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ICD-10-CM 2027 diagnosis code

J12.89Other viral pneumonia

✓ Billable / specificMCC — major complication/comorbidity

J12.89 is a valid, billable ICD-10-CM code for other viral pneumonia. It can be reported on claims for dates of service from October 1, 2026 – September 30, 2027.

Code unchanged since ICD-10-CM took effect on October 1, 2015. Source: official FY2027 ICD-10-CM release from CDC/NCHS and CMS. Page updated September 29, 2026. About our data

About J12.89

J12.89 is the ICD-10-CM diagnosis code for other viral pneumonia. It belongs to category J12 (viral pneumonia, not elsewhere classified), block J09-J18 (influenza and pneumonia) and chapter 10 (diseases of the respiratory system). It is billable, so it can be reported on its own for dates of service from October 1, 2026 through September 30, 2027.

Within J12.8, choose J12.89 (Other viral pneumonia) only when documentation doesn't support a more specific option: pneumonia due to SARS-associated coronavirus (J12.81) and pneumonia due to coronavirus disease 2019 (J12.82).

Code first: associated influenza, if applicable (J09.X1, J10.0-, J11.0-).

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 193 (Simple Pneumonia and Pleurisy with MCC, relative weight 1.2825), DRG 194 (Simple Pneumonia and Pleurisy with CC, relative weight 0.7888), DRG 195 (Simple Pneumonia and Pleurisy without CC/MCC, relative weight 0.6063), DRG 974 (HIV with Major Related Condition with MCC, relative weight 3.0506), DRG 975 (HIV with Major Related Condition with CC, relative weight 1.3252) and DRG 976 (HIV with Major Related Condition without CC/MCC, relative weight 0.8124), in MDC 04 (Diseases and Disorders of the Respiratory System) and MDC 25 (Human Immunodeficiency Virus Infections), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.

It has been part of ICD-10-CM since the code set took effect on October 1, 2015 and hasn't changed since.

Before ICD-10, this condition was coded in ICD-9-CM as 480.8 (pneumonia due to other virus not elsewhere classified).

Notes that apply from higher levels

Instructions written at a parent level also apply to J12.89.

› From J12 Viral pneumonia, not elsewhere classified
Includes
  • bronchopneumonia due to viruses other than influenza viruses
Excludes2
  • 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)
  • congenital pneumonia (P23.0)
  • congenital rubella pneumonitis (P35.0)
  • interstitial pneumonia NOS (J84.9)
  • lipid pneumonia (J69.1)
  • neonatal aspiration pneumonia (P24.-)
Code first
Code also
  • associated abscess, if applicable (J85.1)

Broader instructions also apply from J09-J18 Influenza and pneumonia and Chapter 10: Diseases of the respiratory system.

Alphabetic index entries

2 entries

Terms in the official ICD-10-CM index that lead to J12.89.

MS-DRG v44.0 grouping

All DRGs →

Inpatient MS-DRGs this diagnosis can group to, as the principal or a secondary diagnosis, depending on the rest of the claim.

ICD-9-CM equivalent

Converter →
  • 480.8Pneumonia due to other virus not elsewhere classifiedapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about J12.89

Is J12.89 billable?

Yes. J12.89 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can J12.89 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict J12.89 as a principal diagnosis.

Is J12.89 a CC or MCC?

J12.89 is an MCC (major complication or comorbidity) under MS-DRG v44.0, unless excluded by the principal diagnosis.

What DRG does J12.89 group to?

J12.89 is used in the MS-DRG v44.0 logic for MS-DRG 193 (Simple Pneumonia and Pleurisy with MCC), MS-DRG 194 (Simple Pneumonia and Pleurisy with CC), MS-DRG 195 (Simple Pneumonia and Pleurisy without CC/MCC), MS-DRG 974 (HIV with Major Related Condition with MCC), MS-DRG 975 (HIV with Major Related Condition with CC) and MS-DRG 976 (HIV with Major Related Condition without CC/MCC). Which one applies depends on whether it is the principal diagnosis and on the rest of the claim.

What is the ICD-9 code for J12.89?

The CMS General Equivalence Mappings map J12.89 to ICD-9-CM 480.8.