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J18.2 vs J81.0

J18.2 (Hypostatic pneumonia, unspecified organism) compared with J81.0 (Acute pulmonary edema), from the official CMS tabular data.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Summary

These codes should not be reported together because J81.0’s tabular entry lists J18.2 under Excludes1.

Official rule
What is different?

The conditions named.J18.2 is “Hypostatic pneumonia, unspecified organism”; J81.0 is “Acute pulmonary edema”.

Registry fact

Can these codes be reported together?

No.J81.0’s entry carries an Excludes1 note covering J18.2: “hypostatic pneumonia (J18.2)”. Both may be reported only when the documentation shows the two conditions are unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

Yes.J81.0’s tabular entry: “hypostatic pneumonia (J18.2)”. The note covers J18.2.

Official ruleGuide: Excludes1 vs Excludes2

Nothing found in 4 other checks; 1 check does not apply
Is there an Excludes2 relationship?

None.Neither entry carries an Excludes2 note that names the other code. J18.2 carries 14 Excludes2 notes covering other codes; the side-by-side table quotes them.

Official rule

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

No.Both are billable codes, and neither contains the other.

Registry fact

Are there sequencing instructions?

None.Neither entry carries a Code First or Use Additional Code note that names the other.

Official rule

Are there other coding relationships?

None found.No laterality, encounter-phase, Table of Neoplasms, Table of Drugs and Chemicals, or history-versus-active-disease relationship links these codes.

MedCoder-derived

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Excludes1 — generally not reported together

Excludes1 conflict

J81.0
Acute pulmonary edema
↔
J18.2
Hypostatic pneumonia, unspecified organism

What we found

No — do not report together.J81.0 carries an Excludes1 note covering J18.2: “hypostatic pneumonia (J18.2)”

Sole exception: when the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

What to review

Report one of the two. Both may be reported only when the documentation shows the two conditions are unrelated to each other.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes1 note means the two conditions are not ordinarily reported together for the same encounter, because the classification treats them as mutually exclusive forms of the same condition. The documented exception is when the two conditions are unrelated to each other.

Source / rule

CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a

Official guidance behind these answers

  • Section I.A.12.a — Excludes1 · applies to: Excludes1

    A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. An exception to the Excludes1 definition is the circumstance when the two conditions are unrelated to each other. If it is not clear whether the two conditions involving an Excludes1 note are related or not, query the provider. For example, code F45.8, Other somatoform disorders, has an Excludes1 note for "sleep related teeth grinding (G47.63)," because "teeth grinding" is an inclusion term under F45.8. Only one of these two codes should be assigned for teeth grinding. However psychogenic dysmenorrhea is also an inclusion term under F45.8, and a patient could have both this condition and sleep related teeth grinding. In this case, the two conditions are clearly unrelated to each other, and so it would be appropriate to report F45.8 and G47.63 together.

    ICD-10-CM Official Guidelines FY2027

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

Similar descriptions do not make codes interchangeable. The documentation and the official instructions decide which code applies.

Official descriptionDiffers
J18.2

Hypostatic pneumonia, unspecified organism

J81.0

Acute pulmonary edema

StatusSame for both
Billable
Excludes1Differs
J18.2
  • congenital pneumonia (P23.0)
  • drug-induced interstitial lung disorder (J70.2-J70.4)
  • interstitial pneumonia NOS (J84.9)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonitis due to fumes and vapors (J68.0)
  • usual interstitial pneumonia (J84.178)
J81.0
  • chemical (acute) pulmonary edema (J68.1)
  • hypostatic pneumonia (J18.2)
  • passive pneumonia (J18.2)
  • pulmonary edema due to external agents (J60-J70)
  • pulmonary edema with heart disease NOS (I50.1)
  • pulmonary edema with heart failure (I50.1)
Excludes2Differs
J18.2
  • abscess of lung with pneumonia (J85.1)
  • aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
  • aspiration pneumonia due to anesthesia during pregnancy (O29)
  • aspiration pneumonia due to anesthesia during puerperium (O89.0)
  • aspiration pneumonia due to solids and liquids (J69.-)
  • aspiration pneumonia NOS (J69.0)
  • lipid pneumonia (J69.1)
  • pneumonitis due to external agents (J67-J70)
  • allergic or eosinophilic pneumonia (J82)
  • meconium pneumonia (P24.01)
  • pneumonia due to solids and liquids (J69.-)
  • congenital pneumonia (P23.9)
  • rheumatic pneumonia (I00)
  • ventilator associated pneumonia (J95.851)
J81.0

None at this code

Code firstDiffers
J18.2
  • , if applicable, associated influenza (J09.X1, J10.0-, J11.0-)
J81.0

None at this code

Use additional codeDiffers
J18.2
  • code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
J81.0
  • code to identify:
  • exposure to environmental tobacco smoke (Z77.22)
  • history of tobacco dependence (Z87.891)
  • occupational exposure to environmental tobacco smoke (Z57.31)
  • tobacco dependence (F17.-)
  • tobacco use (Z72.0)
Code alsoDiffers
J18.2
  • , if applicable, any associated condition such as:
  • aspiration pneumonia (J69.-)
J81.0

None at this code

CategoryDiffers
J18.2

J18 Pneumonia, unspecified organism

J81.0

J81 Pulmonary edema

ChapterSame for both

J00-J99 — Diseases of the Respiratory System (J00-J99)

IncludesDiffers
J18.2
  • Hypostatic bronchopneumonia
  • Passive pneumonia
J81.0
  • Acute edema of lung

No 7th character note at either code.

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on. In a row that differs, each code’s own notes are listed under it, and the notes every code shares are listed once beneath them.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources