J81.1 — Chronic pulmonary edema
Is J81.1 billable?
Yes — J81.1 is billable for FY2027. J81.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J81.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.
J81.1 at a glance
| Code | J81.1 |
|---|---|
| Description | Chronic pulmonary edema |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does J81.1 group to?
J81.1 sits in MDC 04 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 189Pulmonary Edema and Respiratory Failuremedical
As a secondary diagnosis, J81.1 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is J81.1 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J81.1. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Edema, edematous › lung (infectious) (pitting) (toxic)
- Edema, edematous › lung › chronic (infectious) (pitting) (toxic)
Inclusion terms
Alternative wording in documentation that is classified to J81.1.
- Pulmonary congestion (chronic) (passive)
- Pulmonary edema NOS
Excludes1 — never code together — inherited from J81
The conditions below can never be reported together with J81.1 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 10
Report an additional code alongside J81.1 to fully describe the condition. J81.1 is sequenced first.
Use additional code — inherited from J81
Report an additional code alongside J81.1 to fully describe the condition. J81.1 is sequenced first.
Excludes2 — not included here — inherited from Chapter 10
The conditions below are not part of J81.1, but a patient may have both at the same time. When documentation supports it, J81.1 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)
How long has J81.1 existed?
J81.1 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.