J12.9

Viral pneumonia, unspecified

FY2027Chapter 10: Diseases of the respiratory system/J09–J18 Influenza and pneumonia

BillableComplete code, valid to report

J12.9 (also written J129) is a billable ICD-10-CM diagnosis code for viral pneumonia, unspecified. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 8 codes in category J12 (Viral pneumonia, not elsewhere classified). The Alphabetic Index lists it under 2 entries. Its coding notes include a Code first instruction, a Use additional code instruction, a Code also instruction and 28 Excludes2 entries.

Code first

If the underlying condition listed here is present and known, sequence it first.

Inherited from J12 Viral pneumonia, not elsewhere classified

Use additional code

Add the listed code as a secondary code, if known.

Also from chapter/block level (8 notes)
Inherited from J09–J18 Influenza and pneumonia
  • code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Inherited from Chapter 10 Diseases of the respiratory system
  • code, where applicable, to identify:
    • exposure to environmental tobacco smoke (Z77.22)
    • exposure to tobacco smoke in the perinatal period (P96.81)
    • history of tobacco dependence (Z87.891)
    • occupational exposure to environmental tobacco smoke (Z57.31)
    • tobacco dependence (F17.-)
    • tobacco use (Z72.0)

Code also

Two codes may be needed to describe the condition. This note gives no sequencing order.

Inherited from J12 Viral pneumonia, not elsewhere classified
  • associated abscess, if applicable (J85.1)

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Inherited from J12 Viral pneumonia, not elsewhere classified
  • aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
  • aspiration pneumonia due to anesthesia during pregnancy (O29)
  • aspiration pneumonia due to anesthesia during puerperium (O89.0)
  • aspiration pneumonia due to solids and liquids (J69.-)
  • aspiration pneumonia NOS (J69.0)
  • congenital pneumonia (P23.0)
  • congenital rubella pneumonitis (P35.0)
  • interstitial pneumonia NOS (J84.9)
  • lipid pneumonia (J69.1)
  • neonatal aspiration pneumonia (P24.-)
Also from chapter/block level (18 notes)
Inherited from J09–J18 Influenza and pneumonia
  • allergic or eosinophilic pneumonia (J82)
  • aspiration pneumonia NOS (J69.0)
  • meconium pneumonia (P24.01)
  • neonatal aspiration pneumonia (P24.-)
  • pneumonia due to solids and liquids (J69.-)
  • congenital pneumonia (P23.9)
  • lipid pneumonia (J69.1)
  • rheumatic pneumonia (I00)
  • ventilator associated pneumonia (J95.851)
Inherited from Chapter 10 Diseases of the respiratory system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • smoke inhalation (T59.81-)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Respiratory clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital MCC

Counts as a major complication or comorbidity (MCC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 121 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

Includes

Further defines or gives examples of the content of the category.

Inherited from J12 Viral pneumonia, not elsewhere classified
  • bronchopneumonia due to viruses other than influenza viruses

Notes

Also from chapter/block level (1 note)
Inherited from Chapter 10 Diseases of the respiratory system
  • 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).

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 2 entries