2027 ICD-10-CM Diagnosis Code J12.81Pneumonia due to SARS-associated coronavirus
ICD-10-CM Codes›J00–J99›J09-J18›J12
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Not Chronic
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 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 193 through 195, 974 through 976. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 130 closely related codes. 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
Code Classification
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
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to J12.81: its own notes plus those printed at J12, block J09-J18, and Chapter 10. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- bronchopneumonia due to viruses other than influenza viruses
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Severe acute respiratory syndrome NOS
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
- aspiration pneumonia due to anesthesia during pregnancy (O29)
- aspiration pneumonia due to anesthesia during puerperium (O89.0)
- aspiration pneumonia due to solids and liquids (J69.-)
- aspiration pneumonia NOS (J69.0)
- congenital pneumonia (P23.0)
- congenital rubella pneumonitis (P35.0)
- interstitial pneumonia NOS (J84.9)
- lipid pneumonia (J69.1)
- neonatal aspiration pneumonia (P24.-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- smoke inhalation (T59.81-)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code First
The underlying condition named in the note is sequenced before this code.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name J12.81, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming J12.81: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming J12.81: its condition is not part of those codes, and both may be reported when the patient has both.
- U07.1 COVID-19pneumonia due to SARS-associated coronavirus (J12.81)
Use Additional Code 1
These codes say to use an additional code from the note, and J12.81 is one of the codes named.
- J95.89 Other postprocedural complications and disorders of respiratory system, not elsewhere classified
Code Also 2
These codes say J12.81 may also be needed to fully describe the condition. The note gives no sequencing direction.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Syndrome See Also: Disease;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Pneumonia, Viral
inflammation of the lung parenchyma that is caused by a viral infection.
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.
Code HistoryHistory
Questions About J12.81Overview
What is the ICD-10 code for pneumonia due to SARS-associated coronavirus?
The ICD-10-CM code for pneumonia due to SARS-associated coronavirus is J12.81 (sometimes written as J1281). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
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, 2026 through September 30, 2027.
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 195, 193, 194, 974, 976, 975, with relative weights from 0.6062 to 3.0488 depending on complications. Higher weights mean higher Medicare reimbursement.
Is J12.81 a CC or MCC?
CMS lists J12.81 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 130 closely related codes in its exclusion list.
