J93.12
J93.12: Secondary spontaneous pneumothorax
Billable / specific codeICD-10-CM
J93.12 is a billable, specific ICD-10-CM code for secondary spontaneous pneumothorax. It is valid for submission on a claim.
Check J93.12 with the rest of the claim: free scrubberCode first
The underlying condition must be sequenced before this code.
- underlying condition, such as:
- catamenial pneumothorax due to endometriosis (N80.B-)
- cystic fibrosis (E84.-)
- eosinophilic pneumonia (J82.81-J82.82)
- lymphangioleiomyomatosis (J84.81)
- malignant neoplasm of bronchus and lung (C34.-)
- Marfan syndrome (Q87.4-)
- pneumonia due to Pneumocystis carinii (B59)
- secondary malignant neoplasm of lung (C78.0-)
- spontaneous rupture of the esophagus (K22.3)
Excludes1 inherited from the categories above J93.12
A category’s note binds every code beneath it.
Other codes that can never be billed with J93.12
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
J93.12 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A57205Billing and Coding: Oximetry Services
- A57224Billing and Coding: Respiratory Care
Alphabetic index entries that lead here
- Pneumothorax NOS›spontaneous NOS›secondary
Code history
Unchanged in every release from FY2024 to FY2027.