J16
J16: Pneumonia due to other infectious organisms, not elsewhere classified
Non-billable headerICD-10-CM
J16 is a non-billable header ICD-10-CM code for pneumonia due to other infectious organisms, not elsewhere classified. It cannot be billed on its own: choose one of the more specific child codes below.
Excludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Other codes that can never be billed with J16
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead J16
2 child codes. Green means billable.