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).

What cannot be coded together with J09.X1?

J09.X1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J09.X1 (J09) and apply to it just the same.

J09.X1

J09.X1 — Influenza due to identified novel influenza A virus with pneumonia

Billable / specific codeICD-10-CM

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

Excludes1 inherited from the categories above J09.X1

These are not written on J09.X1, but they bind it: a note on a category applies to every code beneath it. Billing J09.X1 with anything listed here is a denial.

Written on J09 — Influenza due to certain identified influenza viruses

influenza A/H1N1 (J10.-)
influenza due to other identified influenza virus (J10.-)
influenza due to unidentified influenza virus (J11.-)
seasonal influenza due to other identified influenza virus (J10.-)
seasonal influenza due to unidentified influenza virus (J11.-)

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

The condition this code belongs to

Every code for the condition on one page, which one applies when, and the mistake coders make with it.

Influenza ICD-10 codes

Code history

J09.X1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

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).
What cannot be coded together with J09.X1?: J09.X1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J09.X1 (J09) and apply to it just the same.