Is ICD-10-CM code J69 billable?

No, J69 (Pneumonitis due to solids and liquids) is a non-billable ICD-10-CM code. It must be coded to a more specific subcategory before it can be used for reimbursement.

What chapter does ICD-10-CM code J69 belong to?

J69 belongs to Chapter 10 of the ICD-10-CM tabular list: J00–J99 (Diseases of the Respiratory System).

J69Not billable, use a more specific code below

Pneumonitis due to solids and liquids

In Lung diseases due to external agents (J60-J70), chapter 10: Diseases of the Respiratory System

3 billable codes under J69: all are an MCC; all map to HCC 282 (Aspiration and Specified Bacterial Pneumonias).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.

Instructional notes

Excludes1: not coded here, use a different code

neonatal aspiration syndromes (P24.-)
postprocedural pneumonitis (J95.4)

Code also: add a code for this too, order depends on the encounter

if applicable, other types of pneumonias, such as:
bacterial pneumonia (J13-J15.-)
viral pneumonia (J12.-)

Also applies, from Lung diseases due to external agents (J60-J70)

These notes sit on J60-J70 and apply to every code under it, including J69.

Excludes2: not included here, code separately if applicable

asthma (J45.-)
malignant neoplasm of bronchus and lung (C34.-)

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)

Read Section I.C.10 (page 56)

All codes under J69

J69 can't be used on a claim. Pick a billable code below; grey headings group them.

J69 MS-DRGs

As the principal diagnosis, the billable codes under J69 group to MS-DRG 177, 178, 179, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.

DRG 177 Respiratory Infections and Inflammations with MCC (3 of 3 codes)
DRG 178 Respiratory Infections and Inflammations with CC (3 of 3 codes)
DRG 179 Respiratory Infections and Inflammations without CC/MCC (3 of 3 codes)
DRG 791 Prematurity with Major Problems (2 of 3 codes)
DRG 793 Full Term Neonate with Major Problems (2 of 3 codes)

Other codes that refer to J69

Notes on these codes point to J69.

J09-J18 Excludes2: pneumonia due to solids and liquids (J69.-)
J12 Excludes2: aspiration pneumonia due to solids and liquids (J69.-)
J13 Code Also: aspiration pneumonia (J69.-)
J14 Code Also: aspiration pneumonia (J69.-)
J15 Code Also: aspiration pneumonia (J69.-)
J16 Code Also: aspiration pneumonia (J69.-)
J17 Code Also: aspiration pneumonia (J69.-)
J18 Excludes2: aspiration pneumonia due to solids and liquids (J69.-)
J18 Code Also: aspiration pneumonia (J69.-)
J95 Excludes2: aspiration pneumonia (J69.-)
J95.89 Use Additional Code: aspiration pneumonia (J69.-)

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.

Code history

Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.