J94 vs R09.1
J94 (Other pleural conditions) compared with R09.1 (Pleurisy), 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. J94 carries an Excludes1 note covering R09.1: “pleurisy NOS (R09.1)”
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
| J94Other pleural conditions | R09.1Pleurisy | |
|---|---|---|
| Billing status | Non-billable header | Billable |
| Classification | J00-J99 — Diseases of the Respiratory System (J00-J99) | R00-R99 — Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) |
| Definition | Other pleural conditions is a non-billable ICD-10-CM category code (J94). | Pleurisy is a billable ICD-10-CM diagnosis code (R09.1). |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources