FY2027
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Excludes1 pair

J80 vs J96-

J80 and J96 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on J96
acute respiratory distress syndrome (J80)
J80

Acute respiratory distress syndrome

Billable
Chapter 10
Diseases of the respiratory system
Section
J80-J84
Use when the record says
  • Acute respiratory distress syndrome in adult or child
  • Adult hyaline membrane disease
Indexed under
  • Shock › lung
  • Syndrome › acute respiratory distress (adult) (child)
  • Syndrome › shock-lung
  • Distress › acute respiratory › syndrome (adult) (child)
  • Disease, diseased › hyaline › membrane › adult
J96

Respiratory failure, not elsewhere classified

Not billable
Chapter 10
Diseases of the respiratory system
Section
J96-J99

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