J09.X1 — Influenza due to identified novel influenza A virus with pneumonia
J09.X1 is a billable, specific ICD-10-CM code for influenza due to identified novel influenza a virus with pneumonia. It is valid for submission on a claim.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable, associated:
- lung abscess (J85.1)
- other specified type of pneumonia
Risk adjustment
J09.X1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
J09.X1 is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
How J09.X1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J09.X1.
- Influenza›due to›identified novel influenza A virus›with›pneumonia
Related codes at this level
Codes that share J09.X. If J09.X1 is not quite right, the correct code is usually one of these.
Questions about J09.X1
- Is J09.X1 a billable ICD-10-CM code?
- Yes. J09.X1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J09.X1 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).