J95.04
Tracheo-esophageal fistula following tracheostomy
J95.04 (also written J9504) is a billable ICD-10-CM diagnosis code for tracheo-esophageal fistula following tracheostomy. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 32 codes in category J95 (Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified). The Alphabetic Index lists it under 2 entries. Its coding notes include a Use additional code instruction and 13 Excludes2 entries.
Guidelines tip
From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.
Intraoperative and postprocedural complications are coded from the body system chapters unless the complication is specifically indexed to a T code.
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (7 notes)
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (9 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 Complex Nursing Interventions 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 12 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 CIPF Comorbidity
On the CMS IPF comorbidity list.
| Comorbidity category | Factor |
|---|---|
| Tracheostomy | 1.09 |
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. 2 entries