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Home/Diagnosis/ICD-10 Coding for Empyema

ICD-10 Coding for Empyema

J86.0
J86.9
J85.1

Complete ICD-10-CM coding and documentation guide for icd-10 coding for empyema includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Pyothorax
Pleural empyema
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Key Information: ICD-10 Coding for Empyema

Essential facts and insights about ICD-10 Coding for Empyema

Use ICD-10 code J86.0 for pyothorax with fistula, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Pyothorax with fistula

Billable Code
J86.0
Billable

Diagnostic Criteria

  • • Presence of bronchopleural or pleurocutaneous fistula

Applicable To

  • • Bronchopleural fistula
  • • Pleurocutaneous fistula

Important Notes

  • • Ensure documentation specifies fistula presence.

Pyothorax without fistula

Billable Code
J86.9
Billable

Diagnostic Criteria

  • • Pleural fluid analysis showing pus
  • • Imaging showing loculated pleural effusion

Applicable To

  • • Empyema without fistula

Important Notes

  • • Ensure documentation specifies presence of pus.

Abscess of lung with pneumonia

Billable Code
J85.1
Billable

Diagnostic Criteria

  • • Imaging showing lung abscess
  • • Concurrent empyema

Applicable To

  • • Lung abscess with empyema

Important Notes

  • • Sequence pneumonia code first if it is the underlying cause.
Ancillary Codes

Additional codes that may be used with this diagnosis

B95-B97

Bacterial and viral infectious agents

Use when the causative organism is identified.

Frequently Asked Questions

What is the ICD-10 code for empyema?

The ICD-10 code for empyema without fistula is J86.9, while empyema with fistula is coded as J86.0.

How do you code empyema secondary to pneumonia?

Code the underlying pneumonia first (e.g., J18.9) followed by the empyema code (J86.9).

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