J69.0: Pneumonitis due to inhalation of food and vomit
J69.0 is a billable, specific ICD-10-CM code for pneumonitis due to inhalation of food and vomit. It is valid for submission on a claim.
Check J69.0 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.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- any associated foreign body in respiratory tract (T17.-)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Aspiration pneumonia NOS
- Aspiration pneumonia (due to) food (regurgitated)
- Aspiration pneumonia (due to) gastric secretions
- Aspiration pneumonia (due to) milk
- Aspiration pneumonia (due to) vomit
Risk adjustment
J69.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 282 Aspiration and Specified Bacterial Pneumonias0.440 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
J69.0 is named in 8 Medicare coverage policies: 8 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
- A56621Billing and Coding: Swallowing Studies for Dysphagia
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
Alphabetic index entries that lead here
- Aspiration›bronchitis
- Aspiration›pneumonia
- Aspiration›pneumonitis
- Bronchitis›aspiration(due to food and vomit)
- Deglutition›pneumonia
- Pneumonia›aspiration
- Pneumonitis›aspiration
- Injury›lung›aspiration
- Pneumonitis›due to›food, vomit(aspiration)
- Injury›intrathoracic›lung›aspiration
- Pneumonia›aspiration›due to›food(regurgitated)
- Pneumonia›aspiration›due to›gastric secretions
The condition this code belongs to
Code history
Unchanged in every release from FY2024 to FY2027.