What is ICD-10 code J67.5?

J67.5 is the ICD-10-CM diagnosis code for Mushroom-worker's lung. An allergic lung inflammation caused by inhaling dust from moldy mushrooms or mushroom compost, affecting workers in mushroom cultivation. It belongs to the ICD-10-CM chapter for diseases of the respiratory system (j00-j99). J67.5 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. J67.5 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. J67.5 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. J67.5 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 J67.5?

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 J67.5, 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 J67.5?

Document exposure to mushroom dust or compost in the occupational history This condition is related to mold spores in mushroom growing environments Because J67.5 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.

2026 ICD-10-CM J67.5: Mushroom-worker's lung

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupJ67.5Effective 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)

J67.5

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

Mushroom-worker's lung

An allergic lung inflammation caused by inhaling dust from moldy mushrooms or mushroom compost, affecting workers in mushroom cultivation.

Buddy Insight

Mushroom-worker's lung is a hypersensitivity pneumonitis caused by inhalation of thermophilic actinomycetes and mold spores in mushroom compost.

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

J67Hypersensitivity pneumonitis due to organic dust

J67.5Mushroom-worker's lung

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J67.5 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J67.5 in this effective period.

Related Child Codes

Official

J67.0Farmer's lung

J67.1Bagassosis

J67.2Bird fancier's lung

J67.3Suberosis

J67.4Maltworker's lung

Includes

Official

allergic alveolitis and pneumonitis due to inhaled organic dust and particles of fungal, actinomycetic or other origin

Excludes 1

Official

pneumonitis due to inhalation of chemicals, gases, fumes or vapors (J68.0)

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J67.5 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J67.5 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J67.5 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Documented occupational exposure to mushroom compost or mushroom cultivation dust

Employment history in mushroom farming or processing operations

Classification as acute, subacute, or chronic disease

Chest imaging and pulmonary function test results

MEAT Support

HCC Buddy guidance

Documented occupational exposure to mushroom compost or mushroom cultivation dust

Employment history in mushroom farming or processing operations

Classification as acute, subacute, or chronic disease

Chest imaging and pulmonary function test results

Audit Caution

HCC Buddy guidance

Defaulting to farmer's lung (J67.0) when the exposure is specifically to mushroom cultivation environments

Not documenting the specific mushroom compost or cultivation exposure to support the code

Using unspecified hypersensitivity pneumonitis when the mushroom exposure is known

Failing to classify the disease stage (acute, subacute, chronic) for treatment planning

Common Mistakes

HCC Buddy guidance

J67.0 (Farmer's lung) — general agricultural mold exposure vs. specific mushroom compost exposure

J67.8 (Hypersensitivity pneumonitis due to other organic dusts) — use J67.5 when mushroom dust is identified

J67.4 (Maltworker's lung) — grain malt exposure, not mushroom compost

J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust) — use J67.5 when mushroom exposure is documented

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 J67.5 an HCC code?

Yes. J67.5 (Mushroom-worker's lung) 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), with a community non-dual aged RAF of 0.319. It is billable for payment year 2026.

Coder answer: J67.5 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: J67.5
Description: Mushroom-worker's lung
HCC (V28): HCC 280 — Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
RAF: 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

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 J67.5 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for J67.5

For J67.5 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 J67.5 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

J67.5 is the ICD-10-CM diagnosis code for mushroom-worker's lung. An allergic lung inflammation caused by inhaling dust from moldy mushrooms or mushroom compost, affecting workers in mushroom cultivation. J67.5 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, J67.5 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, J67.5 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 exposure to mushroom dust or compost in the occupational history. Because J67.5 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 J67.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document exposure to mushroom dust or compost in the occupational history
•This condition is related to mold spores in mushroom growing environments

Clinical Significance

Mushroom-worker's lung is a hypersensitivity pneumonitis caused by inhalation of thermophilic actinomycetes and mold spores in mushroom compost. It is relevant for risk adjustment as a chronic occupational lung disease that can cause progressive fibrosis with ongoing exposure, requiring medical management and workplace modifications.

Documentation Requirements

✓Documented occupational exposure to mushroom compost or mushroom cultivation dust
✓Employment history in mushroom farming or processing operations
✓Classification as acute, subacute, or chronic disease
✓Chest imaging and pulmonary function test results
✓Serum precipitin or specific antibody testing if available
✓Treatment plan including exposure avoidance strategies

Commonly Confused Codes

•J67.0 (Farmer's lung): general agricultural mold exposure vs. specific mushroom compost exposure
•J67.8 (Hypersensitivity pneumonitis due to other organic dusts): use J67.5 when mushroom dust is identified
•J67.4 (Maltworker's lung): grain malt exposure, not mushroom compost
•J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust): use J67.5 when mushroom exposure is documented