J11.00 — Influenza due to unidentified influenza virus with unspecified type of pneumonia
Is J11.00 billable?
Yes, but J11.00 is an unspecified code. J11.00 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, J11.00 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting J11.00 — the more specific alternatives are listed below.
More specific alternatives
J11.00 at a glance
| Code | J11.00 |
|---|---|
| Description | Influenza due to unidentified influenza virus with unspecified type of pneumonia |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does J11.00 group to?
J11.00 sits in MDC 04 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 177Respiratory Infections and Inflammations with MCCmedical
- 178Respiratory Infections and Inflammations with CCmedical
- 179Respiratory Infections and Inflammations without CC/MCCmedical
As a secondary diagnosis, J11.00 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is J11.00 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J11.00. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Influenza › with › pneumonia (bronchial) (epidemic) (respiratory (upper)) (unidentified influenza virus)
Inclusion terms
Alternative wording in documentation that is classified to J11.00.
- Influenza with pneumonia NOS
Use additional code — inherited from Chapter 10
Report an additional code alongside J11.00 to fully describe the condition. J11.00 is sequenced first.
Use additional code — inherited from J09-J18
Report an additional code alongside J11.00 to fully describe the condition. J11.00 is sequenced first.
- code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Excludes2 — not included here — inherited from Chapter 10
The conditions below are not part of J11.00, but a patient may have both at the same time. When documentation supports it, J11.00 and the excluded code may both be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- smoke inhalation (T59.81-)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Excludes2 — not included here — inherited from J09-J18
The conditions below are not part of J11.00, but a patient may have both at the same time. When documentation supports it, J11.00 and the excluded code may both be reported.
Code also — inherited from J11.0
Two codes may be needed to describe the condition fully. Whether J11.00 is sequenced first depends on the reason for the encounter.
- associated lung abscess, if applicable (J85.1)
How long has J11.00 existed?
J11.00 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.