J62.0
BillablePneumoconiosis due to talc dust
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is J62.0 an HCC code?
Yes. J62.0 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
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for J62.0
For J62.0to 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 J62.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
J62.0 is the ICD-10-CM diagnosis code for pneumoconiosis due to talc dust. A lung disease caused by inhaling talc dust, which accumulates in the lungs and causes scarring over time. J62.0 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, J62.0 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, J62.0 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 documentation of talc dust exposure in occupational or environmental history. Because J62.0 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 J62.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Requires documentation of talc dust exposure in occupational or environmental history
- •Ensure talc is specifically identified as the causative agent, not other silica-containing dusts
Clinical Significance
Pneumoconiosis due to talc dust (talcosis) is an occupational lung disease resulting from chronic inhalation of talc (hydrated magnesium silicate) dust, occurring in mining, ceramics, rubber manufacturing, and cosmetics production. Talcosis can present as either talc pneumoconiosis or talc granulomatosis and may progress to pulmonary fibrosis.
Documentation Requirements
- ✓Documented occupational or environmental history of talc dust exposure
- ✓Chest imaging showing characteristic findings: diffuse small nodules, ground-glass opacities, or fibrosis
- ✓Pulmonary function testing showing restrictive and/or obstructive pattern
- ✓Provider diagnosis specifically linking pneumoconiosis to talc dust exposure
- ✓Duration and intensity of exposure
- ✓Current symptom assessment and functional limitations
- ✓Differentiation from talc granulomatosis in IV drug users if applicable
Commonly Confused Codes
- •J62.8 — Pneumoconiosis due to other dust containing silica: use for silicosis or other silicate dusts (not talc specifically)
- •J63.0 — Aluminosis: different metal dust exposure
- •J64 — Unspecified pneumoconiosis: less specific; use J62.0 when talc exposure is documented
- •J61 — Asbestosis: different mineral fiber; talc may be contaminated with asbestos in some settings