.0)
Source: J40-J4B (section, inherited).
Excludes2
cystic fibrosis (E84.-)
Source: J40-J4B (section, inherited).
Includes
allergic (predominantly) asthma
Source: J45 (category, inherited).
Includes
allergic bronchitis NOS
Source: J45 (category, inherited).
Includes
allergic rhinitis with asthma
Source: J45 (category, inherited).
Includes
atopic asthma
Source: J45 (category, inherited).
Includes
extrinsic allergic asthma
Source: J45 (category, inherited).
Includes
hay fever with asthma
Source: J45 (category, inherited).
Includes
idiosyncratic asthma
Source: J45 (category, inherited).
Includes
intrinsic nonallergic asthma
Source: J45 (category, inherited).
Includes
nonallergic asthma
Source: J45 (category, inherited).
Instructional note
code to identify:
Source: J45 (category, inherited).
Instructional note
eosinophilic asthma (J82.83)
Source: J45 (category, inherited).
Instructional note
exposure to environmental tobacco smoke (Z77.22)
Source: J45 (category, inherited).
Instructional note
exposure to tobacco smoke in the perinatal period (P96.81)
Source: J45 (category, inherited).
Instructional note
history of tobacco dependence (Z87.891)
Source: J45 (category, inherited).
Instructional note
occupational exposure to environmental tobacco smoke (Z57.31)
Source: J45 (category, inherited).
Instructional note
tobacco dependence (F17.-)
Source: J45 (category, inherited).
Instructional note
tobacco use (Z72.0)
Source: J45 (category, inherited).
Excludes1
detergent asthma (J69.8)
Source: J45 (category, inherited).
Excludes1
miner's asthma (J60)
Source: J45 (category, inherited).
Excludes1
wheezing NOS (R06.2)
Source: J45 (category, inherited).
Excludes1
wood asthma (J67.8)
Source: J45 (category, inherited).
Excludes2
asthma with chronic obstructive pulmonary disease (J44.89)
Source: J45 (category, inherited).
Excludes2
chronic asthmatic (obstructive) bronchitis (J44.89)
Source: J45 (category, inherited).
Excludes2
chronic obstructive asthma (J44.89)
Source: J45 (category, inherited).
Excludes2
other specified chronic obstructive pulmonary disease (J44.89)
Source: J45 (category, inherited).
Compare the FY2027 additions, removals and billable-status changes
What does J45.41 mean in FY2027?
The official ICD-10-CM descriptor is Moderate persistent asthma with (acute) exacerbation. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is J45.41 billable in FY2027?
The FY2027 order file marks J45.41 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does J45.41 map to an HCC?
J45.41 has no CMS-HCC V28 category in the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: no ESRD category; RxHCC HCC 229. Coefficients for these models are pending verification for payment year 2027. HHS-HCC: HCC 161.2 under the HHS-HCC 2026 benefit year mapping (no RAF; HHS-HCC weights vary by metal level). CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). The PACE mapping is still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition