Other pleural conditions
In Other diseases of the pleura (J90-J94), chapter 10: Diseases of the Respiratory System
5 billable codes under J94: 3 are a CC; none map to an HCC.A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment.
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Instructional notes
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)
All codes under J94
J94 can't be used on a claim. Pick a billable code below; grey headings group them.
J94 MS-DRGs
As the principal diagnosis, the billable codes under J94 group to these 10 MS-DRGs (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 186 Pleural Effusion with MCC (3 of 5 codes)
- DRG 187 Pleural Effusion with CC (3 of 5 codes)
- DRG 188 Pleural Effusion without CC/MCC (3 of 5 codes)
- DRG 791 Prematurity with Major Problems (3 of 5 codes)
- DRG 793 Full Term Neonate with Major Problems (3 of 5 codes)
- DRG 193 Simple Pneumonia and Pleurisy with MCC (2 of 5 codes)
- DRG 194 Simple Pneumonia and Pleurisy with CC (2 of 5 codes)
- DRG 195 Simple Pneumonia and Pleurisy without CC/MCC (2 of 5 codes)
- DRG 205 Other Respiratory System Diagnoses with MCC (1 of 5 codes)
- DRG 206 Other Respiratory System Diagnoses without MCC (1 of 5 codes)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Pleural Disorders
Your pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Between the layers of the pleura is a very thin space. Normally it's filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as your lungs breathe air in and out.
Read more about pleural disorders on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.