2027 ICD-10-CM Diagnosis Code J84.170Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
J84.170 is a billable ICD-10-CM diagnosis code for interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere. 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 a manifestation code that cannot be reported as the principal diagnosis. Coders also document this condition as pleuroparenchymal fibroelastosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified and unspecified lower respiratory disease.
For Medicare Advantage risk adjustment, J84.170 maps to CMS-HCC Category 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) under the V28 model, adding a risk factor of about 0.818 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for J84.170.
Medicare Risk Adjustment (HCC)Billing
J84.170 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.
- Pleuroparenchymal fibroelastosis
- Pleuroparenchymal fibroelastosis due to connective tissue disease
- Pleuroparenchymal fibroelastosis due to idiopathic pulmonary fibrosis
- Secondary pleuroparenchymal fibroelastosis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to J84.170: its own notes plus those printed at J84.1, J84, 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.
- Progressive fibrotic interstitial lung disease
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- pulmonary fibrosis (chronic) following radiation (J70.1)
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)
Code First
The underlying condition named in the note is sequenced before this code.
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- if applicable, pulmonary fibrosis (chronic) due to inhalation of chemicals, gases, fumes or vapors (J68.4)
- if applicable, associated condition
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 J84.170, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disease, diseased See Also: Syndrome;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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.
Code History & ChangesHistory
Replacement J84.170 replaces the following previously assigned code(s):
- J84.17 - Oth interstit pulmon dis w fibrosis in dis classd elswhr
Questions About J84.170Overview
Is J84.170 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does J84.170 group to?
On inpatient claims, interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere maps to MS-DRG 198, 197, 196, with relative weights from 0.7256 to 1.8335 depending on complications. Higher weights mean higher Medicare reimbursement.
Can J84.170 be a principal diagnosis?
No. This is a manifestation code: interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.
Can J84.170 be reported with J70.1?
Not as a rule. The Excludes1 note at J84.1, which applies to J84.170, lists "pulmonary fibrosis (chronic) following radiation (J70.1)". 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 is coded first with J84.170?
The Code First note reads: underlying disease, such as: lung diseases due to external agents (J60-J70); rheumatoid arthritis (M05.00-M06.9); sarcoidosis (D86.-); systemic connective tissue disorders (M30-M36). When one of these applies, it is sequenced before J84.170.
What HCC is J84.170?
J84.170 (interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere) maps to CMS-HCC Category 278 (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis), commonly written as HCC 278, 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. In the Part D prescription drug model it maps to RxHCC 226.
Does J84.170 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, J84.170 adds a risk adjustment factor of about 0.818 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.650 to 1.640 depending on the payment segment). A more severe related category (HCC 276 and HCC 277) supersedes it when both are reported. See the full factor table on the HCC 278 category page.