2027 ICD-10-CM Diagnosis Code J65Pneumoconiosis associated with tuberculosis
ICD-10-CM Codes›J00–J99›J60-J70›J65
- Billable — Valid for Submission
- Risk Adjusts — HCC 280
- Chronic Condition
J65 is a billable ICD-10-CM diagnosis code for pneumoconiosis associated with tuberculosis. 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. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Lung disease due to external agents and Tuberculosis.
For Medicare Advantage risk adjustment, J65 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
Code Classification
Medicare Risk Adjustment (HCC)Billing
J65 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.
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.
- Pneumoconiosis associated with tuberculosis
- Pneumoconiosis caused by silica
- Silicotuberculosis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to J65: 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.
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.
- 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.
- code, if applicable, for associated cachexia (E88.A)
Notes
General instructions on how these codes are used.
- 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 J65, its category, or a range that includes it.
Excludes1 9
These codes carry an Excludes1 note naming J65: they are not reported together with it, unless the two conditions are unrelated.
- Block A15-A19 Tuberculosispneumoconiosis associated with tuberculosis, any type in A15 (J65)
- Block A15-A19 Tuberculosissilicotuberculosis (J65)
- J60 Coalworker's pneumoconiosiscoalworker pneumoconiosis with tuberculosis, any type in A15 (J65)
- J61 Pneumoconiosis due to asbestos and other mineral fiberspneumoconiosis with tuberculosis, any type in A15 (J65)
- J62 Pneumoconiosis due to dust containing silicapneumoconiosis with tuberculosis, any type in A15 (J65)
- J63 Pneumoconiosis due to other inorganic dustspneumoconiosis with tuberculosis, any type in A15 (J65)
- J64 Unspecified pneumoconiosispneumonoconiosis with tuberculosis, any type in A15 (J65)
- J39.3 Upper respiratory tract hypersensitivity reaction, site unspecified
- J81 Pulmonary edema
Excludes2 4
These codes carry an Excludes2 note naming J65: its condition is not part of those codes, and both may be reported when the patient has both.
Code First 1
These codes say to code first a condition named in the note, and J65 is one of the conditions named.
- J84.170 Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
Use Additional Code 1
These codes say to use an additional code from the note, and J65 is one of the codes named.
- Block T51-T65 Toxic effects of substances chiefly nonmedicinal as to source
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Tuberculosis, tubercular, tuberculous (calcification) (calcified) (caseous) (chromogenic acid-fast bacilli) (degeneration) (fibrocaseous) (fistula) (interstitial) (isolated circumscribed lesions) (necrosis) (parenchymatous) (ulcerative) A15.9
collier's J65
grinder's J65
miner's J65
molder's J65
potter's J65
sandblaster's J65
stonemason's J65
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Silicotuberculosis
pulmonary or extrapulmonary infection caused by mycobacterium tuberculosis or nontuberculous mycobacteria in a patient with silicosis.
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
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Convert J65 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About J65Overview
What is the ICD-10 code for pneumoconiosis associated with tuberculosis?
The ICD-10-CM code for pneumoconiosis associated with tuberculosis is J65. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is J65 (Pneumoconiosis associated with tuberculosis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report pneumoconiosis associated with tuberculosis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does J65 group to?
When pneumoconiosis associated with tuberculosis 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.
Does J65 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code, if applicable, for associated cachexia (E88.A). The additional code is reported after J65.
What is the ICD-9 equivalent of J65?
Under the General Equivalence Mappings, pneumoconiosis associated with tuberculosis converts to ICD-9-CM 505 (pneumoconiosis NOS). The mapping is approximate, so confirm the match fits the documentation.
What HCC is J65?
J65 (pneumoconiosis associated with tuberculosis) 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 J65 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, J65 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.
