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ICD-10-CM J15.5: Pneumonia due to Escherichia coli

J15.5 is the billable ICD-10-CM code for pneumonia due to Escherichia coli, in category J15 (Bacterial pneumonia, not elsewhere classified) of the Influenza and pneumonia section. As a principal diagnosis it groups to MS-DRG 177 Respiratory Infections and Inflammations with MCC, MS-DRG 178 Respiratory Infections and Inflammations with CC, MS-DRG 179 Respiratory Infections and Inflammations 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). It maps to HCC 282 (Aspiration and Specified Bacterial Pneumonias) in CMS-HCC V28. As a secondary diagnosis it is an MCC, excluded with 129 principal diagnoses. 4 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
J15.5
billable FY2027 ICD-10-CM code
Category
J15 Bacterial pneumonia, not elsewhere classified
Chapter
10: Diseases of the respiratory system (J00-J99)
CC/MCC (MS-DRG v44)
MCC
CMS-HCC V28
HCC 282
POA reporting
Required

Tabular list notes for J15.5

The tabular list has no notes on J15.5 itself; the notes below apply from its parent headings.

Inherited from J15 (Bacterial pneumonia, not elsewhere classified)

Includes
  • bronchopneumonia due to bacteria other than S. pneumoniae and H. influenzae
Excludes1 (never coded together)
  • chlamydial pneumonia (J16.0)
  • congenital pneumonia (P23.-)
  • Legionnaires' disease (A48.1)
  • spirochetal pneumonia (A69.8)
Code first
  • , if applicable, associated influenza (J09.X1, J10.0-, J11.0-)
Code also
  • , if applicable, any associated condition such as:
  • abscess (J85.1)
  • aspiration pneumonia (J69.-)

MS-DRG grouping when J15.5 is the principal diagnosis

MS-DRG v44 groups for J15.5 as principal diagnosis
MDCMS-DRGs
04 MDC 04: Diseases and Disorders of the Respiratory System177178179
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 J15.5 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, J15.5 is an MCC under MS-DRG v44, unless the principal diagnosis is one of the 129 codes in its exclusion list. Check J15.5 against a principal diagnosis.

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

CMS-HCC V28 risk adjustment

In the PY2027 mapping, J15.5 maps to HCC 282 (Aspiration and Specified Bacterial Pneumonias). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list J15.5

4 current Medicare billing and coding articles list J15.5 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM J15.5 mean?

J15.5 means pneumonia due to Escherichia coli. It is one of 14 billable codes under J15, bacterial pneumonia, not elsewhere classified.

What can't be coded with J15.5?

Excludes1 at J15: chlamydial pneumonia (J16.0); congenital pneumonia (P23.-); Legionnaires' disease (A48.1); spirochetal pneumonia (A69.8). These are never reported together with J15.5.

Which MS-DRG does J15.5 group to?

As the principal diagnosis, J15.5 groups to MS-DRG 177 Respiratory Infections and Inflammations with MCC, MS-DRG 178 Respiratory Infections and Inflammations with CC, MS-DRG 179 Respiratory Infections and Inflammations 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.

Does J15.5 map to an HCC?

Yes: HCC 282, Aspiration and Specified Bacterial Pneumonias, in the PY2027 CMS-HCC V28 mapping.

Is J15.5 a CC or MCC?

J15.5 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.