J86.0

Pyothorax with fistula

FY2027Chapter 10: Diseases of the respiratory system/J85–J86 Suppurative and necrotic conditions of the lower respiratory tract

BillableComplete code, valid to report

J86.0 (also written J860) is a billable ICD-10-CM diagnosis code for pyothorax with fistula. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 2 codes in category J86 (Pyothorax). The Alphabetic Index lists it under 35 entries. Its coding notes include a Use additional code instruction, a Code also instruction, 2 Excludes1 entries and 9 Excludes2 entries.

Use additional code

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

Inherited from J86 Pyothorax
  • code (B95-B97) to identify infectious agent.
Also from chapter/block level (7 notes)
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.

This code
  • , if applicable, disruption of internal operation (surgical) wound (T81.32-)

Excludes1

Not coded here. The listed conditions generally should not be reported together.

Inherited from J86 Pyothorax
  • abscess of lung (J85.-)
  • pyothorax due to tuberculosis (A15.6)

Excludes2

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

Also from chapter/block level (9 notes)
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 12 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

IPF Comorbidity

On the CMS IPF comorbidity list.

Comorbidity categoryFactor
Chronic Obstructive Pulmonary Disease and Sleep Apnea1.09
It counts as a comorbidity when reported as a secondary diagnosis and actively treated during the stay. An IPF receives only one adjustment within a category and can receive adjustments in more than one category.

Source: CMS IPF PPS FY 2027 final rule (CMS-1847-F), Addendum B-3 (comorbidity codes with adjustment factor); effective for discharges on or after October 1, 2026

Inclusion terms

Conditions classified to this code.

This code
  • Bronchocutaneous fistula
  • Bronchopleural fistula
  • Hepatopleural fistula
  • Mediastinal fistula
  • Pleural fistula
  • Thoracic fistula
  • Any condition classifiable to J86.9 with fistula

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. 35 entries

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