J18.9
J18.9: Pneumonia, unspecified organism
Billable / specific codeICD-10-CM
J18.9 is a billable, specific ICD-10-CM code for pneumonia, unspecified organism. It is valid for submission on a claim.
Check J18.9 with the rest of the claim: free scrubberExcludes1 inherited from the categories above J18.9
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above J18.9
Not part of this code, but both may be coded when both are present.
Written on J18: Pneumonia, unspecified organism
- 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)
Other codes that can never be billed with J18.9
Their own Excludes1 notes name this code, so the conflict is not listed above.
- J16Pneumonia due to other infectious organisms, not elsewhere classified
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J18.9 is named in 13 Medicare coverage policies: 13 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
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A56730Billing and Coding: Respiratory Therapy and Oximetry Services
Alphabetic index entries that lead here
- Pneumonia(acute) (double) (migratory) (purulent) (septic) (unresolved)
- Infection, infected, infective›lung
- Pneumonia›atypical NEC
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.