J13
Pneumonia due to Streptococcus pneumoniae
HCC risk adjustment mapping
CMS-HCC ESRD V24
Pneumococcal Pneumonia, Empyema, Lung Abscess
Coding notes
Excludes 1 never coded together · Excludes 2 may co-exist
congenital pneumonia due to S. pneumoniae (P23.6) lobar pneumonia, unspecified organism (J18.1) pneumonia due to other streptococci (J15.3-J15.4)
, if applicable, any associated condition such as: abscess (J85.1) aspiration pneumonia (J69.-)
Bronchopneumonia due to S. pneumoniae
allergic or eosinophilic pneumonia (J82) aspiration pneumonia NOS (J69.0) meconium pneumonia (P24.01) neonatal aspiration pneumonia (P24.-) pneumonia due to solids and liquids (J69.-) congenital pneumonia (P23.9) lipid pneumonia (J69.1) rheumatic pneumonia (I00) ventilator associated pneumonia (J95.851)
code, if applicable, to identify resistance to antimicrobial drugs (Z16.-)
certain conditions originating in the perinatal period (P04-P96) certain infectious and parasitic diseases (A00-B99) complications of pregnancy, childbirth and the puerperium (O00-O9A) congenital malformations, deformations and chromosomal abnormalities (Q00-Q99) endocrine, nutritional and metabolic diseases (E00-E88) injury, poisoning and certain other consequences of external causes (S00-T88) neoplasms (C00-D49) smoke inhalation (T59.81-) symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
code, where applicable, to identify: exposure to environmental tobacco smoke (Z77.22) exposure to tobacco smoke in the perinatal period (P96.81) history of tobacco dependence (Z87.891) occupational exposure to environmental tobacco smoke (Z57.31) tobacco dependence (F17.-) tobacco use (Z72.0)
When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Official Guidelines for J13
FY 2026 ›Sections that reference J13
- I.C.10.d.2)Ventilator associated Pneumonia Develops after Admission
A patient may be admitted with one type of pneumonia (e.g., code J13, Pneumonia due to Streptococcus pneumonia) and subsequently develop VAP. In this instance, the principal diagnosis would be the …
- I.C.10.d.1)Documentation of Ventilator associated Pneumonia
… Do not assign an additional code from categories J12-J18 to identify the type of pneumonia. …
Sections whose FY 2026 text names J13, its J13 category, or a range containing it — the chapter guidance above is the authoritative source.
Find J13 in the alphabetic index
13 index paths lead to this code
- Pneumonia › diplococcal, diplococcus
- Pneumonia › pneumococcal
- Pneumonia › Streptococcus pneumoniae
- Pneumonia › broncho-, bronchial › diplococcal
- Pneumonia › broncho-, bronchial › pneumococcal
- Pneumonia › in › Diplococcus
- Pneumonia › in › pneumococcus
- Pneumonia › lobar › pneumococcal
- Pneumonia › lobar › Streptococcus pneumoniae
- Embolism › pyemic › pneumococcal › with pneumonia
- Infection, infected, infective › pneumococcus, pneumococcal NEC › generalized › with pneumonia
- Pneumonia › broncho-, bronchial › streptococcal NEC › pneumoniae
- Pneumonia › in › Streptococcus › pneumoniae