J11 ICD-10-CM Code: Influenza due to unidentified influenza virus
HCC Buddy Code Card
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FY 2026 Apr update / Diseases of the respiratory system (J00-J99) / Influenza and pneumonia (J09-J18)
J11
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceInfluenza due to unidentified influenza virus
Influenza due to unidentified influenza virus
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for J11 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for J11 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for J11 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for J11 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for J11 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for J11 in this effective period.
Code Also
OfficialICD-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.