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J63.0 ICD-10-CM Code: Aluminosis (of lung)

J63.0 maps to CMS-HCC V28 280. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

HCC Buddy Code Card

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

J63.0

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

Aluminosis (of lung)

Aluminosis is a lung disease caused by inhaling aluminum dust or particles over time, leading to inflammation and scarring of lung tissue. This occupational condition typically affects workers in aluminum manufacturing, welding, or related industries.

Buddy the Bee presenting code insight

Buddy Insight

Aluminosis is an occupational pneumoconiosis caused by chronic inhalation of aluminum dust or fumes, occurring in aluminum smelting, welding, explosives manufacturing, and pyrotechnics.

CMS-HCC V28

HCC 280

Code-level coefficient reference

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 162

Code-level coefficient reference

ESRD/PACE

HCC 112

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
J63Pneumoconiosis due to other inorganic dusts
J63.0Aluminosis (of lung)

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J63.0 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J63.0 in this effective period.

Related Child Codes

Official
J63.1Bauxite fibrosis (of lung)
J63.2Berylliosis
J63.3Graphite fibrosis (of lung)
J63.4Siderosis
J63.5Stannosis

Includes

Official

ICD-10-CM does not list Includes notes for J63.0 in this effective period.

Excludes 1

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

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J63.0 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J63.0 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J63.0 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documented occupational history of aluminum dust or fume exposure
Chest imaging showing characteristic pulmonary changes: diffuse fibrosis, ground-glass opacities
Pulmonary function testing demonstrating restrictive and/or obstructive impairment
Provider diagnosis linking pneumoconiosis to aluminum exposure

MEAT Support

HCC Buddy guidance
Documented occupational history of aluminum dust or fume exposure
Chest imaging showing characteristic pulmonary changes: diffuse fibrosis, ground-glass opacities
Pulmonary function testing demonstrating restrictive and/or obstructive impairment
Provider diagnosis linking pneumoconiosis to aluminum exposure

Audit Caution

HCC Buddy guidance
Using unspecified pneumoconiosis when the aluminum exposure history is clearly documented
Confusing aluminosis with bauxite fibrosis (Shaver's disease) — bauxite contains aluminum oxide but is a distinct exposure
Not coding coexisting COPD or respiratory failure when present alongside pneumoconiosis
Failing to document the occupational exposure history that clinically supports this diagnosis

Common Mistakes

HCC Buddy guidance
J63.1 — Bauxite fibrosis of lung (Shaver's disease): related but specifically caused by bauxite fumes, not pure aluminum
J62.8 — Pneumoconiosis due to dust containing silica: different causative mineral
J61 — Asbestosis: different fiber type
J64 — Unspecified pneumoconiosis: less specific; use J63.0 when aluminum exposure is identified

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 J63.0 an HCC code?

Yes. J63.0 (Aluminosis (of lung)) maps to HCC 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.319. 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: J63.0 is billable and maps to V28 HCC 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
J63.0
Description
Aluminosis (of lung)
HCC (V28)
HCC 280 — Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
RAF reference coefficient
0.319
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
0.319
ESRDHCC 112, Fibrosis of Lung and Other Chronic Lung Disorders
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 J63.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for J63.0

For J63.0 to 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 J63.0 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

J63.0 is the ICD-10-CM diagnosis code for aluminosis (of lung). Aluminosis is a lung disease caused by inhaling aluminum dust or particles over time, leading to inflammation and scarring of lung tissue. This occupational condition typically affects workers in aluminum manufacturing, welding, or related industries. J63.0 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, J63.0 maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders (HCC 280) with a source-labeled community, non-dual, aged reference coefficient of 0.319. No V24 mapping is shown for J63.0; use the applicable model and payment year when reviewing the V28 mapping. 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. 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.

Verify occupational history and exposure to aluminum dust to support the diagnosis, as this is an occupational lung disease that should be linked to work-related exposure. Because J63.0 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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 J63.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify occupational history and exposure to aluminum dust to support the diagnosis, as this is an occupational lung disease that should be linked to work-related exposure
  • •Do not confuse with other pneumoconiosis codes (J60-J64 range); ensure aluminum is specifically documented as the causative agent

Clinical Significance

Aluminosis is an occupational pneumoconiosis caused by chronic inhalation of aluminum dust or fumes, occurring in aluminum smelting, welding, explosives manufacturing, and pyrotechnics. It can present as pulmonary fibrosis, granulomatous disease, or alveolar proteinosis, representing a significant chronic respiratory condition for affected workers.

Documentation Requirements

  • ✓Documented occupational history of aluminum dust or fume exposure
  • ✓Chest imaging showing characteristic pulmonary changes: diffuse fibrosis, ground-glass opacities
  • ✓Pulmonary function testing demonstrating restrictive and/or obstructive impairment
  • ✓Provider diagnosis linking pneumoconiosis to aluminum exposure
  • ✓Duration and intensity of aluminum exposure documented
  • ✓Current symptom assessment and functional status
  • ✓Exclusion of other causes of pulmonary fibrosis

Commonly Confused Codes

  • •J63.1: Bauxite fibrosis of lung (Shaver's disease): related but specifically caused by bauxite fumes, not pure aluminum
  • •J62.8: Pneumoconiosis due to dust containing silica: different causative mineral
  • •J61: Asbestosis: different fiber type
  • •J64: Unspecified pneumoconiosis: less specific; use J63.0 when aluminum exposure is identified
  • •J84.10: Pulmonary fibrosis, unspecified: does not capture the occupational aluminum etiology

Child Codes

J63.0Aluminosis (of lung)
HCC 280
J63.1Bauxite fibrosis (of lung)
HCC 280
J63.2Berylliosis
HCC 280
J63.3Graphite fibrosis (of lung)
HCC 280
J63.4Siderosis
HCC 280
J63.5Stannosis
HCC 280
J63.6Pneumoconiosis due to other specified inorganic dusts
HCC 280

Code Hierarchy

└J63Pneumoconiosis due to other inorganic dusts└J63.0Aluminosis (of lung)
└J63.0Aluminosis (of lung)

Because J63.0 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

J63.0 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. The mapping identifies a payment HCC category for J63.0. 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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