ED Coding and Reimbursement Alert

Reader Question:

Identify Acute or Obstructive For COPD With Bronchitis

Question: Can someone tell me what diagnosis code would be appropriate for COPD with bronchitis?

Nebraska Subscriber

Answer: The correct code choice will de driven by the precise diagnostic information available. If the chart documentation does not state acute bronchitis, the code would be 491.20 (Obstructive chronic bronchitis; without exacerbation). Other possibilities are 491.21 (Obstructive chronic bronchitis; with [acute] exacerbation) or 491.22 (Obstructive chronic bronchitis; with acute bronchitis) if the chart provides that level of detail. As we transition to ICD-10 these code choices will become more difficult because of the significantly increased granularity of diagnostic codes available.