J12.81
J12.81: Pneumonia due to SARS-associated coronavirus
Billable / specific codeICD-10-CM
J12.81 is a billable, specific ICD-10-CM code for pneumonia due to sars-associated coronavirus. It is valid for submission on a claim.
Check J12.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Severe acute respiratory syndrome NOS
Excludes2 inherited from the categories above J12.81
Not part of this code, but both may be coded when both are present.
Written on J12: Viral pneumonia, not elsewhere classified
- 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.-)
Other codes that can never be billed with J12.81
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
J12.81 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
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
- A57205Billing and Coding: Oximetry Services
Alphabetic index entries that lead here
- Pneumonia›SARS-associated coronavirus
- Syndrome›severe acute respiratory(SARS)
- Pneumonia›viral, virus›SARS-associated coronavirus
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.