J12 vs P23.0
J12 (Viral pneumonia, not elsewhere classified) compared with P23.0 (Congenital pneumonia due to viral agent), 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. J12 carries an Excludes2 note covering P23.0: “congenital pneumonia (P23.0)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| J12Viral pneumonia, not elsewhere classified | P23.0Congenital pneumonia due to viral agent | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | J00-J99 — Diseases of the Respiratory System (J00-J99) | P00-P96 — Certain Conditions Originating in the Perinatal Period (P00-P96) |
| Definition | Viral pneumonia, not elsewhere classified is a non-billable ICD-10-CM category code (J12). | Congenital pneumonia due to viral agent is a billable ICD-10-CM diagnosis code (P23.0). |
| Includes | bronchopneumonia due to viruses other than influenza viruses | infective pneumonia acquired in utero or during birth |
| Use additional code | code, if applicable, to identify resistance to antimicrobial drugs (Z16.-) | code (B97) to identify organism |
| Code first | associated influenza, if applicable (J09.X1, J10.0-, J11.0-) | — |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources