octoHealth

J96.21

Billable

Acute and chronic respiratory failure with hypoxia

Chapter 10: Diseases of the respiratory system

Additional Information

From parent codes: J00-J99 (Chapter 10)

Excludes 2 — Not Included HereFrom J00-J99

Excludes2 means 'NOT INCLUDED HERE!' An Excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time.

  • 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)
Use Additional CodeFrom J00-J99

The 'use additional code' note instructs that a secondary code should be added to provide more detail.

  • 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)
NotesFrom J00-J99

Additional notes from parent codes that apply to this code.

  • 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).

Inpatient DRG Payments

DRG 18989,991 discharges

Pulmonary Edema And Respiratory Failure

Avg. Medicare Payment

$9,974

Total Payment$12,197
Patient Responsibility$2,223
Hospital Charge$57,943
DRG 928546 discharges

Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc

Avg. Medicare Payment

$71,876

Total Payment$84,626
Patient Responsibility$12,750
Hospital Charge$353,988
DRG 93416 discharges

Full Thickness Burn Without Skin Graft Or Inhalation Injury

Avg. Medicare Payment

$21,354

Total Payment$23,384
Patient Responsibility$2,031
Hospital Charge$34,681