J81.0 Acute pulmonary edema

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applicable to

• Acute edema of lung

Applies from J81 Pulmonary edema

Excludes1 (never code together)

• chemical (acute) pulmonary edema (J68.1)
• hypostatic pneumonia (J18.2)
• passive pneumonia (J18.2)
• pulmonary edema due to external agents (J60-J70)
• pulmonary edema with heart disease NOS (I50.1)
• pulmonary edema with heart failure (I50.1)

Use additional code

• code to identify:
• exposure to environmental tobacco smoke (Z77.22)
• history of tobacco dependence (Z87.891)
• occupational exposure to environmental tobacco smoke (Z57.31)
• tobacco dependence (F17.-)
• tobacco use (Z72.0)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 213 — Cardio-Respiratory Failure and Shock
• CMS-HCC V22: HCC 84 — Cardio-Respiratory Failure and Shock
• ESRD V24: HCC 84

MS-DRG index

Defines the logic of DRG(s) 189 in MDC 04.

Approximate ICD-9-CM (GEMs)

• 518.4 Acute edema of lung, unspecified

Code annotations containing back-references to J81.0

Back-references to J81.0

• Use Additional: I16.1 Hypertensive emergency ("acute pulmonary edema (left and/or right ventricular failure) (J81.0, I50.-)")

Back-references to J81

• Type 1 Excludes: I50.1 Left ventricular failure, unspecified ("edema of lung without heart disease or heart failure (J81.-)")
• Type 1 Excludes: I50.1 Left ventricular failure, unspecified ("pulmonary edema without heart disease or failure (J81.-)")
• Type 1 Excludes: J68.1 Pulmonary edema due to chemicals, gases, fumes and vapors ("pulmonary edema (acute) (chronic) NOS (J81.-)")
• Type 1 Excludes: R60 Edema, not elsewhere classified ("pulmonary edema (J81.-)")

Diagnosis Index entries for J81.0

• Edema, edematous (infectious) (pitting) (toxic) › lung › acute

Nearby codes

• J81 Pulmonary edema
• J81.0 Acute pulmonary edema (this code)
• J81.1 Chronic pulmonary edema