J82.81 ICD-10-CM Code: Chronic eosinophilic pneumonia
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Other respiratory diseases principally affecting the interstitium (J80-J84)
J82.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceChronic eosinophilic pneumonia
Long-term lung inflammation characterized by an abnormal increase in a specific type of white blood cell (eosinophils) in the lungs.
Buddy Insight
Chronic eosinophilic pneumonia is a rare but clinically important condition characterized by progressive respiratory symptoms with peripheral and pulmonary eosinophilia.
CMS-HCC V28
MappedHCC 280
RAF 0.319
CMS-HCC V24
MappedHCC 111
RAF 0.335
ACA/HHS
MappedHCC 160
Varies by metal level
ESRD/PACE
MappedHCC 111
RAF 0.058
RXHCC
MappedHCC 229
RAF 0.237
Code Book Path
Inclusion Terms
Official- Eosinophilic pneumonia, NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for J82.81 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for J82.81 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for J82.81 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for J82.81 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for J82.81 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for J82.81 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 J82.81 an HCC code?
Yes. J82.81 (Chronic eosinophilic pneumonia) maps to Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders under the CMS-HCC V28 risk adjustment model (and Chronic Obstructive Pulmonary Disease under V24), with a community non-dual aged RAF of 0.319. It is billable for payment year 2026.
Coder answer: J82.81 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
- J82.81
- Description
- Chronic eosinophilic pneumonia
- 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
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 J82.81 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for J82.81
For J82.81 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 J82.81 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
J82.81 is the ICD-10-CM diagnosis code for chronic eosinophilic pneumonia. Long-term lung inflammation characterized by an abnormal increase in a specific type of white blood cell (eosinophils) in the lungs. J82.81 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering other respiratory diseases principally affecting the interstitium (j80-j84).
Under the CMS-HCC V28 risk adjustment model, J82.81 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, J82.81 maps to Chronic Obstructive Pulmonary Disease (HCC 111) with a community, non-dual, aged base RAF weight of 0.335. 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 any known underlying cause (drug reaction, parasitic infection, malignancy) if identified. Because J82.81 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 J82.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document any known underlying cause (drug reaction, parasitic infection, malignancy) if identified
- •Confirm eosinophilic infiltration through pathology or imaging findings documented in the medical record
Clinical Significance
Chronic eosinophilic pneumonia is a rare but clinically important condition characterized by progressive respiratory symptoms with peripheral and pulmonary eosinophilia. It is significant for risk adjustment because it requires long-term corticosteroid therapy, frequently relapses when steroids are tapered, and maps to COPD HCCs reflecting its chronic nature and resource intensity.
Documentation Requirements
- ✓Peripheral blood eosinophilia with documentation of levels
- ✓Chest imaging showing characteristic peripheral 'photographic negative of pulmonary edema' pattern
- ✓Bronchoalveolar lavage showing eosinophilic predominance if performed
- ✓Exclusion of other causes (parasitic infections, drug reactions, ABPA, eosinophilic granulomatosis with polyangiitis)
- ✓Duration and chronicity of symptoms
- ✓Treatment plan including corticosteroid regimen and taper schedule
- ✓Relapse history if applicable
Commonly Confused Codes
- •J82.83 (Eosinophilic asthma): eosinophilic asthma is primarily an airway disease; chronic eosinophilic pneumonia is an interstitial/alveolar process
- •J82.89 (Other pulmonary eosinophilia): use J82.81 specifically when the chronic eosinophilic pneumonia pattern is documented
- •M30.1 (Eosinophilic granulomatosis with polyangiitis): systemic vasculitis with eosinophilia vs. isolated pulmonary eosinophilia
- •J84.89 (Other specified interstitial pulmonary diseases): use J82.81 when eosinophilic pattern is confirmed