ICD-10 J86
Non-Billable HeaderPyothorax
About ICD-10-CM J86
ICD-10-CM code J86 represents Pyothorax. This is a non-billable header code in the Respiratory System chapter (block J86). The 2026 edition of ICD-10-CM J86 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 J86. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- abscess of lung (J85.-)
- pyothorax due to tuberculosis (A15.6)
Use Additional Code
When coding J86, also report these additional codes when applicable.
- code (B95-B97) to identify infectious agent.
Medicare LCD Coverage for J86
Local Coverage Determinations (LCDs) from CMS MACs that list J86 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 J86.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but J86 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with J86
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 J86
Other codes in section J85-J86 (Suppurative and necrotic conditions of the lower respiratory tract).
ICD-10 J86, Billing FAQ
Is ICD-10 code J86 billable? +
No, J86 is a non-billable header code. Use a more specific child code from block J86 when submitting claims.
What codes are Type 1 Excludes for J86? +
Type 1 Excludes (never code together with J86): abscess of lung (J85.-); pyothorax due to tuberculosis (A15.6)
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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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