ICD-10 J18
Non-Billable HeaderPneumonia, unspecified organism
About ICD-10-CM J18
ICD-10-CM code J18 represents Pneumonia, unspecified organism. This is a non-billable header code in the Respiratory System chapter (block J18). The 2026 edition of ICD-10-CM J18 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with J18. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- congenital pneumonia (P23.0)
- drug-induced interstitial lung disorder (J70.2-J70.4)
- interstitial pneumonia NOS (J84.9)
- neonatal aspiration pneumonia (P24.-)
- pneumonitis due to fumes and vapors (J68.0)
- usual interstitial pneumonia (J84.178)
Type 2 Excludes
Not included here, the excluded code is not part of J18, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- abscess of lung with pneumonia (J85.1)
- 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)
- lipid pneumonia (J69.1)
- pneumonitis due to external agents (J67-J70)
Coding Notes
Code Also
- , if applicable, any associated condition such as:
- aspiration pneumonia (J69.-)
Code First
- , if applicable, associated influenza (J09.X1, J10.0-, J11.0-)
Medicare LCD Coverage for J18
Local Coverage Determinations (LCDs) from CMS MACs that list J18 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J18.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but J18 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with J18
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To J18
Other codes in section J09-J18 (Influenza and pneumonia).
ICD-10 J18, Billing FAQ
Is ICD-10 code J18 billable? +
No, J18 is a non-billable header code. Use a more specific child code from block J18 when submitting claims.
What codes are Type 1 Excludes for J18? +
Type 1 Excludes (never code together with J18): congenital pneumonia (P23.0); drug-induced interstitial lung disorder (J70.2-J70.4); interstitial pneumonia NOS (J84.9)
What codes are Type 2 Excludes for J18? +
Type 2 Excludes (may be coded together when both conditions exist): abscess of lung with pneumonia (J85.1); aspiration pneumonia due to anesthesia during labor and delivery (O74.0); aspiration pneumonia due to anesthesia during pregnancy (O29)
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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