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    OpenPayerBilling CodesInfluenza and pneumoniaICD-10-CM j13-pneumonia-due-to-streptococcus-pneumoniae
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    ICD-10-CM Code For Pneumonia Due To Streptococcus Pneumoniae: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group J13 includes pneumonia caused by Streptococcus pneumoniae, covering bacterial lobar and bronchopneumonia attributed to this organism. These ICD-10-CM diagnosis codes are used to document clinical encounters where Streptococcus pneumoniae is identified or strongly suspected as the causative pathogen, capturing disease severity and pulmonary involvement. Accurate coding within the ICD-10-CM J13 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM J13: Pneumonia Due To Streptococcus Pneumoniae Overview

    The diagnoses in this group represent pneumonia caused specifically by Streptococcus pneumoniae, an infection of the lower respiratory tract affecting the lungs. These codes target bacterial pneumonias and related pulmonary involvement. Accurate coding is important for clinical documentation and impacts reimbursement and quality reporting.

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    When to Use

    Use a code from this group when clinical documentation or laboratory testing identifies Streptococcus pneumoniae as the causative organism of the pneumonia. Codes are appropriate for encounters where the diagnosis specifies pneumonia due to Streptococcus pneumoniae, including initial and subsequent encounters as documented.

    ICD-10-CM Codes

    1 rows

    ICD-10-CM CodeDescription
    J13Pneumonia due to Streptococcus pneumoniae

    DRG Codes

    8 rows

    DRG CodeDescription
    193Simple Pneumonia and Pleurisy with MCC
    194Simple Pneumonia and Pleurisy with CC
    195Simple Pneumonia and Pleurisy without CC/MCC
    791Prematurity with Major Problems
    793Full Term Neonate with Major Problems
    974HIV with Major Related Condition with MCC
    975HIV with Major Related Condition with CC
    976HIV with Major Related Condition without CC/MCC

    Typical Clinical Scenarios

    • An older adult presents to the emergency department with acute onset fever, productive cough with purulent sputum, pleuritic chest pain, and dyspnea. Chest radiograph shows a lobar consolidation, and sputum culture returns positive for Streptococcus pneumoniae; a diagnosis from this group is assigned for acute bacterial lobar pneumonia caused by that organism. Typical codes: J13
    • A middle-aged patient with well-controlled chronic obstructive pulmonary disease develops increased cough, purulent sputum, and hypoxia over 48 hours; evaluation in the clinic and chest imaging demonstrate new focal consolidation, and a positive urinary antigen test identifies Streptococcus pneumoniae as the pathogen. Because the acute infective process is due to that organism in a patient with chronic lung disease, a code from this group is used as the pneumonia diagnosis. Typical codes: J13
    • An inpatient on a medical ward being treated for septicemia now has new fever, increased oxygen requirements, and a chest x-ray showing new focal consolidation; blood cultures grow Streptococcus pneumoniae, indicating secondary bacterial pneumonia complicating systemic infection. The pneumonia due to that organism is documented and coded from this group as the causative pneumonia diagnosis. Typical codes: J13

    Related Codes

    J09-INFLUENZA-DUE-TO-CERTAIN-IDENTIFIED-INFLUENZA-VIRUSES

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

    J10-INFLUENZA-DUE-TO-OTHER-IDENTIFIED-VIRUS

    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

    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. 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. 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. 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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