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    v1.0.28
    OpenPayerBilling CodesChronic lower respiratory diseasesICD-10-CM j4a-chronic-lung-allograft-dysfunction
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    ICD-10-CM Code For Chronic Lung Allograft Dysfunction: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group J4A includes diagnoses for chronic dysfunction of lung allografts, including bronchiolitis obliterans syndrome and other chronic forms of pulmonary graft failure following lung transplantation. These ICD-10-CM diagnosis codes are used to document progressive post-transplant airway and parenchymal complications, capturing graft involvement, chronicity, and severity of respiratory impairment relevant to this group. Accurate coding within the ICD-10-CM J4A group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM J4A: Chronic Lung Allograft Dysfunction Overview

    Chronic lung allograft dysfunction represents the progressive decline in lung function following lung transplantation due to chronic rejection and related pathologies affecting the pulmonary graft. These diagnoses target the respiratory system and complications specific to transplanted lungs. Accurate coding is important for proper claim adjudication and to reflect clinical complexity for reimbursement.

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    When to Use

    Use a code from this group when documenting progressive decline in lung function attributable to chronic lung allograft dysfunction following transplantation. These codes apply when clinical evaluation attributes persistent airway obstruction or graft failure to chronic rejection or long-term transplant-related pathology.

    ICD-10-CM Codes

    3 rows

    ICD-10-CM CodeDescription
    J4A.0Restrictive allograft syndrome
    J4A.8Other chronic lung allograft dysfunction
    J4A.9Chronic lung allograft dysfunction, unspecified

    DRG Codes

    3 rows

    DRG CodeDescription
    190Chronic Obstructive Pulmonary Disease with MCC
    191Chronic Obstructive Pulmonary Disease with CC
    192Chronic Obstructive Pulmonary Disease without CC/MCC

    Typical Clinical Scenarios

    • A lung transplant recipient presents to the transplant clinic months to years after transplantation with gradually progressive exertional dyspnea, decline in spirometry (decreasing FEV1 compared with baseline), and insidious worsening cough without fever. Imaging shows bronchial wall thickening and air trapping on CT, and infectious workup is negative, suggesting a chronic, noninfectious decline in graft function; a chronic lung allograft dysfunction diagnosis is assigned to document long-term graft-related airflow limitation. Typical codes: J4A.0, J4A.9
    • An emergency department visit for acute worsening of shortness of breath and hypoxemia in a patient with a prior lung transplant who has known bronchiolitis obliterans phenotype of chronic graft dysfunction; evaluation excludes acute rejection and infection but shows acute on chronic decline requiring supplemental oxygen and adjustment of immunosuppression. Because the presentation represents an exacerbation superimposed on established chronic allograft dysfunction, a code from the group capturing chronic lung allograft dysfunction with acute exacerbation or specified phenotype is used. Typical codes: J4A.8, J4A.0
    • A hospitalized patient with multiple comorbidities (diabetes, chronic kidney disease) and a history of lung transplantation is admitted for nonpulmonary surgery and is found on preoperative assessment to have significant chronic obstructive physiology related to chronic graft dysfunction with reduced baseline pulmonary reserve. The chronic lung allograft dysfunction is documented as a comorbidity affecting perioperative risk and postoperative planning, so an appropriate chronic graft dysfunction code is assigned for the hospitalization record. Typical codes: J4A.9

    Related Codes

    J40-BRONCHITIS-NOT-SPECIFIED

    ICD-10-CM Code For Bronchitis Not Specified As Acute Or Chronic: Group Overview

    J41-SIMPLE-AND-MUCOPURULENT-CHRONIC-BRONCHITIS

    ICD-10-CM Code For Simple And Mucopurulent Chronic Bronchitis: Group Overview

    J42-UNSPECIFIED-CHRONIC-BRONCHITIS

    ICD-10-CM Code For Unspecified Chronic Bronchitis: Group Overview

    J43-EMPHYSEMA

    ICD-10-CM Code For Emphysema: Group Overview

    J44-OTHER-CHRONIC-OBSTRUCTIVE-PULMONARY-DISEASE

    ICD-10-CM Code For Other Chronic Obstructive Pulmonary Disease: Group Overview

    J45-ASTHMA

    ICD-10-CM Code For Asthma: Group Overview

    J47-BRONCHIECTASIS

    ICD-10-CM Code For Bronchiectasis: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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