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J44.81 ICD-10-CM Code: Bronchiolitis obliterans and bronchiolitis obliterans syndrome

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

Coding at a Glance

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 v43, 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 J44.81 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on J44.81 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.

  • Obliterative bronchiolitis

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-J4A

Excludes2 — Not Included Here

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

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, if applicable:
  • complication of bone marrow transplant (T86.09)
  • complication of stem cell transplant (T86.5)
  • heart-lung transplant rejection (T86.31)
  • lung transplant rejection (T86.810)
  • other complications of heart-lung transplant (T86.39)
  • other complications of lung transplant (T86.818)

Code Also

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

  • Code also, if applicable, associated conditions, such as:
  • chronic graft-versus-host disease (D89.811)
  • chronic lung allograft dysfunction (J4A.-)
  • chronic respiratory conditions due to chemicals, gases, fumes and vapors (J68.4)
  • type of asthma, if applicable (J45.-) inherited from J44

Coder workflow for J44.81

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

Before you code J44.81

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with J44.81. 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 J44.81’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

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then J44.81.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewT86.09, T86.5, T86.31, T86.810, T86.39, T86.818

Consider J44.81. 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).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes1 — check before selecting J44.81(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with J44.81: 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 J44.81(7 notes)

    Coding workflow: The conditions named in this note are not included in J44.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareJ47, J42, J41, J43, E84

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

  • Code First — sequencing check(7 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before J44.81. Do not add an underlying condition the record does not document.

    ReviewT86.09, T86.5, T86.31, T86.810, T86.39, T86.818

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(5 notes)

    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.

    ReviewD89.811, J4A, J68.4, J45

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

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition J44.81 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewJ68.0

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewT86.09, T86.5, T86.31, T86.810, T86.39, T86.818

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.

Code Overview

Bronchiolitis obliterans and bronchiolitis obliterans syndrome is a billable ICD-10-CM diagnosis code (J44.81).

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 (9)

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.

Decision Points

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

  1. Sequencing: 7 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 5 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 7 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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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 J44.81 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 2 Excludes1 notes: J42 — Unspecified chronic bronchitis (via J44.-), J42 — Unspecified chronic bronchitis.

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.

Referenced by 3 Code Also instructions: J4A — Chronic lung allograft dysfunction, J4A.0 — Restrictive allograft syndrome, J68.4 — Chronic respiratory conditions due to chemicals, gases, fumes and vapors.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

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 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.

J41.1 — 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, J44.1 — Chronic obstructive pulmonary disease with (acute) exacerbation, 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, J63.0 — Aluminosis (of lung), +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, J44.1 — Chronic obstructive pulmonary disease with (acute) exacerbation, 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 term “Bronchiolitis”; these codes share that main term but sit in a different category of the Tabular List.

J21.0 — Acute bronchiolitis due to respiratory syncytial virus (due to, respiratory syncytial virus), J21.1 — Acute bronchiolitis due to human metapneumovirus (due to, human metapneumovirus), J21.8 — Acute bronchiolitis due to other specified organisms (due to, specified organism NEC), J21.9 — Acute bronchiolitis, unspecified, J68.0 — Bronchitis and pneumonitis due to chemicals, gases, fumes and vapors (chemical, acute), J68.4 — Chronic respiratory conditions due to chemicals, gases, fumes and vapors (chemical), J84.115 — Respiratory bronchiolitis interstitial lung disease (respiratory, interstitial lung disease), J84.89 — Other specified interstitial pulmonary diseases (obliterans, with organizing pneumonia)

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 J44.81 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 J44.81 with these 15 related codes in Claim Check

Hierarchy

Code First

Code Also

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-fy2026
  • J41 — Simple and mucopurulent chronic bronchitis[Excludes2](via J44.-): “chronic obstructive bronchitis (J44.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
  • J43 — Emphysema[Excludes2](via J44.-): “emphysema with chronic (obstructive) bronchitis (J44.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

Referenced by Code Also 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. 3,998 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries (9)

  • Bronchiolitis (acute) (infective) (subacute), chronic (fibrosing), obliterative[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), fibrosa obliterans[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), obliterans[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), obliterans, syndrome[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), obliterative (chronic) (subacute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), obliterative (chronic) (subacute), due to chemicals, gases, fumes or vapors (inhalation)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Bronchiolitis (acute) (infective) (subacute), obliterative (chronic) (subacute), due to fumes or vapors[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Syndrome, bronchiolitis obliterans[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • and 1 more

Nearest codes

Change history

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 FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 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 — v43 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 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. "J44.81 — Bronchiolitis obliterans and bronchiolitis obliterans syndrome." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/j44.81-bronchiolitis-obliterans-and-bronchiolitis-obliterans-syndrome

Change history

  • FY2024 — October 1, 2023
    Added to the code set
    Bronchiolitis obliterans and bronchiolitis obliterans syndrome
    FY2024 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J44.81 in its code family, with their registry titles.

View all codes in the J44 family