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J12.82 ICD-10-CM Code: Pneumonia due to coronavirus disease 2019

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

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 193 — SIMPLE PNEUMONIA AND PLEURISY WITH MCC (MDC 04)
  • MS-DRG 194 — SIMPLE PNEUMONIA AND PLEURISY WITH CC (MDC 04)
  • MS-DRG 195 — SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC (MDC 04)
  • MS-DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)
  • MS-DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)
  • MS-DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)

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.

Official Registry Overview & Definition

Pneumonia due to coronavirus disease 2019 is a billable ICD-10-CM diagnosis code (J12.82).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for J12.82 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • bronchopneumonia due to viruses other than influenza viruses

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Pneumonia due to 2019 novel coronavirus (SARS-CoV-2)
  • Pneumonia due to COVID-19

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code First

Underlying conditions that must be sequenced before this code.

Code Also

Additional codes that may be required to fully describe the encounter.

  • associated abscess, if applicable (J85.1)

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)

Indexed Clinical Terms (6)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • COVID-19, pneumonia
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), 2019coronavirus (novel)
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), coronavirus2019 (novel) (disease)
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), COVID-19
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), SARS-CoV-2
  • Syndrome, severe acute respiratory (SARS), coronavirus 2, pneumonia

Frequently Compared Codes

The official Excludes notes on J12.82 name these codes. Each comparison page covers when the two can — or must not — be reported together.

Change history

  • FY2022 — 2021-10-01
    Added to the code set
    Pneumonia due to coronavirus disease 2019
    FY2022 changes

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

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

Relationships & Classification

Other codes that name J12.82 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.

2 Use Additional Code instructions across 2 chapters: J95.89 (via J12.-), U07.1.

3 Code Also instructions across 3 chapters: D81.82 (via J12.-), J69 (via J12.-), M35.81.

Potential MS-DRG Relationships (FY2026)

Not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity.

Named in the grouper logic of 6 MS-DRGs: DRG 193 (MDC 04), DRG 194 (MDC 04), DRG 195 (MDC 04), DRG 974 (MDC 25), DRG 975 (MDC 25), DRG 976 (MDC 25).

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

Clinical classification (AHRQ CCSR):INF012 — COVID-19; RSP002 — Pneumonia (except that caused by tuberculosis) (default).

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 category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (COVID-19, Pneumonia (except that caused by tuberculosis)).

J10.00 — Influenza due to other identified influenza virus with unspecified type of pneumonia, J10.01 — Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia, J10.08 — Influenza due to other identified influenza virus with other specified pneumonia, J11.00 — Influenza due to unidentified influenza virus with unspecified type of pneumonia, J11.08 — Influenza due to unidentified influenza virus with specified pneumonia, J12.0 — Adenoviral pneumonia, J12.1 — Respiratory syncytial virus pneumonia, J12.2 — Parainfluenza virus pneumonia, J12.3 — Human metapneumovirus pneumonia, J12.81 — Pneumonia due to SARS-associated coronavirus, J12.89 — Other viral pneumonia, J12.9 — Viral pneumonia, unspecified, J13 — Pneumonia due to Streptococcus pneumoniae, J14 — Pneumonia due to Hemophilus influenzae, J15.0 — Pneumonia due to Klebsiella pneumoniae, J15.1 — Pneumonia due to Pseudomonas, J15.20 — Pneumonia due to staphylococcus, unspecified, J15.211 — Pneumonia due to Methicillin susceptible Staphylococcus aureus, J15.212 — Pneumonia due to Methicillin resistant Staphylococcus aureus, J15.29 — Pneumonia due to other staphylococcus, +50 more

Lab tests where this diagnosis supports Medicare coverage

Medicare's National Coverage Determinations list this diagnosis as medical justification for these lab tests.

Blood Glucose Test

Contextual Map

Every relationship of J12.82 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.

