J85.1

Abscess of lung with pneumonia

Risk-adjusting (HCC)Billable code

HCC risk adjustment mapping

CMS-HCC V28

HCC283

Empyema, Lung Abscess

CMS-HCC ESRD V24

HCC115

Pneumococcal Pneumonia, Empyema, Lung Abscess

Coding notes

Excludes 1 never coded together · Excludes 2 may co-exist

This code · J85.1
Code also

the type of pneumonia

Inherited from J85Abscess of lung and mediastinum
Use additional

code (B95-B97) to identify infectious agent.

Inherited from chapter 10Diseases of the respiratory system
Excludes 2

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)

Use additional

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)

Note

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 J85.1

FY 2026 ›

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