J95.4 — Chemical pneumonitis due to anesthesia
J95.4 is a billable, specific ICD-10-CM code for chemical pneumonitis due to anesthesia. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
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
Other codes that can never be billed with J95.4
These codes carry an Excludes1 note pointing at J95.4. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J95.4 alone.
Risk adjustment
J95.4 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
J95.4 is named in 1 Medicare coverage policy — 1 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57205Billing and Coding: Oximetry Services
How J95.4 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J95.4.
- 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
Related codes at this level
Codes that share J95. If J95.4 is not quite right, the correct code is usually one of these.
- J95.0Tracheostomy complications
- J95.1Acute pulmonary insufficiency following thoracic surgery
- J95.2Acute pulmonary insufficiency following nonthoracic surgery
- J95.3Chronic pulmonary insufficiency following surgery
- J95.5Postprocedural subglottic stenosis
- J95.6Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating a procedure
- J95.7Accidental puncture and laceration of a respiratory system organ or structure during a procedure
- J95.8Other intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified
Questions about J95.4
- Is J95.4 a billable ICD-10-CM code?
- Yes. J95.4 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J95.4 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified (J95).
- What cannot be coded together with J95.4?
- J95.4 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.