J11.00
J11.00: Influenza due to unidentified influenza virus with unspecified type of pneumonia
Billable / specific codeICD-10-CM
J11.00 is a billable, specific ICD-10-CM code for influenza due to unidentified influenza virus with unspecified type of pneumonia. It is valid for submission on a claim.
Check J11.00 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Influenza with pneumonia NOS
Other codes that can never be billed with J11.00
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J11.00 is named in 5 Medicare coverage policies: 5 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)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
Alphabetic index entries that lead here
- Influenza›with›pneumonia
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.