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J60 ICD-10-CM Code: Coalworker's pneumoconiosis

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FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Lung diseases due to external agents (J60-J70)

J60

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

Coalworker's pneumoconiosis

A lung disease caused by inhaling coal dust over many years, leading to scarring and reduced lung function.

Buddy the Bee presenting code insight

Buddy Insight

Coalworker's pneumoconiosis (black lung disease) is an occupational lung disease caused by chronic inhalation of coal dust, leading to coal macule formation and progressive pulmonary fibrosis.

CMS-HCC V28

HCC 280

RAF 0.319

CMS-HCC V24

HCC 112

RAF 0.219

ACA/HHS

HCC 162

Varies by metal level

ESRD/PACE

HCC 112

RAF 0.058

RXHCC

N/A

—

Not mapped

Code Book Path

Official
J6Lung diseases due to external agents (J60-J70)
J60Coalworker's pneumoconiosis

Inclusion Terms

Official
  • Anthracosilicosis
  • Anthracosis
  • Black lung disease
  • Coalworker's lung

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J60 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under J60 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for J60 in this effective period.

Excludes 1

Official
  • coalworker pneumoconiosis with tuberculosis, any type in A15 (J65)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J60 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J60 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J60 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documented history of coal dust exposure with duration and intensity
Chest imaging showing characteristic findings: small rounded opacities, progressive massive fibrosis
Pulmonary function testing demonstrating restrictive and/or obstructive pattern
Provider diagnosis of coalworker's pneumoconiosis or black lung disease

MEAT Support

HCC Buddy guidance
Documented history of coal dust exposure with duration and intensity
Chest imaging showing characteristic findings: small rounded opacities, progressive massive fibrosis
Pulmonary function testing demonstrating restrictive and/or obstructive pattern
Provider diagnosis of coalworker's pneumoconiosis or black lung disease

Audit Caution

HCC Buddy guidance
Using unspecified pneumoconiosis (J64) when the coal dust etiology is clearly documented
Not coding associated complications like COPD (J44.x) when they coexist with pneumoconiosis
Failing to recognize that mixed-dust pneumoconiosis may require multiple codes
Confusing coalworker's pneumoconiosis with silicosis — coal dust and silica are different exposures (though they may co-occur in mining)

Common Mistakes

HCC Buddy guidance
J61 — Pneumoconiosis due to asbestos: different causative agent (asbestos vs. coal dust)
J62.8 — Pneumoconiosis due to other dust containing silica: silicosis from silica dust, not coal dust specifically
J64 — Unspecified pneumoconiosis: less specific; use J60 when coal dust exposure is documented
J84.10 — Pulmonary fibrosis, unspecified: does not capture the occupational etiology

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 J60 an HCC code?

Yes. J60 maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders under the CMS-HCC V28 risk adjustment model (and Fibrosis of Lung and Other Chronic Lung Disorders under V24).

HCC Category Mapping

V28HCC 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
0.319
V24HCC 112, Fibrosis of Lung and Other Chronic Lung Disorders
0.219
ESRDHCC 112, Fibrosis of Lung and Other Chronic Lung Disorders
0.058

Each model's RAF is its CMS base weight for that model's standard population, so 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 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.

Work J60 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for J60

For J60to 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 J60 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

J60 is the ICD-10-CM diagnosis code for coalworker's pneumoconiosis. A lung disease caused by inhaling coal dust over many years, leading to scarring and reduced lung function. J60 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering lung diseases due to external agents (j60-j70).

Under the CMS-HCC V28 risk adjustment model, J60 maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders (HCC 280) with a community, non-dual, aged base RAF weight of 0.319. Under the older CMS-HCC V24 model, J60 maps to Fibrosis of Lung and Other Chronic Lung Disorders (HCC 112) with a community, non-dual, aged base RAF weight of 0.219. 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.

Requires occupational history documentation indicating coal mining exposure. Because J60 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 J60 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Requires occupational history documentation indicating coal mining exposure
  • •Differentiate from other pneumoconiosis codes based on specific dust exposure type

Clinical Significance

Coalworker's pneumoconiosis (black lung disease) is an occupational lung disease caused by chronic inhalation of coal dust, leading to coal macule formation and progressive pulmonary fibrosis. It is an irreversible condition with significant implications for disability determination, workers' compensation, and long-term respiratory care planning.

Documentation Requirements

  • ✓Documented history of coal dust exposure with duration and intensity
  • ✓Chest imaging showing characteristic findings: small rounded opacities, progressive massive fibrosis
  • ✓Pulmonary function testing demonstrating restrictive and/or obstructive pattern
  • ✓Provider diagnosis of coalworker's pneumoconiosis or black lung disease
  • ✓Current symptom assessment: dyspnea, cough, exercise limitation
  • ✓Occupational history detailing coal mining exposure
  • ✓Any associated complications: progressive massive fibrosis, tuberculosis, cor pulmonale

Excludes 1, Do NOT code together

  • coalworker pneumoconiosis with tuberculosis, any type in A15 (J65)

Commonly Confused Codes

  • •J61: Pneumoconiosis due to asbestos: different causative agent (asbestos vs. coal dust)
  • •J62.8: Pneumoconiosis due to other dust containing silica: silicosis from silica dust, not coal dust specifically
  • •J64: Unspecified pneumoconiosis: less specific; use J60 when coal dust exposure is documented
  • •J84.10: Pulmonary fibrosis, unspecified: does not capture the occupational etiology

Code Hierarchy

└J60Coalworker's pneumoconiosis
└J60Coalworker's pneumoconiosis

Because J60 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.

J60 maps to CMS-HCC V28 category 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works.

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