ICD-10 Code J12.1 – Respiratory syncytial virus pneumonia (2026): Diagnosis, Symptoms & Billing Guide
2026 ICD-10-CM Diagnosis Code J12.1 – Respiratory syncytial virus pneumonia
What it is
J12.1 identifies pneumonia caused by respiratory syncytial virus (RSV). Use it when the provider documents RSV as the cause of the pneumonia, not just a nonspecific viral respiratory infection.
Clinical signs
Clinical features vary; refer to documentation. Typical findings may include cough, fever, wheezing, dyspnea, and radiographic evidence of pneumonia with RSV confirmed or stated as the cause.
When to use this code
Use this code when the medical record clearly links pneumonia to RSV, such as “RSV pneumonia” or “pneumonia due to respiratory syncytial virus.” It also fits when RSV is documented as the etiologic agent and pneumonia is present. Check documentation if the cause is unclear.
Do not use for
Do not use J12.1 for RSV bronchiolitis, upper respiratory infection, or unspecified viral pneumonia without RSV attribution. If pneumonia is not documented, choose the code for the stated RSV condition instead.
Coding tip
Code the causative organism only when the provider explicitly documents RSV as the pneumonia cause.