ICD-10 J94.8
Billable / Specific CCOther specified pleural conditions
About ICD-10-CM J94.8
ICD-10-CM code J94.8 represents Other specified pleural conditions. This is a billable/specific code in the Respiratory System chapter (block J94). The 2026 edition of ICD-10-CM J94.8 became effective on October 1, 2025.
Coding Tips for J94.8
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
J94.8 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 J94.8. Per CMS ICD-10-CM Tabular 2026.
- Hydropneumothorax
- Hydrothorax
Inpatient DRG Impact, CC
code Other specified pleural conditions. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for J94.8
Local Coverage Determinations (LCDs) from CMS MACs that list J94.8 as a covered diagnosis.
Showing top 10 of 137 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing J94.8.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with J94.8
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.
Convert J94.8 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 |
|---|---|---|
| J94.8 | 5110 | 10000 |
| J94.8 | 51189 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To J94.8
Other codes in section J90-J94 (Other diseases of the pleura).
ICD-10 J94.8, Billing FAQ
Is ICD-10 code J94.8 billable? +
Yes, J94.8 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 J94.8? +
ICD-10 J94.8 includes: Hydropneumothorax; Hydrothorax.
Is J94.8 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 ICD-9 codes does J94.8 map to? +
Per CMS GEMs, J94.8 maps to ICD-9 codes: 5110, 51189. 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 May 31, 2026.
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