J18.2 vs J81
J18.2 and J81 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on J81
hypostatic pneumonia (J18.2)
J18.2
Hypostatic pneumonia, unspecified organism
BillableUnspecified
- Chapter 10
- Diseases of the respiratory system
- Section
- J09-J18
Use when the record says
- Hypostatic bronchopneumonia
- Passive pneumonia
Indexed under
- Anasarca › lung
- Anasarca › pulmonary
- Pneumonia › adynamic (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › hypostatic (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › orthostatic (acute) (double) (migratory) (purulent) (septic) (unresolved)
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