2025 ICD-10-CM code J81
(Active) Effective Date: N/A Diseases of the respiratory system - Other respiratory diseases principally affecting the interstitium 10 Feed
Pulmonary edema.
Medical necessity for services related to pulmonary edema should be supported by documentation indicating the severity of the condition and the need for intervention to improve oxygenation and prevent respiratory failure.
Clinicians responsible for diagnosing and managing pulmonary edema include pulmonologists, critical care specialists, cardiologists, and hospitalists, depending on the underlying cause and severity.
In simple words: Fluid has accumulated in your lungs, making it hard to breathe. This happens when the lungs can't transfer oxygen into the blood effectively.If you don't have enough oxygen in your blood, you may feel short of breath.
Pulmonary edema is a condition characterized by excess fluid in the lungs, making it difficult to breathe.It can be acute or chronic.
Example 1: A 65-year-old patient with a history of heart failure presents to the emergency room with shortness of breath and coughing up pink frothy sputum.J81 is used to code the pulmonary edema., A 25-year-old mountain climber experiences high altitude pulmonary edema (HAPE) after a rapid ascent. J81 is appropriate for this scenario as well., A patient undergoing chemotherapy develops pulmonary edema as a side effect of the medication. Again, J81 is used to represent the pulmonary edema.
Documentation should include evidence of fluid in the lungs (e.g., from physical exam, chest X-ray, or other imaging), symptoms (e.g. shortness of breath, cough), oxygen saturation levels, and any associated conditions like heart failure. Contributing factors and temporal parameters should also be documented.
- Specialties:Pulmonology, Critical Care, Cardiology, Internal Medicine, Hospital Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office,Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home.