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J15.7

Billable

Pneumonia due to Mycoplasma pneumoniae

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

This is a lung infection caused by a specific bacterium called Mycoplasma pneumoniae, which typically causes a mild to moderate pneumonia often called 'walking pneumonia' because patients can sometimes continue their daily activities despite being sick.

Coding Tips

  • Ensure the documentation specifically identifies Mycoplasma pneumoniae as the causative organism; do not use this code for pneumonia of unspecified organism
  • This code is more specific than general pneumonia codes, so use it when the organism is confirmed through culture, PCR, or serological testing rather than presumptive diagnosis

Code Hierarchy

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