ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group J09 includes influenza due to certain identified influenza viruses, covering cases where a specific influenza virus strain has been confirmed and when associated complications such as pneumonia are present. These ICD-10-CM diagnosis codes are used to document confirmed viral etiology, respiratory system involvement, and any complication status or severity that affects clinical management. Accurate coding within the ICD-10-CM J09 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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ICD-10-CM J09: Influenza Due To Certain Identified Influenza Viruses Overview

This group captures influenza infections attributed to specific identified influenza virus strains and their complications, primarily affecting the respiratory system. Accurate coding distinguishes viral etiology and documents severity, complication status, and any associated organ involvement. Correct assignment supports appropriate reimbursement and reflects clinical complexity for claims processing.

When to Use

Assign a code from this group when laboratory testing or clinical documentation identifies a specific influenza virus as the cause of illness or when influenza is documented with complications such as pneumonia. Use these codes to indicate confirmed viral etiology and to capture any associated organ involvement or severity that impacts clinical care and billing.

ICD-10-CM Codes

4 rows

ICD-10-CM Code	Description
J09.X1	Influenza due to identified novel influenza A virus with pneumonia
J09.X2	Influenza due to identified novel influenza A virus with other respiratory manifestations
J09.X3	Influenza due to identified novel influenza A virus with gastrointestinal manifestations
J09.X9	Influenza due to identified novel influenza A virus with other manifestations

DRG Codes

10 rows

DRG Code	Description
193	Simple Pneumonia and Pleurisy with MCC
194	Simple Pneumonia and Pleurisy with CC
195	Simple Pneumonia and Pleurisy without CC/MCC
791	Prematurity with Major Problems
793	Full Term Neonate with Major Problems
865	Viral Illness with MCC
866	Viral Illness without MCC
974	HIV with Major Related Condition with MCC
975	HIV with Major Related Condition with CC
976	HIV with Major Related Condition without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with acute high fever, myalgias, cough, and rapidly worsening shortness of breath over 48 hours after testing positive by PCR for an identified influenza A virus strain; chest auscultation and oxygen saturation indicate hypoxemia requiring supplemental oxygen. A diagnosis from this group is assigned because influenza due to a specified influenza virus is the confirmed etiology of the current acute respiratory illness. Typical codes: J09.X1, J09.X3
An elderly nursing home resident develops sudden fever, productive cough, and confusion; chest x-ray shows lobar consolidation consistent with pneumonia, and nasopharyngeal swab identifies a specific influenza B virus. Because the pneumonia is caused by a documented influenza virus, a code from this group is used to capture influenza with lower respiratory tract involvement and increased risk due to age and comorbidity. Typical codes: J09.X2, J09.X3
A previously healthy child is seen in urgent care for high fever, severe vomiting, and altered mental status after testing positive for a known influenza strain; the clinician documents an influenza-related complication (encephalopathy) requiring hospital observation. A code from this group is assigned to indicate influenza due to a specified virus as the underlying cause of the neurologic complication. Typical codes: J09.X1, J09.X9

ICD-10-CM Code For Influenza Due To Other Identified Influenza Virus: Group Overview

J11-INFLUENZA-UNIDENTIFIED-VIRUS

ICD-10-CM Code For Influenza Due To Unidentified Influenza Virus: Group Overview

J12-VIRAL-PNEUMONIA-NOT-ELSEWHERE-CLASSIFIED

ICD-10-CM Code For Viral Pneumonia Not Elsewhere Classified: Group Overview

J13-PNEUMONIA-DUE-TO-STREPTOCOCCUS-PNEUMONIAE

ICD-10-CM Code For Pneumonia Due To Streptococcus Pneumoniae: Group Overview

J14-PNEUMONIA-DUE-TO-HEMOPHILUS-INFLUENZAE

ICD-10-CM Code For Pneumonia Due To Hemophilus Influenzae: Group Overview

J17-PNEUMONIA-IN-DISEASES-CLASSIFIED-ELSEWHERE

ICD-10-CM Code For Pneumonia In Diseases Classified Elsewhere: Group Overview

J18-PNEUMONIA-UNSPECIFIED-ORGANISM

ICD-10-CM Code For Pneumonia Unspecified Organism: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

