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J44.1 ICD-10-CM Code: Chronic obstructive pulmonary disease with (acute) exacerbation

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
10 inclusion terms · 1 Excludes1 · 9 Excludes2 · 1 code-also instruction
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 111 · RxHCC V08 category 229

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 190 — CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC (MDC 04)
  • MS-DRG 191 — CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC (MDC 04)
  • MS-DRG 192 — CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC (MDC 04)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 280 — Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders

Other models: CMS-HCC V22 HCC 111 · RxHCC V08 HCC 229

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for J44.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on J44.1 itself; “inherited from” names the category or block whose note applies here.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • asthma with chronic obstructive pulmonary disease
  • chronic asthmatic (obstructive) bronchitis
  • chronic bronchitis with airway obstruction
  • chronic bronchitis with emphysema
  • chronic emphysematous bronchitis
  • chronic obstructive asthma
  • chronic obstructive bronchitis
  • chronic obstructive tracheobronchitis

Source: inherited from J44

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Decompensated COPD
  • Decompensated COPD with (acute) exacerbation

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from J40-J4B

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • type of asthma, if applicable (J45.-)

Source: inherited from J44

Coder workflow for J44.1

MedCoder structured workflow — derived from this code’s own official record

Before you code J44.1

  1. J44.1’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with J44.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in J44.1’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewJ68.0

Consider J44.1. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
Acuity
Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting J44.1(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with J44.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareJ68.0

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of J44.1(9 notes)

    Coding workflow: The conditions named in this note are not included in J44.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareJ44.0, J47, J42, J41, J43, E84

    See the official tabular notes · Guidelines I.A.12.b

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewJ45

    See the official tabular notes · Guidelines I.A.17

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse J44.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of J44.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • J68.0— Excludes1 conflict (Excludes1 — generally not reported together)

    Not coded here — the tabular list excludes this pair for the same encounter.

    Not reported together with this code, except where the two conditions are documented as unrelated.

    What moves you there: Documentation of bronchitis due to chemicals, gases, fumes and vapors moves the case to J68.0; the two are not reported together unless documented as unrelated.

    Full comparison: J44.1 vs J68.0 →

  • J44.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Chronic obstructive pulmonary disease, unspecified” takes J44.9; specificity in the record moves it back here.

    Full comparison: J44.1 vs J44.9 →

  • J44.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of chronic obstructive pulmonary disease [COPD] with acute bronchitis adds J44.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: J44.1 vs J44.0 →

  • J60— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of lung diseases due to external agents adds J60; it is not part of this code and both may be reported when both are documented.

    Full comparison: J44.1 vs J60 →

  • J70— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of lung diseases due to external agents adds J70; it is not part of this code and both may be reported when both are documented.

    Full comparison: J44.1 vs J70 →

  • J47— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of bronchiectasis adds J47; it is not part of this code and both may be reported when both are documented.

    Full comparison: J44.1 vs J47 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Code Overview

Chronic obstructive pulmonary disease with (acute) exacerbation is a billable ICD-10-CM diagnosis code (J44.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (11)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 10: Diseases of the Respiratory System (J00-J99), U07.0 a. Chronic Obstructive Pulmonary Disease [COPD] and Asthma 1) Acute exacerbation of chronic obstructive bronchitis and asthma

The codes in categories J44 and J45 distinguish between uncomplicated cases and those in acute exacerbation. An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.

Coding Notes

MedCoder editorial — not official ICD-10-CM text; reviewed against the cited source

What this code means

J44.1 reports chronic obstructive pulmonary disease in acute exacerbation — a documented worsening or decompensation of the COPD itself. Its inclusion terms are “Decompensated COPD” and “Decompensated COPD with (acute) exacerbation.” It answers a different question than J44.0: the exacerbation code says the chronic disease itself flared; the infection code says something acute was superimposed on it.

Coding guidance

  • An exacerbation is not an infection. Section I.C.10.a.1: “An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.”
  • When both situations are documented, J44.1 and J44.0 may both be reported, along with the infection code J44.0’s Code Also note requires — the note between them is an Excludes2 (“chronic obstructive pulmonary disease [COPD] with acute bronchitis (J44.0)”), which permits the pair.
  • A documented asthma type takes its own J45.- code under the category’s Code Also note.
  • Lung diseases due to external agents (J60–J70) are an Excludes2 — conditions classified elsewhere, reportable alongside when documented.

Decision-rule scenarios

Documentation: The record documents “COPD exacerbation” and, separately, “acute bronchitis.”

Coding question: One J44 code or two?

