2027 ICD-10-CM Diagnosis Code J61Pneumoconiosis due to asbestos and other mineral fibers

ICD-10-CM Codes›J00–J99›J60-J70›J61

ICD-10-CM J61
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

J61 is a billable ICD-10-CM diagnosis code for pneumoconiosis due to asbestos and other mineral fibers. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 196 through 198. The code is restricted by the Medicare Code Editor to adult patients (age 15 through 124). Coders also document this condition as asbestosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Lung disease due to external agents.

For Medicare Advantage risk adjustment, J61 maps to CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) under the V28 model, adding a risk factor of about 0.319 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
J61
Billable Status
Yes — Valid for Submission
Code Describes
Pneumoconiosis due to asbestos and other mineral fibers
Short Description
Pneumoconiosis due to asbestos and other mineral fibers
Same as the full description in the CMS dataset.
Chapter
J60-J70
Lung diseases due to external agents

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ60-J70Lung diseases due to external agents
CategoryJ61Pneumoconiosis due to asbestos and other mineral fibers
This CodeJ61Pneumoconiosis due to asbestos and other mineral fibers

Code EditsBilling

Medicare Code Editor checks that affect claim validity for J61.

Adult diagnoses
The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

Medicare Risk Adjustment (HCC)Billing

J61 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 280— Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
Payment HCC · PY 2027 one of 79 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.319
community, non-dual, aged · ranges 0.209–0.390 across segments
Hierarchy
Superseded by HCC 276, HCC 277, HCC 278, and HCC 279
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 112
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 112 · ESRD (V21): HCC 112 · ESRD (V24): HCC 112
ESRD V21 weights: 0.066 dialysis, 0.281–0.299 functioning graft · ESRD V24 weights: 0.058 dialysis, 0.080–0.256 functioning graft
Part D (RxHCC)
Not mapped
J61 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Asbestosis
  • Pneumoconiosis caused by silicate
  • Wollastonite pneumoconiosis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to J61: its own notes plus those printed at block J60-J70 and Chapter 10. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Asbestosis

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • pleural plaque with asbestosis (J92.0)
  • pneumoconiosis with tuberculosis, any type in A15 (J65)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block J60-J70 Lung diseases due to external agents applies to 45 codes
  • asthma (J45.-)
  • malignant neoplasm of bronchus and lung (C34.-)
From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • smoke inhalation (T59.81-)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Notes

General instructions on how these codes are used.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name J61, its category, or a range that includes it.

Applicable To 1

These notes mention J61.

  • J65 Pneumoconiosis associated with tuberculosis
    Any condition in J60-J64 with tuberculosis, any type in A15 names J60-J64, which includes this code

Excludes1 2

These codes carry an Excludes1 note naming J61: they are not reported together with it, unless the two conditions are unrelated.

  • J39.3 Upper respiratory tract hypersensitivity reaction, site unspecified
    pneumoconiosis (J60-J67.9) names J60-J67.9, which includes this code
  • J81 Pulmonary edema
    pulmonary edema due to external agents (J60-J70) names J60-J70, which includes this code

Excludes2 5

These codes carry an Excludes2 note naming J61: its condition is not part of those codes, and both may be reported when the patient has both.

  • J66 Airway disease due to specific organic dust
    asbestosis (J61)
  • J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
    lung diseases due to external agents (J60-J70) names J60-J70, which includes this code
  • J44.9 Chronic obstructive pulmonary disease, unspecified
    lung diseases due to external agents (J60-J70) names J60-J70, which includes this code
  • J45.909 Unspecified asthma, uncomplicated
    lung diseases due to external agents (J60-J70) names J60-J70, which includes this code
  • J84 Other interstitial pulmonary diseases
    lung diseases due to external agents (J60-J70) names J60-J70, which includes this code

Code First 1

These codes say to code first a condition named in the note, and J61 is one of the conditions named.

  • J84.170 Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
    lung diseases due to external agents (J60-J70) names J60-J70, which includes this code

Use Additional Code 1

These codes say to use an additional code from the note, and J61 is one of the codes named.

  • Block T51-T65 Toxic effects of substances chiefly nonmedicinal as to source
    for all associated manifestations of toxic effect, such as: respiratory conditions due to external agents (J60-J70) names J60-J70, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR RSP013
Lung disease due to external agents
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Asbestosis

    a form of pneumoconiosis caused by inhalation of asbestos fibers which elicit potent inflammatory responses in the parenchyma of the lung. the disease is characterized by interstitial fibrosis of the lung, varying from scattered sites to extensive scarring of the alveolar interstitium.

Patient EducationClinical

Interstitial Lung Diseases

Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and scarring make it hard to get enough oxygen. The scarring is called pulmonary fibrosis.

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert J61 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
501 Asbestosis
Approximate The match is approximate rather than exact.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About J61Overview

What is the ICD-10 code for pneumoconiosis due to asbestos and other mineral fibers?

The ICD-10-CM code for pneumoconiosis due to asbestos and other mineral fibers is J61. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is J61 (Pneumoconiosis due to asbestos and other mineral fibers) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report pneumoconiosis due to asbestos and other mineral fibers on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does J61 group to?

When pneumoconiosis due to asbestos and other mineral fibers is the principal diagnosis on an inpatient stay, it groups to MS-DRG 198, 197, 196, with relative weights from 0.7256 to 1.8335 depending on complications. Higher weights mean higher Medicare reimbursement.

Who can J61 be reported for?

The Medicare Code Editor checks pneumoconiosis due to asbestos and other mineral fibers against patient demographics: this code is intended for adult patients (age 15 through 124). Claims outside these limits are flagged as inconsistent.

Can J61 be reported with J92.0?

Not as a rule. The Excludes1 note on J61 lists "pleural plaque with asbestosis (J92.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What HCC is J61?

J61 (pneumoconiosis due to asbestos and other mineral fibers) maps to CMS-HCC Category 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders), commonly written as HCC 280, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 112 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does J61 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, J61 adds a risk adjustment factor of about 0.319 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.209 to 0.390 depending on the payment segment). A more severe related category (HCC 276, HCC 277, HCC 278, and HCC 279) supersedes it when both are reported. See the full factor table on the HCC 280 category page.