J84.114 ICD-10-CM Code: Acute interstitial pneumonitis

Code

J84.114

Description

Acute interstitial pneumonitis

HCC (V28)

HCC 280 — Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders

RAF reference coefficient

0.319

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work J84.114 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for J84.114

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for J84.114 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Verify the acute onset and distinguish from chronic interstitial pneumonitis (J84.111)
• •Document the underlying cause if identifiable, as this may affect coding specificity

Clinical Significance

Acute interstitial pneumonitis (Hamman-Rich syndrome) is a rare, rapidly progressive form of interstitial lung disease that often requires intensive care unit admission and mechanical ventilation. This fulminant condition has high mortality and represents extreme resource utilization. Capturing this diagnosis is important for reflecting the acute severity and complexity of care required.

Documentation Requirements

• ✓Documentation of acute onset (days to weeks) of respiratory failure without identifiable cause
• ✓High-resolution computed tomography showing diffuse bilateral ground-glass opacities and consolidation
• ✓Lung biopsy showing diffuse alveolar damage pattern if performed
• ✓Exclusion of other causes of acute respiratory distress syndrome including infection, drug reaction, and connective tissue disease
• ✓Documentation of severity including ventilator requirements, oxygen needs, and ICU status

Commonly Confused Codes

• •J80: Acute respiratory distress syndrome (ARDS) is a clinical syndrome with a known trigger, while acute interstitial pneumonitis is idiopathic ARDS
• •J84.111: Idiopathic interstitial pneumonia NOS is used for chronic presentations, not the acute fulminant form
• •J18.9: Pneumonia unspecified describes infectious pneumonia, not the non-infectious acute interstitial pneumonitis
• •J84.112: IPF is a chronic progressive disease, unlike the acute onset of Hamman-Rich syndrome

Child Codes