J15.4

J15.4: Pneumonia due to other streptococci

Billable / specific codeICD-10-CM

J15.4 is a billable, specific ICD-10-CM code for pneumonia due to other streptococci. It is valid for submission on a claim.

Check J15.4 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

pneumonia due to streptococcus, group B (J15.3)
pneumonia due to Streptococcus pneumoniae (J13)

Excludes1 inherited from the categories above J15.4

A category’s note binds every code beneath it.

Written on J15: Bacterial pneumonia, not elsewhere classified

chlamydial pneumonia (J16.0)
congenital pneumonia (P23.-)
Legionnaires' disease (A48.1)
spirochetal pneumonia (A69.8)

Other codes that can never be billed with J15.4

Their own Excludes1 notes name this code, so the conflict is not listed above.

J13Pneumonia due to Streptococcus pneumoniae

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

J15.4 is named in 10 Medicare coverage policies: 10 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›streptococcal NEC(broncho) (lobar)
Pneumonia›broncho-, bronchial›streptococcal NEC
Pneumonia›in›Streptococcus
Pneumonia›lobar›streptococcal NEC
Pneumonia›in›Streptococcus›specified NEC
Pneumonia›streptococcal NEC›group›A
Pneumonia›streptococcal NEC›group›specified NEC