J15.211
BillablePneumonia due to Methicillin susceptible Staphylococcus aureus
HCC Category Mapping
V28HCC 282 — Aspiration and Specified Bacterial Pneumonias
0.711V24HCC 114 — Aspiration and Specified Bacterial Pneumonias
0.339ESRDHCC 114 — Aspiration and Specified Bacterial Pneumonias
0.000What This Code Means
Pneumonia caused by Methicillin-susceptible Staphylococcus aureus (MSSA), a strain of staph bacteria that responds to standard antibiotics.
Coding Tips
- •Ensure susceptibility testing confirms methicillin susceptibility before using this code
- •This distinction is important for antibiotic selection and treatment guidance
Clinical Significance
Pneumonia due to Methicillin-susceptible Staphylococcus aureus (MSSA) is a significant bacterial respiratory infection that increases morbidity, particularly in elderly and immunocompromised patients. MSSA pneumonia, while susceptible to standard anti-staphylococcal antibiotics, still represents a serious infection particularly in post-influenza settings and may cause necrotizing pneumonia. Accurate organism identification impacts treatment decisions, infection control measures, and risk stratification.
Documentation Requirements
- ✓Documentation of pneumonia diagnosis with causative organism identified as Methicillin-susceptible Staphylococcus aureus (MSSA)
- ✓Chest imaging (X-ray or CT) findings consistent with pneumonia
- ✓Clinical signs and symptoms documented (fever, cough, dyspnea, sputum production)
- ✓Culture, sputum, or molecular testing results confirming the specific organism
- ✓Antibiotic therapy prescribed and documented
- ✓Severity assessment (need for oxygen, hospitalization, intensive care)
- ✓Susceptibility testing results documenting methicillin resistance or susceptibility
Commonly Confused Codes
J15.212 — MRSA pneumonia; resistance pattern is the critical distinction — verify susceptibility resultsJ15.20 — Staphylococcal pneumonia, unspecified; use only when susceptibility is not yet determinedJ15.29 — Pneumonia due to other staphylococcus; use for non-aureus speciesJ18.9 — Pneumonia, unspecified organism; do not use when the causative organism has been identified
Code Hierarchy
└J15Bacterial pneumonia, not elsewhere classified└J15.2Pneumonia due to staphylococcus└J15.21Pneumonia due to staphylococcus aureus└J15.211Pneumonia due to Methicillin susceptible Staphylococcus aureus
└J15.211Pneumonia due to Methicillin susceptible Staphylococcus aureus