Pleural Effusion ICD-10-CM Codes | 2023

What ICD-10 codes can be used for plural effusion?

1. J91.0

• This ICD-10 code stands for Malignant pleural effusion. This is meant to be used only on patients who are confirmed to have malignant pleural effusion, which is a life-threatening problem. Malignant pleural effusion, or MPE for short, is the term used for the buildup of fluid and cancer cells between the chest wall and the lung. Individuals experiencing this condition may encounter chest discomfort and potentially experience difficulty breathing. It is a complication that can arise from various types of cancer.

2. J91.8

• This ICD-10 code stands for Pleural effusion in other conditions classified elsewhere. This is meant to be used on patients who are dealing with certain conditions, and these conditions result in pleural effusion. These could be caused by  bacterial infection, congestive heart failure, malignant neoplastic disease, etc.

3. J94.8

• This ICD-10 code stands for Other specified pleural conditions. This is meant to be used only on patients who are confirmed to be dealing with pleural conditions that are not specific to or not covered by other ICD-10 codes. There are for pleural disorders: pleurisy, pleural effusion (which is the focus of this guide), pneumothorax, and hemothorax. If your patient has another type of pleural effusion and other ICD-10 codes don’t cover it, you may use this.

4. A15.6

• This ICD-10 code stands for Tuberculous pleurisy. Pleurisy is a type of pleural disorder in which the pleura becomes inflamed. An inflamed pleura makes breathing not only difficult but also painful. It can even give rise to pleural effusion. If your patient is confirmed to have Tuberculous pleurisy, then use this code.

5. A49.9

• This ICD-10 code stands for Bacterial infection, unspecified. This is meant to be used on patients who are confirmed to have a bacterial infection, but it’s not specific as to what kind of bacterial infection it is. This can be used as a general ICD-10 code when no further information has been obtained yet.

Which of these pleural effusion codes are billable?

All of the aforementioned codes are billable codes and can be used to designate a patient for reimbursement purposes.

Clinical information:

Pleural Effusion is a type of pleural disorder characterized by the buildup of fluids in the tissues between the lungs and chest wall. When effusion happens, there is an abnormal and excessive collection of fluid in the space. This causes chest pain, characterized by a sharp pain that becomes even more painful whenever the person coughs or takes a deep breath. It can also cause coughing, fever, chills, shortness of breath, rapid breathing, and even hiccups.

Healthcare professionals will often conduct CT scans or X-rays to check on patients for pleural effusion. They may also get some fluid to test it and check for infections, cancer cells, protein levels, and more to see if an underlying condition is causing it. The treatment will depend on the findings. In the case of pleural effusion alone, the fluid will be removed. However, if additional tests identify other issues, the fluid will still be drained while simultaneous efforts are made to address the underlying condition.

Synonyms include:

• Pleural effusion associated with hepatic disorder
• Pleural effusion associated with pulmonary infection
• Pleural effusion due to another disorder
• Pleural effusion due to bacterial infection
• Pleural effusion due to congestive heart failure
• Pleural effusion due to disorder of pancreas
• Pleural effusion due to malignant neoplastic disease
• Pleural effusion due to neoplastic disease
• Pleural effusion due to pancreatitis