2026 ICD-10-CM Diagnosis Code J80Acute respiratory distress syndrome

ICD-10-CM CodesJ00–J99J80-J84J80

ICD-10-CM J80
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

J80 is a billable ICD-10-CM diagnosis code for acute respiratory distress syndrome. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 189. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 22 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Respiratory failure; insufficiency; arrest.

For Medicare Advantage risk adjustment, J80 maps to CMS-HCC Category 213 (Cardio-Respiratory Failure and Shock) under the V28 model, adding a risk factor of about 0.370 for a community, non-dual, aged beneficiary in payment year 2026.

Code Identity

ICD-10-CM Code
J80
Billable Status
Yes — Valid for Submission
Code Describes
Acute respiratory distress syndrome
Short Description
Acute respiratory distress syndrome
Same as the full description in the CMS dataset.
Chapter
J80-J84
Other respiratory diseases principally affecting the interstitium

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ80-J84Other respiratory diseases principally affecting the interstitium
CategoryJ80Acute respiratory distress syndrome
This CodeJ80Acute respiratory distress syndrome

Medicare Risk Adjustment (HCC)Billing

J80 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.

CMS-HCC V28 Category (Payment Model)
HCC 213— Cardio-Respiratory Failure and Shock
Payment HCC · PY 2026 one of 36 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.370
community, non-dual, aged · ranges 0.258–0.662 across segments
Hierarchy
Superseded by HCC 211 and HCC 212
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 84
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 84 · ESRD (V21): HCC 84 · ESRD (V24): HCC 84
ESRD V21 weights: 0.044 dialysis, 0.311–0.345 functioning graft · ESRD V24 weights: 0.061 dialysis, 0.199–0.613 functioning graft
Part D (RxHCC)
Not mapped
J80 does not risk-adjust in the RxHCC prescription drug model

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.

  • Acute respiratory distress syndrome
  • Acute respiratory distress syndrome due to COVID-19
  • Acute respiratory distress syndrome due to dabbing
  • Acute respiratory distress syndrome due to vaping
  • Disorder due to vaping
  • Falciparum malaria
  • Infectious edema
  • Interstitial lung disorder due to dabbing
  • Interstitial lung disorder due to vaping
  • Malarial shock lung
  • Postoperative pulmonary edema
  • Pulmonary insufficiency following shock
  • Pulmonary insufficiency following surgery
  • Pulmonary insufficiency following trauma

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Acute respiratory distress syndrome in adult or child
  • Adult hyaline membrane disease

Type 1 Excludes

  • respiratory distress syndrome in newborn perinatal P22.0

Index to Diseases and InjuriesGuidance

Clinical ClassificationClinical

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

CCSR RSP012
Respiratory failure; insufficiency; arrest
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Falciparum Malaria

    malaria resulting from infection by plasmodium falciparum.

Patient EducationClinical

Respiratory Failure

Respiratory failure is a condition in which your blood doesn't have enough oxygen or has too much carbon dioxide. Sometimes you can have both problems.

The full article covers:

  • What is respiratory failure?
  • What causes respiratory failure?
  • What are the symptoms of respiratory failure?
  • How is respiratory failure diagnosed?
  • What are the treatments for respiratory failure?

Read the full article at MedlinePlus

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

Convert J80 to ICD-9-CMHistory

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

ICD-9-CM
518.82 Other pulmonary insuff
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 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About J80Overview

What is the ICD-10 code for acute respiratory distress syndrome?

The ICD-10-CM code for acute respiratory distress syndrome is J80. It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

Is J80 (Acute respiratory distress syndrome) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report acute respiratory distress syndrome on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does J80 group to?

When acute respiratory distress syndrome is the principal diagnosis on an inpatient stay, it groups to MS-DRG 189 (pulmonary Edema and Respiratory Failure), which carries a relative weight of 1.2354. Higher weights mean higher Medicare reimbursement.

Is J80 a CC or MCC?

CMS lists J80 as an MCC (major complication or comorbidity) for FY 2026. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 22 closely related codes in its exclusion list.

What is the ICD-9 equivalent of J80?

Under the General Equivalence Mappings, acute respiratory distress syndrome converts to ICD-9-CM 518.82 (other pulmonary insuff). The mapping is approximate, so confirm the match fits the documentation.

What HCC is J80?

J80 (acute respiratory distress syndrome) maps to CMS-HCC Category 213 (Cardio-Respiratory Failure and Shock), commonly written as HCC 213, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2026. It mapped to HCC 84 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 J80 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, J80 adds a risk adjustment factor of about 0.370 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.258 to 0.662 depending on the payment segment). A more severe related category (HCC 211 and HCC 212) supersedes it when both are reported. See the full factor table on the HCC 213 category page.