2026 ICD-10-CM Diagnosis Code J61Pneumoconiosis due to asbestos and other mineral fibers
ICD-10-CM Codes›J00–J99›J60-J70›J61
- Billable — Valid for Submission
- Risk Adjusts — HCC 280
- Chronic Condition
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 2026 (October 1, 2025 through September 30, 2026) 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 2026.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for J61.
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 2026.
Source: CMS Payment Year 2026 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
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
- Asbestosis
Type 1 Excludes
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Code HistoryHistory
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
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 196, 197, 198, with relative weights from 0.7162 to 1.8872 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.
What is the ICD-9 equivalent of J61?
Under the General Equivalence Mappings, pneumoconiosis due to asbestos and other mineral fibers converts to ICD-9-CM 501 (asbestosis). The mapping is approximate, so confirm the match fits the documentation.
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 2026. 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.
