J91.0 — Malignant pleural effusion
Is J91.0 billable?
Yes — J91.0 is billable for FY2027. J91.0 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J91.0 may be submitted for encounters from October 1, 2026 through September 30, 2027.
J91.0 at a glance
| Code | J91.0 |
|---|---|
| Description | Malignant pleural effusion |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to J91.0?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name J91.0 directly.
This code describes a manifestation of an underlying disease. The underlying condition must be sequenced before it, so it can never be the principal or first-listed diagnosis.
Which MS-DRGs does J91.0 group to?
J91.0 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.
- 180Respiratory Neoplasms with MCCmedical
- 181Respiratory Neoplasms with CCmedical
- 182Respiratory Neoplasms without CC/MCCmedical
As a secondary diagnosis, J91.0 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is J91.0 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to J91.0. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Effusion › malignant pleural
- Effusion › pleura, pleurisy, pleuritic, pleuropericardial › malignant
Code first
The underlying condition below must be sequenced before J91.0. J91.0 describes a manifestation and cannot be the principal or first-listed diagnosis.
- underlying neoplasm (C00-D49)
Use additional code — inherited from Chapter 10
Report an additional code alongside J91.0 to fully describe the condition. J91.0 is sequenced first.
Excludes2 — not included here — inherited from Chapter 10
The conditions below are not part of J91.0, but a patient may have both at the same time. When documentation supports it, J91.0 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 J91
The conditions below are not part of J91.0, but a patient may have both at the same time. When documentation supports it, J91.0 and the excluded code may both be reported.
How long has J91.0 existed?
J91.0 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 J91.0?
ICD-10-CM declares these codes mutually exclusive with J91.0 — exactly one of each pair can be correct for a given encounter.