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B06.81 ICD-10-CM Code: Rubella pneumonia

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
1 Excludes1

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 865 — VIRAL ILLNESS WITH MCC (MDC 18)
  • MS-DRG 866 — VIRAL ILLNESS WITHOUT MCC (MDC 18)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for B06.81 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on B06.81 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from B06

Coder workflow for B06.81

MedCoder structured workflow — derived from this code’s own official record

Before you code B06.81

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with B06.81. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in B06.81’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewP35.0

Consider B06.81. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

  • Excludes1 — check before selecting B06.81(1 note)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with B06.81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareP35.0

    See the official tabular notes · Guidelines I.A.12.a

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition B06.81 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewP35.0

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Rubella pneumonia is a billable ICD-10-CM diagnosis code (B06.81).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Verify Before Coding

  • CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name B06.81 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: J17 — Pneumonia in diseases classified elsewhere.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: H67 — Otitis media in diseases classified elsewhere (via B06.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 24 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 4 MS-DRGs: DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 865 (MDC 18), DRG 866 (MDC 18).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):RSP002 — Pneumonia (except that caused by tuberculosis) (default); INF008 — Viral infection.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

A74.81 — Chlamydial peritonitis, A74.89 — Other chlamydial diseases, A74.9 — Chlamydial infection, unspecified, A96.2 — Lassa fever, A98.3 — Marburg virus disease, A98.4 — Ebola virus disease, B06.00 — Rubella with neurological complication, unspecified, B06.01 — Rubella encephalitis, B06.02 — Rubella meningitis, B06.09 — Other neurological complications of rubella, B06.89 — Other rubella complications, B06.9 — Rubella without complication, B33.24 — Viral cardiomyopathy, B33.4 — Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS], B33.8 — Other specified viral diseases, B34.1 — Enterovirus infection, unspecified, B34.2 — Coronavirus infection, unspecified, B34.4 — Papovavirus infection, unspecified, B34.8 — Other viral infections of unspecified site, B92 — Sequelae of leprosy, +3 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Pneumonia (except that caused by tuberculosis), Viral infection).

A37.11 — Whooping cough due to Bordetella parapertussis with pneumonia, A37.81 — Whooping cough due to other Bordetella species with pneumonia, A37.91 — Whooping cough, unspecified species with pneumonia, A43.0 — Pulmonary nocardiosis, A48.1 — Legionnaires' disease, A50.04 — Early congenital syphilitic pneumonia, A52.72 — Syphilis of lung and bronchus, A54.84 — Gonococcal pneumonia, B01.2 — Varicella pneumonia, B05.2 — Measles complicated by pneumonia, B25.0 — Cytomegaloviral pneumonitis, B37.1 — Pulmonary candidiasis, B38.0 — Acute pulmonary coccidioidomycosis, B38.1 — Chronic pulmonary coccidioidomycosis, B38.2 — Pulmonary coccidioidomycosis, unspecified, B39.0 — Acute pulmonary histoplasmosis capsulati, B39.1 — Chronic pulmonary histoplasmosis capsulati, B39.2 — Pulmonary histoplasmosis capsulati, unspecified, B58.3 — Pulmonary toxoplasmosis, B59 — Pneumocystosis, +347 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Pneumonia”; these codes share that main term but sit in a different category of the Tabular List.

A37.91 — Whooping cough, unspecified species with pneumonia (in, whooping cough), A42.0 — Pulmonary actinomycosis (in, actinomycosis), A43.0 — Pulmonary nocardiosis (in, nocardiosis, nocardiasis), A50.04 — Early congenital syphilitic pneumonia (alba), A54.84 — Gonococcal pneumonia (gonococcal), A69.8 — Other specified spirochetal infections (spirochetal NEC), A70 — Chlamydia psittaci infections (psittacosis), A78 — Q fever (in, Q fever), B01.2 — Varicella pneumonia (varicella), B05.2 — Measles complicated by pneumonia (giant cell), B25.0 — Cytomegaloviral pneumonitis (cytomegaloviral), B37.1 — Pulmonary candidiasis (Candida), B38.0 — Acute pulmonary coccidioidomycosis (in, coccidioidomycosis, acute), B38.1 — Chronic pulmonary coccidioidomycosis (in, coccidioidomycosis, chronic), B38.2 — Pulmonary coccidioidomycosis, unspecified (in, coccidioidomycosis), B39.0 — Acute pulmonary histoplasmosis capsulati (in, histoplasmosis, acute), B39.1 — Chronic pulmonary histoplasmosis capsulati (in, histoplasmosis, chronic), B39.2 — Pulmonary histoplasmosis capsulati, unspecified (in, histoplasmosis), B44.9 — Aspergillosis, unspecified (in, aspergillosis), B58.3 — Pulmonary toxoplasmosis (in, toxoplasmosis), +82 more

Contextual Map

Every relationship of B06.81 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run B06.81 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Code First instructions

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026
  • MDC 18 — Infectious and Parasitic Diseases, Systemic or Unspecified Sites[MDC crossing]: “Infectious and Parasitic Diseases, Systemic or Unspecified Sites — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), in (due to), rubella[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (10)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "B06.81 — Rubella pneumonia." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/b06.81-rubella-pneumonia

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Rubella pneumonia

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to B06.81 in its code family, with their registry titles.

View all codes in the B06 family