2027 ICD-10-CM Diagnosis Code J95.821Acute postprocedural respiratory failure
ICD-10-CM Codes›J00–J99›J95›J95
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
J95.821 is a billable ICD-10-CM diagnosis code for acute postprocedural respiratory failure. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 189, 928 through 929, 934. 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 13 closely related codes. Coders also document this condition as acute lung injury. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Postprocedural or postoperative respiratory system complication and Respiratory failure; insufficiency; arrest.
J95.821 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 84 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 84, ESRD (V21) category 84, and ESRD (V24) category 84 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
J95.821 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
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.
- Acute lung injury
- Acute respiratory failure requiring reintubation
- Indirect acute lung injury
- Post extubation acute respiratory failure requiring reintubation
- Postprocedural respiratory failure
- Trauma and postoperative pulmonary insufficiency
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to J95.821: its own notes plus those printed at J95.82, J95, 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.
- Postprocedural respiratory failure NOS
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.
- respiratory failure in other conditions (J96.-)
- 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)
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 J95.821, its category, or a range that includes it.
Excludes1 1
These codes carry an Excludes1 note naming J95.821: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming J95.821: its condition is not part of those codes, and both may be reported when the patient has both.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
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 J95.821 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About J95.821Overview
What is the ICD-10 code for acute postprocedural respiratory failure?
The ICD-10-CM code for acute postprocedural respiratory failure is J95.821 (sometimes written as J95821). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is J95.821 (Postprocedural respiratory failure) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report acute postprocedural respiratory failure on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does J95.821 group to?
When acute postprocedural respiratory failure is the principal diagnosis on an inpatient stay, it groups to MS-DRG 189, 929, 934, 928, with relative weights from 1.2107 to 7.6444 depending on complications. Higher weights mean higher Medicare reimbursement.
Is J95.821 a CC or MCC?
CMS lists J95.821 as an MCC (major complication or comorbidity) for FY 2027. 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 13 closely related codes in its exclusion list.
What is the ICD-9 equivalent of J95.821?
Under the General Equivalence Mappings, acute postprocedural respiratory failure converts to ICD-9-CM 518.51 (ac resp flr fol trma/srg). The mapping is approximate, so confirm the match fits the documentation.
Does J95.821 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. J95.821 mapped to HCC 84 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 84 (Cardio-Respiratory Failure and Shock), ESRD (V21) category 84 (Cardio-Respiratory Failure and Shock), and ESRD (V24) category 84 (Cardio-Respiratory Failure and Shock).
