J67.7
BillableAir conditioner and humidifier lung
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is J67.7 an HCC code?
Yes. J67.7 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 J67.7
For J67.7to 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 J67.7 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
J67.7 is the ICD-10-CM diagnosis code for air conditioner and humidifier lung. An allergic lung inflammation caused by inhaling contaminated water droplets or mold from air conditioning systems and humidifiers. J67.7 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, J67.7 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, J67.7 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 contaminated air conditioning or humidifier systems. Because J67.7 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 J67.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document exposure to contaminated air conditioning or humidifier systems
- •Often associated with thermophilic actinomycetes or other microorganisms in water systems
Clinical Significance
Air conditioner and humidifier lung is a form of hypersensitivity pneumonitis caused by contaminated water systems in HVAC equipment, making it one of the more commonly encountered hypersensitivity pneumonitis variants in non-agricultural settings. It is significant for risk adjustment as a chronic respiratory condition that may affect multiple building occupants and requires environmental remediation in addition to medical treatment.
Documentation Requirements
- ✓Documentation of exposure to contaminated air conditioning, humidifier, or HVAC systems
- ✓Identification of the specific microorganism if available (thermophilic actinomycetes, Naegleria, etc.)
- ✓Temporal relationship between symptoms and building/HVAC exposure
- ✓Chest imaging and pulmonary function test results
- ✓Classification as acute, subacute, or chronic
- ✓Environmental assessment results if available
Commonly Confused Codes
- •J67.8 (Hypersensitivity pneumonitis due to other organic dusts) — use J67.7 when contaminated HVAC systems are identified
- •J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust) — use J67.7 when the HVAC source is documented
- •J68.x (Respiratory conditions due to chemicals, gases, fumes) — chemical irritant exposure, not microbial contamination
- •J67.0 (Farmer's lung) — agricultural mold vs. indoor HVAC contamination