J15.4
BillablePneumonia due to other streptococci
HCC Category Mapping
V24HCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess
0.339ESRDHCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess
0.000What This Code Means
A bacterial lung infection caused by streptococcal bacteria other than Group B Streptococcus.
Coding Tips
- •Use this code only when the specific streptococcal organism is identified but is not Group B
- •Review documentation to ensure the organism is confirmed as streptococcal rather than other bacterial types
Clinical Significance
Pneumonia caused by streptococcal species other than Streptococcus pneumoniae or Group B Streptococcus represents a specified bacterial pneumonia requiring targeted antibiotic therapy. Accurate organism identification is essential for appropriate treatment and proper risk adjustment coding, as specified bacterial pneumonias carry higher risk weights than unspecified infections.
Documentation Requirements
- ✓Documentation of the specific streptococcal species (e.g., Group A, Group C, Group G Streptococcus) when available
- ✓Culture, sensitivity, or other microbiological evidence supporting the diagnosis
- ✓Clinical presentation consistent with pneumonia: cough, fever, dyspnea, crackles or consolidation on exam
- ✓Radiographic confirmation of pneumonia
- ✓Antibiotic treatment plan with documentation of targeted therapy
Excludes 1 — Do NOT code together
Commonly Confused Codes
J13 — Pneumonia due to Streptococcus pneumoniae: use specifically for pneumococcal pneumoniaJ15.3 — Pneumonia due to streptococcus, group B: use when Group B Streptococcus (S. agalactiae) is specifically identifiedJ15.9 — Unspecified bacterial pneumonia: use only when no organism identified; always prefer specificityJ18.1 — Lobar pneumonia, unspecified organism: describes a pattern of pneumonia, not organism-specific
Code Hierarchy
└J15Bacterial pneumonia, not elsewhere classified└J15.4Pneumonia due to other streptococci
└J15.4Pneumonia due to other streptococci