ICD-10 · PDGM grouping
J96 Respiratory failure, not elsewhere classified
All 12 codes in the J96 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
12
Can lead a claim
12
Cannot lead a claim
0
What CMS assigns to J96
All 12 codes group to MMTA - Respiratory. 6 of the 12 count toward the Respiratory Failure and Atelectasis comorbidity subgroup; 6 are assigned none. Every code can lead a claim.
- Respiratory Failure and Atelectasis: counts toward the high comorbidity tier only in an interaction pair.
Every code in J96
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| J96.0 Acute respiratory failure | ||||
| J96.00 | Acute respiratory failure, unspecified whether with hypoxia or hypercapniaCMS: Acute respiratory failure, unsp w hypoxia or hypercapnia | Can lead a claim | L | None |
| J96.01 | Acute respiratory failure with hypoxia | Can lead a claim | L | None |
| J96.02 | Acute respiratory failure with hypercapnia | Can lead a claim | L | None |
| J96.1 Chronic respiratory failure | ||||
| J96.10 | Chronic respiratory failure, unspecified whether with hypoxia or hypercapniaCMS: Chronic respiratory failure, unsp w hypoxia or hypercapnia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.11 | Chronic respiratory failure with hypoxia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.12 | Chronic respiratory failure with hypercapnia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.2 Acute and chronic respiratory failure | ||||
| J96.20 | Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapniaCMS: Acute and chr resp failure, unsp w hypoxia or hypercapnia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.21 | Acute and chronic respiratory failure with hypoxia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.22 | Acute and chronic respiratory failure with hypercapnia | Can lead a claim | L | Respiratory Failure and Atelectasis |
| J96.9 Respiratory failure, unspecified | ||||
| J96.90 | Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapniaCMS: Respiratory failure, unsp, unsp w hypoxia or hypercapnia | Can lead a claim | L | None |
| J96.91 | Respiratory failure, unspecified with hypoxia | Can lead a claim | L | None |
| J96.92 | Respiratory failure, unspecified with hypercapnia | Can lead a claim | L | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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