Alphabetic Index FY2027

J96.21

Acute and chronic respiratory failure with hypoxia

FY2027Chapter 10: Diseases of the respiratory system/J96–J99 Other diseases of the respiratory system

BillableComplete code, valid to report
Care settingsHome Health Primary · MMTA - RespiratoryHospital MCCIPF Comorbidity · Chronic Obstructive Pulmonary Disease and Sleep Apnea

J96.21 (also written J9621) is a billable ICD-10-CM diagnosis code for acute and chronic respiratory failure with hypoxia. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 12 codes in category J96 (Respiratory failure, not elsewhere classified). The Alphabetic Index lists it under 1 entry. Its coding notes include a Use additional code instruction, 7 Excludes1 entries and 9 Excludes2 entries.

Guidelines tip

From the FY2027 Official Guidelines. ICD10Ref adds no rules of its own.

Acute respiratory failure can be a principal diagnosis when it is chiefly responsible for the admission. Otherwise it is a secondary diagnosis.

Guidelines I.C.10.b.1; I.C.10.b.2Acute respiratory failureRead the official text

Use additional code

Add the listed code as a secondary code, if known.

Also from chapter/block level (7 notes)
Inherited from Chapter 10 Diseases of the respiratory system
  • code, where applicable, to identify:
    • exposure to environmental tobacco smoke (Z77.22)
    • exposure to tobacco smoke in the perinatal period (P96.81)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from J96 Respiratory failure, not elsewhere classified
  • acute respiratory distress syndrome (J80)
  • cardiorespiratory failure (R09.2)
  • newborn respiratory distress syndrome (P22.0)
  • postprocedural respiratory failure (J95.82-)
  • respiratory arrest (R09.2)
  • respiratory arrest of newborn (P28.81)
  • respiratory failure of newborn (P28.5)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (9 notes)
Inherited from Chapter 10 Diseases of the respiratory system
  • 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, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 22 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 C

IPF Comorbidity

On the CMS IPF comorbidity list.

Comorbidity categoryFactor
Chronic Obstructive Pulmonary Disease and Sleep Apnea1.09
It counts as a comorbidity when reported as a secondary diagnosis and actively treated during the stay. An IPF receives only one adjustment within a category and can receive adjustments in more than one category.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum B-3 (comorbidity codes with adjustment factor); effective for discharges on or after October 1, 2026

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 10 Diseases of the respiratory system
  • 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. 1 entry