Pneumonia in diseases classified elsewhere
In Influenza and pneumonia (J09-J18), chapter 10: Diseases of the Respiratory System
- J17 is billable and valid on claims for FY 2027. If the record has more detail, check the other codes under J09-J18 below.
- As a secondary diagnosis it is an MCC (major complication), which can raise the MS-DRG payment. It doesn't count when the principal diagnosis is one of 129 closely related codes.
- Doesn't count toward a Medicare Advantage risk score (no HCC in V28).
- AHRQ's Chronic Condition Indicator classes it as not chronic (an acute or short-term condition).
- Can't be the principal diagnosis: code the underlying condition first. (Manifestation list)
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Instructional notes
Excludes1: not coded here, use a different code
- candidial pneumonia (B37.1)
- chlamydial pneumonia (J16.0)
- gonorrheal pneumonia (A54.84)
- histoplasmosis pneumonia (B39.0-B39.2)
- measles pneumonia (B05.2)
- nocardiosis pneumonia (A43.0)
- pneumocystosis (B59)
- pneumonia due to Pneumocystis carinii (B59)
- pneumonia due to Pneumocystis jirovecii (B59)
- pneumonia in actinomycosis (A42.0)
- pneumonia in anthrax (A22.1)
- pneumonia in ascariasis (B77.81)
- pneumonia in aspergillosis (B44.0-B44.1)
- pneumonia in coccidioidomycosis (B38.0-B38.2)
- pneumonia in cytomegalovirus disease (B25.0)
- pneumonia in toxoplasmosis (B58.3)
- rubella pneumonia (B06.81)
- salmonella pneumonia (A02.22)
- spirochetal infection NEC with pneumonia (A69.8)
- tularemia pneumonia (A21.2)
- typhoid fever with pneumonia (A01.03)
- varicella pneumonia (B01.2)
- whooping cough with pneumonia (A37 with fifth-character 1)
Code first: code the underlying condition first, then this code
- underlying disease, such as:
- Q fever (A78)
- rheumatic fever (I00)
- schistosomiasis (B65.0-B65.9)
Also applies, from Influenza and pneumonia (J09-J18)
These notes sit on J09-J18 and apply to every code under it, including J17.
Excludes2: not included here, code separately if applicable
Use additional code: add a second code for this, listed after this one
- code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
Covers COPD and asthma exacerbations, sequencing of acute respiratory failure, confirmed versus suspected identified influenza, ventilator associated pneumonia, and vaping-related disorders.
- Chronic Obstructive Pulmonary Disease [COPD] and Asthma (page 56)
- Acute Respiratory Failure (page 56)
- Influenza due to certain identified influenza viruses (page 57)
- Ventilator associated Pneumonia (page 57)
- Vaping-related disorders (page 58)
Other codes under J09-J18
Influenza and pneumonia (J09-J18)
- J09Influenza due to certain identified influenza viruses
- J10Influenza due to other identified influenza virus
- J11Influenza due to unidentified influenza virus
- J12Viral pneumonia, not elsewhere classified
- J13Pneumonia due to Streptococcus pneumoniae
- J14Pneumonia due to Hemophilus influenzae
- J15Bacterial pneumonia, not elsewhere classified
- J16Pneumonia due to other infectious organisms, not elsewhere classified
- J17Pneumonia in diseases classified elsewhere(this code)
- J18Pneumonia, unspecified organism
J17 MS-DRGs
As the principal diagnosis, J17 groups to MS-DRG 177, 178, or 179 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Related conditions
Grouped by AHRQ's Clinical Classifications Software Refined (CCSR), which sorts every diagnosis code into clinically meaningful categories.
J17 is in Pneumonia (except that caused by tuberculosis) (RSP002), with 68 codes. Others in it:
Medicare coverage articles listing J17
These 5 Medicare billing and coding articles list J17 as a diagnosis that supports medical necessity for the services they cover. From the CMS Medicare Coverage Database; check your own contractor's article before billing.
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Pneumonia
Pneumonia is an infection in one or both of the lungs. It causes the air sacs of the lungs to fill up with fluid or pus. It can range from mild to severe, depending on the type of germ causing the infection, your age, and your overall health.
Read more about pneumonia on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.
ICD-9-CM equivalent
Legacy crosswalk from the CMS General Equivalence Mappings (last updated 2018).
- 484.7 Pneumonia in other systemic mycoses (approximate)
- 484.8 Pneumonia in other infectious diseases classified elsewhere (approximate)
- 517.1 Rheumatic pneumonia (approximate)