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J93.11

Billable

Primary spontaneous pneumothorax

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

What This Code Means

A collapsed lung that occurs suddenly without any underlying lung disease or external injury, typically caused by a small air pocket rupturing in the lung tissue. This is a relatively common condition that can happen spontaneously, especially in tall, thin young adults.

Coding Tips

  • Verify whether the pneumothorax is primary (no underlying lung disease) or secondary (associated with COPD, cystic fibrosis, or other lung conditions) as this affects code selection
  • Document laterality (right vs. left lung) and whether it is the initial episode or a recurrent occurrence, as these details may be required for complete coding

Code Hierarchy

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