2022 ICD-10-CM Code J11.0

Influenza due to unidentified influenza virus with pneumonia

Version 2021

Not Valid for Submission

ICD-10:J11.0
Short Description:Influenza due to unidentified influenza virus with pneumonia
Long Description:Influenza due to unidentified influenza virus with pneumonia

Code Classification

  • Diseases of the respiratory system (J00–J99)
    • Influenza and pneumonia (J09-J18)
      • Influenza due to unidentified influenza virus (J11)

J11.0 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of influenza due to unidentified influenza virus with pneumonia. The code is not specific and is NOT valid for the year 2022 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding for Influenza due to unidentified influenza virus with pneumonia

Non-specific codes like J11.0 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for influenza due to unidentified influenza virus with pneumonia:

  • BILLABLE CODE - Use J11.00 for Influenza due to unidentified influenza virus with unspecified type of pneumonia
  • BILLABLE CODE - Use J11.08 for Influenza due to unidentified influenza virus with specified pneumonia

Tabular List of Diseases and Injuries

The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code J11.0:


Code Also

Code Also
A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.

Information for Patients


Flu

What is the flu?

The flu, also called influenza, is a respiratory infection caused by viruses. Each year, millions of Americans get sick with the flu. Sometimes it causes mild illness. But it can also be serious or even deadly, especially for people over 65, newborn babies, and people with certain chronic illnesses.

What causes the flu?

The flu is caused by flu viruses that spread from person to person. When someone with the flu coughs, sneezes, or talks, they spray tiny droplets. These droplets can land in the mouths or noses of people who are nearby. Less often, a person may get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose, or possibly their eyes.

What are the symptoms of the flu?

Symptoms of the flu come on suddenly and may include

Some people may also have vomiting and diarrhea. This is more common in children.

Sometimes people have trouble figuring out whether they have a cold or the flu. There are differences between them. The symptoms of a cold usually come on more slowly and are less severe than symptoms of the flu. Colds rarely cause a fever or headaches.

Sometimes people say that they have a "flu" when they really have something else. For example, "stomach flu" isn't the flu; it's gastroenteritis.

What other problems can the flu cause?

Some people who get the flu will develop complications. Some of these complications can be serious or even life-threatening. They include

The flu also can make chronic health problems worse. For example, people with asthma may have asthma attacks while they have flu.

Certain people are more likely to have complications from the flu, including

How is the flu diagnosed?

To diagnose the flu, health care providers will first do a medical history and ask about your symptoms. There are several tests for the flu. For the tests, your provider will swipe the inside of your nose or the back of your throat with a swab. Then the swab will be tested for the flu virus.

Some tests are quick and give results in 15-20 minutes. But these tests are not as accurate as other flu tests. These other tests can give you the results in one hour or several hours.

What are the treatments for the flu?

Most people with the flu recover on their own without medical care. People with mild cases of the flu should stay home and avoid contact with others, except to get medical care.

But if you have symptoms of flu and are in a high risk group or are very sick or worried about your illness, contact your health care provider. You might need antiviral medicines to treat your flu. Antiviral medicines can make the illness milder and shorten the time you are sick. They also can prevent serious flu complications. They usually work best when you start taking them within 2 days of getting sick.

Can the flu be prevented?

The best way to prevent the flu is to get flu vaccine every year. But it's also important to have good health habits like covering your cough and washing your hands often. This can help stop the spread of germs and prevent the flu.

Centers for Disease Control and Prevention


[Learn More in MedlinePlus]

Pneumonia

What is 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.

What causes pneumonia?

Bacterial, viral, and fungal infections can cause pneumonia.

Bacteria are the most common cause. Bacterial pneumonia can occur on its own. It can also develop after you've had certain viral infections such as a cold or the flu. Several different types of bacteria can cause pneumonia, including

Viruses that infect the respiratory tract may cause pneumonia. Viral pneumonia is often mild and goes away on its own within a few weeks. But sometimes it is serious enough that you need to get treatment in a hospital. If you have viral pneumonia, you are at risk of also getting bacterial pneumonia. The different viruses that can cause pneumonia include

Fungal pneumonia is more common in people who have chronic health problems or weakened immune systems. Some of the types include

Who is at risk for pneumonia?

Anyone can get pneumonia, but certain factors can increase your risk:

What are the symptoms of pneumonia?

The symptoms of pneumonia can range from mild to severe and include

The symptoms can vary for different groups. Newborns and infants may not show any signs of the infection. Others may vomit and have a fever and cough. They might seem sick, with no energy, or be restless.

Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness.

What other problems can pneumonia cause?

Sometimes pneumonia can cause serious complications such as

How is pneumonia diagnosed?

Sometimes pneumonia can be hard to diagnose. This is because it can cause some of the same symptoms as a cold or the flu. It may take time for you to realize that you have a more serious condition.

Your health care provider may use many tools to make a diagnosis:

If you are in the hospital, have serious symptoms, are older, or have other health problems, you may also have more tests, such as

What are the treatments for pneumonia?

Treatment for pneumonia depends on the type of pneumonia, which germ is causing it, and how severe it is:

You may need to be treated in a hospital if your symptoms are severe or if you are at risk for complications. While there, you may get additional treatments. For example, if your blood oxygen level is low, you may receive oxygen therapy.

It may take time to recover from pneumonia. Some people feel better within a week. For other people, it can take a month or more.

Can pneumonia be prevented?

Vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus. Having good hygiene, not smoking, and having a healthy lifestyle may also help prevent pneumonia.

NIH: National Heart, Lung, and Blood Institute


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Code History

  • 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 (First year ICD-10-CM implemented into the HIPAA code set)