J13

Billable

ChapterJ00–J99

Rankcategory

Official Description

Pneumonia due to Streptococcus pneumoniae

Metadata & Insights

•Billable/specific code (valid for reimbursement).
•Chapter 10: Diseases of the Respiratory System (J00-J99).

CH10 Parent Instructions

Excludes2(Not included here. Code separately if applicable.)

certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
smoke inhalation (T59.81-)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Use Additional Code

code, where applicable, to identify:
exposure to environmental tobacco smoke (Z77.22)
exposure to tobacco smoke in the perinatal period (P96.81)
history of tobacco dependence (Z87.891)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)

J09-J18 Parent Instructions

Excludes2(Not included here. Code separately if applicable.)

allergic or eosinophilic pneumonia (J82)
aspiration pneumonia NOS (J69.0)
meconium pneumonia (P24.01)
neonatal aspiration pneumonia (P24.-)
pneumonia due to solids and liquids (J69.-)
congenital pneumonia (P23.9)
lipid pneumonia (J69.1)
rheumatic pneumonia (I00)
ventilator associated pneumonia (J95.851)

Use Additional Code

code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)

Instructional Notes

Includes

Bronchopneumonia due to S. pneumoniae

Excludes1(Not coded here. Use a different code.)

congenital pneumonia due to S. pneumoniae (P23.6)
lobar pneumonia, unspecified organism (J18.1)
pneumonia due to other streptococci (J15.3-J15.4)

Code First

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

Code Also

, if applicable, any associated condition such as:
abscess (J85.1)
aspiration pneumonia (J69.-)

Clinical Hierarchy

BillableHas subcodes

CH10Diseases of the respiratory system (J00-J99)

J09-J18Influenza and pneumonia (J09-J18)

J13Pneumonia due to Streptococcus pneumoniaeBillable

Applicable Ancestor Context

The following parent sections contain instructions or notes that apply to J13:

Influenza and pneumonia (J09-J18)

View context instructions

chapterCH10

Diseases of the respiratory system (J00-J99)

View context instructions

MS-DRG Classification

2026 v43.1

This code is grouped within the following Diagnosis Related Group(s) for clinical reimbursement:

Simple Pneumonia and Pleurisy with MCC

Simple Pneumonia and Pleurisy with CC

Simple Pneumonia and Pleurisy without CC/MCC

Prematurity with Major Problems

Full Term Neonate with Major Problems

HIV with Major Related Condition with MCC

HIV with Major Related Condition with CC

HIV with Major Related Condition without CC/MCC

Cross Reference

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