J15 ICD-10-CM Code: Bacterial pneumonia, not elsewhere classified
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)
J15
Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidanceBacterial pneumonia, not elsewhere classified
Bacterial pneumonia, not elsewhere classified
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
Code Trumping
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Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for J15 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for J15 in this effective period.
Related Child Codes
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
OfficialICD-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