J90
J90: Pleural effusion, not elsewhere classified
Billable / specific codeICD-10-CM
J90 is a billable, specific ICD-10-CM code for pleural effusion, not elsewhere classified. It is valid for submission on a claim.
Check J90 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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Encysted pleurisy
- Pleural effusion NOS
- Pleurisy with effusion (exudative) (serous)
Other codes that can never be billed with J90
Their own Excludes1 notes name this code, so the conflict is not listed above.
- R09.1Pleurisy
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J90 is named in 8 Medicare coverage policies: 8 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56464Billing and Coding: Flow Cytometry
- 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
- Effusion›pleura, pleurisy, pleuritic, pleuropericardial
- Pleurisy›pneumococcal
- Pleurisy›streptococcal
- Pleurisy›with›effusion
Code history
Unchanged in every release from FY2024 to FY2027.