2025 ICD-10-CM code J15
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Infectious Disease - Bacterial pneumonia Chapter 10: Diseases of the respiratory system Feed
Bacterial pneumonia, not elsewhere classified.This code is used when a bacterial pneumonia is present but the specific type of bacteria is unknown.
Modifiers may be applicable depending on the circumstances of service (e.g., place of service, type of service). Consult the official coding guidelines for specific modifier usage.
Medical necessity for J15 is established by clinical findings consistent with bacterial pneumonia, including symptoms (e.g., cough, fever, shortness of breath, chest pain), physical exam findings, and imaging findings (e.g., chest X-ray showing infiltrates or consolidation).
Diagnosis and management of bacterial pneumonia, including ordering and interpreting diagnostic tests (e.g., chest x-ray, blood cultures, sputum cultures), prescribing appropriate antibiotics, monitoring patient response to treatment, and managing complications.
In simple words: This code means you have a lung infection (pneumonia) caused by bacteria.The doctor doesn't know the exact type of bacteria causing the infection.
J15, Bacterial pneumonia, not elsewhere classified, is an ICD-10-CM code used to classify cases of pneumonia caused by bacteria when the specific type of bacteria cannot be identified. This code encompasses various bacterial pneumonias not explicitly specified by other ICD-10-CM codes.It includes bronchopneumonia due to bacteria other than Streptococcus pneumoniae and Haemophilus influenzae.If an abscess is present, code J85.1 should be used in addition to J15.If influenza is present, code that condition first using codes J09.X1, J10.0-, or J11.0-, then code J15.The code excludes specific types of pneumonia such as chlamydial pneumonia (J16.0), congenital pneumonia (P23.-), Legionnaires' disease (A48.1), spirochetal pneumonia (A69.8), and others.
Example 1: A 65-year-old male presents with cough, fever, shortness of breath, and chest pain. Chest X-ray reveals consolidation consistent with pneumonia. Sputum culture is pending. J15 is coded pending culture results., A 30-year-old female with a history of cystic fibrosis is admitted with worsening cough and increased sputum production.Chest X-ray shows bilateral infiltrates.Sputum culture reveals multiple bacterial pathogens. J15 is used along with additional codes to specify the causative organisms., A 78-year-old with a history of COPD is admitted with shortness of breath. Chest X-ray shows a right lower lobe infiltrate. Gram stain is positive for bacteria but definitive identification pending. J15 is used as the primary code.
Complete history and physical examination, chest x-ray report, laboratory findings (e.g., complete blood count, blood cultures, sputum cultures, arterial blood gas), and treatment plan (including antibiotics administered).
** This code should only be used when the specific type of bacteria causing pneumonia cannot be identified.Further investigation may be required to identify the specific organism for more precise coding.
- Payment Status: Active
- Modifier TC rule: Not applicable
- Specialties:Pulmonology, Internal Medicine, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital, Office