Hierarchy

  • J00-J99 — Chapter 10: Diseases of the Respiratory System (J00-J99) (J00-J99) [Hierarchy]
  • J09-J18 — Influenza and pneumonia [Hierarchy]

Referenced by Use Additional Code instructions

  • J95.89 — Other postprocedural complications and disorders of respiratory system, not elsewhere classified [Use Additional Code](via J12.-): “bacterial or viral pneumonia (J12-J18)” · check together
  • U07.1 — COVID-19 [Use Additional Code]: “pneumonia due to COVID-19 (J12.82)” · check together

Referenced by Code Also instructions

  • D81.82 — Activated Phosphoinositide 3-kinase Delta Syndrome [APDS] [Code Also](via J12.-): “pneumonia (J12-J18)” · check together
  • J69 — Pneumonitis due to solids and liquids [Code Also](via J12.-): “viral pneumonia (J12.-)” · check together
  • M35.81 — Multisystem inflammatory syndrome [Code Also]: “pneumonia due to COVID-19 (J12.82)” · check together

Clinical classification (CCSR)

  • INF012 — COVID-19 [CCSR]
  • RSP002 — Pneumonia (except that caused by tuberculosis) [CCSR]

Potential MS-DRG

  • DRG 193 — SIMPLE PNEUMONIA AND PLEURISY WITH MCC [MS-DRG]: “SIMPLE PNEUMONIA AND PLEURISY WITH MCC (MDC 04)”
  • DRG 194 — SIMPLE PNEUMONIA AND PLEURISY WITH CC [MS-DRG]: “SIMPLE PNEUMONIA AND PLEURISY WITH CC (MDC 04)”
  • DRG 195 — SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC [MS-DRG]: “SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC (MDC 04)”
  • DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC [MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)”
  • DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC [MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)”
  • DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC [MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)”

MDC crossing · procedures (3998)

  • MDC 04 — Diseases and Disorders of the Respiratory System [MDC crossing]: “Diseases and Disorders of the Respiratory System — 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.”
  • MDC 25 — Human Immunodeficiency Virus Infections [MDC crossing]: “Human Immunodeficiency Virus Infections — 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.”
  • 008Q0ZZ — Division of Vagus Nerve, Open Approach [Same-MDC procedure]: “Division of Vagus Nerve, Open Approach — grouped in MDC 04, the procedure side of this code's crossing.” · check together
  • 008Q3ZZ — Division of Vagus Nerve, Percutaneous Approach [Same-MDC procedure]: “Division of Vagus Nerve, Percutaneous Approach — grouped in MDC 04, the procedure side of this code's crossing.” · check together
  • 008Q4ZZ — Division of Vagus Nerve, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Division of Vagus Nerve, Percutaneous Endoscopic Approach — grouped in MDC 04, the procedure side of this code's crossing.” · check together
  • 021P08A — Bypass Pulmonary Trunk from Innominate Artery with Zooplastic Tissue, Open Approach [Same-MDC procedure]: “Bypass Pulmonary Trunk from Innominate Artery with Zooplastic Tissue, Open Approach — grouped in MDC 04, the procedure side of this code's crossing.” · check together
  • 021P08B — Bypass Pulmonary Trunk from Subclavian with Zooplastic Tissue, Open Approach [Same-MDC procedure]: “Bypass Pulmonary Trunk from Subclavian with Zooplastic Tissue, Open Approach — grouped in MDC 04, the procedure side of this code's crossing.” · check together
  • and 3993 more

Index entries

  • COVID-19, pneumonia[Index term]
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), 2019coronavirus (novel)[Index term]
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), coronavirus2019 (novel) (disease)[Index term]
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), COVID-19[Index term]
  • Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), SARS-CoV-2[Index term]
  • Syndrome, severe acute respiratory (SARS), coronavirus 2, pneumonia[Index term]

Nearest codes (9)

  • J12 — Viral pneumonia, not elsewhere classified [Sibling]
  • J12.0 — Adenoviral pneumonia [Sibling]
  • J12.1 — Respiratory syncytial virus pneumonia [Sibling]
  • J12.2 — Parainfluenza virus pneumonia [Sibling]
  • J12.3 — Human metapneumovirus pneumonia [Sibling]
  • J12.8 — Other viral pneumonia [Sibling]
  • J12.81 — Pneumonia due to SARS-associated coronavirus [Sibling]
  • J12.89 — Other viral pneumonia [Sibling]
  • and 1 more

Change history

  • FY2022 — Added to the code set [Change history]

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J12.82 in its code family, with their registry titles.

  • J12 — Viral pneumonia, not elsewhere classified
  • J12.0 — Adenoviral pneumonia
  • J12.1 — Respiratory syncytial virus pneumonia
  • J12.2 — Parainfluenza virus pneumonia
  • J12.3 — Human metapneumovirus pneumonia
  • J12.8 — Other viral pneumonia
  • J12.81 — Pneumonia due to SARS-associated coronavirus
  • J12.89 — Other viral pneumonia
  • J12.9 — Viral pneumonia, unspecified

View all codes in the J12 family