ICD-10 · PDGM grouping

J09-J18 — Influenza and pneumonia

Every ICD-10-CM code in this range and the PDGM clinical group CMS assigns to it, read from the CMS grouper crosswalk v07.1.26.

OASIS-E2 v1.00.0 · ingested 2026-04-26

Codes in range

53

No clinical group

2

A period cannot be grouped from these.

Barred as primary

1

CMS rejects these in the primary position.

Where these codes group

47 of the 53 codes in J09-J18 group to MMTA - Respiratory, but the range is not uniform — it spreads across 2 clinical groups. A further 2 are assigned no clinical group at all, which means a 30-day period cannot be grouped from them.

Every code in J09-J18

Descriptions are CMS’s own, abbreviated as CMS abbreviates them.

CodeDescriptionClinical groupPrimary position
J09X1Influenza due to ident novel influenza A virus w pneumoniaLAccepted
J09X2Flu due to ident novel influenza A virus w oth resp manifestLAccepted
J09X3Influenza due to ident novel influenza A virus w GI manifestLAccepted
J09X9Flu due to ident novel influenza A virus w oth manifestLAccepted
J1000Flu due to oth ident flu virus w unsp type of pneumoniaLAccepted
J1001Flu due to oth ident flu virus w same oth ident flu virus pnLAccepted
J1008Influenza due to oth ident influenza virus w oth pneumoniaLAccepted
J101Flu due to oth ident influenza virus w oth resp manifestLAccepted
J102Influenza due to oth ident influenza virus w GI manifestLAccepted
J1081Influenza due to oth ident influenza virus w encephalopathyLAccepted
J1082Influenza due to oth ident influenza virus w myocarditisAAccepted
J1083Influenza due to oth ident influenza virus w otitis mediaAAccepted
J1089Influenza due to oth ident influenza virus w oth manifestLAccepted
J1100Flu due to unidentified flu virus w unsp type of pneumoniaLAccepted
J1108Flu due to unidentified flu virus w specified pneumoniaLAccepted
J111Flu due to unidentified influenza virus w oth resp manifestLAccepted
J112Influenza due to unidentified influenza virus w GI manifestLAccepted
J1181Flu due to unidentified influenza virus w encephalopathyLAccepted
J1182Influenza due to unidentified influenza virus w myocarditisAAccepted
J1183Influenza due to unidentified influenza virus w otitis mediaAAccepted
J1189Influenza due to unidentified influenza virus w oth manifestLAccepted
J120Adenoviral pneumoniaLAccepted
J121Respiratory syncytial virus pneumoniaLAccepted
J122Parainfluenza virus pneumoniaLAccepted
J123Human metapneumovirus pneumoniaLAccepted
J1281Pneumonia due to SARS-associated coronavirusLAccepted
J1282Pneumonia due to coronavirus disease 2019NoneNot accepted
J1289Other viral pneumoniaLAccepted
J129Viral pneumonia, unspecifiedLAccepted
J13Pneumonia due to Streptococcus pneumoniaeLAccepted
J14Pneumonia due to Hemophilus influenzaeLAccepted
J150Pneumonia due to Klebsiella pneumoniaeLAccepted
J151Pneumonia due to PseudomonasLAccepted
J1520Pneumonia due to staphylococcus, unspecifiedLAccepted
J15211Pneumonia due to methicillin suscep staphLAccepted
J15212Pneumonia due to Methicillin resistant Staphylococcus aureusLAccepted
J1529Pneumonia due to other staphylococcusLAccepted
J153Pneumonia due to streptococcus, group BLAccepted
J154Pneumonia due to other streptococciLAccepted
J155Pneumonia due to Escherichia coliLAccepted
J1561Pneumonia due to Acinetobacter baumanniiLAccepted
J1569Pneumonia due to other Gram-negative bacteriaLAccepted
J157Pneumonia due to Mycoplasma pneumoniaeLAccepted
J158Pneumonia due to other specified bacteriaLAccepted
J159Unspecified bacterial pneumoniaLAccepted
J160Chlamydial pneumoniaLAccepted
J168Pneumonia due to other specified infectious organismsLAccepted
J17Pneumonia in diseases classified elsewhereNoneCannot group
J180Bronchopneumonia, unspecified organismLAccepted
J181Lobar pneumonia, unspecified organismLAccepted
J182Hypostatic pneumonia, unspecified organismLAccepted
J188Other pneumonia, unspecified organismLAccepted
J189Pneumonia, unspecified organismLAccepted

Source: CMS HH PPS Grouper Software v07.1.26, effective 2026-04-01. 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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