ICD-10 · PDGM grouping
J11 Influenza due to unidentified influenza virus
All 8 codes in the J11 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
8
Can lead a claim
8
Cannot lead a claim
0
What CMS assigns to J11
All 8 codes group to MMTA - Respiratory (6) and MMTA - Other (2). All 8 count toward the Influenza comorbidity subgroup. Every code can lead a claim.
- Influenza
Every code in J11
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| J11.0 Influenza due to unidentified influenza virus with pneumonia | ||||
| J11.00 | Influenza due to unidentified influenza virus with unspecified type of pneumoniaCMS: Flu due to unidentified flu virus w unsp type of pneumonia | Can lead a claim | L | Influenza |
| J11.08 | Influenza due to unidentified influenza virus with specified pneumoniaCMS: Flu due to unidentified flu virus w specified pneumonia | Can lead a claim | L | Influenza |
| J11.1 | Influenza due to unidentified influenza virus with other respiratory manifestationsCMS: Flu due to unidentified influenza virus w oth resp manifest | Can lead a claim | L | Influenza |
| J11.2 | Influenza due to unidentified influenza virus with gastrointestinal manifestationsCMS: Influenza due to unidentified influenza virus w GI manifest | Can lead a claim | L | Influenza |
| J11.8 Influenza due to unidentified influenza virus with other manifestations | ||||
| J11.81 | Influenza due to unidentified influenza virus with encephalopathyCMS: Flu due to unidentified influenza virus w encephalopathy | Can lead a claim | L | Influenza |
| J11.82 | Influenza due to unidentified influenza virus with myocarditisCMS: Influenza due to unidentified influenza virus w myocarditis | Can lead a claim | A | Influenza |
| J11.83 | Influenza due to unidentified influenza virus with otitis mediaCMS: Influenza due to unidentified influenza virus w otitis media | Can lead a claim | A | Influenza |
| J11.89 | Influenza due to unidentified influenza virus with other manifestationsCMS: Influenza due to unidentified influenza virus w oth manifest | Can lead a claim | L | Influenza |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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