2027 ICD-10-CM Diagnosis Code J98.3Compensatory emphysema

ICD-10-CM Codes›J00–J99›J96-J99›J98

ICD-10-CM J98.3
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

J98.3 is a billable ICD-10-CM diagnosis code for compensatory emphysema. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 205 through 206. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pleurisy, pleural effusion and pulmonary collapse.

For Medicare Advantage risk adjustment, J98.3 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

ICD-10-CM Code
J98.3
Billable Status
Yes — Valid for Submission
Code Describes
Compensatory emphysema
Short Description
Compensatory emphysema
Same as the full description in the CMS dataset.
Parent Code
J98
Other respiratory disorders

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ96-J99Other diseases of the respiratory system
CategoryJ98Other respiratory disorders
This CodeJ98.3Compensatory emphysema

Medicare Risk Adjustment (HCC)Billing

J98.3 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.

CMS-HCC V28 Category (Payment Model)
HCC 280— Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
Payment HCC · PY 2027 one of 79 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.319
community, non-dual, aged · ranges 0.209–0.390 across segments
Hierarchy
Superseded by HCC 276, HCC 277, HCC 278, and HCC 279
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 111
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 111 · ESRD (V21): HCC 111 · ESRD (V24): HCC 111
ESRD V21 weights: 0.072 dialysis, 0.299–0.313 functioning graft · ESRD V24 weights: 0.058 dialysis, 0.187–0.344 functioning graft
Part D (RxHCC)
RxHCC 229 — Chronic Obstructive Pulmonary Disease, Bronchiectasis, and Other Asthma
also risk-adjusts in the Part D prescription drug model (V08)

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.

  • Compensatory emphysema

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to J98.3: its own notes plus those printed at J98 and Chapter 10. A note printed at a category, block or chapter applies to every code under it.

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From J98 Other respiratory disorders applies to 12 codes

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.

From J98 Other respiratory disorders applies to 12 codes
From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • 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.

From J98 Other respiratory disorders applies to 12 codes
  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Notes

General instructions on how these codes are used.

From Chapter 10 (J00-J99) Diseases of the respiratory system applies to 366 codes
  • 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 J98.3, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming J98.3: they are not reported together with it, unless the two conditions are unrelated.

  • J43 Emphysema
    compensatory emphysema (J98.3)

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.

CCSR RSP011
Pleurisy, pleural effusion and pulmonary collapse
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Emphysema

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

The full article covers:

  • What is emphysema?
  • What causes emphysema?
  • Who is at risk for emphysema?
  • What are the symptoms of emphysema?
  • How is emphysema diagnosed?
  • What are the treatments for emphysema?
  • Can emphysema be prevented?

Read the full article at MedlinePlus

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

Convert J98.3 to ICD-9-CMHistory

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

ICD-9-CM
518.2 Compensatory emphysema
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About J98.3Overview

What is the ICD-10 code for compensatory emphysema?

The ICD-10-CM code for compensatory emphysema is J98.3 (sometimes written as J983). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is J98.3 (Other respiratory disorders) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report compensatory emphysema on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does J98.3 group to?

When compensatory emphysema is the principal diagnosis on an inpatient stay, it groups to MS-DRG 206, 205, with relative weights from 0.9255 to 1.8244 depending on complications. Higher weights mean higher Medicare reimbursement.

Can J98.3 be reported with a code from P28.4?

Not as a rule. The Excludes1 note at J98, which applies to J98.3, lists "newborn apnea (P28.4-)". 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).

Does J98.3 need an additional code?

When the condition applies, yes. The Use Additional Code note at J98, which applies to J98.3, reads: code to identify: exposure to environmental tobacco smoke (Z77.22); exposure to tobacco smoke in the perinatal period (P96.81); history of tobacco dependence (Z87.891); occupational exposure to environmental tobacco smoke (Z57.31); tobacco dependence (F17.-); and 1 more listed in the Instructional Notes section. The additional code is reported after J98.3.

What HCC is J98.3?

J98.3 (compensatory emphysema) 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 111 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 229.

Does J98.3 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, J98.3 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.