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FY2027 ICD-10-CM reference

J18: Pneumonia, unspecified organism

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Pneumonia, unspecified organism. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Nonbillable heading. Verified against the official FY2027 order file.

CMS-HCC V28

Not applicable to this nonbillable heading

CMS-HCC V24

Not applicable to this nonbillable heading

ESRD

Not applicable to this nonbillable heading

PACE

Not applicable to this nonbillable heading

RxHCC

Not applicable to this nonbillable heading

HHS-HCC

Not applicable to this nonbillable heading

More specific FY2027 codes

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Instructional note

When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).

Source: J00-J99 (chapter, inherited).

Instructional note

code, where applicable, to identify:

Source: J00-J99 (chapter, inherited).

Instructional note

exposure to environmental tobacco smoke (Z77.22)

Source: J00-J99 (chapter, inherited).

Instructional note

exposure to tobacco smoke in the perinatal period (P96.81)

Source: J00-J99 (chapter, inherited).

Instructional note

history of tobacco dependence (Z87.891)

Source: J00-J99 (chapter, inherited).

Instructional note

occupational exposure to environmental tobacco smoke (Z57.31)

Source: J00-J99 (chapter, inherited).

Instructional note

tobacco dependence (F17.-)

Source: J00-J99 (chapter, inherited).

Instructional note

tobacco use (Z72.0)

Source: J00-J99 (chapter, inherited).

Excludes2

certain conditions originating in the perinatal period (P04-P96)

Source: J00-J99 (chapter, inherited).

Excludes2

certain infectious and parasitic diseases (A00-B99)

Source: J00-J99 (chapter, inherited).

Excludes2

complications of pregnancy, childbirth and the puerperium (O00-O9A)

Source: J00-J99 (chapter, inherited).

Excludes2

congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)

Source: J00-J99 (chapter, inherited).

Excludes2

endocrine, nutritional and metabolic diseases (E00-E88)

Source: J00-J99 (chapter, inherited).

Excludes2

injury, poisoning and certain other consequences of external causes (S00-T88)

Source: J00-J99 (chapter, inherited).

Excludes2

neoplasms (C00-D49)

Source: J00-J99 (chapter, inherited).

Excludes2

smoke inhalation (T59.81-)

Source: J00-J99 (chapter, inherited).

Excludes2

symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: J00-J99 (chapter, inherited).

Instructional note

code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)

Source: J09-J18 (section, inherited).

Excludes2

allergic or eosinophilic pneumonia (J82)

Source: J09-J18 (section, inherited).

Excludes2

aspiration pneumonia NOS (J69.0)

Source: J09-J18 (section, inherited).

Excludes2

meconium pneumonia (P24.01)

Source: J09-J18 (section, inherited).

Excludes2

neonatal aspiration pneumonia (P24.-)

Source: J09-J18 (section, inherited).

Excludes2

pneumonia due to solids and liquids (J69.-)

Source: J09-J18 (section, inherited).

Excludes2

congenital pneumonia (P23.9)

Source: J09-J18 (section, inherited).

Excludes2

lipid pneumonia (J69.1)

Source: J09-J18 (section, inherited).

Excludes2

rheumatic pneumonia (I00)

Source: J09-J18 (section, inherited).

Excludes2

ventilator associated pneumonia (J95.851)

Source: J09-J18 (section, inherited).

Code first

, if applicable, associated influenza (J09.X1, J10.0-, J11.0-)

Source: J18 (category, direct).

Code also

, if applicable, any associated condition such as:

Source: J18 (category, direct).

Code also

aspiration pneumonia (J69.-)

Source: J18 (category, direct).

Excludes1

congenital pneumonia (P23.0)

Source: J18 (category, direct).

Excludes1

drug-induced interstitial lung disorder (J70.2-J70.4)

Source: J18 (category, direct).

Excludes1

interstitial pneumonia NOS (J84.9)

Source: J18 (category, direct).

Excludes1

neonatal aspiration pneumonia (P24.-)

Source: J18 (category, direct).

Excludes1

pneumonitis due to fumes and vapors (J68.0)

Source: J18 (category, direct).

Excludes1

usual interstitial pneumonia (J84.178)

Source: J18 (category, direct).

Excludes2

abscess of lung with pneumonia (J85.1)

Source: J18 (category, direct).

Excludes2

aspiration pneumonia due to anesthesia during labor and delivery (O74.0)

Source: J18 (category, direct).

Excludes2

aspiration pneumonia due to anesthesia during pregnancy (O29)

Source: J18 (category, direct).

Excludes2

aspiration pneumonia due to anesthesia during puerperium (O89.0)

Source: J18 (category, direct).

Excludes2

aspiration pneumonia due to solids and liquids (J69.-)

Source: J18 (category, direct).

Excludes2

aspiration pneumonia NOS (J69.0)

Source: J18 (category, direct).

Excludes2

lipid pneumonia (J69.1)

Source: J18 (category, direct).

Excludes2

pneumonitis due to external agents (J67-J70)

Source: J18 (category, direct).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does J18 mean in FY2027?

The official ICD-10-CM descriptor is Pneumonia, unspecified organism. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is J18 billable in FY2027?

The FY2027 order file marks J18 as a nonbillable heading. Select a complete billable child code.

Does J18 map to an HCC?

Risk-model mapping is not applicable to this nonbillable heading. Check a complete billable child code.

Source: CMS FY2027 ICD-10-CM order file. Payment model: CMS CY 2027 Rate Announcement. Read the FY2027 Official Guidelines.

Review the FY2026 April edition