ICD-10 J93.9
Billable / Specific CCPneumothorax, unspecified
About ICD-10-CM J93.9
ICD-10-CM code J93.9 represents Pneumothorax, unspecified. This is a billable/specific code in the Respiratory System chapter (block J93). The 2026 edition of ICD-10-CM J93.9 became effective on October 1, 2025.
Coding Tips for J93.9
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J93.9 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under J93.9. Per CMS ICD-10-CM Tabular 2026.
- Pneumothorax NOS
Inpatient DRG Impact, CC
codes Pneumothorax, unspecified. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for J93.9
Local Coverage Determinations (LCDs) from CMS MACs that list J93.9 as a covered diagnosis.
Showing top 10 of 39 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J93.9.
3 Medicare
1 Aetna
CPT Codes Commonly Billed with J93.9
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 71046 Chest X-ray 2 views — cough, dyspnea, wheezing, chest pain, pneumonia, COPD exacerbation, asthma exacerbation, respiratory failure, lung nodule, pneumothorax, heart failure, hx pneumonia, TB, hypoxemia Radiology
- 71250 CT chest without contrast — pulmonary nodule, lung mass, lung cancer, pulmonary mets, chronic cough, dyspnea, pneumothorax, PE, lung disease, hx lung cancer, bronchial neoplasm Radiology
Convert J93.9 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| J93.9 | 51289 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J93.9
Other codes in section J90-J94 (Other diseases of the pleura).
ICD-10 J93.9, Billing FAQ
Is ICD-10 code J93.9 billable? +
Yes, J93.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to J93.9? +
ICD-10 J93.9 includes: Pneumothorax NOS.
Is J93.9 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with J93.9? +
Procedures frequently paired with J93.9 include: 71046, 71250.
What ICD-9 codes does J93.9 map to? +
Per CMS GEMs, J93.9 maps to ICD-9 codes: 51289. Useful for legacy data review and historical claim analysis.
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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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