Coding and coverage · ICD-10-CM

J18

J18.1 Lobar pneumonia, unspecified organism

BillableNo payment HCCChapter 10
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Instructional notes

Chapter 10

Excludes2Not included here: the patient may have both; report both when both are present.
  • 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)
Use additional codeAdd a second code for the full picture.
  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
Notes
  • 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).

Section J09-J18

Excludes2Not included here: the patient may have both; report both when both are present.
  • allergic or eosinophilic pneumonia (J82)
  • aspiration pneumonia NOS (J69.0)
  • meconium pneumonia (P24.01)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonia due to solids and liquids (J69.-)
  • congenital pneumonia (P23.9)
  • lipid pneumonia (J69.1)
  • rheumatic pneumonia (I00)
  • ventilator associated pneumonia (J95.851)
Use additional codeAdd a second code for the full picture.
  • code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)

J18

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • congenital pneumonia (P23.0)
  • drug-induced interstitial lung disorder (J70.2-J70.4)
  • interstitial pneumonia NOS (J84.9)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonitis due to fumes and vapors (J68.0)
  • usual interstitial pneumonia (J84.178)
Excludes2Not included here: the patient may have both; report both when both are present.
  • abscess of lung with pneumonia (J85.1)
  • 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)
  • lipid pneumonia (J69.1)
  • pneumonitis due to external agents (J67-J70)
Code firstSequence the underlying condition first.
Code also
  • , if applicable, any associated condition such as:
  • aspiration pneumonia (J69.-)

Chapter 10: Diseases of the respiratory system · J09-J18 Influenza and pneumonia (J09-J18)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.