Influenza and Pneumonia

I know that there are combination codes for Influenza and pneumonia, and that would be sequenced first in cases of influenza with pneumonia. But, do we have to make influenza with pneumonia as PDx every time?

My provider documented: "1. Gram negative Pneumonia likely HCAP, due to patient is from nursing home, 2. Influenza positive. Plan: Start Ertepenem and Tamiflu" 

Provider no where documented that pneumonia is related to influenza, but instead he repeatedly documented that pneumonia is likely HCAP. What do we make as Principle diagnosis in this case?


  • If you look at the pneumonia codes within the tabular list there are code first notes which instruct you to code first any associated influenza if present. for example J15 code grouping for bacterial pneumonia has a note underneath which states- "code first any associated influenza if applicable (J09.X1, J10.0-, J11.0-). 
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