J95.4

J95.4: Chemical pneumonitis due to anesthesia

Billable / specific codeICD-10-CM

J95.4 is a billable, specific ICD-10-CM code for chemical pneumonitis due to anesthesia. It is valid for submission on a claim.

Check J95.4 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

aspiration pneumonitis due to anesthesia complicating labor and delivery (O74.0)
aspiration pneumonitis due to anesthesia complicating pregnancy (O29)
aspiration pneumonitis due to anesthesia complicating the puerperium (O89.01)

Use additional code

Add a secondary code to capture the detail described below.

code for adverse effect, if applicable, to identify drug (T41.- with fifth or sixth character 5)

Inclusion terms

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

Mendelson's syndrome
Postprocedural aspiration pneumonia

Excludes2 inherited from the categories above J95.4

Not part of this code, but both may be coded when both are present.

Written on J95: Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified

aspiration pneumonia (J69.-)
emphysema (subcutaneous) resulting from a procedure (T81.82)
hypostatic pneumonia (J18.2)
pulmonary manifestations due to radiation (J70.0-J70.1)

Other codes that can never be billed with J95.4

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

J69Pneumonitis due to solids and liquids
J69.0Pneumonitis due to inhalation of food and vomit

Risk adjustment

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

Medicare coverage

J95.4 is named in 1 Medicare coverage policy: 1 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A57205Billing and Coding: Oximetry Services

Alphabetic index entries that lead here

Mendelson's syndrome(due to anesthesia)
Pneumonitis›postanesthetic
Pneumonitis›postoperative
Pneumonia›aspiration›postprocedural
Pneumonitis›chemical›due to anesthesia
Complication›respiratory system›postoperative›Mendelson's syndrome(chemical pneumonitis)
Pneumonitis›aspiration›due to›anesthesia

Code history

Unchanged in every release from FY2024 to FY2027.