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 CodesJ11.2

J11.2

Influenza due to unidentified influenza virus with gastrointestinal manifestations

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

Code Description

ICD-10 J11.2 is a billable code used to indicate a diagnosis of influenza due to unidentified influenza virus with gastrointestinal manifestations.

Key Diagnostic Point:

J11.2 refers to influenza caused by an unidentified influenza virus that presents with gastrointestinal manifestations. Clinically, patients may exhibit respiratory symptoms such as cough, sore throat, and fever, alongside gastrointestinal symptoms like nausea, vomiting, diarrhea, and abdominal pain. The influenza virus primarily affects the respiratory system, leading to inflammation of the airways and lungs, which can exacerbate pre-existing lung conditions such as asthma or chronic obstructive pulmonary disease (COPD). Disease progression typically begins with the onset of respiratory symptoms, followed by gastrointestinal symptoms, which can lead to dehydration and electrolyte imbalances, particularly in vulnerable populations such as the elderly and young children. Diagnostic considerations include clinical evaluation, patient history, and laboratory tests such as PCR or rapid antigen tests to confirm influenza infection, although the specific strain may remain unidentified. It is crucial to differentiate J11.2 from other influenza codes (e.g., J10.1 for influenza due to identified virus with pneumonia) to ensure appropriate treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other respiratory and gastrointestinal conditions.
  • Treatment complexity: May involve antiviral medications and supportive care for dehydration.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires accurate identification of symptoms and potential complications.

Audit Risk Factors

  • Common coding errors: Misclassification of influenza type or symptoms.
  • Documentation gaps: Incomplete records regarding symptomatology and treatment.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Gastroenterology

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

The clinical significance of J11.2 lies in its potential to cause severe illness, particularly in high-risk populations. The combination of respiratory and gastrointestinal symptoms can lead to increased healthcare utilization, including hospitalizations and emergency visits. Understanding the epidemiology of influenza, especially during peak seasons, is crucial for public health measures and quality improvement initiatives aimed at reducing morbidity and mortality associated with influenza infections.

ICD-9 vs ICD-10

The clinical significance of J11.2 lies in its potential to cause severe illness, particularly in high-risk populations. The combination of respiratory and gastrointestinal symptoms can lead to increased healthcare utilization, including hospitalizations and emergency visits. Understanding the epidemiology of influenza, especially during peak seasons, is crucial for public health measures and quality improvement initiatives aimed at reducing morbidity and mortality associated with influenza infections.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear clinical evidence of influenza infection and its manifestations. Common denials may arise from insufficient documentation or failure to demonstrate the medical necessity of the services provided. Coders should ensure that all relevant symptoms are documented and that the treatment plan aligns with the diagnosis to avoid billing challenges.

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 J11.2?

J11.2 covers influenza infections caused by unidentified strains of the influenza virus that present with gastrointestinal symptoms. This includes cases where patients exhibit both respiratory and gastrointestinal manifestations, necessitating careful clinical assessment.

When should J11.2 be used instead of related codes?

J11.2 should be used when a patient presents with influenza-like symptoms alongside gastrointestinal manifestations, and the specific strain of the virus is unidentified. It is important to differentiate this from codes that specify identified strains or additional complications such as pneumonia.

What documentation supports J11.2?

Documentation for J11.2 should include a detailed clinical history, symptomatology, laboratory test results confirming influenza infection, and any relevant treatment notes. It is essential to document both respiratory and gastrointestinal symptoms to support the use of this code.