J15.20
Pneumonia due to staphylococcus, unspecified
J15.20 (also written J1520) is a billable ICD-10-CM diagnosis code for pneumonia due to staphylococcus, unspecified. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 14 codes in category J15 (Bacterial 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, 4 Excludes1 entries and 18 Excludes2 entries.
Code first
If the underlying condition listed here is present and known, sequence it first.
Use additional code
Add the listed code as a secondary code, if known.
Also from chapter/block level (8 notes)
- code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
Code also
Two codes may be needed to describe the condition. This note gives no sequencing order.
Excludes1
Not coded here. The listed conditions generally should not be reported together.
Excludes2
Not included here. Both codes may be reported if the patient has both conditions.
Also from chapter/block level (18 notes)
- 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, 2026Hospital 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 129 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 CIncludes
Further defines or gives examples of the content of the category.
- bronchopneumonia due to bacteria other than S. pneumoniae and H. influenzae
Notes
Also from chapter/block level (1 note)
- 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