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J15 ICD-10-CM Code: Bacterial pneumonia, not elsewhere classified

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

J15

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

Bacterial pneumonia, not elsewhere classified

Bacterial pneumonia, not elsewhere classified

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

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Code Book Path

Official
J1Influenza and pneumonia (J09-J18)
J15Bacterial pneumonia, not elsewhere classified

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J15 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J15 in this effective period.

Related Child Codes

Official
J15.0Pneumonia due to Klebsiella pneumoniae
J15.1Pneumonia due to Pseudomonas
J15.2Pneumonia due to staphylococcus
J15.3Pneumonia due to streptococcus, group B
J15.4Pneumonia due to other streptococci

Includes

Official
  • bronchopneumonia due to bacteria other than S. pneumoniae and H. influenzae

Excludes 1

Official
  • chlamydial pneumonia (J16.0)
  • congenital pneumonia (P23.-)
  • Legionnaires' disease (A48.1)
  • spirochetal pneumonia (A69.8)

Code First

Official
  • , if applicable, associated influenza (J09.X1, J10.0-, J11.0-)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for J15 in this effective period.

Code Also

Official
  • , if applicable, any associated condition such as:
  • abscess (J85.1)
  • aspiration pneumonia (J69.-)

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

J15 is the ICD-10-CM diagnosis code for bacterial pneumonia, not elsewhere classified. J15 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 J15 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 J15'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 J15 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Includes

  • bronchopneumonia due to bacteria other than S. pneumoniae and H. influenzae

Excludes 1, Do NOT code together

  • chlamydial pneumonia (J16.0)
  • congenital pneumonia (P23.-)
  • Legionnaires' disease (A48.1)
  • spirochetal pneumonia (A69.8)

Code First

Code Also

  • , if applicable, any associated condition such as:
  • abscess (J85.1)
  • aspiration pneumonia (J69.-)

Child Codes

Code Hierarchy

J15Bacterial pneumonia, not elsewhere classified
J15Bacterial pneumonia, not elsewhere classified

More on J15

Referenced in blog posts

Work J15 in HCC Buddy

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