Influenza with pneumonia

This code signifies a diagnosis of influenza that has progressed to involve pneumonia. It indicates a direct causal relationship where the influenza virus is the underlying etiology for the pulmonary inflammation and consolidation.

Use this code when the medical record clearly documents both influenza and pneumonia, and the physician explicitly states or implies that the pneumonia is a complication or direct result of the influenza infection. Documentation should specify the type of influenza if known (e.g., avian, swine, seasonal) and the type of pneumonia (e.g., viral, bacterial secondary to viral).

• Ensure the documentation explicitly links the pneumonia to the influenza; otherwise, code influenza and pneumonia separately.
• Do not use this code if the pneumonia is determined to be of a different etiology, even if influenza is also present.
• Consider additional codes for specific types of influenza (e.g., avian, novel H1N1) if documented, as these may require a secondary code.