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ICD-10 Guide
ICD-10 CodesJ15.29

J15.29

Pneumonia due to other staphylococcus

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J15.29 is a billable code used to indicate a diagnosis of pneumonia due to other staphylococcus.

Key Diagnostic Point:

Pneumonia due to other staphylococcus (J15.29) is a type of bacterial pneumonia caused by staphylococcal species other than Staphylococcus aureus. Clinically, patients may present with symptoms such as cough, fever, chills, chest pain, and difficulty breathing. The condition primarily affects the lungs, leading to inflammation and consolidation of lung tissue, which can impair gas exchange. Disease progression can vary, with some patients experiencing rapid deterioration, especially if they have underlying health conditions or compromised immune systems. Diagnostic considerations include chest X-rays, CT scans, and sputum cultures to identify the causative organism. Early diagnosis and appropriate antibiotic therapy are crucial to prevent complications such as lung abscesses or sepsis. This code is particularly relevant in cases where pneumonia is not attributed to more common pathogens, necessitating a thorough investigation to determine the specific staphylococcus involved.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires identification of specific staphylococcal species.
  • Treatment complexity: May involve specialized antibiotic regimens.
  • Documentation requirements: Detailed clinical notes and lab results needed.
  • Coding specificity: Requires accurate identification of pneumonia type.

Audit Risk Factors

  • Common coding errors: Misidentifying the causative organism.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Pneumonia due to other staphylococcus has significant clinical implications, particularly in vulnerable populations such as the elderly or immunocompromised individuals. Understanding the epidemiology of this condition can aid in public health initiatives aimed at reducing pneumonia incidence. Quality measures may include monitoring antibiotic resistance patterns and treatment outcomes, which can inform healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

Pneumonia due to other staphylococcus has significant clinical implications, particularly in vulnerable populations such as the elderly or immunocompromised individuals. Understanding the epidemiology of this condition can aid in public health initiatives aimed at reducing pneumonia incidence. Quality measures may include monitoring antibiotic resistance patterns and treatment outcomes, which can inform healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear linkage between the diagnosis and the services rendered. Common denials may arise from insufficient documentation or failure to specify the causative organism. Best practices include regular audits of documentation and coding accuracy to ensure compliance with payer requirements.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J15.29?

J15.29 covers pneumonia caused by staphylococcus species other than Staphylococcus aureus, including but not limited to Staphylococcus epidermidis and Staphylococcus saprophyticus. Diagnosis typically requires laboratory confirmation through sputum culture or other microbiological tests.

When should J15.29 be used instead of related codes?

J15.29 should be used when pneumonia is specifically attributed to non-aureus staphylococci, as opposed to other pneumonia codes that may cover more common pathogens like Streptococcus pneumoniae or Haemophilus influenzae. Accurate pathogen identification is crucial for appropriate coding.

What documentation supports J15.29?

Documentation supporting J15.29 should include clinical notes detailing symptoms, diagnostic imaging results, and laboratory findings confirming the presence of staphylococcus species. Treatment plans and responses to therapy should also be documented to support the diagnosis.