2025 ICD-10-CM code J85.1
(Active) Effective Date: N/A Diseases of the respiratory system - Suppurative and necrotic conditions of the lower respiratory tract 10 Feed
Abscess of lung with pneumonia.
Medical necessity for J85.1 is established when both a lung abscess and pneumonia are confirmed through diagnostic testing and clinical evaluation. The code signifies an active infection requiring medical intervention.
In simple words: Lung abscess occurring together with pneumonia.
Abscess of lung with pneumonia.
Example 1: A patient presents with fever, cough, and chest pain. Imaging reveals a lung abscess and widespread pulmonary infiltrates consistent with pneumonia., A patient with a history of aspiration pneumonia develops a lung abscess. The abscess is identified on a CT scan of the chest., A patient undergoing treatment for bacterial pneumonia develops a cavitary lesion in the lung, indicating an abscess formation secondary to the infection.
Documentation should include imaging evidence (e.g. CT scan, X-ray) demonstrating the presence of both a lung abscess and pneumonia. Microbial cultures and sensitivity tests may help in identifying the causative organism, though not required for this code. Clinical findings such as fever, cough, chest pain, and shortness of breath should also be documented.
** For pneumonia due to a specific organism, use codes J09-J18.If both a specific organism and a lung abscess are present, code both the specific pneumonia and J85.1, as instructed for code J15.
- Specialties:Pulmonology, Infectious Disease, Internal Medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital