2026 ICD-10-CM Diagnosis Code J12.81Pneumonia due to SARS-associated coronavirus

ICD-10-CM Codes›J00–J99›J09-J18›J12

ICD-10-CM J12.81
CMSSource: CMS FY 2026 ICD-10-CM dataset · Effective Oct 1, 2025 – Sep 30, 2026

J12.81 is a billable ICD-10-CM diagnosis code for pneumonia due to SARS-associated coronavirus. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 193 through 195, 974 through 976. Coders also document this condition as disorder confirmed. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pneumonia (except that caused by tuberculosis) and Viral infection.

Code Identity

ICD-10-CM Code
J12.81
Billable Status
Yes — Valid for Submission
Code Describes
Pneumonia due to SARS-associated coronavirus
Short Description
Pneumonia due to SARS-associated coronavirus
Same as the full description in the CMS dataset.
Parent Code
J12.8
Other viral pneumonia

Code Classification

ChapterJ00–J99Diseases of the respiratory system
SectionJ09-J18Influenza and pneumonia
CategoryJ12Viral pneumonia, not elsewhere classified
This CodeJ12.81Pneumonia due to SARS-associated coronavirus

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Disorder confirmed
  • Healthcare associated severe acute respiratory syndrome
  • Pneumonia caused by Human coronavirus
  • Pneumonia caused by Severe acute respiratory syndrome coronavirus
  • SARS confirmed
  • Severe acute respiratory syndrome
  • Severe acute respiratory syndrome of upper respiratory tract

Tabular List NotesGuidance

Coding notes and annotation back-references applicable to this code.

Inclusion Terms

  • Severe acute respiratory syndrome NOS

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

External Cause of Injuries IndexGuidance

References for this code in the External Cause of Injuries Index.

    • Pneumonia(acute) (double) (migratory) (purulent) (septic) (unresolved)
      • SARS-associated coronavirus
    • Pneumonia(acute) (double) (migratory) (purulent) (septic) (unresolved)
      • viral, virus (broncho) (interstitial) (lobar)
        • SARS-associated coronavirus
    • Syndrome
      • severe acute respiratory (SARS)

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR RSP002
Pneumonia (except that caused by tuberculosis)
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INF008
Viral infection
Default principal diagnosis: inpatient No · outpatient No

Clinical InformationClinical

  • COVID-19

    a viral disorder generally characterized by high fever; cough; dyspnea; chills; persistent tremor; muscle pain; headache; sore throat; a new loss of taste and/or smell (see ageusia and anosmia) and other symptoms of a viral pneumonia. a coronavirus, sars-cov-2 virus, in the genus betacoronavirus is the causative agent.

  • COVID-19 Testing

    diagnosis of covid-19 by assaying bodily fluids or tissues for the presence of covid-19 antibodies, sars-cov-2 antigens or the viral rna of sars-cov-2.

  • SARS-CoV-2

    a species of betacoronavirus causing atypical respiratory disease (covid-19) in humans. the organism was first identified in 2019 in wuhan, china. the natural host is the chinese intermediate horseshoe bat, rhinolophus affinis.

  • Severe Acute Respiratory Syndrome

    a viral disorder characterized by high fever, dry cough, shortness of breath (dyspnea) or breathing difficulties, and atypical pneumonia. a virus in the genus coronavirus is the suspected agent.

  • Severe acute respiratory syndrome-related coronavirus

    a species of coronavirus causing atypical respiratory disease (severe acute respiratory syndrome) in humans. the organism is believed to have first emerged in guangdong province, china, in 2002. the natural host is the chinese horseshoe bat, rhinolophus sinicus.

Patient EducationClinical

Pneumonia

Pneumonia is an infection in one or both of your lungs. It causes the air sacs of your lungs to fill up with fluid or pus. Pneumonia can range from mild to severe, depending on what caused it, your age, and your overall health.

The full article covers:

  • What is pneumonia?
  • What causes pneumonia?
  • Who is more likely to develop pneumonia?
  • What are the symptoms of pneumonia?
  • What other problems can pneumonia cause?
  • How is pneumonia diagnosed?
  • What are the treatments for pneumonia?
  • Can pneumonia be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert J12.81 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
480.3 Pneumonia due to SARS
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2025No changes
FY 2026CurrentCurrent code set, no changesEffective October 1, 2025 through September 30, 2026.

Questions About J12.81Overview

Is J12.81 (Other viral pneumonia) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report pneumonia due to SARS-associated coronavirus on HIPAA-covered claims from October 1, 2025 through September 30, 2026.

What MS-DRG does J12.81 group to?

When pneumonia due to SARS-associated coronavirus is the principal diagnosis on an inpatient stay, it groups to MS-DRG 193, 194, 195, 974, 975, 976, with relative weights from 0.6285 to 2.8860 depending on complications. Higher weights mean higher Medicare reimbursement.

What is the ICD-9 equivalent of J12.81?

Under the General Equivalence Mappings, pneumonia due to SARS-associated coronavirus converts to ICD-9-CM 480.3 (pneumonia due to SARS). The mapping is a direct match.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.