What is ICD-10 code J15.8?

J15.8 is the ICD-10-CM diagnosis code for Pneumonia due to other specified bacteria. A lung infection caused by a specific bacterium that does not fit into the other bacterial pneumonia categories. It belongs to the ICD-10-CM chapter for diseases of the respiratory system (j00-j99). J15.8 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. J15.8 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. J15.8 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. J15.8 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does J15.8 map to under V28?

J15.8 maps to CMS-HCC V28 HCC 282 (Aspiration and Specified Bacterial Pneumonias). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM J15.8: Pneumonia due to other

J15.8 maps to CMS-HCC V28 282. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupJ15.8Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

J15.8

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Pneumonia due to other specified bacteria

A lung infection caused by a specific bacterium that does not fit into the other bacterial pneumonia categories.

Buddy Insight

This code captures pneumonia caused by specified bacteria not classified elsewhere in the J15 category, such as Staphylococcus aureus (non-MRSA strains covered under J15.

CMS-HCC V28

Mapped

HCC 282

Aspiration and Specified Bact...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 163

HHS-HCC 163 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 114

Aspiration and Specified Bact...

Code-level coefficient reference

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

J15Bacterial pneumonia, not elsewhere classified

J15.8Pneumonia due to other specified bacteria

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for J15.8 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for J15.8 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 J15.8 in this effective period.

Code Also

Official

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

Buddy Documentation Tip

HCC Buddy guidance

Identification of the specific bacterial organism causing the pneumonia

Confirmation that the organism does not have its own more specific ICD-10 code

Clinical findings consistent with pneumonia: symptoms, physical exam, vital signs

Radiographic evidence of pulmonary infiltrate or consolidation

MEAT Support

HCC Buddy guidance

Identification of the specific bacterial organism causing the pneumonia

Confirmation that the organism does not have its own more specific ICD-10 code

Clinical findings consistent with pneumonia: symptoms, physical exam, vital signs

Radiographic evidence of pulmonary infiltrate or consolidation

Audit Caution

HCC Buddy guidance

Using J15.8 when a more specific code exists for the identified organism (always check J15.0-J15.69 first)

Confusing 'other specified' (J15.8) with 'unspecified' (J15.9) — J15.8 requires a named organism

Not querying when the provider documents an unusual organism but does not link it to the pneumonia diagnosis

Common Mistakes

HCC Buddy guidance

J15.9 — Unspecified bacterial pneumonia: use only when no organism is identified; J15.8 requires a named organism

J15.2 — Pneumonia due to staphylococcus, unspecified: use for staphylococcal pneumonia when specific species not stated

J15.21 — Pneumonia due to MRSA: use specifically for methicillin-resistant Staphylococcus aureus

J16.0 — Chlamydial pneumonia: atypical organisms have their own codes outside J15

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is J15.8 an HCC code?

Yes. J15.8 (Pneumonia due to other specified bacteria) maps to HCC 282, Aspiration and Specified Bacterial Pneumonias under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.440. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: J15.8 is billable and maps to V28 HCC 282, Aspiration and Specified Bacterial Pneumonias. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: J15.8
Description: Pneumonia due to other specified bacteria
HCC (V28): HCC 282 — Aspiration and Specified Bacterial Pneumonias
RAF reference coefficient: 0.440
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 282, Aspiration and Specified Bacterial Pneumonias

0.440

ESRDHCC 114, Aspiration and Specified Bacterial Pneumonias

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work J15.8 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for J15.8

For J15.8 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed J15.8 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

J15.8 is the ICD-10-CM diagnosis code for pneumonia due to other specified bacteria. A lung infection caused by a specific bacterium that does not fit into the other bacterial pneumonia categories. J15.8 sits in the ICD-10-CM chapter for diseases of the respiratory system (j00-j99), within the section covering influenza and pneumonia (j09-j18).

Under the CMS-HCC V28 risk adjustment model, J15.8 maps to Aspiration and Specified Bacterial Pneumonias (HCC 282) with a source-labeled community, non-dual, aged reference coefficient of 0.440. No V24 mapping is shown for J15.8; use the applicable model and payment year when reviewing the V28 mapping. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Document the specific bacterial organism identified to support medical necessity. Because J15.8 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for J15.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Document the specific bacterial organism identified to support medical necessity
•Review all J15 subcategories to ensure a more specific code is not available before using this code

Clinical Significance

This code captures pneumonia caused by specified bacteria not classified elsewhere in the J15 category, such as Staphylococcus aureus (non-MRSA strains covered under J15.2), Legionella, or other uncommon bacterial pathogens. Organism-specific coding demonstrates a higher level of diagnostic precision and appropriately captures illness severity for risk adjustment.

Documentation Requirements

✓Identification of the specific bacterial organism causing the pneumonia
✓Confirmation that the organism does not have its own more specific ICD-10 code
✓Clinical findings consistent with pneumonia: symptoms, physical exam, vital signs
✓Radiographic evidence of pulmonary infiltrate or consolidation
✓Antibiotic treatment plan targeting the identified organism

Commonly Confused Codes

•J15.9: Unspecified bacterial pneumonia: use only when no organism is identified; J15.8 requires a named organism
•J15.2: Pneumonia due to staphylococcus, unspecified: use for staphylococcal pneumonia when specific species not stated
•J15.21: Pneumonia due to MRSA: use specifically for methicillin-resistant Staphylococcus aureus
•J16.0: Chlamydial pneumonia: atypical organisms have their own codes outside J15
•J15.0 through J15.69: Check for specific organism codes before defaulting to J15.8