ICD 10 Multifocal Pneumonia: Coding & Clinical Guide

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Multifocal pneumonia is a type of pneumonia where multiple areas of the lungs are infected at the same time. This condition is serious and often requires hospitalization. For healthcare providers, accurate documentation and correct ICD 10 coding are essential to ensure proper care, billing, and reporting.

This guide explains the ICD 10 code for multifocal pneumonia, how it should be used, and the latest U.S. coding guidelines.

What is Multifocal Pneumonia?

Multifocal pneumonia means the infection appears in more than one lobe of the lung. It is most often caused by bacteria such as Streptococcus pneumoniae, viruses like influenza, or in some cases fungi. Patients usually present with:

  • Fever and chills
  • Productive cough
  • Chest pain
  • Shortness of breath
  • Fatigue

Because multiple lung areas are involved, the condition is considered more severe than simple lobar pneumonia.

ICD 10 Code for Multifocal Pneumonia

The most accurate code under ICD 10-CM is:

  • J18.9 — Pneumonia, unspecified organism

If the documentation specifies the type of pneumonia or organism, you should use a more detailed code, such as:

  • J13 — Pneumonia due to Streptococcus pneumoniae
  • J14 — Pneumonia due to Hemophilus influenzae
  • J15.9 — Bacterial pneumonia, unspecified

Since multifocal pneumonia describes location rather than cause, coders should combine the diagnosis of pneumonia with the correct code for the causative organism (if identified).

U.S. Coding Guidelines (Latest Updates)

According to the 2025 ICD-10-CM Official Guidelines for Coding and Reporting:

  1. Always document the organism if known. This allows coders to use the most specific code.
  2. If the pneumonia is multifocal but the organism is not documented, use J18.9.
  3. When coding hospital admissions, list pneumonia as the principal diagnosis if it is the main reason for admission.
  4. Do not code multifocal pneumonia as a separate code. The term describes distribution, not a unique ICD 10 diagnosis.
  5. If the patient also has conditions like sepsis or acute respiratory failure, code these in addition to pneumonia.

Why Accurate Coding Matters

Correct ICD 10 coding for multifocal pneumonia ensures:

  • Proper reimbursement for hospitals and providers
  • Accurate public health tracking of respiratory illnesses
  • Reduced claim denials due to vague or incorrect codes

Key Takeaways

  • ICD 10 multifocal pneumonia is generally coded as J18.9 unless the causative organism is specified.
  • Documenting the infectious agent improves coding accuracy.
  • Follow the official U.S. ICD 10-CM guidelines for pneumonia coding to avoid errors in billing and compliance.

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