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Influenza in ICD-10-CM is classified in the following categories:

  • J09 Influenza due to certain identified influenza viruses – this includes the following types:

o   Avian

o   Bird

o   A/H1N1

o   Swine

o   Other influenza of animal origin (not bird/not swine) 

  • J10 Influenza due to other identified influenza viruses – this includes any specified type not of animal origin and not listed as one of the types under the novel influenza A virus category
  • J11 Influenza due to unidentified influenza viruses – not documented as a specific type

When coding for the influenza virus, ICD-10-CM has combination codes. The three categories include the following combination code complications or manifestations:

  • Gastrointestinal manifestations
  • Encephalopathy
  • Myocarditis
  • Otitis media

Note: for other and unspecified influenza, use an additional code to identify ruptured tympanic membrane

  • Pneumonia

For all categories, use an additional code to identify any associated lung abscess

For the novel influenza A and unspecified influenza, specify type and/or organism or if it is an unspecified type with an additional code.

For other identified influenza, the following options are available:

  • With the same influenza virus pneumonia
  • Other specified type (specified in documentation)
  • Unspecified type
  • Other respiratory manifestations – Use an additional code to identify any associated:

o   Pleural effusion

o   Sinusitis

  • Other specified manifestations (specified in documentation)

In order to report the combination codes, the physician should have documented the associated between the complications or manifestations as ‘due to’, ‘with’, ‘associated with/to’ or anything similar. 

Author: 
Bonnie G. Schreck, BS, CCS, CPC, COC, CC