J20 vs J40
J20 and J40 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter. The distinction is acute vs chronic.
The official note, declared on J20
bronchitis NOS (J40)
J20
Acute bronchitis
Not billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J20-J22
Use when the record says
- acute and subacute bronchitis (with) bronchospasm
- acute and subacute bronchitis (with) tracheitis
- acute and subacute bronchitis (with) tracheobronchitis, acute
- acute and subacute fibrinous bronchitis
- acute and subacute membranous bronchitis
- acute and subacute purulent bronchitis
- acute and subacute septic bronchitis
J40
Bronchitis, not specified as acute or chronic
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J40-J4B
Use when the record says
- Bronchitis NOS
- Bronchitis with tracheitis NOS
- Catarrhal bronchitis
- Tracheobronchitis NOS
Indexed under
- Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous)
- Bronchitis › catarrhal (diffuse) (fibrinous) (hypostatic) (infective) (membranous)
- Bronchitis › with › tracheitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous)
- Tracheitis › with › bronchitis (catarrhal) (infantile) (membranous) (plastic) (septal) (suppurative) (viral)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027