I97.1 vs J95.1
I97.1 (Other postprocedural cardiac functional disturbances) compared with J95.1 (Acute pulmonary insufficiency following thoracic surgery), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Can these codes be reported together?
Yes, when both are documented. I97.1 carries an Excludes2 note covering J95.1: “acute pulmonary insufficiency following thoracic surgery (J95.1)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Yes, when both are documented. J95.1 carries an Excludes2 note covering I97.1: “Functional disturbances following cardiac surgery (I97.0, I97.1-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| I97.1Other postprocedural cardiac functional disturbances | J95.1Acute pulmonary insufficiency following thoracic surgery | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | I00-I99 — Diseases of the Circulatory System (I00-I99) | J00-J99 — Diseases of the Respiratory System (J00-J99) |
| Definition | Other postprocedural cardiac functional disturbances is a non-billable ICD-10-CM category code (I97.1). | Acute pulmonary insufficiency following thoracic surgery is a billable ICD-10-CM diagnosis code (J95.1). |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources