J84.115
BillableRespiratory bronchiolitis interstitial lung disease
HCC Category Mapping
V28HCC 280 — Chronic Obstructive Pulmonary Disease
0.334V24HCC 112 — Fibrosis of Lung and Other Chronic Lung Disorders
0.268ESRDHCC 112 — Fibrosis of Lung and Other Chronic Lung Disorders
0.000RxHCCHCC 227 — Sarcoidosis, Pulmonary Alveolar Disorders
0.000What This Code Means
A lung disease where inflammation occurs in the small airways and surrounding tissue, typically seen in smokers with progressive breathing difficulty.
Coding Tips
- •Confirm smoking history documentation, as this condition is strongly associated with tobacco use
- •Ensure distinction from other interstitial lung diseases with similar presentations
Clinical Significance
Respiratory bronchiolitis interstitial lung disease is a smoking-related interstitial lung disease that bridges the gap between simple respiratory bronchiolitis and more severe ILDs. This condition indicates significant small-airway and interstitial involvement requiring smoking cessation intervention, monitoring, and potential immunosuppressive therapy. Capturing this diagnosis reflects the chronic respiratory management burden.
Documentation Requirements
- ✓Documented smoking history (typically heavy, current or former smoker)
- ✓High-resolution computed tomography showing centrilobular ground-glass nodules, bronchial wall thickening, and patchy ground-glass opacities
- ✓Lung biopsy showing respiratory bronchiolitis pattern with interstitial involvement if performed
- ✓Pulmonary function tests documenting the severity and type of ventilatory defect
- ✓Documentation distinguishing this from simple respiratory bronchiolitis (which does not have ILD component)
Commonly Confused Codes
J84.117 — Desquamative interstitial pneumonia is a related but more severe smoking-related ILD with more extensive macrophage accumulationJ44.1 — COPD with acute exacerbation is a distinct obstructive disease; RB-ILD has restrictive or mixed physiologyJ84.111 — Idiopathic interstitial pneumonia NOS should not be used when RB-ILD is specifically documentedJ68.4 — Chronic respiratory conditions due to chemicals/fumes is used for non-tobacco inhalational exposures
Code Hierarchy
└J84Other interstitial pulmonary diseases└J84.1Other interstitial pulmonary diseases with fibrosis└J84.11Idiopathic interstitial pneumonia└J84.115Respiratory bronchiolitis interstitial lung disease
└J84.115Respiratory bronchiolitis interstitial lung disease