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J94.9

Billable

Pleural condition, unspecified

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

What This Code Means

A pleural condition or disease affecting the lung lining when the specific type has not been determined or documented.

Coding Tips

  • This is a default code; attempt to obtain more specific documentation from the provider before coding
  • Query the physician if imaging or clinical findings suggest a more specific pleural diagnosis

Code Hierarchy

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