ED Coding and Reimbursement Alert

Question: Our ED physician saw a patient presenting with symptoms of coughing, shortness of breath, a scratchy throat, headaches, and irritated sinuses. The patient was a firefighter and had been battling wildfires in the area. The ED physician ordered a CT scan to check for additional damage to the patient’s lungs. The physician didn’t find any internal damage and diagnosed the patient as having experienced smoke inhalation. We aren’t sure whether to report J70.0, J70.3, or J70.4. Can you advise?

Codify Subscriber

Answer: No, you would instead report J70.5 (Respiratory conditions due to smoke inhalation) to code the diagnosis. However, the notes under the descriptor instruct you to use the appropriate code from the T59.81- (Toxic effect of smoke) family first. In this case, you would use T59.811A (Toxic effect of smoke, accidental (unintentional), initial encounter) as the inhalation of smoke was a hazard of the patient’s occupation.

Smoke inhalation occurs when the patient breathes in smoke and the products of combustion during a fire. Codes J70.3 (Chronic drug-induced interstitial lung disorders) and J70.4 (Drug-induced interstitial lung disorders, unspecified) deal with interstitial lung diseases caused by antibiotics, chemotherapy drugs, statins, and antiarrhythmic agents. Code J70.0 (Acute pulmonary manifestations due to radiation) covers symptoms, such as cough, dyspnea, chest discomfort, pleuritic pain, and a low-grade fever following the completion of a radiotherapy course.