J10.1

J10.1: Influenza due to other identified influenza virus with other respiratory manifestations

Billable / specific codeICD-10-CM

J10.1 is a billable, specific ICD-10-CM code for influenza due to other identified influenza virus with other respiratory manifestations. It is valid for submission on a claim.

Check J10.1 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code for associated pleural effusion, if applicable (J91.8)
code for associated sinusitis, if applicable (J01.-)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Influenza due to other identified influenza virus NOS
Influenza due to other identified influenza virus with laryngitis
Influenza due to other identified influenza virus with pharyngitis
Influenza due to other identified influenza virus with upper respiratory symptoms

Excludes1 inherited from the categories above J10.1

A category’s note binds every code beneath it.

Written on J10: Influenza due to other identified influenza virus

influenza due to avian influenza virus (J09.X-)
influenza due to swine flu (J09.X-)
influenza due to unidentifed influenza virus (J11.-)

Other codes that can never be billed with J10.1

Their own Excludes1 notes name this code, so the conflict is not listed above.

J00Acute nasopharyngitis [common cold]
J02.9Acute pharyngitis, unspecified
J03.9Acute tonsillitis, unspecified
J06Acute upper respiratory infections of multiple and unspecified sites
J09Influenza due to certain identified influenza viruses

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

J10.1 is named in 11 Medicare coverage policies: 11 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52466Nebulizers - Policy Article
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
A57205Billing and Coding: Oximetry Services

Alphabetic index entries that lead here

Influenza›novel H1N1 influenza(2009)
Influenza›novel influenza A/H1N1
Influenza›due to›identified influenza virus NEC
Influenza›due to›identified influenza virus NEC›with›laryngitis
Influenza›due to›identified influenza virus NEC›with›pharyngitis
Influenza›due to›identified influenza virus NEC›with›respiratory manifestations NEC