J67.0
BillableFarmer's lung
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is J67.0 an HCC code?
Yes. J67.0 maps to Chronic Obstructive Pulmonary Disease 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 J67.0
For J67.0to 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 J67.0 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
J67.0 is the ICD-10-CM diagnosis code for farmer's lung. An allergic lung disease affecting farmers exposed to moldy hay, grain, or other agricultural materials. It causes inflammation and breathing difficulties, typically occurring after exposure to contaminated hay. J67.0 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, J67.0 maps to Chronic Obstructive Pulmonary Disease (HCC 280) with a community, non-dual, aged base RAF weight of 0.334. Under the older CMS-HCC V24 model, J67.0 maps to Fibrosis of Lung and Other Chronic Lung Disorders (HCC 112) with a community, non-dual, aged base RAF weight of 0.268. 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.
Confirm agricultural exposure, particularly to moldy hay or grain dust, in the patient's occupational history. Because J67.0 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 J67.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm agricultural exposure, particularly to moldy hay or grain dust, in the patient's occupational history
- •Document whether this is acute, subacute, or chronic hypersensitivity pneumonitis for complete clinical assessment
Clinical Significance
Farmer's lung is one of the most common and clinically significant forms of hypersensitivity pneumonitis, caused by exposure to thermophilic actinomycetes in moldy hay. It is important for risk adjustment because chronic forms can progress to irreversible pulmonary fibrosis, requiring ongoing treatment with corticosteroids and monitoring for disease progression.
Documentation Requirements
- ✓Documented agricultural exposure to moldy hay, grain, or other contaminated agricultural materials
- ✓Classification as acute, subacute, or chronic hypersensitivity pneumonitis
- ✓Serum precipitin testing or specific IgG antibodies if available
- ✓Chest imaging findings (ground-glass opacities, fibrosis, air trapping)
- ✓Pulmonary function test results
- ✓Treatment plan including corticosteroids and exposure avoidance measures
Commonly Confused Codes
- •J67.4 (Maltworker's lung) — grain exposure in malting process, not general farming
- •J67.8 (Hypersensitivity pneumonitis due to other organic dusts) — use J67.0 when moldy hay/agricultural exposure is the cause
- •J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust) — use J67.0 when farming exposure is documented
- •J84.112 (Idiopathic pulmonary fibrosis) — chronic farmer's lung can mimic IPF but has an identifiable cause