J94.0

J94.0: Chylous effusion

Billable / specific codeICD-10-CM

J94.0 is a billable, specific ICD-10-CM code for chylous effusion. It is valid for submission on a claim.

Check J94.0 with the rest of the claim: free scrubber

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Chyliform effusion

Excludes1 inherited from the categories above J94.0

A category’s note binds every code beneath it.

Written on J94: Other pleural conditions

pleurisy NOS (R09.1)
traumatic hemopneumothorax (S27.2)
traumatic hemothorax (S27.1)
tuberculous pleural conditions (current disease) (A15.-)

Other codes that can never be billed with J94.0

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.

Medicare coverage

J94.0 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

Chylothorax(nonfilarial)
Effusion›chylous, chyliform(pleura)
Effusion›pleura, pleurisy, pleuritic, pleuropericardial›chylous, chyliform
Pleurisy›with›effusion›chylous, chyliform

Code history

Unchanged in every release from FY2024 to FY2027.