4 rows

ICD-10-CM Code	Description
J09.X1	Influenza due to identified novel influenza A virus with pneumonia
J09.X2	Influenza due to identified novel influenza A virus with other respiratory manifestations
J09.X3	Influenza due to identified novel influenza A virus with gastrointestinal manifestations
J09.X9	Influenza due to identified novel influenza A virus with other manifestations

DRG Codes

10 rows

DRG Code	Description
193	Simple Pneumonia and Pleurisy with MCC
194	Simple Pneumonia and Pleurisy with CC
195	Simple Pneumonia and Pleurisy without CC/MCC
791	Prematurity with Major Problems
793	Full Term Neonate with Major Problems
865	Viral Illness with MCC
866	Viral Illness without MCC
974	HIV with Major Related Condition with MCC
975	HIV with Major Related Condition with CC
976	HIV with Major Related Condition without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with acute high fever, myalgias, cough, and rapidly worsening shortness of breath over 48 hours after testing positive by PCR for an identified influenza A virus strain; chest auscultation and oxygen saturation indicate hypoxemia requiring supplemental oxygen. A diagnosis from this group is assigned because influenza due to a specified influenza virus is the confirmed etiology of the current acute respiratory illness. Typical codes: J09.X1, J09.X3
An elderly nursing home resident develops sudden fever, productive cough, and confusion; chest x-ray shows lobar consolidation consistent with pneumonia, and nasopharyngeal swab identifies a specific influenza B virus. Because the pneumonia is caused by a documented influenza virus, a code from this group is used to capture influenza with lower respiratory tract involvement and increased risk due to age and comorbidity. Typical codes: J09.X2, J09.X3
A previously healthy child is seen in urgent care for high fever, severe vomiting, and altered mental status after testing positive for a known influenza strain; the clinician documents an influenza-related complication (encephalopathy) requiring hospital observation. A code from this group is assigned to indicate influenza due to a specified virus as the underlying cause of the neurologic complication. Typical codes: J09.X1, J09.X9

ICD-10-CM Code For Influenza Due To Other Identified Influenza Virus: Group Overview

J11-INFLUENZA-UNIDENTIFIED-VIRUS

ICD-10-CM Code For Influenza Due To Unidentified Influenza Virus: Group Overview

J12-VIRAL-PNEUMONIA-NOT-ELSEWHERE-CLASSIFIED

ICD-10-CM Code For Viral Pneumonia Not Elsewhere Classified: Group Overview

J13-PNEUMONIA-DUE-TO-STREPTOCOCCUS-PNEUMONIAE

ICD-10-CM Code For Pneumonia Due To Streptococcus Pneumoniae: Group Overview

J14-PNEUMONIA-DUE-TO-HEMOPHILUS-INFLUENZAE

ICD-10-CM Code For Pneumonia Due To Hemophilus Influenzae: Group Overview

J17-PNEUMONIA-IN-DISEASES-CLASSIFIED-ELSEWHERE

ICD-10-CM Code For Pneumonia In Diseases Classified Elsewhere: Group Overview

J18-PNEUMONIA-UNSPECIFIED-ORGANISM

ICD-10-CM Code For Pneumonia Unspecified Organism: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview

Sign up for ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview policy alerts

ICD-10-CM J09: Influenza Due To Certain Identified Influenza Viruses Overview

ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview

Sign up for ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview policy alerts

ICD-10-CM J09: Influenza Due To Certain Identified Influenza Viruses Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

References

ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview

Sign up for ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview policy alerts

ICD-10-CM J09: Influenza Due To Certain Identified Influenza Viruses Overview

ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview

Sign up for ICD-10-CM Code For Influenza Due To Certain Identified Influenza Viruses: Group Overview policy alerts

ICD-10-CM J09: Influenza Due To Certain Identified Influenza Viruses Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

When should I assign a code from the `J09` group?

What specific subcodes exist within the `J09` group and what do they indicate?

How does accurate coding within `J09` affect reimbursement and claims processing?

Are there related DRGs that coders should consider when assigning a `J09` code?

Does the `J09` group address both respiratory system involvement and other organ manifestations?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

When should I assign a code from the `J09` group?

What specific subcodes exist within the `J09` group and what do they indicate?

How does accurate coding within `J09` affect reimbursement and claims processing?

Are there related DRGs that coders should consider when assigning a `J09` code?

Does the `J09` group address both respiratory system involvement and other organ manifestations?

References