Skip to main content

J84.170 ICD-10-CM Code: Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere

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

Coding at a Glance

Tabular directives
1 inclusion term · 3 Excludes1 · 1 Excludes2 · 5 code-first instructions · 2 code-also instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 112 · RxHCC V08 category 226

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 196 — INTERSTITIAL LUNG DISEASE WITH MCC (MDC 04)
  • MS-DRG 197 — INTERSTITIAL LUNG DISEASE WITH CC (MDC 04)
  • MS-DRG 198 — INTERSTITIAL LUNG 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 278 — Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis (supersedes HCC 279, HCC 280)

Other models: CMS-HCC V22 HCC 112 · RxHCC V08 HCC 226

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 J84.170 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 J84.170 itself; “inherited from” names the category or block whose note applies here.

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Progressive fibrotic interstitial lung disease

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).

Excludes2 — Not Included Here

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

Source: inherited from J84

Code First

Underlying conditions that must be sequenced before this code.

  • 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)

Code Also

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

  • Code also, if applicable, pulmonary fibrosis (chronic) due to inhalation of chemicals, gases, fumes or vapors (J68.4) inherited from J84.1
  • Code also, if applicable, associated condition inherited from J84

Coder workflow for J84.170

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

Before you code J84.170

  1. J84.170 is a manifestation code (“in diseases classified elsewhere”). Confirm the underlying condition is documented and sequence it first; a manifestation code is not reported as the first-listed or principal diagnosis. The etiology/manifestation convention (Guidelines I.A.13).

    See the official tabular notes · Guide: Manifestation codes and Code First sequencing →

  2. J84.170’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 →

  3. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with J84.170. 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 J84.170’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.

    ReviewJ70.1, J98.2

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then J84.170.
    No → A manifestation code needs its underlying condition — query before reporting it.

    ReviewD86

Consider J84.170. 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 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).
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 J84.170(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with J84.170: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareJ70.1, J98.2

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

  • Excludes2 — not part of J84.170(1 note)

    Coding workflow: The conditions named in this note are not included in J84.170. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

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

  • Code First — sequencing check(5 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before J84.170. Do not add an underlying condition the record does not document.

    ReviewD86

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

  • Code Also — related condition(2 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.

    ReviewJ68.4

    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 J84.170 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).

ReviewJ70.1, J98.2

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is J84.170 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

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).

ReviewD86

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

Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere is a billable ICD-10-CM diagnosis code (J84.170).

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 (1)

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.

Decision Points

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

  1. Sequencing: 5 Code First instructions — the underlying condition is sequenced before this code when present. See the Code First notes
  2. 2 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. 3 Excludes1 entries — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
  4. 1 Excludes2 entry — 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

  • Principal-diagnosis restriction. This is a manifestation code: the Medicare Code Editor requires the underlying condition (etiology) to be sequenced first, with this code reported after it.

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 J84.170 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 Code Also instruction: I27.23 — Pulmonary hypertension due to lung diseases and hypoxia (via J84.-).

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 196 (MDC 04), DRG 197 (MDC 04), DRG 198 (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):RSP016 — Other specified and unspecified lower respiratory disease.

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

Related Codes

Principal diagnosis restriction (Medicare Code Editor)

Manifestation code — the underlying condition is sequenced first.

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis) for risk-adjusted payment.

J84.112 — Idiopathic pulmonary fibrosis, M30.1 — Polyarteritis with lung involvement [Churg-Strauss], M34.81 — Systemic sclerosis with lung involvement

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, Severe Persistent Asthma, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified lower respiratory disease).

J84.09 — Other alveolar and parieto-alveolar conditions, J84.10 — Pulmonary fibrosis, unspecified, J84.111 — Idiopathic interstitial pneumonia, not otherwise specified, J84.112 — Idiopathic pulmonary fibrosis, J84.113 — Idiopathic non-specific interstitial pneumonitis, J84.114 — Acute interstitial pneumonitis, J84.115 — Respiratory bronchiolitis interstitial lung disease, J84.116 — Cryptogenic organizing pneumonia, J84.117 — Desquamative interstitial pneumonia, J84.17 — Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere, J84.178 — Other interstitial pulmonary diseases with fibrosis in diseases classified elsewhere, J84.2 — Lymphoid interstitial pneumonia, J84.81 — Lymphangioleiomyomatosis, J84.82 — Adult pulmonary Langerhans cell histiocytosis, J84.83 — Surfactant mutations of the lung, J84.841 — Neuroendocrine cell hyperplasia of infancy, J84.842 — Pulmonary interstitial glycogenosis, J84.843 — Alveolar capillary dysplasia with vein misalignment, J84.848 — Other interstitial lung diseases of childhood, J84.89 — Other specified interstitial pulmonary diseases, +59 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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of J84.170 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 J84.170 with these 9 related codes in Claim Check

Hierarchy

Code First (21)

Referenced by Code Also instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 278 — Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis [CMS-HCC]: “Idiopathic Pulmonary Fibrosis and Lung Involvement in Systemic Sclerosis — supersedes HCC 279 (Severe Persistent Asthma), HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders)”— 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

  • Disease, diseased, lung, interstitial, with progressive fibrotic phenotype, in diseases classified elsewhere[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (30)

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
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. "J84.170 — Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/j84.170-interstitial-lung-disease-with-progressive-fibrotic-phenotype-in-diseases-classified-elsewhere

Change history

  • FY2021 — October 1, 2020
    Added to the code set
    Interstitial lung disease with progressive fibrotic phenotype in diseases classified elsewhere
    FY2021 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J84.170 in its code family, with their registry titles.

View all codes in the J84 family