2026 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 2026 (October 1, 2025 through September 30, 2026) 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 2026.
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 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.
- Pneumoconiosis associated with tuberculosis
- Pneumoconiosis caused by silica
- Silicotuberculosis
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Inclusion Terms
Use Additional Code
- code, if applicable, for associated cachexia E88.A
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.
The “use additional code” indicates that a secondary code could be used to further specify the patient’s condition. This note is not mandatory and is only used if enough information is available to assign an additional code.
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.Mycobacterium tuberculosis
a species of gram-positive, aerobic bacteria that produces tuberculosis in humans, other primates, cattle; dogs; and some other animals which have contact with humans. growth tends to be in serpentine, cordlike masses in which the bacilli show a parallel orientation.
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, 2025 through September 30, 2026.
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, 2025 through September 30, 2026.
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 196, 197, 198, with relative weights from 0.7162 to 1.8872 depending on complications. Higher weights mean higher Medicare reimbursement.
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 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 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.
