# Acute exacerbation of COPD



## KRekow (Jul 30, 2010)

I have been coding acute exacerbation of COPD to 491.21, as directed in the ICD manual.  I have a biller that is in disagreement because the documentation we have doesn't state Obstructive Chronic Bronchitis as stated by code 491.2 in the ICD manual.  I have tried to explain the interrelationship between brochitis, copd, and emphysema to no avail.

So please, any advice or I guess confirmation would be greatly appreciated

Thank you in advance.


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## GWALLA (Jul 31, 2010)

If you look at ICD 9 2010 page 154 in the tabular listings, under 491.21 the very first listing is "Acute exacerbation of chronic obstructive pulmonary disease (COPD)". I believe this should demonstrate that according to ICD 9 491.21 is the appropriate code.


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## ohn0disaster (Aug 2, 2010)

You were correct in coding 491.21 for copd with exacerbation. Agreed with GWALLA, if you look at the Tabular List for these codes, it is right there in black and white. You may want to bring this to your biller's attention. Coding from the index is a bad habit. All codes should be cross-referenced in the tabular list, regardless, although many don't practice this. I would think that the biller would have never had this arguement had they taken a look.


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