ICDcodes.org
FY2027

J16Pneumonia due to other infectious organisms, not elsewhere classified

Not billable

Is J16 billable?

No — J16 is a non-billable header code. J16 groups more specific codes and cannot be submitted on a claim. A valid ICD-10-CM code must be reported at the highest level of specificity available in its branch. Select one of the 2 billable codes beneath J16.

J16 at a glance

CodeJ16
DescriptionPneumonia due to other infectious organisms, not elsewhere classified
BillableNo — header code
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

Excludes1 — never code together

The conditions below can never be reported together with J16 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.

  • congenital pneumonia (P23.-)
  • ornithosis (A70)
  • pneumocystosis (B59)
  • pneumonia NOS (J18.9)

Code first

The underlying condition below must be sequenced before J16. J16 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 J16 is sequenced first depends on the reason for the encounter.

  • , if applicable, any associated condition such as:
  • abscess (J85.1)
  • aspiration pneumonia (J69.-)

Use additional code — inherited from Chapter 10

Report an additional code alongside J16 to fully describe the condition. J16 is sequenced first.

  • code, where applicable, to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • exposure to tobacco smoke in the perinatal period (P96.81)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)

Use additional code — inherited from J09-J18

Report an additional code alongside J16 to fully describe the condition. J16 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 J16, but a patient may have both at the same time. When documentation supports it, J16 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 J16, but a patient may have both at the same time. When documentation supports it, J16 and the excluded code may both be reported.

  • allergic or eosinophilic pneumonia (J82)
  • aspiration pneumonia NOS (J69.0)
  • meconium pneumonia (P24.01)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonia due to solids and liquids (J69.-)
  • congenital pneumonia (P23.9)
  • lipid pneumonia (J69.1)
  • rheumatic pneumonia (I00)
  • ventilator associated pneumonia (J95.851)

What codes fall under J16? (2)

How long has J16 existed?

J16 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 J16?

ICD-10-CM declares these codes mutually exclusive with J16 — exactly one of each pair can be correct for a given encounter.