J11
J11 — Influenza due to unidentified influenza virus
Non-billable headerICD-10-CM
J11 is a non-billable header ICD-10-CM code for influenza due to unidentified influenza virus. It cannot be billed on its own: choose one of the more specific child codes below.
Other codes that can never be billed with J11
These codes carry an Excludes1 note pointing at J11. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J11 alone.
- A08Viral and other specified intestinal infections
- G94Other disorders of brain in diseases classified elsewhere
- H67Otitis media in diseases classified elsewhere
- I41Myocarditis in diseases classified elsewhere
- J00Acute nasopharyngitis [common cold]
- J02.9Acute pharyngitis, unspecified
- J03.9Acute tonsillitis, unspecified
- J06Acute upper respiratory infections of multiple and unspecified sites
Risk adjustment
J11 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.
Code to one of these instead J11
4 child codes. Green means billable.
- J11.0Influenza due to unidentified influenza virus with pneumonia
- J11.1Influenza due to unidentified influenza virus with other respiratory manifestations
- J11.2Influenza due to unidentified influenza virus with gastrointestinal manifestations
- J11.8Influenza due to unidentified influenza virus with other manifestations
Questions about J11
- Is J11 a billable ICD-10-CM code?
- No. J11 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
- Where does J11 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).