J95.811 — Postprocedural pneumothorax
J95.811 is a billable, specific ICD-10-CM code for postprocedural pneumothorax. It is valid for submission on a claim.
Other codes that can never be billed with J95.811
These codes carry an Excludes1 note pointing at J95.811. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J95.811 alone.
- J93Pneumothorax and air leak
Risk adjustment
J95.811 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
J95.811 is named in 5 Medicare coverage policies — 5 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How J95.811 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 J95.811.
- Pneumothorax NOS›postprocedural
- Complication›respiratory system›postoperative›pneumothorax
Related codes at this level
Codes that share J95.81. If J95.811 is not quite right, the correct code is usually one of these.
Questions about J95.811
- Is J95.811 a billable ICD-10-CM code?
- Yes. J95.811 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J95.811 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).