ICD-10-CM category J96
Respiratory failure, not elsewhere classified: every J96 code with its CMS-HCC V28 status
J96, Respiratory failure, not elsewhere classified, holds 17 codes in the FY2026 ICD-10-CM set: 12 billable codes and 5 header codes that need a further character. Every one of them maps to a CMS-HCC V28 payment category (HCC 213) for payment year 2026.
CMS-HCC V28 categories in J96 (1)
Coefficients are the code-level reference values from the CMS V28 factor file (community, non-dual, aged), not a member's score. Hierarchy, interactions, and enrollment segment decide what a documented condition contributes.
All 17 J96 codes (FY2026)
Descriptors are the FY2026 order-file text. Header codes need a further character and cannot be reported; open any billable code for its tabular notes, MEAT guidance, and mapping detail.
| Code | Description | FY2026 | CMS-HCC V28 |
|---|---|---|---|
| J96 | Respiratory failure, not elsewhere classified | Header | Header code, not reportable |
| J96.0 | Acute respiratory failure | Header | Header code, not reportable |
| J96.00 | Acute respiratory failure, unspecified whether with hypoxia or hypercapnia | Billable | HCC 213 |
| J96.01 | Acute respiratory failure with hypoxia | Billable | HCC 213 |
| J96.02 | Acute respiratory failure with hypercapnia | Billable | HCC 213 |
| J96.1 | Chronic respiratory failure | Header | Header code, not reportable |
| J96.10 | Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia | Billable | HCC 213 |
| J96.11 | Chronic respiratory failure with hypoxia | Billable | HCC 213 |
| J96.12 | Chronic respiratory failure with hypercapnia | Billable | HCC 213 |
| J96.2 | Acute and chronic respiratory failure | Header | Header code, not reportable |
| J96.20 | Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia | Billable | HCC 213 |
| J96.21 | Acute and chronic respiratory failure with hypoxia | Billable | HCC 213 |
| J96.22 | Acute and chronic respiratory failure with hypercapnia | Billable | HCC 213 |
| J96.9 | Respiratory failure, unspecified | Header | Header code, not reportable |
| J96.90 | Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia | Billable | HCC 213 |
| J96.91 | Respiratory failure, unspecified with hypoxia | Billable | HCC 213 |
| J96.92 | Respiratory failure, unspecified with hypercapnia | Billable | HCC 213 |
Documentation guides for J96
Frequently asked questions
How many J96 codes are there?
The J96 category (Respiratory failure, not elsewhere classified) has 17 codes in the FY2026 ICD-10-CM order file: 12 billable and 5 header codes, counting the category itself. Only a billable code can be reported on a claim.
Which J96 codes map to an HCC under CMS-HCC V28?
12 billable codes in J96 map to HCC 213 in the CMS-HCC V28 model for payment year 2026. HCC 213 (Cardio-Respiratory Failure and Shock) carries the most, with 12 codes.
Which J96 codes are not billable?
J96 itself and 4 subcategory codes are header codes that need a further character before they can be reported: J96.0 (Acute respiratory failure), J96.1 (Chronic respiratory failure), J96.2 (Acute and chronic respiratory failure), J96.9 (Respiratory failure, unspecified). Each one is listed in the table with the billable codes beneath it.
Source: FY2026 ICD-10-CM order file (FY 2026 Apr update) for codes, billability, and descriptors; CMS-HCC V28 PY2026 final ICD-10-CM mappings and relative factors for payment status. Table generated 2026-09-10.