Version 2024

No Valid Principal Dx

2024 ICD-10-CM Diagnosis Code R09.1

Pleurisy

ICD-10-CM:: R09.1
Short Description:: Pleurisy
Is Billable?: Yes - Valid for Submission
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Code Classification

Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
(R00–R99)
- Symptoms and signs involving the circulatory and respiratory systems
  (R00-R09)
  - Oth symptoms and signs involving the circ and resp sys
    (R09)

R09.1 is a billable diagnosis code used to specify a medical diagnosis of pleurisy. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.

1. Approximate Synonyms
2. Clinical Information
3. Tabular List of Diseases and Injuries
4. Index to Diseases and Injuries References
5. Diagnostic Related Groups - MS-DRG Mapping
6. Convert to ICD-9 Code
7. Patient Education
8. Other Codes Used Similar Conditions
9. Code History

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

Acute dry pleurisy
Asbestos pleurisy
Bacterial pleurisy
Basal pleurisy
Chronic dry pleurisy
Diaphragmatic pleurisy
Drug-induced pleurisy
Dry pleurisy
Fibrinous pleurisy
Infective pleurisy
Interlobar pleurisy
Obliterative pleuritis
Pleural aspergillosis
Pleurisy
Pleurisy without effusion or active tuberculosis
Serositis
Serositis
Sterile pleurisy
Viral pleurisy

Clinical Information

Pleurisy-. inflammation of pleura, the lining of the lung. when parietal pleura is involved, there is pleuritic chest pain.
Tuberculosis, Pleural-. tuberculosis of the serous membrane lining the thoracic cavity and surrounding the lungs.
Serositis-. inflammation of a serous membrane.

Tabular List of Diseases and Injuries

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

Type 1 Excludes

pleurisy with effusion J90

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Pleurisy (acute) (adhesive) (chronic) (costal) (diaphragmatic) (double) (dry) (fibrinous) (fibrous) (interlobar) (latent) (plastic) (primary) (residual) (sicca) (sterile) (subacute) (unresolved) - R09.1

Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
193	SIMPLE PNEUMONIA AND PLEURISY WITH MCC	04	1.3266
194	SIMPLE PNEUMONIA AND PLEURISY WITH CC	04	0.8222
195	SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC	04	0.6256

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 to ICD-9-CM Code

Source ICD-10-CM Code		Target ICD-9-CM Code
R09.1		511.0 - Pleurisy w/o effus or TB
Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.

Patient Education

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]

Code History

FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
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. This was the first year ICD-10-CM was implemented into the HIPAA code set.