Rule: Two — the exacerbation and the acute lower respiratory infection are distinct documented facts, and the J44.1/J44.0 relationship is an Excludes2, not an Excludes1. The deciding elements are the exacerbation statement and the named infection.

Documentation: A COPD patient is admitted with pneumonia; no worsening of the COPD itself is documented.

Coding question: Does J44.1 belong on the claim?

Rule: No — the guideline separates an infection superimposed on the chronic condition from a decompensation of it. Without a documented exacerbation, the picture is J44.0 territory; the deciding element is an explicit worsening or decompensation statement.

Scenarios state the decision rule, not a code assignment — code selection always follows the provider's documentation and the ICD-10-CM Official Guidelines.

Documentation checklist

  • An explicit exacerbation or decompensation statement — the word that selects the 4th character.
  • Any acute lower respiratory infection, named (adds J44.0 and the infection’s own code).
  • The asthma type, when asthma coexists (adds the J45.- code).

Codes are assigned from provider documentation; a coder never infers a diagnosis.

Common mistakes

  • Defaulting every admitted COPD patient to J44.1 — the exacerbation must be documented, not inferred from the admission.
  • Dropping J44.1 because J44.0 is present, or the reverse — the Excludes2 permits both.
  • Treating a triggering infection as proof of exacerbation — the guideline says an exacerbation may be TRIGGERED by an infection, not that an infection is one.

Clinical context (coding perspective)

“Decompensated COPD” in a chart is this code’s own inclusion term. Clinicians often document exacerbation and infection in one breath; the classification keeps them as two facts with two codes, which is why the coder reads for both statements independently.

Written and reviewed by MedCoder against the official ICD-10-CM files; educational, not medical or billing advice. The official tabular notes and guidelines above take precedence in every case.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  3. 9 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name J44.1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: J42 — Unspecified chronic bronchitis (via J44.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 3 Excludes2 notes: J20 — Acute bronchitis (via J44.-), J41 — Simple and mucopurulent chronic bronchitis (via J44.-), J43 — Emphysema (via J44.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code First instruction: I21.A1 — Myocardial infarction type 2 (via J44.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 6 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 190 (MDC 04), DRG 191 (MDC 04), DRG 192 (MDC 04).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):RSP008 — Chronic obstructive pulmonary disease and bronchiectasis (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

J10.08 — Influenza due to other identified influenza virus with other specified pneumonia, J41.1 — Mucopurulent chronic bronchitis, J41.8 — Mixed simple and mucopurulent chronic bronchitis, J42 — Unspecified chronic bronchitis, J44.0 — Chronic obstructive pulmonary disease with (acute) lower respiratory infection

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) for risk-adjusted payment.

J41.0 — Simple chronic bronchitis, J41.1 — Mucopurulent chronic bronchitis, J41.8 — Mixed simple and mucopurulent chronic bronchitis, J42 — Unspecified chronic bronchitis, J43.0 — Unilateral pulmonary emphysema [MacLeod's syndrome], J43.1 — Panlobular emphysema, J43.2 — Centrilobular emphysema, J43.8 — Other emphysema, J43.9 — Emphysema, unspecified, J44.0 — Chronic obstructive pulmonary disease with (acute) lower respiratory infection, J44.81 — Bronchiolitis obliterans and bronchiolitis obliterans syndrome, J44.89 — Other specified chronic obstructive pulmonary disease, J44.9 — Chronic obstructive pulmonary disease, unspecified, J47.0 — Bronchiectasis with acute lower respiratory infection, J47.1 — Bronchiectasis with (acute) exacerbation, J47.9 — Bronchiectasis, uncomplicated, J60 — Coalworker's pneumoconiosis, J61 — Pneumoconiosis due to asbestos and other mineral fibers, J62.0 — Pneumoconiosis due to talc dust, J62.8 — Pneumoconiosis due to other dust containing silica, +58 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Lung Transplant Status/Complications, Cystic Fibrosis, Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis, Severe Persistent Asthma

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Chronic obstructive pulmonary disease and bronchiectasis).

J41.0 — Simple chronic bronchitis, J41.1 — Mucopurulent chronic bronchitis, J41.8 — Mixed simple and mucopurulent chronic bronchitis, J42 — Unspecified chronic bronchitis, J43.0 — Unilateral pulmonary emphysema [MacLeod's syndrome], J43.1 — Panlobular emphysema, J43.2 — Centrilobular emphysema, J43.8 — Other emphysema, J43.9 — Emphysema, unspecified, J44.0 — Chronic obstructive pulmonary disease with (acute) lower respiratory infection, J44.81 — Bronchiolitis obliterans and bronchiolitis obliterans syndrome, J44.89 — Other specified chronic obstructive pulmonary disease, J44.9 — Chronic obstructive pulmonary disease, unspecified, J47.0 — Bronchiectasis with acute lower respiratory infection, J47.1 — Bronchiectasis with (acute) exacerbation, J47.9 — Bronchiectasis, uncomplicated, J4A.8 — Other chronic lung allograft dysfunction, J4A.9 — Chronic lung allograft dysfunction, unspecified

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Asthma, asthmatic”, “Bronchitis”; these codes share that main term but sit in a different category of the Tabular List.

