2022 ICD-10-CM Code J93.12
Secondary spontaneous pneumothorax
Code Classification
J93.12 is a billable diagnosis code used to specify a medical diagnosis of secondary spontaneous pneumothorax. The code J93.12 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code J93.12 might also be used to specify conditions or terms like secondary spontaneous pneumothorax or spontaneous pneumothorax.
The code J93.12 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
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 J93.12:
Code First
Code FirstCertain 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.
- underlying condition, such as:
- catamenial pneumothorax due to endometriosis N80.8
- cystic fibrosis E84
- eosinophilic pneumonia J82
- lymphangioleiomyomatosis J84.81
- malignant neoplasm of bronchus and lung C34
- Marfan's syndrome Q87.4
- pneumonia due to Pneumocystis carinii B59
- secondary malignant neoplasm of lung C78.0
- spontaneous rupture of the esophagus K22.3
Entries in the Index to Diseases and Injuries with references to J93.12
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code J93.12 are found in the index:
- - Pneumothorax NOS - J93.9
- - spontaneous NOS - J93.83
- - secondary - J93.12
- - spontaneous NOS - J93.83
Code Edits
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Approximate Synonyms
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Secondary spontaneous pneumothorax
- Spontaneous pneumothorax
Diagnostic Related Groups - MS-DRG Mapping
The ICD-10 code J93.12 is grouped in the following groups for version MS-DRG V39.0 What are Diagnostic Related Groups?
The Diagnostic Related Groups (DRGs) are a patient classification scheme which provides a means of relating the type of patients a hospital treats. The DRGs divides all possible principal diagnoses into mutually exclusive principal diagnosis areas referred to as Major Diagnostic Categories (MDC). applicable from 10/01/2021 through 09/30/2022.
| MS-DRG | MS-DRG Title | MCD | Relative Weight |
|---|---|---|---|
| 199 | PNEUMOTHORAX WITH MCC | 04 | 1.7876 |
| 200 | PNEUMOTHORAX WITH CC | 04 | 1.075 |
| 201 | PNEUMOTHORAX WITHOUT CC/MCC | 04 | 0.7095 |
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 J93.12 to ICD-9 Code
- 512.82 - Sec spont pneumothorax
Information for Patients
Pleural Disorders
Your pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Between the layers of the pleura is a very thin space. Normally it's filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as your lungs breathe air in and out.
Disorders of the pleura include
- Pleurisy - inflammation of the pleura that causes sharp pain with breathing
- Pleural effusion - excess fluid in the pleural space
- Pneumothorax - buildup of air or gas in the pleural space
- Hemothorax - buildup of blood in the pleural space
Many different conditions can cause pleural problems. Viral infection is the most common cause of pleurisy. The most common cause of pleural effusion is congestive heart failure. Lung diseases, like COPD, tuberculosis, and acute lung injury, cause pneumothorax. Injury to the chest is the most common cause of hemothorax. Treatment focuses on removing fluid, air, or blood from the pleural space, relieving symptoms, and treating the underlying condition.
NIH: National Heart, Lung, and Blood Institute
[Learn More in MedlinePlus]
Related Codes
| ICD Code | Description | Valid for Submission |
|---|---|---|
| J93 | Pneumothorax and air leak | NON-BILLABLE CODE |
| J93.0 | Spontaneous tension pneumothorax | BILLABLE CODE |
| J93.1 | Other spontaneous pneumothorax | NON-BILLABLE CODE |
| J93.11 | Primary spontaneous pneumothorax | BILLABLE CODE |
| J93.8 | Other pneumothorax and air leak | NON-BILLABLE CODE |
| J93.81 | Chronic pneumothorax | BILLABLE CODE |
| J93.82 | Other air leak | BILLABLE CODE |
| J93.83 | Other pneumothorax | BILLABLE CODE |
| J93.9 | Pneumothorax, unspecified | BILLABLE CODE |
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)
