Pneumonia, NOS

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ICD10 Diagnosis
Dx: Pneumonia, NOS
ICD10 code: J18
Pre-ICD10 counterpart: CAP-Community Acquired Pneumonia, HAP-Hospital Acquired Pneumonia, VAP - Ventilator Associated Pneumonia
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: Respiratory Infection
External ICD10 Documentation
This diagnosis is a part of ICD10 collection.



Additional Info

  • Mainly, this code is used when it's believed an infectious pneumonia is present, but if the type of organism is not known (i.e. it can not be coded more specifically).


VAP supersedes this code

HAP vs CAP

  • For coding of hospital-acquired Pneumonia, NOS, see Hospital-acquired pneumonia (HAP) in ICD10
  • To decide about whether a CAP or HAP has occurred, requires clinical correlation.
    • For example, sputum is almost never sterile -- bugs will always grow from it. It's even true that bronchoscopic lower respiratory samples are almost never sterile, which is why quantitative culture is used to interpret them. THUS, respiratory fluid that grows bugs cannot by itself be used to interpret the presence of pneumonia EXCEPT in the rare cases of bugs that are never pathogens in the respiratory system -- that list is mainly limited to: TB, Legionella, and Pneumocystis jiroveci. Thus, a (+) sputum culture can almost never by itself be used to identify the presence of a pneumonia. Instead, it's a combination of clinical signs such as fever, leukocytosis and new (or presumed new) CXR changes that helps to figure it out. Indeed, one can diagnose CAP or VAP in the absence of a (+)sputum culture in the right situation (e.g. patient has been on antibiotics for some reason prior).

Alternate ICD10s to consider coding instead or in addition

Pneumonia codes:

Candidate Combined ICD10 codes

Infections

Infections in ICD10 have combined coding requirements for some of their pathogens. Any that have antibiotic resistances would store those as Combined ICD10 codes as well. If the infection is acquired in the hospital, see Nosocomial infection, NOS. See Lab and culture reports for confirmation and details about tests. See Infections in ICD10 for more general info.

Infection requiring pathogen

This diagnosis is an infection that requires a pathogen to be coded.

Pathogens codes:

Attribution of infections

See Attribution of infections

Related CCI Codes

Data Integrity Checks (SMW)

 AppStatus
Check Inf Pathogens must have Infection requiring pathogen or Potential InfectionCCMDB.accdbimplemented
Query check ICD10 Inf Infection req Pathogen must have oneCCMDB.accdbimplemented

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