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2025 ICD-10-CM code J95

Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified.

When using J95, it is important to exclude conditions that have their own specific codes, such as aspiration pneumonia or pulmonary manifestations due to radiation. Always use the most specific code available. Use additional codes if necessary to fully describe the patient’s condition, such as exposure to environmental tobacco smoke (Z77.22).

Medical necessity must be established by demonstrating the causal relationship between the procedure and the respiratory complication.The documentation needs to support the diagnosis and any associated treatment provided.Any additional procedures or treatments required to manage the complication should also be clearly documented and justified.

Physicians use this code to document and report respiratory complications that occur during or after medical procedures. It's crucial to ensure proper documentation to support the medical necessity of any subsequent treatments.

IMPORTANT:Excludes2: aspiration pneumonia (J69.-) emphysema (subcutaneous) resulting from a procedure (T81.82) hypostatic pneumonia (J18.2) pulmonary manifestations due to radiation (J70.0-J70.1)

In simple words: This code is used for breathing problems that happen during or after a medical procedure, like surgery, when there isn't a more specific code to describe the problem. Examples include issues with a tracheostomy (a breathing tube in the neck).

This code encompasses a range of respiratory complications and disorders arising during or after surgical and other medical procedures, not classified elsewhere.It includes conditions such as tracheostomy malfunction, hemorrhage from tracheostomy stoma, obstruction of tracheostomy airway, sepsis of tracheostomy stoma, and tracheo-oesophageal fistula following tracheostomy.

Example 1: A patient develops a tracheo-esophageal fistula (an abnormal connection between the trachea and esophagus) following a tracheostomy procedure., A patient experiences hemorrhage from their tracheostomy stoma post-operatively., A patient develops sepsis at the tracheostomy stoma site after a tracheostomy.

Documentation should clearly specify the type of respiratory complication, its relationship to the procedure performed, and the clinical manifestations. The physician's notes should provide sufficient detail to justify the use of this code, indicating that the condition is a direct result of the intraoperative or postprocedural period.

** For more detailed information, including specific documentation requirements for each subcategory and potential NCCI edits, refer to the iFrameAI product.

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