2024 ICD-10-CM Diagnosis Code J86.0

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Acquired bronchoesophageal fistula
• Acquired fistula of esophagus
• Acquired fistula of esophagus
• Acquired tracheal fistula
• Acquired tracheocutaneous fistula
• Acquired tracheo-esophageal fistula
• Bronchial fistula
• Bronchocutaneous fistula
• Broncho-esophageal fistula
• Bronchopleural fistula
• Bronchopleural fistula
• Bronchopleural subphrenic fistula
• Congenital esophageal fistula
• Congenital esophagotracheal fistula
• Congenital tracheal fistula
• Empyema with bronchocutaneous fistula
• Empyema with bronchopleural fistula
• Empyema with fistula
• Empyema with hepatopleural fistula
• Empyema with mediastinal fistula
• Pleuroperitoneal fistula
• Tracheal esophageal fistula cough
• Tracheoesophageal fistula
• Tracheo-esophageal fistula without atresia of esophagus
• Traumatic bronchopleural fistula

Clinical Information

• Bronchial Fistula

  an abnormal passage or communication between a bronchus and another part of the body.

• Tracheoesophageal Fistula

  abnormal passage between the esophagus and the trachea, acquired or congenital, often associated with esophageal atresia.

• Empyema with Fistula

  an empyema with a fistula.

J86.0 is grouped with Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
177	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC	04	1.6964
178	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC	04	0.9867
179	RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC	04	0.7633

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert J86.0 to ICD-9-CM

• ICD-9-CM Code: 510.0 - Empyema with fistula
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.
• ICD-9-CM Code: 530.84 - Tracheoesophageal fstula
  Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Bacteria, viruses, parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are red, raised and painful. Abscesses inside your body may not be obvious and can damage organs, including the brain, lungs and others. Treatments include drainage and antibiotics.

[Learn More in MedlinePlus]

Chest Injuries and Disorders

What is the chest?

The chest is the part of your body between your neck and your abdomen (belly). The medical term for your chest is thorax.

Your chest holds many important structures for breathing, digestion, blood circulation, and other important body functions. These structures include your:

• Ribs and breastbone
• Esophagus, the tube between your mouth and stomach
• Trachea, your windpipe
• Bronchi, the tubes that carry air from your windpipe to your lungs
• Lungs
• Pleura, a thin layer of tissue that covers the lungs and lines the inside wall of the chest space
• Heart and large blood vessels
• Thymus, a gland that's part of your immune system
• Nerves

What are chest injuries and disorders?

Chest injuries and disorders are problems that affect any of the organs or structures located in your chest.

There are many types of chest injuries and disorders, for example:

• Broken ribs
• Esophagus disorders
• Swallowing disorders, also called dysphagia
• Tracheal disorders
• Bronchial disorders
• Lung diseases and collapsed lung
• Pleural disorders
• Heart diseases
• Mediastinal diseases, which are tumors, inflammation, and other problems with the structures in the mediastinum, which is the space between your lungs, breastbone, and spine
• Thoracic aortic aneurysm
• Thoracic outlet syndrome

Chest injuries may happen from the force of car accidents, falls, or sports injuries. Or the chest may be pierced by a bullet or sharp object. Because your chest holds so many important structures, certain chest injuries may be life-threatening.

How are chest injuries and disorders diagnosed?

Diagnosis of chest injuries or disorders depends on the type of symptoms you're having and whether you've had a chest injury. Injuries are usually obvious, but in most cases, you'll need tests to know how serious an injury is.

There are many types of tests for diagnosing different types of chest injuries and disorders, for example:

• Diagnostic imaging tests
• Heart tests
• Lung function tests
• Bronchoscopy
• Pleural fluid analysis
• Dysphagia tests
• Biopsy

Treatments will depend on the type of chest injury or disorder you have.

[Learn More in MedlinePlus]

Fistulas

A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between the esophagus and the windpipe or the bowel and the vagina. They can also develop between two blood vessels, such as between an artery and a vein or between two arteries.

Some people are born with a fistula. Other common causes of fistulas include:

• Complications from surgery
• Injury
• Infection
• Diseases, such as Crohn's disease or ulcerative colitis

Treatment depends on the cause of the fistula, where it is, and how bad it is. Some fistulas will close on their own. In some cases, you may need antibiotics and/or surgery.

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.