J85.1 — Abscess of lung with pneumonia
Is J85.1 billable?
Yes — J85.1 is billable for FY2027. J85.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J85.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.
J85.1 at a glance
| Code | J85.1 |
|---|---|
| Description | Abscess of lung with pneumonia |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does J85.1 group to?
J85.1 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, J85.1 is a major complication or comorbidity (MCC), which can move a stay into a higher-paying DRG.
How is J85.1 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J85.1. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Abscess › lung › with pneumonia (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Pneumonia › with › lung abscess (acute) (double) (migratory) (purulent) (septic) (unresolved)
Code also
Two codes may be needed to describe the condition fully. Whether J85.1 is sequenced first depends on the reason for the encounter.
- the type of pneumonia
Use additional code — inherited from Chapter 10
Report an additional code alongside J85.1 to fully describe the condition. J85.1 is sequenced first.
Use additional code — inherited from J85
Report an additional code alongside J85.1 to fully describe the condition. J85.1 is sequenced first.
- code (B95-B97) to identify infectious agent.
Excludes2 — not included here — inherited from Chapter 10
The conditions below are not part of J85.1, but a patient may have both at the same time. When documentation supports it, J85.1 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 J85.1 existed?
J85.1 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.