J94.9

J94.9: Pleural condition, unspecified

Billable / specific codeICD-10-CM

J94.9 is a billable, specific ICD-10-CM code for pleural condition, unspecified. It is valid for submission on a claim.

Check J94.9 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above J94.9

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.-)

Risk adjustment

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

Medicare coverage

J94.9 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
A57361Billing and Coding: Monitored Anesthesia Care

Alphabetic index entries that lead here

Disease, diseased›pleura(cavity)

Code history

Unchanged in every release from FY2024 to FY2027.