Pleural Effusion ICD-10-CM codes

J90 is pleural effusion not elsewhere classified and is the default for an effusion with no stated cause, including parapneumonic effusion. Pleurisy without effusion is R09.1. Malignant pleural effusion is J91.0 with the neoplasm coded first, and J91.8 is used for effusion due to another underlying condition such as influenza, with that condition sequenced first.

Pleural effusion in heart failure is usually integral to the heart failure and is not coded separately. J91 carries an Excludes2 note for effusion in heart failure, so when the provider documents the effusion as a distinct problem that is evaluated or treated, such as with a thoracentesis, J91.8 may be added after the I50.- code.

Other pleural fluid collections have specific codes: chylous effusion J94.0, nontraumatic hemothorax J94.2, and empyema (pyothorax) J86.9 or J86.0 with fistula. A traumatic hemothorax is coded from S27.1- in chapter 19. Pleural effusion associated with tuberculosis is classified to A15.6, not J90.