J95.1 Acute pulmonary insufficiency following thoracic surgery

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

Excludes2 (not included here)

• Functional disturbances following cardiac surgery (I97.0, I97.1-)

Applies from J95 Intraoperative and postprocedural complications and disorders of respiratory system, not elsewhere classified

Excludes2 (not included here)

• aspiration pneumonia (J69.-)
• emphysema (subcutaneous) resulting from a procedure (T81.82)
• hypostatic pneumonia (J18.2)
• pulmonary manifestations due to radiation (J70.0-J70.1)

Risk adjustment (HCC)

• 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)

• 518.52 Other pulmonary insufficiency, not elsewhere classified, following trauma and surgery (approximate)

Code annotations containing back-references to J95.1

Back-references to J95.1

• Type 2 Excludes: I97.1 Other postprocedural cardiac functional disturbances ("acute pulmonary insufficiency following thoracic surgery (J95.1)")
• Type 2 Excludes: I97.7 Intraoperative cardiac functional disturbances ("acute pulmonary insufficiency following thoracic surgery (J95.1)")
• Type 2 Excludes: J95.89 Other postprocedural complications and disorders of respiratory system, not elsewhere classified ("acute pulmonary insufficiency following thoracic surgery (J95.1)")
• Type 1 Excludes: J98.4 Other disorders of lung ("pulmonary insufficiency following surgery (J95.1-J95.2)")

Back-references to J95

• Type 2 Excludes: T81 Complications of procedures, not elsewhere classified ("intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)")

Diagnosis Index entries for J95.1

• Complication (s) (from) (of) › respiratory system › postoperative › pulmonary insufficiency (acute) (after nonthoracic surgery) › following thoracic surgery
• Complication (s) (from) (of) › surgical procedure (on) › pulmonary insufficiency (acute) › following thoracic surgery
• Insufficiency, insufficient › pulmonary › acute, following surgery (nonthoracic) › thoracic

Nearby codes

• J95.01 Hemorrhage from tracheostomy stoma
• J95.02 Infection of tracheostomy stoma
• J95.03 Malfunction of tracheostomy stoma
• J95.04 Tracheo-esophageal fistula following tracheostomy
• J95.09 Other tracheostomy complication
• J95.1 Acute pulmonary insufficiency following thoracic surgery (this code)
• J95.2 Acute pulmonary insufficiency following nonthoracic surgery
• J95.3 Chronic pulmonary insufficiency following surgery
• J95.4 Chemical pneumonitis due to anesthesia
• J95.5 Postprocedural subglottic stenosis
• J95.6 Intraoperative hemorrhage and hematoma of a respiratory system organ or structure complicating a procedure