J95.2 vs J98.4
J95.2 and J98.4 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 official note, declared on J98.4
pulmonary insufficiency following surgery (J95.1-J95.2)
J95.2
Acute pulmonary insufficiency following nonthoracic surgery
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J95
Indexed under
- Complication › surgical procedure › pulmonary insufficiency (s) (from) (of)
- Insufficiency, insufficient › pulmonary › acute, following surgery
- Complication › respiratory system › postoperative › pulmonary insufficiency (s) (from) (of)
J98.4
Other disorders of lung
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J96-J99
Use when the record says
- Calcification of lung
- Cystic lung disease (acquired)
- Lung disease NOS
- Pulmolithiasis
Indexed under
- Honeycomb lung
- Pneumatocele (lung)
- Pneumonitis (acute) (primary)
- Pneumopathy NEC
- Pulmolithiasis
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