J17
J17: Pneumonia in diseases classified elsewhere
Billable / specific codeICD-10-CM
J17 is a billable, specific ICD-10-CM code for pneumonia in diseases classified elsewhere. It is valid for submission on a claim.
Check J17 with the rest of the claim: free scrubberExcludes1: never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
- candidial pneumonia (B37.1)
- chlamydial pneumonia (J16.0)
- gonorrheal pneumonia (A54.84)
- histoplasmosis pneumonia (B39.0-B39.2)
- measles pneumonia (B05.2)
- nocardiosis pneumonia (A43.0)
- pneumocystosis (B59)
- pneumonia due to Pneumocystis carinii (B59)
- pneumonia due to Pneumocystis jirovecii (B59)
- pneumonia in actinomycosis (A42.0)
- pneumonia in anthrax (A22.1)
- pneumonia in ascariasis (B77.81)
- pneumonia in aspergillosis (B44.0-B44.1)
- pneumonia in coccidioidomycosis (B38.0-B38.2)
- pneumonia in cytomegalovirus disease (B25.0)
- pneumonia in toxoplasmosis (B58.3)
- rubella pneumonia (B06.81)
- salmonella pneumonia (A02.22)
- spirochetal infection NEC with pneumonia (A69.8)
- tularemia pneumonia (A21.2)
- typhoid fever with pneumonia (A01.03)
- varicella pneumonia (B01.2)
- whooping cough with pneumonia (A37 with fifth-character 1)
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.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J17 is named in 5 Medicare coverage policies: 5 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
- A57205Billing and Coding: Oximetry Services
Code history
Unchanged in every release from FY2024 to FY2027.