FY2027 ICD-10-CM reference
J80: Acute respiratory distress syndrome
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Acute respiratory distress syndrome. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
CMS-HCC V28
- HCC 213: Cardio-Respiratory Failure and Shock · RAF 0.370, Community Non-Dual Aged (CNA)
Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.
CMS-HCC V24
Not used for payment year 2027 Medicare Advantage payment
ESRD
- HCC 84: Cardio-Respiratory Failure and Shock
Coefficient pending: payment year 2027 coefficients for this model are not yet verified, so no RAF is shown. Mapping: PY2026 CMS mapping; CMS 2027 initial file unchanged.
PACE
Source verification pending
RxHCC
No category in the PY2026 CMS mapping; CMS 2027 initial file unchanged
HHS-HCC
Source verification pending
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Source: J00-J99 (chapter, inherited).
Instructional note
code, where applicable, to identify:
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to environmental tobacco smoke (Z77.22)
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to tobacco smoke in the perinatal period (P96.81)
Source: J00-J99 (chapter, inherited).
Instructional note
history of tobacco dependence (Z87.891)
Source: J00-J99 (chapter, inherited).
Instructional note
occupational exposure to environmental tobacco smoke (Z57.31)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco dependence (F17.-)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco use (Z72.0)
Source: J00-J99 (chapter, inherited).
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: J00-J99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: J00-J99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: J00-J99 (chapter, inherited).
Excludes2
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Source: J00-J99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: J00-J99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: J00-J99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: J00-J99 (chapter, inherited).
Excludes2
smoke inhalation (T59.81-)
Source: J00-J99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: J00-J99 (chapter, inherited).
Instructional note
Acute respiratory distress syndrome in adult or child
Source: J80 (category, direct).
Instructional note
Adult hyaline membrane disease
Source: J80 (category, direct).
Excludes1
respiratory distress syndrome in newborn (perinatal) (P22.0)
Source: J80 (category, direct).
Compare the FY2027 additions, removals and billable-status changes
What does J80 mean in FY2027?
The official ICD-10-CM descriptor is Acute respiratory distress syndrome. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is J80 billable in FY2027?
The FY2027 order file marks J80 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does J80 map to an HCC?
In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), J80 maps to CMS-HCC V28 HCC 213 (Cardio-Respiratory Failure and Shock). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. Under the PY2026 CMS mapping; CMS 2027 initial file unchanged: ESRD HCC 84; no RxHCC category. Coefficients for these models are pending verification for payment year 2027. CMS-HCC V24: not used for payment year 2027 Medicare Advantage payment (CMS CY 2027 Rate Announcement). PACE and HHS-HCC mappings are still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.
Review the FY2026 April edition