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J4A.8 ICD-10-CM Code: Other chronic lung allograft dysfunction

J4A.8 maps to CMS-HCC V28 276. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupJ4A.8

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

J4A.8

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

Other chronic lung allograft dysfunction

This code describes a chronic condition where a transplanted lung is not functioning properly due to reasons other than the more common types of rejection or infection. It represents long-term problems with how well the transplanted lung works after surgery.

Buddy the Bee presenting code insight

Buddy Insight

Other chronic lung allograft dysfunction captures CLAD presentations that do not fit the classic restrictive allograft syndrome or bronchiolitis obliterans syndrome patterns.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 276

Coefficient HCC 276: 2.531 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 158

Code-level coefficient reference

ESRD/PACE

HCC 186

Code-level coefficient reference

RXHCC

HCC 396

Code-level coefficient reference

Code Book Path

Official
J4AChronic lung allograft dysfunctionJ4A.8Other chronic lung allograft dysfunction

Inclusion Terms

Official

No inclusion terms are included in this display for J4A.8. Check the code and parent instructions in the Code Book.

Excludes 2

Official
  • certain conditions originating in the perinatal period (P04-P96)Inherited from J00-J99, J40-J4A
  • certain infectious and parasitic diseases (A00-B99)Inherited from J00-J99, J40-J4A
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from J00-J99, J40-J4A
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from J00-J99, J40-J4A
  • endocrine, nutritional and metabolic diseases (E00-E88)Inherited from J00-J99, J40-J4A
  • injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from J00-J99, J40-J4A
  • neoplasms (C00-D49)Inherited from J00-J99, J40-J4A
  • smoke inhalation (T59.81-)Inherited from J00-J99, J40-J4A
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from J00-J99, J40-J4A
  • cystic fibrosis (E84.-)Inherited from J00-J99, J40-J4A

Related Codes

Official
J4A.0Restrictive allograft syndromeJ4A.9Chronic lung allograft dysfunction, unspecified

Includes

Official

No Includes notes are included in this display for J4A.8. Check the code and parent instructions in the Code Book.

Excludes 1

Official
  • bronchitis due to chemicals, gases, fumes and vapors (J68.0)Inherited from J40-J4A

Code First

Official
  • , if applicable:Inherited from J4A
  • heart-lung transplant rejection (T86.31)Inherited from J4A
  • lung transplant rejection (T86.810)Inherited from J4A
  • other complications of heart-lung transplant (T86.39)Inherited from J4A
  • other complications of lung transplant (T86.818)Inherited from J4A

Use Additional

Official
  • code, where applicable, to identify:Inherited from J00-J99
  • exposure to environmental tobacco smoke (Z77.22)Inherited from J00-J99
  • exposure to tobacco smoke in the perinatal period (P96.81)Inherited from J00-J99
  • history of tobacco dependence (Z87.891)Inherited from J00-J99
  • occupational exposure to environmental tobacco smoke (Z57.31)Inherited from J00-J99
  • tobacco dependence (F17.-)Inherited from J00-J99
  • tobacco use (Z72.0)Inherited from J00-J99

Code Also

Official
  • , if applicable, bronchiolitis obliterans syndrome (J44.81)Inherited from J4A

Buddy Documentation Tip

HCC Buddy guidance
Lung transplant history with date of transplantation
Documentation of chronic lung allograft dysfunction that does not meet criteria for RAS or BOS
Pulmonary function testing showing persistent decline from post-transplant baseline
Imaging findings supporting chronic allograft changes

MEAT Support

HCC Buddy guidance
Lung transplant history with date of transplantation
Documentation of chronic lung allograft dysfunction that does not meet criteria for RAS or BOS
Pulmonary function testing showing persistent decline from post-transplant baseline
Imaging findings supporting chronic allograft changes

Audit Caution

HCC Buddy guidance
Using this code when documentation clearly describes RAS (J4A.0) or BOS (J44.81)
Not coding lung transplant status (Z94.2) as an additional diagnosis
Confusing chronic allograft dysfunction with acute rejection — different treatment and prognosis

Common Mistakes

HCC Buddy guidance
J4A.0 — Restrictive allograft syndrome: use when restrictive pattern is specifically documented
J4A.9 — Chronic lung allograft dysfunction, unspecified: use when the type cannot be determined
J44.81 — Bronchiolitis obliterans syndrome: use when obstructive pattern is documented
T86.810 — Lung transplant rejection: use for acute rejection episodes

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 J4A.8 an HCC code?

