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J95.863 ICD-10-CM Code: Postprocedural seroma of a respiratory system organ or structure following other procedure

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

Coding at a Glance

Tabular directives
4 Excludes2

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 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.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for J95.863 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on J95.863 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

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

Source: inherited from J95

Coder workflow for J95.863

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

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

  • Excludes2 — not part of J95.863(4 notes)

    Coding workflow: The conditions named in this note are not included in J95.863. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareJ69, T81.82, J18.2

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

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

Postprocedural seroma of a respiratory system organ or structure following other procedure is a billable ICD-10-CM diagnosis code (J95.863).

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

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.

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.

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.

I85.01 — Esophageal varices with bleeding, I85.11 — Secondary esophageal varices with bleeding, I97.3 — Postprocedural hypertension, J95.61 — Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating a respiratory system procedure, J95.62 — Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating other procedure, J95.830 — Postprocedural hemorrhage of a respiratory system organ or structure following a respiratory system procedure, J95.831 — Postprocedural hemorrhage of a respiratory system organ or structure following other procedure, J95.860 — Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure, J95.861 — Postprocedural hematoma of a respiratory system organ or structure following other procedure, J95.862 — Postprocedural seroma of a respiratory system organ or structure following a respiratory system procedure, K21.9 — Gastro-esophageal reflux disease without esophagitis, K25.0 — Acute gastric ulcer with hemorrhage, K25.2 — Acute gastric ulcer with both hemorrhage and perforation, K25.4 — Chronic or unspecified gastric ulcer with hemorrhage, K25.6 — Chronic or unspecified gastric ulcer with both hemorrhage and perforation, K26.0 — Acute duodenal ulcer with hemorrhage, K26.2 — Acute duodenal ulcer with both hemorrhage and perforation, K26.4 — Chronic or unspecified duodenal ulcer with hemorrhage, K26.6 — Chronic or unspecified duodenal ulcer with both hemorrhage and perforation, K27.0 — Acute peptic ulcer, site unspecified, with hemorrhage, +55 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Postprocedural or postoperative respiratory system complication).

J95.61 — Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating a respiratory system procedure, J95.62 — Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating other procedure, J95.71 — Accidental puncture and laceration of a respiratory system organ or structure during a respiratory system procedure, J95.72 — Accidental puncture and laceration of a respiratory system organ or structure during other procedure, J95.811 — Postprocedural pneumothorax, J95.812 — Postprocedural air leak, J95.821 — Acute postprocedural respiratory failure, J95.822 — Acute and chronic postprocedural respiratory failure, J95.830 — Postprocedural hemorrhage of a respiratory system organ or structure following a respiratory system procedure, J95.831 — Postprocedural hemorrhage of a respiratory system organ or structure following other procedure, J95.84 — Transfusion-related acute lung injury (TRALI), J95.850 — Mechanical complication of respirator, J95.851 — Ventilator associated pneumonia, J95.859 — Other complication of respirator [ventilator], J95.860 — Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure, J95.861 — Postprocedural hematoma of a respiratory system organ or structure following other procedure, J95.862 — Postprocedural seroma of a respiratory system organ or structure following a respiratory system procedure, J95.87 — Transfusion-associated dyspnea (TAD), J95.88 — Other intraoperative complications of respiratory system, not elsewhere classified, J95.89 — Other postprocedural complications and disorders of respiratory system, not elsewhere classified, +11 more

Contextual Map

Every relationship of J95.863 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

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • 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. 32,029 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Complication (s) (from) (of), postprocedural, seroma (of), respiratory system, following other procedure[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (40)

Change history

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

Change history

  • FY2017 — October 1, 2016
    Added to the code set
    Postprocedural seroma of a respiratory system organ or structure following other procedure
    FY2017 changes

Nearest Codes in This Family

Official ICD-10-CM classifications closest to J95.863 in its code family, with their registry titles.

View all codes in the J95 family