J12
J12: Viral pneumonia, not elsewhere classified
Non-billable headerICD-10-CM
J12 is a non-billable header ICD-10-CM code for viral pneumonia, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
- aspiration pneumonia due to anesthesia during pregnancy (O29)
- aspiration pneumonia due to anesthesia during puerperium (O89.0)
- aspiration pneumonia due to solids and liquids (J69.-)
- aspiration pneumonia NOS (J69.0)
- congenital pneumonia (P23.0)
- congenital rubella pneumonitis (P35.0)
- interstitial pneumonia NOS (J84.9)
- lipid pneumonia (J69.1)
- neonatal aspiration pneumonia (P24.-)
Code first
The underlying condition must be sequenced before this code.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- associated abscess, if applicable (J85.1)
Includes
Conditions this code covers.
- bronchopneumonia due to viruses other than influenza viruses
Other codes that can never be billed with J12
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.
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead J12
6 child codes. Green means billable.