Is J16.8 a billable ICD-10-CM code?

Yes. J16.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J16.8 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 J16.8?

J16.8 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 J16.8 (J16) and apply to it just the same.

J16.8

J16.8 — Pneumonia due to other specified infectious organisms

Billable / specific codeICD-10-CM

J16.8 is a billable, specific ICD-10-CM code for pneumonia due to other specified infectious organisms. It is valid for submission on a claim.

Excludes1 inherited from the categories above J16.8

These are not written on J16.8, but they bind it: a note on a category applies to every code beneath it. Billing J16.8 with anything listed here is a denial.

Written on J16 — Pneumonia due to other infectious organisms, not elsewhere classified

congenital pneumonia (P23.-)
ornithosis (A70)
pneumocystosis (B59)
pneumonia NOS (J18.9)

Risk adjustment

J16.8 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

J16.8 is named in 15 Medicare coverage policies — 15 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 J16.8 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 J16.8.

Pneumonia›broncho-, bronchial›specified organism NEC
Pneumonia›lobar›specified organism NEC
Pneumonia›specified NEC›organism NEC
Pneumonia›in›specified›organism NEC

Code history

J16.8 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 J16. If J16.8 is not quite right, the correct code is usually one of these.

J16.0Chlamydial pneumonia

Questions about J16.8

Is J16.8 a billable ICD-10-CM code?: Yes. J16.8 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J16.8 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 J16.8?: J16.8 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 J16.8 (J16) and apply to it just the same.