J10.1 — Influenza due to other identified influenza virus with other respiratory manifestations
J10.1 is a billable, specific ICD-10-CM code for influenza due to other identified influenza virus with other respiratory manifestations. It is valid for submission on a claim.
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Add a secondary code to capture the detail described below.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Influenza due to other identified influenza virus NOS
- Influenza due to other identified influenza virus with laryngitis
- Influenza due to other identified influenza virus with pharyngitis
- Influenza due to other identified influenza virus with upper respiratory symptoms
Other codes that can never be billed with J10.1
These codes carry an Excludes1 note pointing at J10.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading J10.1 alone.
Risk adjustment
J10.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
J10.1 is named in 15 Medicare coverage policies — 15 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
How J10.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to J10.1.
- Influenza›novel H1N1 influenza(2009)
- Influenza›novel influenza A/H1N1
- Influenza›due to›identified influenza virus NEC
- Influenza›due to›identified influenza virus NEC›with›laryngitis
- Influenza›due to›identified influenza virus NEC›with›pharyngitis
- Influenza›due to›identified influenza virus NEC›with›respiratory manifestations NEC
Related codes at this level
Codes that share J10. If J10.1 is not quite right, the correct code is usually one of these.
Questions about J10.1
- Is J10.1 a billable ICD-10-CM code?
- Yes. J10.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does J10.1 sit in the tabular list?
- Diseases of the respiratory system (J00-J99), in the block Influenza and pneumonia (J09-J18).