2022 ICD-10-CM Code J12

Viral pneumonia, not elsewhere classified

Version 2021

Not Valid for Submission

ICD-10:J12
Short Description:Viral pneumonia, not elsewhere classified
Long Description:Viral pneumonia, not elsewhere classified

Code Classification

  • Diseases of the respiratory system (J00–J99)
    • Influenza and pneumonia (J09-J18)
      • Viral pneumonia, not elsewhere classified (J12)

J12 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of viral pneumonia, not elsewhere classified. 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 Viral pneumonia, not elsewhere classified

Non-specific codes like J12 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 viral pneumonia, not elsewhere classified:

  • BILLABLE CODE - Use J12.0 for Adenoviral pneumonia
  • BILLABLE CODE - Use J12.1 for Respiratory syncytial virus pneumonia
  • BILLABLE CODE - Use J12.2 for Parainfluenza virus pneumonia
  • BILLABLE CODE - Use J12.3 for Human metapneumovirus pneumonia
  • NON-BILLABLE CODE - J12.8 for Other viral pneumonia
  • BILLABLE CODE - Use J12.81 for Pneumonia due to SARS-associated coronavirus
  • BILLABLE CODE - Use J12.82 for Pneumonia due to coronavirus disease 2019
  • BILLABLE CODE - Use J12.89 for Other viral pneumonia
  • BILLABLE CODE - Use J12.9 for Viral pneumonia, unspecified

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 J12:


Includes

Includes
This note appears immediately under a three character code title to further define, or give examples of, the content of the category.

Code First

Code First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.

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.

Type 1 Excludes

Type 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.

Information for Patients


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


[Learn More in MedlinePlus]

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)