What is ICD-10 code J61?

J61 is the ICD-10-CM diagnosis code for Pneumoconiosis due to asbestos and other mineral fibers. A lung disease caused by inhaling asbestos fibers or other mineral fibers, which can cause scarring and breathing problems. It belongs to the ICD-10-CM chapter for diseases of the respiratory system (j00-j99). J61 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. J61 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. J61 is a payment HCC under the CMS risk adjustment model. Under the CMS-HCC V28 risk adjustment model it maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders with a community, non-dual, aged base RAF weight of 0.319. Under the older CMS-HCC V24 model it maps to Fibrosis of Lung and Other Chronic Lung Disorders at RAF 0.219. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. HCC Buddy maintains the V28 and V24 mapping, RAF weight, and MEAT documentation criteria for J61 sourced directly from the CMS-HCC model files.

Yes. J61 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. J61 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for J61?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For J61, V28 maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders at RAF 0.319 while V24 mapped to Fibrosis of Lung and Other Chronic Lung Disorders at RAF 0.219. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting J61?

Document specific exposure history to asbestos or other mineral fibers Distinguish from other pneumoconiosis codes; asbestos exposure is a key differentiator Because J61 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.

J61: Pneumoconiosis due to asbestos and other mineral fibers — ICD-10 | Chronic Obstructive

ICD-10-CM Code View

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Code lookupJ61Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

J61

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

Pneumoconiosis due to asbestos and other mineral fibers

A lung disease caused by inhaling asbestos fibers or other mineral fibers, which can cause scarring and breathing problems.

Buddy Insight

CMS-HCC V28

Mapped

HCC 280

Chronic Obstructive Pulmonary...

RAF 0.319

CMS-HCC V24

Mapped

HCC 112

Fibrosis of Lung and Other Ch...

RAF 0.219

ACA/HHS

Mapped

HCC 162

HHS-HCC 162

Varies by metal level

ESRD/PACE

Mapped

HCC 112

Fibrosis of Lung and Other Ch...

RAF 0.058

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

J6Lung diseases due to external agents (J60-J70)

J61Pneumoconiosis due to asbestos and other mineral fibers

Inclusion Terms

Official

Asbestosis

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J61 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under J61 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for J61 in this effective period.

Excludes 1

Official

pleural plaque with asbestosis (J92.0)
pneumoconiosis with tuberculosis, any type in A15 (J65)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J61 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J61 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J61 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented history of asbestos exposure with duration, intensity, and occupational context

Chest imaging (CT preferred) showing characteristic findings: subpleural fibrosis, honeycombing, pleural plaques

Pulmonary function testing showing restrictive pattern with decreased diffusion capacity

Provider diagnosis of asbestosis or pneumoconiosis due to asbestos

MEAT Support

HCC Buddy guidance

Documented history of asbestos exposure with duration, intensity, and occupational context

Chest imaging (CT preferred) showing characteristic findings: subpleural fibrosis, honeycombing, pleural plaques

Pulmonary function testing showing restrictive pattern with decreased diffusion capacity

Provider diagnosis of asbestosis or pneumoconiosis due to asbestos

Audit Caution

HCC Buddy guidance

Confusing asbestosis (parenchymal fibrosis, J61) with asbestos-related pleural disease (pleural plaques, J92.0)

Not coding associated malignancies (lung cancer, mesothelioma) separately when present

Using pulmonary fibrosis codes (J84.x) instead of asbestosis code when the asbestos etiology is documented

Failing to document the occupational exposure history that supports the diagnosis

Common Mistakes

HCC Buddy guidance

J60 — Coalworker's pneumoconiosis: different causative dust (coal vs. asbestos)

J92.0 — Pleural plaque with presence of asbestos: isolated pleural plaques without parenchymal disease

J84.10 — Pulmonary fibrosis, unspecified: does not capture the asbestos etiology

C45.0 — Mesothelioma of pleura: a malignancy associated with asbestos, not the pneumoconiosis itself

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 J61 an HCC code?

Yes. J61 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 J61 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for J61

For J61to 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 J61 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

J61 is the ICD-10-CM diagnosis code for pneumoconiosis due to asbestos and other mineral fibers. A lung disease caused by inhaling asbestos fibers or other mineral fibers, which can cause scarring and breathing problems. J61 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, J61 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, J61 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.

Document specific exposure history to asbestos or other mineral fibers. Because J61 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 J61 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document specific exposure history to asbestos or other mineral fibers
•Distinguish from other pneumoconiosis codes; asbestos exposure is a key differentiator

Clinical Significance

Pneumoconiosis due to asbestos (asbestosis) is an irreversible occupational lung disease caused by chronic inhalation of asbestos fibers, leading to progressive pulmonary fibrosis predominantly affecting the lower lobes. Asbestosis carries significant implications for lung cancer risk, mesothelioma screening, and medicolegal documentation requirements.

Documentation Requirements

✓Documented history of asbestos exposure with duration, intensity, and occupational context
✓Chest imaging (CT preferred) showing characteristic findings: subpleural fibrosis, honeycombing, pleural plaques
✓Pulmonary function testing showing restrictive pattern with decreased diffusion capacity
✓Provider diagnosis of asbestosis or pneumoconiosis due to asbestos
✓Latency period documentation (typically 15-20+ years from exposure to disease)
✓Current symptoms and functional limitations
✓Screening plan for asbestos-related malignancies (lung cancer, mesothelioma)

Excludes 1, Do NOT code together

pleural plaque with asbestosis (J92.0)
pneumoconiosis with tuberculosis, any type in A15 (J65)

Commonly Confused Codes

•J60: Coalworker's pneumoconiosis: different causative dust (coal vs. asbestos)
•J92.0: Pleural plaque with presence of asbestos: isolated pleural plaques without parenchymal disease
•J84.10: Pulmonary fibrosis, unspecified: does not capture the asbestos etiology
•C45.0: Mesothelioma of pleura: a malignancy associated with asbestos, not the pneumoconiosis itself
•J62.8: Pneumoconiosis due to other dust containing silica: different exposure type

Code Hierarchy

└J61Pneumoconiosis due to asbestos and other mineral fibers

J61 ICD-10-CM Code: Pneumoconiosis due to asbestos and other mineral fibers

HCC Buddy Code Card

J61

Is J61 an HCC code?

HCC Category Mapping

MEAT Criteria for J61

Get the V28 RAF + MEAT cheat sheet

What This Code Means

Coding Tips

Clinical Significance

Documentation Requirements

Excludes 1, Do NOT code together

Commonly Confused Codes

Code Hierarchy

Work J61 in HCC Buddy