FY2027
MenuClose
Excludes1 pair

J06.9 vs J22

J06.9 and J22 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.

The official note, declared on J22
upper respiratory infection (acute) (J06.9)
J06.9

Acute upper respiratory infection, unspecified

BillableUnspecified
Chapter 10
Diseases of the respiratory system
Section
J00-J06
Use when the record says
  • Upper respiratory disease, acute
  • Upper respiratory infection NOS
Indexed under
  • Tracheopharyngitis (acute)
  • Inflammation, inflamed, inflammatory › respiratory, upper
  • Disease, diseased › respiratory › acute or subacute NOS
  • Infection, infected, infective › respiratory NEC › upper NOS (acute)
  • Virus, viral › respiratory syncytial › upper respiratory infection
J22

Unspecified acute lower respiratory infection

BillableUnspecified
Chapter 10
Diseases of the respiratory system
Section
J20-J22
Use when the record says
  • Acute (lower) respiratory (tract) infection NOS
Indexed under
  • Infection, infected, infective › chest
  • Infection, infected, infective › respiratory NEC › acute
  • Infection, infected, infective › respiratory NEC › lower (acute)

Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027