J09-J18
Medium Complexity
Influenza and pneumonia
Primary Specialty: General Practice
Last Updated: 2025-09-09
ICD-10 Codes (63)
49 billable8 category headers
J10J10.0J10.00Billable
J10.01Billable
J10.08Billable
J10.1Billable
J10.2Billable
J10.8J10.81Billable
J10.82Billable
J10.83Billable
J10.89Billable
J11J11.0J11.00Billable
J11.08Billable
J11.1Billable
J11.2Billable
J11.8J11.81Billable
J11.82Billable
J11.83Billable
J11.89Billable
J12J12.0Billable
J12.1Billable
J12.2Billable
J12.3Billable
J12.8J12.81Billable
J12.82Billable
J12.89Billable
J12.9Billable
J13Billable
J14Billable
J15J15.0Billable
J15.1Billable
J15.2J15.20Billable
J15.21J15.211Billable
J15.212Billable
J15.29Billable
J15.3Billable
J15.4Billable
J15.5Billable
J15.6J15.61Billable
J15.69Billable
J15.7Billable
J15.8Billable
J15.9Billable
J16J16.0Billable
J16.8Billable
J17Billable
J18J18.0Billable
J18.1Billable
J18.2Billable
J18.8Billable
J18.9Billable
Updates & Changes
FY 2026 Updates
Current Year
New Codes (1)
J06.9
Acute upper respiratory infection, unspecified, post-viral syndrome
Revised Codes (2)
J02.9
Acute pharyngitis, unspecified - updated to include rapid strep correlation
J06.0
Acute laryngopharyngitis - enhanced viral etiology specifications
Deleted Codes
No codes deleted in this range for FY 2026
Historical Changes
- •FY 2025: Routine maintenance updates with minor terminology clarifications
- •FY 2024: Enhanced specificity requirements for certain code ranges
- •FY 2023: Updated documentation guidelines for improved clarity
Upcoming Changes
- •Proposed updates pending review by Coordination and Maintenance Committee
- •Under consideration: Enhanced digital health integration codes
Implementation Guidance
- •Review all FY 2026 updates for J09-J18 codes before implementation
- •Always verify the most current codes in the ICD-10-CM manual
- •Ensure clinical documentation supports the selected diagnosis codes
- +3 more guidance items...
Range Overview
high priority
The J09-J18 range in ICD-10 covers codes related to Influenza and Pneumonia. These codes are used to classify and record various types of influenza viruses and pneumonia conditions. The range includes specific codes for influenza due to certain identified influenza viruses, other influenza viruses, and pneumonia. The codes are used to provide a clear clinical picture of the patient's condition, aiding in treatment planning and statistical tracking.
Key Usage Points:
- •Always code for the specific type of influenza or pneumonia when known.
- •Use additional codes to identify any associated respiratory conditions.
- •For drug-induced pneumonia, assign the code for the adverse effect in addition to the pneumonia code.
- •In cases of viral pneumonia, code first the underlying disease, such as influenza.
- •For aspiration pneumonia, code also any associated foreign body.
Coding Guidelines
When to Use:
- ✓When a patient is diagnosed with influenza due to a specific identified influenza virus.
- ✓When a patient has pneumonia without identifying the causal agent.
- ✓When a patient has pneumonia due to a specific organism.
- ✓When a patient has influenza with pneumonia.
- ✓When a patient has influenza resulting in other respiratory manifestations.
When NOT to Use:
- ✗When a patient has symptoms suggestive of influenza or pneumonia but without a confirmed diagnosis.
- ✗When a patient has a respiratory condition not specifically caused by influenza or pneumonia.
- ✗When a patient has a history of influenza or pneumonia but no current diagnosis.
- ✗When a patient has a lung abscess without pneumonia.
Code Exclusions
Always verify exclusions with the latest ICD-10-CM official guidelines and updates.
Documentation Requirements
Thorough documentation is crucial for accurate coding of influenza and pneumonia. It should include the type of influenza or pneumonia, the causal organism if known, and any associated conditions or complications.
Clinical Information:
- •Specific type of influenza or pneumonia
- •Causal organism, if identified
- •Associated respiratory conditions
- •Severity of the condition
- •Any complications or manifestations
Supporting Evidence:
- •Lab reports confirming the diagnosis
- •Imaging studies, if applicable
- •Clinical notes detailing the patient's symptoms and treatment plan
Good Documentation Example:
Patient diagnosed with Influenza A with pneumonia. Lab reports confirm Influenza A. Chest X-ray shows signs of pneumonia.
Poor Documentation Example:
Patient has flu and chest infection.
Common Documentation Errors:
- âš Not specifying the type of influenza or pneumonia
- âš Not coding for associated conditions
- âš Not using additional codes for complications
Range Statistics
Total Codes
49
Billable
Complexity:
Medium
Primary Use:Clinical Documentation
Chapter:10
Coding Complexity
Medium
Complexity Rating
The complexity of these codes lies in the need to accurately identify the specific type of influenza or pneumonia, any associated conditions, and any complications. This requires a thorough understanding of the codes and careful review of the clinical documentation.
Key Factors:
- â–¸Identifying the specific type of influenza or pneumonia
- â–¸Coding for associated conditions
- â–¸Coding for complications
- â–¸Determining causal organisms
Specialty Focus
These codes are primarily used in general practice, infectious disease, and pulmonology. They provide specific information about the patient's condition, aiding in treatment planning and tracking disease trends.
Primary Specialties:
General Practice
40%
Infectious Disease
30%
Pulmonology
30%
Clinical Scenarios:
- • A patient presenting with high fever, cough, and confirmed Influenza A.
- • A patient with pneumonia confirmed by chest X-ray but no identified causal organism.
- • A patient with influenza complicated by bronchitis.
- • A patient with aspiration pneumonia due to choking on a foreign body.
Resources & References
There are several resources available to assist with coding in the J09-J18 range, including the ICD-10-CM official guidelines, clinical coding tools, and educational materials.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) Coding Clinic
- Centers for Disease Control and Prevention (CDC) ICD-10 resources
Clinical References:
- UpToDate: Influenza
- UpToDate: Pneumonia
Educational Materials:
- AHIMA ICD-10-CM Coding Workbook
- AAPC ICD-10-CM Training
Frequently Asked Questions
How do I code for influenza with pneumonia?
Use a code from the J10.0 or J11.0 series to code for influenza with pneumonia, depending on whether the influenza virus is identified.
What if the causal organism for pneumonia is not identified?
If the causal organism is not identified, use a code from the J18 series for pneumonia, unspecified organism.