ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesJ91

J91

Pleural effusion in conditions classified elsewhere

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 J91 is a used to indicate a diagnosis of pleural effusion in conditions classified elsewhere.

Key Diagnostic Point:

J91 is the ICD-10 code category for pleural effusion that occurs in conditions classified elsewhere. This category encompasses pleural effusions that are secondary to various underlying diseases, such as malignancies, infections, or inflammatory conditions. It is essential for clinicians to recognize that pleural effusions can be a significant complication of many diseases, indicating the need for further evaluation and management. The clinical significance of accurately coding J91 lies in its ability to reflect the complexity of patient conditions and the necessity for appropriate treatment interventions.

  • In practice, J91 is utilized when a patient presents with pleural effusion that is not classified under other specific codes. This can include cases where the effusion is due to heart failure, pneumonia, or cancer. Proper documentation and coding are crucial for ensuring that patients receive the appropriate level of care and that healthcare providers are reimbursed accurately for the services rendered. Clinicians should be aware of the underlying conditions leading to pleural effusion to ensure comprehensive management and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions
  • Need for precise documentation
  • Potential for complications

Audit Risk Factors

  • Inadequate documentation of underlying conditions
  • Misclassification of pleural effusion type
  • Failure to update patient history

Specialty Focus

Medical Specialties

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

Oncology

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 Codes

Child Codes

2 codes
J91.0
Malignant pleural effusion
J91.8
Pleural effusion in other conditions classified elsewhere

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

The clinical impact of J91 is significant as it highlights the need for comprehensive management of patients with pleural effusions. Accurate coding can influence quality measures and patient outcomes, as it reflects the complexity of care required for patients with underlying conditions. Additionally, understanding the population health implications of pleural effusions can aid in identifying trends and improving healthcare delivery.
From an administrative perspective, proper coding and documentation can enhance the accuracy of claims submissions, reduce audit risks, and improve overall healthcare efficiency. As healthcare trends evolve, the importance of precise coding in capturing the full spectrum of patient conditions becomes increasingly critical for both clinical and financial outcomes.

ICD-9 vs ICD-10

The clinical impact of J91 is significant as it highlights the need for comprehensive management of patients with pleural effusions. Accurate coding can influence quality measures and patient outcomes, as it reflects the complexity of care required for patients with underlying conditions. Additionally, understanding the population health implications of pleural effusions can aid in identifying trends and improving healthcare delivery. From an administrative perspective, proper coding and documentation can enhance the accuracy of claims submissions, reduce audit risks, and improve overall healthcare efficiency. As healthcare trends evolve, the importance of precise coding in capturing the full spectrum of patient conditions becomes increasingly critical for both clinical and financial outcomes.

Reimbursement & Billing Impact

financial outcomes.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for J91

Coding & Billing References

  • •
    Official ICD-10 Guidelines for J91

Frequently Asked Questions

What conditions are included in J91?

J91 includes pleural effusions that are secondary to conditions such as malignancies, infections, heart failure, and other inflammatory diseases.

When should I use J91 codes?

J91 codes should be used when a pleural effusion is identified in a patient with an underlying condition that is classified elsewhere in the ICD-10 coding system.

What documentation is required for J91?

Documentation must include the underlying condition causing the pleural effusion, clinical findings, imaging results, and any treatments administered.