J15.69 — Pneumonia due to other Gram-negative bacteria
J15.69 is a billable, specific ICD-10-CM code for pneumonia due to other gram-negative bacteria. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Pneumonia due to other aerobic Gram-negative bacteria
- Pneumonia due to Serratia marcescens
Risk adjustment
J15.69 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
J15.69 is named in 13 Medicare coverage policies — 13 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 J15.69 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 J15.69.
- Pneumonia›Enterobacter
- Pneumonia›gram-negative bacteria NEC
- Pneumonia›Proteus
- Pneumonia›Serratia marcescens
- Pneumonia›broncho-, bronchial›Proteus
- Pneumonia›broncho-, bronchial›Serratia marcescens
- Pneumonia›in›Bacterium anitratum
- Pneumonia›in›Enterobacter
- Pneumonia›in›Herellea
- Pneumonia›in›Proteus
- Pneumonia›in›Serratia marcescens
- Pneumonia›lobar›Proteus
Related codes at this level
Codes that share J15.6. If J15.69 is not quite right, the correct code is usually one of these.
Questions about J15.69
- Is J15.69 a billable ICD-10-CM code?
- Yes. J15.69 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J15.69 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).