ICDcodes.org
FY2027

J91.8Pleural effusion in other conditions classified elsewhere

BillableCC

Is J91.8 billable?

Yes — J91.8 is billable for FY2027. J91.8 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. J91.8 may be submitted for encounters from October 1, 2026 through September 30, 2027.

J91.8 at a glance

CodeJ91.8
DescriptionPleural effusion in other conditions classified elsewhere
BillableYes
Code setICD-10-CM FY2027
Valid for encountersOctober 1, 2026 – September 30, 2027

What Medicare edits apply to J91.8?

The Medicare Code Editor screens inpatient claims before they are grouped. These edits name J91.8 directly.

Manifestation code — never sequenced first — MCE edit 6

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 J91.8 group to?

J91.8 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.

  • 186Pleural Effusion with MCCmedical
  • 187Pleural Effusion with CCmedical
  • 188Pleural Effusion without CC/MCCmedical

As a secondary diagnosis, J91.8 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.

How is J91.8 listed in the Alphabetic Index?

These are the routes through the Alphabetic Index that lead to J91.8. They show the wording a clinician may have documented, which often differs from the Tabular description.

  • Chylothoraxfilarial (nonfilarial)
  • Effusionpleura, pleurisy, pleuritic, pleuropericardialin conditions classified elsewhere
  • Hydrothoraxchylousfilarial (double) (pleura)

Code first

The underlying condition below must be sequenced before J91.8. J91.8 describes a manifestation and cannot be the principal or first-listed diagnosis.

Use additional code — inherited from Chapter 10

Report an additional code alongside J91.8 to fully describe the condition. J91.8 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)

Excludes2 — not included here — inherited from Chapter 10

The conditions below are not part of J91.8, but a patient may have both at the same time. When documentation supports it, J91.8 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 J91.8, but a patient may have both at the same time. When documentation supports it, J91.8 and the excluded code may both be reported.

  • pleural effusion in heart failure (I50.-)
  • pleural effusion in systemic lupus erythematosus (M32.13)

How long has J91.8 existed?

J91.8 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.

What other codes are in the J91 family? (1)