J16 vs J18.9
J16 (Pneumonia due to other infectious organisms, not elsewhere classified) compared with J18.9 (Pneumonia, unspecified organism), 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. J16 carries an Excludes1 note covering J18.9: “pneumonia NOS (J18.9)”
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
| J16Pneumonia due to other infectious organisms, not elsewhere classified | J18.9Pneumonia, unspecified organism | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | J00-J99 — Diseases of the Respiratory System (J00-J99) | J00-J99 — Diseases of the Respiratory System (J00-J99) |
| Definition | Pneumonia due to other infectious organisms, not elsewhere classified is a non-billable ICD-10-CM category code (J16). | Pneumonia, unspecified organism is a billable ICD-10-CM diagnosis code (J18.9). |
| 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