2025 ICD-10-CM code J12.81
(Active) Effective Date: N/A Revision Date: N/A Respiratory Diseases - Influenza and pneumonia Chapter 10: Diseases of the respiratory system Feed
Pneumonia due to SARS-associated coronavirus.
Medical necessity is established by the presence of pneumonia symptoms (fever, cough, shortness of breath, etc.) confirmed through imaging and laboratory tests that identify SARS-associated coronavirus as the cause. Treatment is medically necessary to prevent complications and improve the patient's respiratory function.
Diagnosis and treatment of pneumonia, including assessment of respiratory status, administration of oxygen therapy, antibiotic treatment, and monitoring of clinical progress. Specialist consultation may be required in severe cases.
In simple words: This code is for pneumonia caused by the SARS virus, a type of coronavirus.It's used when a doctor confirms this type of pneumonia through tests.
This ICD-10-CM code classifies pneumonia caused by the SARS-associated coronavirus.It is used to indicate a specific etiology of pneumonia, distinguishing it from other types of pneumonia.The code should be used when the diagnosis of SARS-associated coronavirus pneumonia has been confirmed through laboratory testing or other definitive means.Additional codes may be necessary to specify any complications or comorbidities present.
Example 1: A 60-year-old patient presents with fever, cough, and shortness of breath.Chest X-ray reveals pneumonia.Laboratory testing confirms SARS-associated coronavirus as the causative agent. Code J12.81 is assigned., A 75-year-old patient with a history of chronic obstructive pulmonary disease (COPD) is hospitalized with worsening respiratory distress.Testing confirms pneumonia caused by SARS-associated coronavirus. Code J12.81 is assigned, along with codes reflecting the patient's COPD and any complications., A 35-year-old patient presents to the emergency department with acute onset of pneumonia.Initial laboratory testing is inconclusive.Further testing after a few days confirms SARS-associated coronavirus pneumonia. The code J12.81 is applied.
Complete history and physical examination documenting symptoms (fever, cough, shortness of breath, etc.).Chest X-ray or CT scan showing pneumonia.Laboratory confirmation of SARS-associated coronavirus infection.Documentation of treatment and response to treatment.
** This code is specific to pneumonia caused by SARS-associated coronavirus.It's crucial to differentiate it from other viral pneumonias and other causes of respiratory illness.Always ensure accurate documentation to support the coding choice.
- Payment Status: Active
- Specialties:Pulmonology, Infectious Disease
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital