ICD-10 J91
Non-Billable HeaderPleural effusion in conditions classified elsewhere
About ICD-10-CM J91
ICD-10-CM code J91 represents Pleural effusion in conditions classified elsewhere. This is a non-billable header code in the Respiratory System chapter (block J91). The 2026 edition of ICD-10-CM J91 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 2 Excludes
Not included here, the excluded code is not part of J91, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- pleural effusion in heart failure (I50.-)
- pleural effusion in systemic lupus erythematosus (M32.13)
Medicare LCD Coverage for J91
Local Coverage Determinations (LCDs) from CMS MACs that list J91 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 J91.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but J91 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with J91
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 J91
Other codes in section J90-J94 (Other diseases of the pleura).
ICD-10 J91, Billing FAQ
Is ICD-10 code J91 billable? +
No, J91 is a non-billable header code. Use a more specific child code from block J91 when submitting claims.
What codes are Type 2 Excludes for J91? +
Type 2 Excludes (may be coded together when both conditions exist): pleural effusion in heart failure (I50.-); pleural effusion in systemic lupus erythematosus (M32.13)
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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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