2025 ICD-10-CM code J12.82
(Active) Effective Date: N/A Diseases of the respiratory system - Influenza and pneumonia (J09-J18) J00-J99 Feed
Pneumonia due to coronavirus disease 2019 (COVID-19).
Modifiers are generally not applicable to ICD-10-CM codes.
Medical necessity for J12.82 is established by the confirmed presence of both COVID-19 and pneumonia. The documentation must support the diagnosis of pneumonia as a direct consequence of the COVID-19 infection.
Physicians use this code to specify the cause of pneumonia when it is due to COVID-19. Accurate coding is essential for tracking the disease's impact and ensuring proper treatment.
In simple words: This code indicates pneumonia caused by COVID-19. It's used when someone with COVID-19 develops lung inflammation.
This code specifies pneumonia caused by the SARS-CoV-2 virus, the virus responsible for COVID-19.It should be used following a confirmed diagnosis of COVID-19 (U07.1) if the patient develops pneumonia.
Example 1: A patient diagnosed with COVID-19 (U07.1) develops symptoms such as cough, shortness of breath, and fever. A chest x-ray reveals lung infiltrates, confirming pneumonia.J12.82 is added as a secondary diagnosis., A patient admitted for COVID-19 (U07.1) subsequently develops difficulty breathing. Diagnostic tests confirm pneumonia related to the virus. J12.82 is coded after the primary diagnosis of U07.1., A patient with a history of COVID-19 presents with persistent respiratory issues. After examination and imaging, the physician determines that the patient has pneumonia as a consequence of the past COVID-19 infection. U07.1 and J12.82 are coded.
Documentation should include a confirmed diagnosis of COVID-19 (through a positive lab test or clinical criteria) and evidence of pneumonia (such as abnormal chest imaging, auscultatory findings, or other clinical indicators).
** It is crucial to stay updated on coding guidelines related to COVID-19 as they can evolve.Always consult the latest ICD-10-CM code set and guidelines for accurate coding.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10-CM codes.
- Specialties:Infectious Disease, Pulmonology, Internal Medicine, Family Medicine, Hospitalists, Critical Care
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home