ICD 10 Coding Alert

Question: One of the pulmonologists in our practice examined a patient during a follow-up visit for their COPD. I tried to report J44 to document the COPD, but I received an error saying I needed a 4th character. I’ve read the report several times, and I’m having trouble determining which code from the family I need for my claim.

Can you please explain the differences between the J44 codes?

Missouri Subscriber

Answer: The J44.- (Other chronic obstructive pulmonary disease) parent code indeed carries a 4th character, which means you’ll need to query your provider as to the type of chronic obstructive pulmonary disease (COPD) the patient experiences. If the patient experiences just COPD without any additional complications, you’ll select J44.9 (Chronic obstructive pulmonary disease, unspecified). Additional synonyms for J44.9 include Chronic obstructive airway disease NOS and Chronic obstructive lung disease NOS, so check the documentation for similar wording.

You’ll want to use J44.0 (Chronic obstructive pulmonary disease with (acute) lower respiratory infection) if the patient is suffering from a sudden lower respiratory infection — such as pneumonia, lung abscess, or acute bronchitis — in addition to COPD. This code also features instruction to use appropriate code(s) to identify the infection.

Lastly, you’ll select J44.1 (Chronic obstructive pulmonary disease with (acute) exacerbation) if your provider confirms the patient is experiencing COPD with acute exacerbation. This code carries additional synonyms, such as Decompensated COPD or Decompensated COPD with (acute) exacerbation, which the physician could also document in their report.