J95.861 ICD-10-CM Code: Postprocedural hematoma of a respiratory system organ or structure following other procedure
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 919 — COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)
- MS-DRG 920 — COMPLICATIONS OF TREATMENT WITH CC (MDC 21)
- MS-DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC (MDC 21)
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
Official Tabular Instructional Notes
Sequencing, inclusion, and exclusion notes published for J95.861 in the official ICD-10-CM tabular list.
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- aspiration pneumonia (J69.-) Compare J95.861 vs J69 →
- emphysema (subcutaneous) resulting from a procedure (T81.82) Compare J95.861 vs T81.82 →
- hypostatic pneumonia (J18.2) Compare J95.861 vs J18.2 →
- pulmonary manifestations due to radiation (J70.0-J70.1) Compare J95.861 vs J70.0 →
Change history
- FY2017 — 2016-10-01Added to the code setPostprocedural hematoma of a respiratory system organ or structure following other procedureFY2017 changes
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.
Contextual Map
Every relationship of J95.861 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]
- J95-J95 — Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified [Hierarchy]
Clinical classification (CCSR)
- RSP017 — Postprocedural or postoperative respiratory system complication [CCSR]
Potential MS-DRG
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”
- DRG 919 — COMPLICATIONS OF TREATMENT WITH MCC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITH MCC (MDC 21)”
- DRG 920 — COMPLICATIONS OF TREATMENT WITH CC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITH CC (MDC 21)”
- DRG 921 — COMPLICATIONS OF TREATMENT WITHOUT CC/MCC [MS-DRG]: “COMPLICATIONS OF TREATMENT WITHOUT CC/MCC (MDC 21)”
MDC crossing · procedures (32029)
- MDC 21 — Injuries, Poisonings and Toxic Effects of Drugs [MDC crossing]: “Injuries, Poisonings and Toxic Effects of Drugs — 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.”
- 0016070 — Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Nasopharynx with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016071 — Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Mastoid Sinus with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016072 — Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Atrium with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016073 — Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Blood Vessel with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- 0016074 — Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach [Same-MDC procedure]: “Bypass Cerebral Ventricle to Pleural Cavity with Autologous Tissue Substitute, Open Approach — grouped in MDC 21, the procedure side of this code's crossing.” · check together
- and 32024 more
Index entries
- Complication (s) (from) (of), postprocedural, hematoma (of), respiratory system, following other procedure[Index term]
Nearest codes (40)
- J95 — Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified [Sibling]
- J95.0 — Tracheostomy complications [Sibling]
- J95.00 — Unspecified tracheostomy complication [Sibling]
- J95.01 — Hemorrhage from tracheostomy stoma [Sibling]
- J95.02 — Infection of tracheostomy stoma [Sibling]
- J95.03 — Malfunction of tracheostomy stoma [Sibling]
- J95.04 — Tracheo-esophageal fistula following tracheostomy [Sibling]
- J95.09 — Other tracheostomy complication [Sibling]
- and 32 more
Change history
- FY2017 — Added to the code set [Change history]
Relationships & Classification
Clinical classification (AHRQ CCSR):RSP017 — Postprocedural or postoperative respiratory system complication (default).
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Potential MS-DRG Relationships (FY2026)
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 76 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 3 MS-DRGs: DRG 919 (MDC 21), DRG 920 (MDC 21), DRG 921 (MDC 21).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to J95.861 in its code family, with their registry titles.
- J95.85 — Complication of respirator [ventilator]
- J95.850 — Mechanical complication of respirator
- J95.851 — Ventilator associated pneumonia
- J95.859 — Other complication of respirator [ventilator]
- J95.86 — Postprocedural hematoma and seroma of a respiratory system organ or structure following a procedure
- J95.860 — Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure
- J95.862 — Postprocedural seroma of a respiratory system organ or structure following a respiratory system procedure
- J95.863 — Postprocedural seroma of a respiratory system organ or structure following other procedure
- J95.87 — Transfusion-associated dyspnea (TAD)
- J95.88 — Other intraoperative complications of respiratory system, not elsewhere classified
Indexed Clinical Terms (1)
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.
- Complication (s) (from) (of), postprocedural, hematoma (of), respiratory system, following other procedure