FY2027 ICD-10-CM reference
J85.1: Abscess of lung with pneumonia
By the HCC Buddy Coding Team
The official ICD-10-CM descriptor is Abscess of lung with pneumonia. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Billable code. Verified against the official FY2027 order file.
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 (B95-B97) to identify infectious agent.
Source: J85 (category, inherited).
Code also
the type of pneumonia
Source: J85.1 (self, direct).
Compare the FY2027 additions, removals and billable-status changes
What does J85.1 mean in FY2027?
The official ICD-10-CM descriptor is Abscess of lung with pneumonia. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.
Is J85.1 billable in FY2027?
The FY2027 order file marks J85.1 as billable. Check the complete Tabular instructions and documentation before assigning it.
Does J85.1 map to an HCC?
In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), J85.1 maps to CMS-HCC V28 HCC 283 (Empyema, Lung Abscess). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.
Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.
Review the FY2026 April edition