Suppurative and necrotic conditions of the lower respiratory tract
ICD-10 Codes (3)
Updates & Changes
FY 2026 Updates
New Codes (1)
Revised Codes (2)
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 J85-J86 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
The ICD-10 category J85-J86 encompasses codes for suppurative and necrotic conditions of the lower respiratory tract. These codes are used to document conditions such as abscess of lung and mediastinum (J85) and pyothorax (J86). The codes in this range are specific to the type of condition and its location, providing a detailed picture of the patient's respiratory health.
Key Usage Points:
- •Always code to the highest level of specificity.
- •Use additional codes to identify any associated conditions or manifestations.
- •Use combination codes when necessary to accurately depict the patient's condition.
- •Remember to code for any complications related to the condition.
- •Always verify the code in the Tabular List before finalizing.
Coding Guidelines
When to Use:
- ✓When a patient has an abscess of the lung or mediastinum.
- ✓When a patient has a pyothorax.
- ✓When a patient has a necrotizing pneumonia.
- ✓When a patient has a lung abscess due to aspiration.
When NOT to Use:
- ✗When the condition is not specifically suppurative or necrotic.
- ✗When the condition is not located in the lower respiratory tract.
- ✗When the patient has a condition that is excluded from this range.
- ✗When the condition is a complication of a procedure.
Code Exclusions
Always verify exclusions in the Tabular List to ensure accurate coding.
Documentation Requirements
Proper documentation is crucial for accurate coding. It should include a clear description of the condition, its location, any associated conditions or complications, and the patient's overall health status.
Clinical Information:
- •Detailed description of the condition
- •Location of the condition
- •Any associated conditions or complications
- •Patient's overall health status
Supporting Evidence:
- •Radiological findings
- •Laboratory test results
- •Clinical notes from the treating physician
Good Documentation Example:
Patient diagnosed with abscess of right lung due to aspiration pneumonia. CT scan confirms diagnosis.
Poor Documentation Example:
Lung abscess.
Common Documentation Errors:
- ⚠Not documenting the location of the condition
- ⚠Not including supporting evidence
- ⚠Not specifying associated conditions or complications
- ⚠Using non-specific terminology
Range Statistics
Coding Complexity
The complexity of these codes is medium due to the need to understand the specific conditions included, identify associated conditions or complications, use the correct combination codes, and navigate exclusions.
Key Factors:
- ▸Understanding the specific conditions included in this range
- ▸Identifying associated conditions or complications
- ▸Using the correct combination codes
- ▸Navigating exclusions
Specialty Focus
These codes are most commonly used by pulmonologists and thoracic surgeons. They may also be used by general practitioners and internists.
Primary Specialties:
Clinical Scenarios:
- • Patient with aspiration pneumonia develops a lung abscess.
- • Patient with a history of IV drug use presents with pyothorax.
- • Patient with necrotizing pneumonia requires surgical intervention.
- • Patient with chronic lung disease develops a mediastinal abscess.
Resources & References
Resources for these codes include the ICD-10-CM Official Guidelines for Coding and Reporting, clinical textbooks, and professional coding resources.
Official Guidelines:
- ICD-10-CM Official Guidelines for Coding and Reporting
- American Health Information Management Association (AHIMA) resources
- American Academy of Professional Coders (AAPC) resources
Clinical References:
- Clinical textbooks
- Peer-reviewed journal articles
Educational Materials:
- Coding webinars
- Online coding courses
Frequently Asked Questions
Can I use a J85-J86 code for a condition that is a complication of a procedure?
No, these codes should not be used for conditions that are complications of procedures. Instead, use the appropriate complication code.