2025 ICD-10-CM code J15.211
(Active) Effective Date: N/A Diseases of the respiratory system - Bacterial pneumonia 10 Feed
Pneumonia due to Methicillin susceptible Staphylococcus aureus (MSSA).
Medical necessity is established by the signs, symptoms, and radiographic findings of pneumonia, confirmed by laboratory testing.Treatment is medically necessary to resolve the infection and prevent complications.
The physician is responsible for diagnosing the pneumonia, determining the causative organism through appropriate testing (e.g., sputum culture), and prescribing appropriate antibiotic therapy. They should also monitor the patient's response to treatment and manage any complications.
In simple words: This code indicates pneumonia caused by a staph bacteria that can be treated with common antibiotics like methicillin.
This code describes pneumonia caused by a strain of Staphylococcus aureus bacteria that is susceptible to the antibiotic methicillin.It is distinct from pneumonia caused by methicillin-resistant S. aureus (MRSA).
Example 1: A 65-year-old patient presents with fever, cough, and shortness of breath. A chest X-ray reveals infiltrates consistent with pneumonia. Sputum cultures grow Methicillin-susceptible Staphylococcus aureus. J15.211 is used to code the diagnosis., A 30-year-old patient with a recent history of influenza develops worsening cough and fever.Sputum culture confirms MSSA pneumonia. J15.211, along with a code for the influenza, is used., A patient admitted for a surgical procedure develops post-operative pneumonia. Cultures identify MSSA. J15.211 along with a code for the post-operative pneumonia is used.
Documentation should include signs and symptoms, chest X-ray findings, and laboratory results confirming MSSA as the causative organism.Any underlying conditions or recent infections (like influenza) should also be documented. If applicable, documentation of antibiotic susceptibility testing should be included.
- Payment Status: Active
- Specialties:Pulmonology, Internal Medicine, Infectious Disease, Family Medicine
- Place of Service:Inpatient Hospital, Office, Home, Skilled Nursing Facility