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ICD-10-CM J43.0: Unilateral pulmonary emphysema [MacLeod's syndrome]

J43.0 is the billable ICD-10-CM code for unilateral pulmonary emphysema [MacLeod's syndrome], in category J43 (Emphysema) of the Chronic lower respiratory diseases section. As a principal diagnosis it groups to MS-DRG 190 Chronic Obstructive Pulmonary Disease with MCC, MS-DRG 191 Chronic Obstructive Pulmonary Disease with CC, MS-DRG 192 Chronic Obstructive Pulmonary Disease without CC/MCC (MDC 04 MDC 04: Diseases and Disorders of the Respiratory System). It maps to HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders) in CMS-HCC V28. 18 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
J43.0
billable FY2027 ICD-10-CM code
Category
J43 Emphysema
Chapter
10: Diseases of the respiratory system (J00-J99)
CC/MCC (MS-DRG v44)
Neither
CMS-HCC V28
HCC 280
POA reporting
Required

Tabular list notes for J43.0

The tabular list has no notes on J43.0 itself; the notes below apply from its parent headings.

Inherited from J43 (Emphysema)

Excludes1 (never coded together)
  • compensatory emphysema (J98.3)
  • interstitial emphysema (J98.2)
  • mediastinal emphysema (J98.2)
  • neonatal interstitial emphysema (P25.0)
  • surgical (subcutaneous) emphysema (T81.82)
Excludes2 (not part of this condition, may be coded together)
  • emphysema due to inhalation of chemicals, gases, fumes or vapors (J68.4)
  • emphysema with chronic (obstructive) bronchitis (J44.-)
  • emphysematous (obstructive) bronchitis (J44.-)
  • traumatic subcutaneous emphysema (T79.7)

MS-DRG grouping when J43.0 is the principal diagnosis

MS-DRG v44 groups for J43.0 as principal diagnosis
MDCMS-DRGs
04 MDC 04: Diseases and Disorders of the Respiratory System190191192

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for J43.0 shows the full grouping logic.

CC/MCC status and inpatient edits

J43.0 is neither a CC nor an MCC under MS-DRG v44, so as a secondary diagnosis it does not raise the MS-DRG severity level. Check J43.0 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, J43.0 maps to HCC 280 (Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list J43.0

18 current Medicare billing and coding articles list J43.0 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM J43.0 mean?

J43.0 means unilateral pulmonary emphysema [MacLeod's syndrome]. It is one of 5 billable codes under J43, emphysema.

What can't be coded with J43.0?

Excludes1 at J43: compensatory emphysema (J98.3); interstitial emphysema (J98.2); mediastinal emphysema (J98.2); neonatal interstitial emphysema (P25.0) and 1 more. These are never reported together with J43.0.

Which MS-DRG does J43.0 group to?

As the principal diagnosis, J43.0 groups to MS-DRG 190 Chronic Obstructive Pulmonary Disease with MCC, MS-DRG 191 Chronic Obstructive Pulmonary Disease with CC, MS-DRG 192 Chronic Obstructive Pulmonary Disease without CC/MCC (MDC 04 MDC 04: Diseases and Disorders of the Respiratory System) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does J43.0 map to an HCC?

Yes: HCC 280, Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders, in the PY2027 CMS-HCC V28 mapping.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.