J18
J18: Pneumonia, unspecified organism
Non-billable headerICD-10-CM
J18 is a non-billable header ICD-10-CM code for pneumonia, unspecified organism. 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.
Excludes2: not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- abscess of lung with pneumonia (J85.1)
- aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
- aspiration pneumonia due to anesthesia during pregnancy (O29)
- aspiration pneumonia due to anesthesia during puerperium (O89.0)
- aspiration pneumonia due to solids and liquids (J69.-)
- aspiration pneumonia NOS (J69.0)
- lipid pneumonia (J69.1)
- pneumonitis due to external agents (J67-J70)
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.
- , if applicable, any associated condition such as:
- aspiration pneumonia (J69.-)
Other codes that can never be billed with J18
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.
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.
Code to one of these instead J18
5 child codes. Green means billable.