Is J95.851 a billable ICD-10-CM code?

Yes. J95.851 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does J95.851 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 J95.851?

J95.851 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

J95.851

J95.851 — Ventilator associated pneumonia

Billable / specific codeICD-10-CM

J95.851 is a billable, specific ICD-10-CM code for ventilator associated pneumonia. 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.

ventilator lung in newborn (P27.8)

Use additional code

Add a secondary code to capture the detail described below.

code to identify the organism, if known (B95.-, B96.-, B97.-)

Inclusion terms

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

Ventilator associated pneumonitis

Risk adjustment

J95.851 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 211 Respirator Dependence/Tracheostomy Status/Complications0.879 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

J95.851 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 J95.851 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 J95.851.

Pneumonia›ventilator associated
Pneumonitis›ventilator associated
Pneumonitis›due to›ventilator

Related codes at this level

Codes that share J95.85. If J95.851 is not quite right, the correct code is usually one of these.

Questions about J95.851

Is J95.851 a billable ICD-10-CM code?: Yes. J95.851 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does J95.851 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 J95.851?: J95.851 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.