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2025 ICD-10-CM code J10.1

Influenza due to other identified influenza virus with other respiratory manifestations.

Do not use this code if the influenza is caused by avian influenza (J09.X-), swine flu (J09.X-), or an unidentified influenza virus (J11.-). Use additional codes for any associated complications, such as pneumonia (J10.0) or other manifestations.

Medical necessity for this code is established by the confirmation of influenza through diagnostic testing and the presence of respiratory symptoms. The documentation should clearly link the respiratory manifestations to the influenza infection.

Physicians use this code when a patient presents with influenza caused by an identified seasonal influenza virus, and exhibits respiratory manifestations other than pneumonia.Documentation of the patient's signs and symptoms is crucial. It is the physician’s responsibility to ensure accurate and specific coding to reflect the patient’s condition.

IMPORTANT:Use additional codes for associated pleural effusion (J91.8) or sinusitis (J01.-), if applicable.

In simple words: This code indicates the flu caused by a known type of influenza virus with respiratory symptoms like a sore throat, cough and stuffy nose, but not pneumonia.

This code encompasses influenza caused by a known seasonal influenza virus (not avian, swine, or novel) presenting with respiratory symptoms besides pneumonia. This includes symptoms such as laryngitis, pharyngitis, or upper respiratory symptoms.

Example 1: A patient tests positive for influenza B and presents with a cough, sore throat (pharyngitis), and runny nose., A patient with a confirmed influenza A infection complains of laryngitis and nasal congestion, but their lungs are clear., A child tests positive for a seasonal influenza virus and has a persistent cough and sneezing, but no other symptoms.

Documentation should include the type of influenza virus identified, as well as the specific respiratory manifestations present.Symptoms like cough, sore throat, runny nose, nasal congestion, and laryngitis should be clearly noted. If other symptoms or complications are present (e.g., pleural effusion, sinusitis), these should also be documented and coded.

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