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ICD-10-CM J14: Pneumonia due to Hemophilus influenzae

J14 is the billable ICD-10-CM code for pneumonia due to Hemophilus influenzae, in category J14 (Pneumonia due to Hemophilus influenzae) of the Influenza and pneumonia section. As a principal diagnosis it groups to MS-DRG 193 Simple Pneumonia and Pleurisy with MCC, MS-DRG 194 Simple Pneumonia and Pleurisy with CC, MS-DRG 195 Simple Pneumonia and Pleurisy without CC/MCC (MDC 04 MDC 04: Diseases and Disorders of the Respiratory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period). As a secondary diagnosis it is an MCC, excluded with 129 principal diagnoses. 3 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
J14
billable FY2027 ICD-10-CM code
Category
J14 Pneumonia due to Hemophilus influenzae
Chapter
10: Diseases of the respiratory system (J00-J99)
CC/MCC (MS-DRG v44)
MCC
CMS-HCC V28
Not mapped
POA reporting
Required

Tabular list notes for J14

The tabular list has no notes on J14 itself; the notes below apply from its parent headings.

MS-DRG grouping when J14 is the principal diagnosis

MS-DRG v44 groups for J14 as principal diagnosis
MDCMS-DRGs
04 MDC 04: Diseases and Disorders of the Respiratory System193194195
15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period791793
25 MDC 25: Human Immunodeficiency Virus Infections974975976

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for J14 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, J14 is an MCC under MS-DRG v44, unless the principal diagnosis is one of the 129 codes in its exclusion list. Check J14 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

J14 does not map to a payment HCC in the PY2027 CMS-HCC V28 model, so on its own it does not change a Medicare Advantage risk score.

LCD billing and coding articles that list J14

3 current Medicare billing and coding articles list J14 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM J14 mean?

J14 means pneumonia due to Hemophilus influenzae. It is one of 1 billable codes under J14, pneumonia due to Hemophilus influenzae.

Which MS-DRG does J14 group to?

As the principal diagnosis, J14 groups to MS-DRG 193 Simple Pneumonia and Pleurisy with MCC, MS-DRG 194 Simple Pneumonia and Pleurisy with CC, MS-DRG 195 Simple Pneumonia and Pleurisy without CC/MCC (MDC 04 MDC 04: Diseases and Disorders of the Respiratory System); or MS-DRG 791 Prematurity with Major Problems, MS-DRG 793 Full Term Neonate with Major Problems (MDC 15 MDC 15: Newborns and Other Neonates with Conditions Originating in Perinatal Period) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Is J14 a CC or MCC?

J14 is an MCC under MS-DRG v44; 129 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.