J15.69
J15.69: Pneumonia due to other Gram-negative bacteria
Billable / specific codeICD-10-CM
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.
Check J15.69 with the rest of the claim: free scrubberInclusion 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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
J15.69 is named in 9 Medicare coverage policies: 9 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›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
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.