J12.9
J12.9: Viral pneumonia, unspecified
Billable / specific codeICD-10-CM
J12.9 is a billable, specific ICD-10-CM code for viral pneumonia, unspecified. It is valid for submission on a claim.
Check J12.9 with the rest of the claim: free scrubberExcludes2 inherited from the categories above J12.9
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.-)
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J12.9 is named in 12 Medicare coverage policies: 12 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
- Pneumonia›viral, virus(broncho) (interstitial) (lobar)
- Pneumonia›aspiration›due to›aspiration of microorganisms›viral
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.