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ICD-10-CM 2027 diagnosis code

J94.9Pleural condition, unspecified

✓ Billable / specific

J94.9 is a valid, billable ICD-10-CM code for pleural condition, unspecified. 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 J94.9

J94.9 is the ICD-10-CM diagnosis code for pleural condition, unspecified. It belongs to category J94 (other pleural conditions), block J90-J94 (other diseases of the pleura) 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 J94, choose J94.9 (Pleural condition, unspecified) only when documentation doesn't support a more specific option: Chylous effusion (J94.0), Fibrothorax (J94.1), hemothorax (J94.2) and other specified pleural conditions (J94.8).

It is not a CC or MCC, so as a secondary diagnosis it doesn't change the MS-DRG severity level.

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) and DRG 195 (Simple Pneumonia and Pleurisy without CC/MCC, relative weight 0.6063), in MDC 04 (Diseases and Disorders of the Respiratory System), 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 511.0 (pleurisy without mention of effusion or current tuberculosis).

Notes that apply from higher levels

Instructions written at a parent level also apply to J94.9.

› From J94 Other pleural conditions
Excludes1
  • pleurisy NOS (R09.1)
  • traumatic hemopneumothorax (S27.2)
  • traumatic hemothorax (S27.1)
  • tuberculous pleural conditions (current disease) (A15.-)

Broader instructions also apply from Chapter 10: Diseases of the respiratory system.

Alphabetic index entries

1 entries

Terms in the official ICD-10-CM index that lead to J94.9.

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 →
  • 511.0Pleurisy without mention of effusion or current tuberculosisapproximate

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 J94.9

Is J94.9 billable?

Yes. J94.9 is a billable/specific ICD-10-CM code valid for FY2027 (October 1, 2026 – September 30, 2027).

Can J94.9 be used as a principal diagnosis?

Yes. The Medicare Code Editor doesn't restrict J94.9 as a principal diagnosis.

Is J94.9 a CC or MCC?

No. J94.9 is neither a CC nor an MCC under MS-DRG v44.0.

What DRG does J94.9 group to?

J94.9 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) and MS-DRG 195 (Simple Pneumonia and Pleurisy 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 J94.9?

The CMS General Equivalence Mappings map J94.9 to ICD-9-CM 511.0.