Yes. J4A.8 (Other chronic lung allograft dysfunction) maps to HCC 276, Lung Transplant Status/Complications under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 2.531. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: J4A.8 is billable and maps to V28 HCC 276, Lung Transplant Status/Complications. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
J4A.8
Description
Other chronic lung allograft dysfunction
HCC (V28)
HCC 276 — Lung Transplant Status/Complications
RAF reference coefficient
2.531
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 276, Lung Transplant Status/Complications
2.531
ESRDHCC 186, Major Organ Transplant or Replacement Status
Not separately weighted
RxHCCHCC 396, Heart, Lung, Liver, Intestine, or Pancreas Transplant Status
Not separately weighted

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 J4A.8 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for J4A.8

For J4A.8, 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

J4A.8 is the ICD-10-CM diagnosis code for other chronic lung allograft dysfunction. This code describes a chronic condition where a transplanted lung is not functioning properly due to reasons other than the more common types of rejection or infection. It represents long-term problems with how well the transplanted lung works after surgery. J4A.8 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, J4A.8 maps to Lung Transplant Status/Complications (HCC 276) with a source-labeled community, non-dual, aged reference coefficient of 2.531. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Use this code only after other specific chronic lung allograft dysfunction codes (J4A.0-J4A.7) have been ruled out or are not applicable. For J4A.8, 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. 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, source-labeled coefficient references, and MEAT documentation criteria for J4A.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Use this code only after other specific chronic lung allograft dysfunction codes (J4A.0-J4A.7) have been ruled out or are not applicable
  • •Ensure documentation clearly indicates the dysfunction is chronic (long-term) rather than acute, and that it is related to a lung transplant

Clinical Significance

Other chronic lung allograft dysfunction captures CLAD presentations that do not fit the classic restrictive allograft syndrome or bronchiolitis obliterans syndrome patterns. These may include mixed phenotypes or evolving forms of chronic rejection following lung transplantation, all carrying significant clinical implications for transplant recipients.

Documentation Requirements

  • ✓Lung transplant history with date of transplantation
  • ✓Documentation of chronic lung allograft dysfunction that does not meet criteria for RAS or BOS
  • ✓Pulmonary function testing showing persistent decline from post-transplant baseline
  • ✓Imaging findings supporting chronic allograft changes
  • ✓Immunosuppression management details
  • ✓Differentiation from acute rejection and other post-transplant complications

Commonly Confused Codes

  • •J4A.0: Restrictive allograft syndrome: use when restrictive pattern is specifically documented
  • •J4A.9: Chronic lung allograft dysfunction, unspecified: use when the type cannot be determined
  • •J44.81: Bronchiolitis obliterans syndrome: use when obstructive pattern is documented
  • •T86.810: Lung transplant rejection: use for acute rejection episodes
  • •Z94.2: Lung transplant status: code additionally

Child Codes

J4A.0Restrictive allograft syndrome
HCC 276
J4A.8Other chronic lung allograft dysfunction
HCC 276
J4A.9Chronic lung allograft dysfunction, unspecified
HCC 276

Code Hierarchy

└J4AChronic lung allograft dysfunction└J4A.8Other chronic lung allograft dysfunction
└J4A.8Other chronic lung allograft dysfunction

J4A.8 code history

Code setChange
FY2024 (effective Oct 1, 2023)Added to the code set

Source: official CMS ICD-10-CM order and addenda files, FY2016 through FY2027.

Also searched as

  • J4A 8
  • J4A8

For J4A.8, 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.

J4A.8 maps to CMS-HCC V28 category 276, Lung Transplant Status/Complications. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for J4A.8. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

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Open J4A.8 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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