Pathology/Lab Coding Alert

Question: How can we report the diagnosis of swine flu influenza in ICD-10-CM?

Ohio Subscriber

Answer: For swine flu influenza, look to ICD-10-CM code category J09 (Influenza due to certain identified influenza viruses). Report influenza due to identified novel influenza A virus using (J09._), which also requires a fifth digit to further identify any manifestations. This subcategory of codes includes avian influenza, bird influenza, influenza of other animal origin, and swine influenza.

Look for related conditions: In addition to influenza type, you’ll need to have documentation of any manifestations to choose the correct code, such as one of the following:

• J09.X1, Influenza due to identified novel influenza A virus with pneumonia
• J09.X2, Influenza due to identified novel influenza A virus with other respiratory manifestations
• J09.X3, Influenza due to identified novel influenza A virus with gastrointestinal manifestations
• J09.X9, Influenza due to identified novel influenza A virus with other manifestations.

You should additionally report any conditions related to the influenza such as otitis media or lung abscess.

Example: Code J09.X1 includes this note:

• Code also, if applicable, associated:
• lung abscess (J85.1)
• other specified type of pneumonia

The J10 code set (J10._) includes other identified viruses, such as H1N1 not identified as “Novel” along with influenza B and C types. There is an additional code set for unidentified influenza (J11._) which is used when the influenza type is unknown.

Follow the instructional notes: The ICD-10 Official Guidelines for Coding and Reporting for influenza instruct coders to code only confirmed cases of influenza due to certain identified influenza viruses (category J09), and due to other identified influenza virus (category J10). In this context, “confirmation” does not require documentation of positive laboratory testing specific for avian or other novel influenza A or other identified influenza virus. However, coding should be based on the provider’s diagnostic statement of what strain of influenza the patient has. If the provider records “suspected” or “possible” or “probable” avian influenza, novel influenza, or other identified influenza, coders should report the appropriate influenza code from category J11 (Influenza due to unidentified influenza virus).