EM Coding Alert

Two ICD-9 emphysema codes have a direct match to ICD-10 codes.

If your providers perform cessation counseling, you may find yourself using emphysema diagnosis codes on a regular basis, so learning the new ICD-10 emphysema diagnosis codes will benefit your day-to-day routine. Have no fear; with ICD-10 this fall, you will have twice as many codes to choose from, but the good news is, it is still only six codes.

The six new codes will give your claims more detail. Read on to see what code relates to what type of emphysema.

Let Go of Limited ICD-9 Codes

Today, when your provider diagnoses a patient with emphysema, you use an ICD-9 code from 492 (Emphysema) section. You need to code the fourth digit for the type of emphysema as follows:

• 492.0 (Emphysematous bleb) — This type includes a diagnosis of giant bullous emphysema, ruptured emphysematous bleb, tension pneumatocele, and vanishing lung
• 492.8 (Other emphysema) — includes a diagnosis of emphysema (lung or pulmonary), MacLeod’s syndrome, Swyer-James syndrome, and unilateral hyperlucent lung.

Count the Same Number of Digits

In the future, with ICD-10 codes, instead of 492 codes, you will report a J43 (Emphysema) code. If you have a diagnosis of 492.0, it will be a direct match to code J43.9 (Emphysema, unspecified). If you need a match to 492.8, you will have a choice between four additional codes that describe the type of emphysema:

• J43.0 — Unilateral pulmonary emphysema [MacLeod’s syndrome]
• J43.1 — Panlobular emphysema
• J43.2 — Centrilobular emphysema
• J43.8 — Other emphysema.

Good news: Your physician is likely already documenting the details you’ll need to choose the right code. But if she isn’t, be sure to explain that accurate ICD-10 coding will require very specific details and encourage her to start providing you as much information as possible in her notes.