J95.851 Ventilator associated pneumonia

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

Applicable to

• Ventilator associated pneumonitis

Excludes1 (never code together)

• ventilator lung in newborn (P27.8)

Use additional code

• code to identify the organism, if known (B95.-, B96.-, B97.-)

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 V28: HCC 211 — Respirator Dependence/Tracheostomy Status/Complications
• CMS-HCC V22: HCC 114 — Aspiration and Specified Bacterial Pneumonias
• ESRD V24: HCC 114

MS-DRG index

Defines the logic of DRG(s) 205-206 in MDC 04.

Approximate ICD-9-CM (GEMs)

• 997.31 Ventilator associated pneumonia

Code annotations containing back-references to J95.851

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 J95.851

• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved) › ventilator associated
• Pneumonitis (acute) (primary) › due to › ventilator
• Pneumonitis (acute) (primary) › ventilator associated

Nearby codes

• J95.830 Postprocedural hemorrhage of a respiratory system organ or structure following a respiratory system procedure
• J95.831 Postprocedural hemorrhage of a respiratory system organ or structure following other procedure
• J95.84 Transfusion-related acute lung injury (TRALI)
• J95.85 Complication of respirator [ventilator]
• J95.850 Mechanical complication of respirator
• J95.851 Ventilator associated pneumonia (this code)
• J95.859 Other complication of respirator [ventilator]
• J95.86 Postprocedural hematoma and seroma of a respiratory system organ or structure following a procedure
• J95.860 Postprocedural hematoma of a respiratory system organ or structure following a respiratory system procedure
• J95.861 Postprocedural hematoma of a respiratory system organ or structure following other procedure
• J95.862 Postprocedural seroma of a respiratory system organ or structure following a respiratory system procedure