J44.0
Chronic obstructive pulmonary disease with (acute) lower respiratory infection
J44.0 (also written J440) is a billable ICD-10-CM diagnosis code for chronic obstructive pulmonary disease with (acute) lower respiratory infection. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 5 codes in category J44 (Other chronic obstructive pulmonary disease). The Alphabetic Index lists it under 10 entries. Its coding notes include a Use additional code instruction, a Code also instruction, 1 Excludes1 entry and 16 Excludes2 entries.
Guidelines tip
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
An exacerbation is a worsening of the chronic condition. An infection alone does not make it one.
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (7 notes)
Code also
Two codes may be needed to describe the condition. This note gives no sequencing order.
- to identify the infection
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (10 notes)
- 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)
Care settings
How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.
Home Health Primary
Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Respiratory clinical group.
Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026Hospital CC
Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 6 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.
Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix CIncludes
Further defines or gives examples of the content of the category.
- 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
Notes
Also from chapter/block level (1 note)
- 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).
Alphabetic Index terms
Terms the official Alphabetic Index lists for this code. 10 entries
- Asthma, asthmatic (bronchial) (catarrh) (spasmodic), chronic obstructive, with, acute lower respiratory infection
- Asthma, asthmatic (bronchial) (catarrh) (spasmodic), with, chronic obstructive bronchitis, with, acute lower respiratory infection
- Asthma, asthmatic (bronchial) (catarrh) (spasmodic), with, chronic obstructive pulmonary disease, with, acute lower respiratory infection
- Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), acute or subacute (with bronchospasm or obstruction), with, chronic obstructive pulmonary disease
- Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous), asthmatic, chronic, with, acute lower respiratory infection
- Disease, diseased, lung, obstructive (chronic), with, acute, bronchitis
- Disease, diseased, lung, obstructive (chronic), with, acute, lower respiratory infection
- Disease, diseased, lung, obstructive (chronic), with, bronchitis, with, lower respiratory infection
- Disease, diseased, pulmonary, chronic obstructive, with, acute bronchitis
- Disease, diseased, pulmonary, chronic obstructive, with, lower respiratory infection (acute)