DxCodebookFY2027 · Oct 1, 2026 – Sep 30, 2027

J18.9 diagnosis code · Billable code · FY2027

J18.9 Pneumonia, unspecified organism

  • Billable
  • MCC
  • POA reported

J18.9 ICD-10 code: a billable diagnosis code in FY2027, one of 5 billable codes in category J18.

Where it sits

  1. Chapter 10 Diseases of the respiratory system (J00-J99)
  2. J09-J18 Influenza and pneumonia (J09-J18)
  3. J18 Pneumonia, unspecified organism
  4. J18.9 Pneumonia, unspecified organism
CC / MCC
MCC
MS-DRG
193-195, 791, 793, 974-976
HCC V28
–
POA
Reported
Code Editor
–
Index entries
3

Instructions

Notes that also apply

Excludes1 from J18

  • congenital pneumonia (P23.0) P23.0
  • drug-induced interstitial lung disorder (J70.2-J70.4) J70.2 J70.4
  • interstitial pneumonia NOS (J84.9) J84.9
  • neonatal aspiration pneumonia (P24.-) P24
  • pneumonitis due to fumes and vapors (J68.0) J68.0
  • usual interstitial pneumonia (J84.178) J84.178

Excludes2 from J18

  • abscess of lung with pneumonia (J85.1) J85.1
  • aspiration pneumonia due to anesthesia during labor and delivery (O74.0) O74.0
  • aspiration pneumonia due to anesthesia during pregnancy (O29) O29
  • aspiration pneumonia due to anesthesia during puerperium (O89.0) O89.0
  • aspiration pneumonia due to solids and liquids (J69.-) J69
  • aspiration pneumonia NOS (J69.0) J69.0
  • lipid pneumonia (J69.1) J69.1
  • pneumonitis due to external agents (J67-J70) J67 J70

Code first from J18

  • , if applicable, associated influenza (J09.X1, J10.0-, J11.0-) J09.X1 J10.0 J11.0

Code also from J18

  • , if applicable, any associated condition such as:
  • aspiration pneumonia (J69.-) J69

Block J09-J18 instructions (Excludes2 9, Use additional code 1): printed on the block page.

Chapter 10 instructions (Notes 1, Excludes2 9, Use additional code 7): printed on the chapter 10 page.

Index entries

  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved) → J18.9
  • Infection, infected, infective (opportunistic)lung → J18.9
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved)atypical NEC → J18.9

NCHS Alphabetic Index. Index first, then the Tabular List.

Medicare grouping and edits

CMS files for J18.9
CC / MCCMCC
PDX exclusion list0113 (129 codes)
Appendix BMDC 04 Diseases and Disorders of the Respiratory System, MS-DRG 193-195 (Simple Pneumonia and Pleurisy with MCC…); MDC 15 Newborns and Other Neonates with Conditions Originating in Perinatal Period, MS-DRG 791 (Prematurity with Major Problems…); MDC 15 Newborns and Other Neonates with Conditions Originating in Perinatal Period, MS-DRG 793 (Full Term Neonate with Major Problems…); MDC 25 Human Immunodeficiency Virus Infections, MS-DRG 974-976 (HIV with Major Related Condition with MCC…)
Code Editor–
POAReported
HCC V28–

MCC as a secondary diagnosis, not when the principal diagnosis is on its PDX exclusion list.

CMS: MS-DRG v44 (Appendix B, C), MCE v44, POA list FY2027, 2027 Initial ICD-10-CM Mappings. What the rows mean.

Hierarchy