J13 — Pneumonia due to Streptococcus pneumoniae
Is J13 billable?
Yes — J13 is billable for FY2027. J13 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J13 may be submitted for encounters from October 1, 2026 through September 30, 2027.
J13 at a glance
| Code | J13 |
|---|---|
| Description | Pneumonia due to Streptococcus pneumoniae |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does J13 group to?
J13 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.
- 193Simple Pneumonia and Pleurisy with MCCmedical
- 194Simple Pneumonia and Pleurisy with CCmedical
- 195Simple Pneumonia and Pleurisy without CC/MCCmedical
As a secondary diagnosis, J13 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is J13 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J13. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Pneumonia › diplococcal, diplococcus (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › pneumococcal (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › Streptococcus pneumoniae (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › broncho-, bronchial › diplococcal (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › broncho-, bronchial › pneumococcal (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › in › Diplococcus (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › in › pneumococcus (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › lobar › pneumococcal (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Pneumonia › lobar › Streptococcus pneumoniae (acute) (double) (migratory) (purulent) (septic) (unresolved)
- Embolism › pyemic › pneumococcal › with pneumonia (multiple) (paradoxical)
- Infection, infected, infective › pneumococcus, pneumococcal NEC › generalized › with pneumonia (opportunistic)
- Pneumonia › broncho-, bronchial › streptococcal NEC › pneumoniae (acute) (double) (migratory) (purulent) (septic) (unresolved)
Excludes1 — never code together
The conditions below can never be reported together with J13 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Code first
The underlying condition below must be sequenced before J13. J13 describes a manifestation and cannot be the principal or first-listed diagnosis.
Code also
Two codes may be needed to describe the condition fully. Whether J13 is sequenced first depends on the reason for the encounter.
Inclusion terms
Alternative wording in documentation that is classified to J13.
- Bronchopneumonia due to S. pneumoniae
Use additional code — inherited from Chapter 10
Report an additional code alongside J13 to fully describe the condition. J13 is sequenced first.
Use additional code — inherited from J09-J18
Report an additional code alongside J13 to fully describe the condition. J13 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 J13, but a patient may have both at the same time. When documentation supports it, J13 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 J13, but a patient may have both at the same time. When documentation supports it, J13 and the excluded code may both be reported.
How long has J13 existed?
J13 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.
Which codes are confused with J13?
ICD-10-CM declares these codes mutually exclusive with J13 — exactly one of each pair can be correct for a given encounter.