Is J15.5 a billable ICD-10-CM code?

Yes. J15.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J15.5 sit in the tabular list?

Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).

What cannot be coded together with J15.5?

J15.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J15.5 (J15) and apply to it just the same.

J15.5

J15.5 — Pneumonia due to Escherichia coli

Billable / specific codeICD-10-CM

J15.5 is a billable, specific ICD-10-CM code for pneumonia due to escherichia coli. It is valid for submission on a claim.

Excludes1 inherited from the categories above J15.5

These are not written on J15.5, but they bind it: a note on a category applies to every code beneath it. Billing J15.5 with anything listed here is a denial.

Written on J15 — Bacterial pneumonia, not elsewhere classified

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

Risk adjustment

J15.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 282 Aspiration and Specified Bacterial Pneumonias0.440 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

J15.5 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A52466Nebulizers - Policy Article
A52466Nebulizers - Policy Article
A52466Nebulizers - Policy Article
A52466Nebulizers - Policy Article

How J15.5 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J15.5.

Pneumonia›Escherichia coli(E. coli)
Pneumonia›broncho-, bronchial›Escherichia coli(E. coli)
Pneumonia›in›Escherichia coli(E. coli)
Pneumonia›lobar›Escherichia coli(E. coli)

The condition this code belongs to

Every code for the condition on one page, which one applies when, and the mistake coders make with it.

Pneumonia ICD-10 codes

Code history

J15.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share J15. If J15.5 is not quite right, the correct code is usually one of these.

Questions about J15.5

Is J15.5 a billable ICD-10-CM code?: Yes. J15.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J15.5 sit in the tabular list?: Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).
What cannot be coded together with J15.5?: J15.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above J15.5 (J15) and apply to it just the same.