J13 vs J15.4
J13 (Pneumonia due to Streptococcus pneumoniae) compared with J15.4 (Pneumonia due to other streptococci), from the official CMS tabular data. Do not report these codes together: the official tabular list marks them Excludes1.
Can these codes be reported together?
No — do not report together. J13 carries an Excludes1 note covering J15.4: “pneumonia due to other streptococci (J15.3-J15.4)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
No — do not report together. J15.4 carries an Excludes1 note covering J13: “pneumonia due to Streptococcus pneumoniae (J13)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Side by side
| J13Pneumonia due to Streptococcus pneumoniae | J15.4Pneumonia due to other streptococci | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | J00-J99 — Diseases of the Respiratory System (J00-J99) | J00-J99 — Diseases of the Respiratory System (J00-J99) |
| Definition | Pneumonia due to Streptococcus pneumoniae is a billable ICD-10-CM diagnosis code (J13). | Pneumonia due to other streptococci is a billable ICD-10-CM diagnosis code (J15.4). |
| Includes | Bronchopneumonia due to S. pneumoniae | bronchopneumonia due to bacteria other than S. pneumoniae and H. influenzae |
| Use additional code | code, if applicable, to identify resistance to antimicrobial drugs (Z16.-) | code, if applicable, to identify resistance to antimicrobial drugs (Z16.-) |
| Code first | , if applicable, associated influenza (J09.X1, J10.0-, J11.0-) | , if applicable, associated influenza (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