J69.0 vs J95.4
J69.0 and J95.4 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 J69.0
chemical pneumonitis due to anesthesia (J95.4)
J69.0
Pneumonitis due to inhalation of food and vomit
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J60-J70
Use when the record says
- Aspiration pneumonia NOS
- Aspiration pneumonia (due to) food (regurgitated)
- Aspiration pneumonia (due to) gastric secretions
- Aspiration pneumonia (due to) milk
- Aspiration pneumonia (due to) vomit
Indexed under
- Aspiration › bronchitis
- Aspiration › pneumonia
- Aspiration › pneumonitis
- Bronchitis › aspiration (diffuse) (fibrinous) (hypostatic) (infective) (membranous)
- Deglutition › pneumonia
J95.4
Chemical pneumonitis due to anesthesia
Billable
- Chapter 10
- Diseases of the respiratory system
- Section
- J95
Use when the record says
- Mendelson's syndrome
- Postprocedural aspiration pneumonia
Indexed under
- Mendelson's syndrome (due to anesthesia)
- Pneumonitis › postanesthetic (acute) (primary)
- Pneumonitis › postoperative (acute) (primary)
- Pneumonia › aspiration › postprocedural (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonitis › chemical › due to anesthesia (acute) (primary)
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