J16 vs P23.9
J16 (Pneumonia due to other infectious organisms, not elsewhere classified) compared with P23.9 (Congenital pneumonia, unspecified), 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 P23.9: “congenital pneumonia (P23.-)”
Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).
Yes, when both are documented. J16 carries an Excludes2 note covering P23.9: “congenital pneumonia (P23.9)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
Side by side
| J16Pneumonia due to other infectious organisms, not elsewhere classified | P23.9Congenital pneumonia, unspecified | |
|---|---|---|
| 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 | Pneumonia due to other infectious organisms, not elsewhere classified is a non-billable ICD-10-CM category code (J16). | Congenital pneumonia, unspecified is a billable ICD-10-CM diagnosis code (P23.9). |
| Includes | — | infective pneumonia acquired in utero or during birth |
| Use additional code | code, if applicable, to identify resistance to antimicrobial drugs (Z16.-) | — |
| Code first | , 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