L · MMTA - Respiratory
One of the twelve PDGM clinical groups. CMS maps 235 ICD-10-CM codes to it in grouper v07.2.26.
Group L
ICD-10-CM codes
235
Across 12 ICD-10-CM ranges, in grouper v07.2.26.
Functional bands
≤33 · 34–46 · 47+
OASIS points for low, medium and high functional impairment in this group.
LUPA thresholds
2 to 4 visits
Across the group’s 36 case-mix codes. Fewer visits than the threshold pays per visit.
Every HIPPS code in group L, with its LUPA threshold
1 · Community, Early
2 · Institutional, Early
3 · Community, Late
ICD-10-CM ranges that feed this group
- J09-J18Influenza and pneumonia47
- J40-J4BChronic lower respiratory diseases39
- J60-J70Lung diseases due to external agents33
- J80-J84Other respiratory diseases principally affecting the interstitium27
- J95-J95Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified26
- J96-J99Other diseases of the respiratory system23
- J20-J22Other acute lower respiratory infections15
- J90-J94Other diseases of the pleura13
- J85-J86Suppurative and necrotic conditions of the lower respiratory tract6
- J30-J39Other diseases of upper respiratory tract3
- U00-U49Provisional assignment of new diseases of uncertain etiology or emergency use2
- J00-J06Acute upper respiratory infections1
What lands a period in this group
The clinical group is set by the principal diagnosis on the claim, and it is one of the five things that decide a 30-day period’s case-mix group, alongside admission source, timing, functional impairment level and comorbidity adjustment. CMS maps 235 ICD-10-CM codes to MMTA - Respiratory, spread across 12 ICD-10-CM ranges.
Those ranges are not always the ones you would expect from the chapter. Cerebrovascular disease sits in the circulatory chapter alongside heart failure, but CMS groups strokes as neurological rehabilitation, which is why the chapter a code lives in is a poor guide to how it pays.
The other eleven groups
- AMMTA - Other
- BNeuro Rehabilitation
- CWound
- DComplex Nursing Interventions
- EMusculoskeletal Rehabilitation
- FBehavioral Health
- GMMTA - Surgical Aftercare
- HMMTA - Cardiac and Circulatory
- IMMTA - Endocrine
- JMMTA - Gastrointestinal tract and Genitourinary system
- KMMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases
Source: CMS HH PPS Grouper Software v07.2.26 for the codes and bands, read from the CMS table, not transcribed; CMS’s CY2026 case-mix weights and LUPA thresholds file for the thresholds. Not certified, endorsed or approved by CMS.
The monthly home health regs digest
What CMS changed, what's due next, and what to do about it — one email a month, no fluff. Read the first issue