J20.6 — Acute bronchitis due to rhinovirus (acute or subacute, due to, virus, rhinovirus), J20.7 — Acute bronchitis due to echovirus (acute or subacute, due to, virus, echovirus), J20.8 — Acute bronchitis due to other specified organisms (viral NEC, acute or subacute), J20.9 — Acute bronchitis, unspecified (acute or subacute), J38.5 — Laryngeal spasm (Millar's), J40 — Bronchitis, not specified as acute or chronic, J41.0 — Simple chronic bronchitis (smokers'), J41.1 — Mucopurulent chronic bronchitis (fetid), J41.8 — Mixed simple and mucopurulent chronic bronchitis (mucopurulent, simple), J42 — Unspecified chronic bronchitis (senile), J45.20 — Mild intermittent asthma, uncomplicated (intermittent), J45.21 — Mild intermittent asthma with (acute) exacerbation (intermittent, with, exacerbation), J45.22 — Mild intermittent asthma with status asthmaticus (intermittent, with, status asthmaticus), J45.30 — Mild persistent asthma, uncomplicated (mild persistent), J45.31 — Mild persistent asthma with (acute) exacerbation (mild persistent, with, exacerbation), J45.32 — Mild persistent asthma with status asthmaticus (mild persistent, with, status asthmaticus), J45.40 — Moderate persistent asthma, uncomplicated (moderate persistent), J45.41 — Moderate persistent asthma with (acute) exacerbation (moderate persistent, with, exacerbation), J45.42 — Moderate persistent asthma with status asthmaticus (moderate persistent, with, status asthmaticus), J45.50 — Severe persistent asthma, uncomplicated (severe persistent), +33 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test

Contextual Map

Every relationship of J44.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run J44.1 with these 13 related codes in Claim Check

Hierarchy

Excludes2 (12)

Referenced by Excludes1 notes

Referenced by Excludes2 notes

  • J20 — Acute bronchitis[Excludes2](via J44.-): “chronic obstructive bronchitis (J44.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • J41 — Simple and mucopurulent chronic bronchitis[Excludes2](via J44.-): “chronic obstructive bronchitis (J44.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
  • J43 — Emphysema[Excludes2](via J44.-): “emphysema with chronic (obstructive) bronchitis (J44.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 280 — Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 04 — Diseases and Disorders of the Respiratory System[MDC crossing]: “Diseases and Disorders of the Respiratory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 4,000 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (11)

  • Asthma, asthmatic (bronchial) (catarrh) (spasmodic), chronic obstructive, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Asthma, asthmatic (bronchial) (catarrh) (spasmodic), with, chronic obstructive bronchitis, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Asthma, asthmatic (bronchial) (catarrh) (spasmodic), with, chronic obstructive pulmonary disease, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), asthmatic, chronic, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, lung, obstructive (chronic), decompensated[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, lung, obstructive (chronic), decompensated, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, lung, obstructive (chronic), with, acute, exacerbation NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, lung, obstructive (chronic), with, bronchitis, with, exacerbation (acute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 3 more

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Relevant guides

Real-World Coding Questions

Questions working coders have asked about this code, answered from official sources and reviewed by an editor.

Common coding questions

What has to be documented to use J44.1?

An acute exacerbation — Guidelines Section I.C.10.a.1 defines it as “a worsening or a decompensation of a chronic condition” and states it “is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.” J44.1’s own inclusion term is “Decompensated COPD.” See How do I code COPD?.

Can J44.1 and J44.0 be coded together?

When both an acute exacerbation and an acute lower respiratory infection are documented, J44.1 and J44.0 may both be reported, along with the infection code J44.0 requires — J44.1 carries an Excludes2 note (not an Excludes1) for “chronic obstructive pulmonary disease [COPD] with acute bronchitis (J44.0),” and an Excludes2 permits the pair.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary, coding notes, decision checklist and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "J44.1 — Chronic obstructive pulmonary disease with (acute) exacerbation." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/j44.1-chronic-obstructive-pulmonary-disease-with-acute-exacerbation

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Chronic obstructive pulmonary disease with (acute) exacerbation

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J44.1 in its code family, with their registry titles.

View all codes in the J44 family