2025 ICD-10-CM code J09.X1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Infectious Disease - Influenza and pneumonia Chapter 10: Diseases of the respiratory system Feed
Influenza due to identified novel influenza A virus with pneumonia.
Medical necessity is established by the presence of symptoms and signs consistent with influenza and pneumonia, confirmed by appropriate laboratory testing and imaging.
Diagnosis and treatment of influenza and pneumonia.This often involves taking a patient history, performing a physical exam, ordering laboratory tests (viral testing, chest x-ray, blood tests), and prescribing appropriate antiviral medications and supportive care.
In simple words: This code is for flu caused by a new type of influenza A virus that also includes pneumonia.The doctor needs lab tests to confirm the type of virus.
This ICD-10-CM code classifies influenza caused by a specifically identified novel influenza A virus, accompanied by pneumonia.It's crucial to confirm the novel influenza A virus type through laboratory testing. If influenza is confirmed but the specific virus is not identified, a different code should be used (J11.-).The presence of pneumonia is a significant comorbidity requiring its inclusion in the coding.Associated lung abscess (J85.1) should also be coded separately, if present.
Example 1: A 65-year-old patient presents with fever, cough, shortness of breath, and chest pain.Laboratory testing confirms a novel influenza A virus (H7N9) and chest x-ray reveals pneumonia.The code J09.X1 is used, along with J85.1 if lung abscess is present., A 25-year-old patient returns from travel in Southeast Asia with symptoms consistent with influenza.Testing confirms a novel influenza A virus (H5N1) and pneumonia is diagnosed. The code J09.X1 is applied., A 40-year-old patient with a history of chronic lung disease is hospitalized with severe respiratory symptoms.Laboratory results confirm a new strain of influenza A virus and pneumonia.J09.X1 is used along with codes for the patient’s underlying lung condition.
Complete patient history, physical examination findings, laboratory results confirming the novel influenza A virus type, chest imaging (e.g., chest x-ray or CT scan) showing evidence of pneumonia, details of treatment provided.
** This code is for use when a specific novel influenza A virus is identified.It requires accurate laboratory confirmation of both the influenza virus and pneumonia. The information provided here is for general guidance only and should not be considered exhaustive. Always refer to the latest version of the ICD-10-CM coding manual for the most accurate and up-to-date coding information.
- Payment Status: Active
- Specialties:Infectious Disease, Pulmonology, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital