MCMedicalCodingSoftware
J91

J91: Pleural effusion in conditions classified elsewhere

Non-billable headerICD-10-CM

J91 is a non-billable header ICD-10-CM code for pleural effusion in conditions classified elsewhere. It cannot be billed on its own: choose one of the more specific child codes below.

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.

  • pleural effusion in heart failure (I50.-)
  • pleural effusion in systemic lupus erythematosus (M32.13)

Other codes that can never be billed with J91

Their own Excludes1 notes name this code, so the conflict is not listed above.

  • J90Pleural effusion, not elsewhere classified

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Code history

Unchanged in every release from FY2024 to FY2027.

Code to one of these instead J91

2 child codes. Green means billable.

ICD-10-CMFY2027· effective October 1, 2026

Loaded directly from the CMS/NCHS ICD-10-CM public-domain release: see data sources and our editorial policy. If this page disagrees with the CMS tabular list, this page is wrong. Reference information for professional coders; not medical or billing advice.