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2025 ICD-10-CM code J15.212

Pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA).

Follow current ICD-10-CM coding guidelines and conventions for assigning codes.

Modifiers may apply depending on the circumstances of the encounter and the services provided (e.g., place of service, type of service).

Medical necessity for J15.212 is established by the presence of pneumonia symptoms and laboratory confirmation of MRSA infection. Treatment is required to combat the infection and prevent severe complications, including sepsis and respiratory failure.

Diagnosis and treatment of pneumonia, including antibiotic selection based on the resistance profile of the causative organism (MRSA).

IMPORTANT:Related codes include J15.21 (Pneumonia due to Staphylococcus aureus) and other codes specifying other types of pneumonia based on the causative organism. If influenza is present, code J09-J11 should be used in conjunction with J15.212.

In simple words: This code is for a lung infection (pneumonia) caused by a type of bacteria called MRSA, which is resistant to some antibiotics. The infection causes inflammation in the lungs' air sacs, possibly filling them with fluid or pus, leading to coughing, fever, and breathing difficulties.

This code classifies pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA).It's a type of bacterial pneumonia affecting the lungs' air sacs, causing inflammation and potentially filling them with fluid or pus.This specific code indicates the causative organism is MRSA, a bacterium resistant to certain antibiotics like methicillin.Appropriate coding requires confirmation of MRSA through laboratory testing.

Example 1: A 65-year-old male patient presents with fever, cough, and shortness of breath.Chest X-ray reveals a right lower lobe infiltrate consistent with pneumonia.Sputum culture identifies MRSA as the causative agent. Code J15.212 is used for billing., A 30-year-old female patient with a history of cystic fibrosis is admitted with worsening respiratory symptoms.She is diagnosed with MRSA pneumonia following microbiological testing. J15.212 is applied, alongside codes for cystic fibrosis., A 78-year-old patient in a nursing home is found to have pneumonia. Culture reveals MRSA. The code J15.212 is used.Additional codes would be added to reflect the patient's underlying conditions and the site of service.

* Patient's history and physical examination findings.* Chest X-ray or CT scan findings.* Laboratory results confirming the presence of MRSA (e.g., positive sputum culture).* Documentation of treatment plan and response to treatment.

** Always refer to the most current ICD-10-CM coding manual for the most up-to-date guidelines, as codes and guidelines may be subject to change.Specific payer requirements may also influence coding practices.Consider using a professional medical coding resource for accurate coding practices.

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