Is J69.0 a billable ICD-10-CM code?

Yes. J69.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J69.0 sit in the tabular list?

Diseases of the respiratory system (J00-J99), in the block Lung diseases due to external agents (J60-J70).

What cannot be coded together with J69.0?

J69.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

J69.0

J69.0 — Pneumonitis due to inhalation of food and vomit

Billable / specific codeICD-10-CM

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.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

chemical pneumonitis due to anesthesia (J95.4)
obstetric aspiration pneumonitis (O74.0)

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.

Medicare coverage

J69.0 is named in 14 Medicare coverage policies — 14 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 J69.0 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 J69.0.

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

Related codes at this level

Codes that share J69. If J69.0 is not quite right, the correct code is usually one of these.

Questions about J69.0

Is J69.0 a billable ICD-10-CM code?: Yes. J69.0 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J69.0 sit in the tabular list?: Diseases of the respiratory system (J00-J99), in the block Lung diseases due to external agents (J60-J70).
What cannot be coded together with J69.0?: J69.0 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.