Skip to content

J11 ICD-10-CM Code: Influenza due to unidentified influenza virus

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Influenza and pneumonia (J09-J18)

J11

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Influenza due to unidentified influenza virus

Influenza due to unidentified influenza virus

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

Basket needed

Code Book Path

Official
J1Influenza and pneumonia (J09-J18)
J11Influenza due to unidentified influenza virus

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J11 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J11 in this effective period.

Related Child Codes

Official
J11.0Influenza due to unidentified influenza virus with pneumonia
J11.1Influenza due to unidentified influenza virus with other respiratory manifestations
J11.2Influenza due to unidentified influenza virus with gastrointestinal manifestations
J11.8Influenza due to unidentified influenza virus with other manifestations

Includes

Official

ICD-10-CM does not list Includes notes for J11 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for J11 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for J11 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J11 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for J11 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

What This Code Means

J11 is the ICD-10-CM diagnosis code for influenza due to unidentified influenza virus. J11 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering influenza and pneumonia (j09-j18).

Header codes like J11 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at J11's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for J11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

J11Influenza due to unidentified influenza virus
J11Influenza due to unidentified influenza virus

Open J11 in the Interactive Encoder

See full code details, coding tips, HCC mappings, and related codes in the interactive encoder. Pro includes 14 days to try the full workflow.