J96.90 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applies from J96 Respiratory failure, not elsewhere classified

Excludes1 (never code together)

• 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)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 213 — Cardio-Respiratory Failure and Shock
• CMS-HCC V22: HCC 84 — Cardio-Respiratory Failure and Shock
• ESRD V24: HCC 84

MS-DRG index

Defines the logic of DRG(s) 189 in MDC 04.

Approximate ICD-9-CM (GEMs)

• 518.81 Acute respiratory failure (approximate)

Code annotations containing back-references to J96.90

Back-references to J96

• Code Also: E87.20 Acidosis, unspecified (", if applicable, respiratory failure with hypercapnia (J96. with 5th character 2)")
• Type 1 Excludes: J95.82 Postprocedural respiratory failure ("Respiratory failure in other conditions (J96.-)")
• Type 1 Excludes: R06 Abnormalities of breathing ("respiratory failure (J96.-)")
• Type 1 Excludes: R09 Other symptoms and signs involving the circulatory and respiratory system ("respiratory failure (J96.-)")
• Type 1 Excludes: R09.2 Respiratory arrest ("respiratory failure (J96.-)")

Diagnosis Index entries for J96.90

• Failure, failed › respiration, respiratory

Nearby codes

• J96.2 Acute and chronic respiratory failure
• J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
• J96.21 Acute and chronic respiratory failure with hypoxia
• J96.22 Acute and chronic respiratory failure with hypercapnia
• J96.9 Respiratory failure, unspecified
• J96.90 Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia (this code)
• J96.91 Respiratory failure, unspecified with hypoxia
• J96.92 Respiratory failure, unspecified with hypercapnia