FY2027 ICD-10-CM reference
J13: Pneumonia due to Streptococcus pneumoniae
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Pneumonia due to Streptococcus pneumoniae. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
FY2027 Tabular instructions
Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.
Instructional note
When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Source: J00-J99 (chapter, inherited).
Instructional note
code, where applicable, to identify:
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to environmental tobacco smoke (Z77.22)
Source: J00-J99 (chapter, inherited).
Instructional note
exposure to tobacco smoke in the perinatal period (P96.81)
Source: J00-J99 (chapter, inherited).
Instructional note
history of tobacco dependence (Z87.891)
Source: J00-J99 (chapter, inherited).
Instructional note
occupational exposure to environmental tobacco smoke (Z57.31)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco dependence (F17.-)
Source: J00-J99 (chapter, inherited).
Instructional note
tobacco use (Z72.0)
Source: J00-J99 (chapter, inherited).
Excludes2
certain conditions originating in the perinatal period (P04-P96)
Source: J00-J99 (chapter, inherited).
Excludes2
certain infectious and parasitic diseases (A00-B99)
Source: J00-J99 (chapter, inherited).
Excludes2
complications of pregnancy, childbirth and the puerperium (O00-O9A)
Source: J00-J99 (chapter, inherited).
Excludes2
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
Source: J00-J99 (chapter, inherited).
Excludes2
endocrine, nutritional and metabolic diseases (E00-E88)
Source: J00-J99 (chapter, inherited).
Excludes2
injury, poisoning and certain other consequences of external causes (S00-T88)
Source: J00-J99 (chapter, inherited).
Excludes2
neoplasms (C00-D49)
Source: J00-J99 (chapter, inherited).
Excludes2
smoke inhalation (T59.81-)
Source: J00-J99 (chapter, inherited).
Excludes2
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Source: J00-J99 (chapter, inherited).
Instructional note
code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Source: J09-J18 (section, inherited).
Excludes2
allergic or eosinophilic pneumonia (J82)
Source: J09-J18 (section, inherited).
Excludes2
aspiration pneumonia NOS (J69.0)
Source: J09-J18 (section, inherited).
Excludes2
meconium pneumonia (P24.01)
Source: J09-J18 (section, inherited).
Excludes2
neonatal aspiration pneumonia (P24.-)
Source: J09-J18 (section, inherited).
Excludes2
pneumonia due to solids and liquids (J69.-)
Source: J09-J18 (section, inherited).
Excludes2
congenital pneumonia (P23.9)
Source: J09-J18 (section, inherited).
Excludes2
lipid pneumonia (J69.1)
Source: J09-J18 (section, inherited).
Excludes2
rheumatic pneumonia (I00)
Source: J09-J18 (section, inherited).
Excludes2
ventilator associated pneumonia (J95.851)
Source: J09-J18 (section, inherited).
Instructional note
Bronchopneumonia due to S. pneumoniae
Source: J13 (category, direct).
Code first
, if applicable, associated influenza (J09.X1, J10.0-, J11.0-)
Source: J13 (category, direct).
Code also
, if applicable, any associated condition such as:
Source: J13 (category, direct).
Code also
abscess (J85.1)
Source: J13 (category, direct).
Code also
aspiration pneumonia (J69.-)
Source: J13 (category, direct).
Excludes1
congenital pneumonia due to S. pneumoniae (P23.6)
Source: J13 (category, direct).
Excludes1
lobar pneumonia, unspecified organism (J18.1)
Source: J13 (category, direct).
Excludes1
pneumonia due to other streptococci (J15.3-J15.4)
Source: J13 (category, direct).
Compare the FY2027 additions, removals and billable-status changes
What does J13 mean in FY2027?
The official ICD-10-CM descriptor is Pneumonia due to Streptococcus pneumoniae. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is J13 billable in FY2027?
The FY2027 order file marks J13 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does J13 map to an HCC?
J13 has no CMS-HCC V28 category in the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service). ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.
Review the FY2026 April edition