Otolaryngology Coding Alert

Question: My physician saw a patient with "acute exacerbation of emphysema." In his documentation, he also noted that the patient does not have chronic bronchitis. What diagnosis code should I apply in this situation?

Alaska Subscriber

Answer: Look to 491.21 (Obstructive chronic bronchitis; with [acute] exacerbation). Even though the patient may not have chronic bronchitis, you should report 491.21 anyway. This diagnosis code represents a variety of conditions.

For instance, if you look beyond the initial code descriptor for 491.21 in your ICD-9 manual, you'll see that this ICD-9 code also includes:

• acute exacerbation of chronic obstructive pulmonary disease (COPD)

• decompensated chronic obstructive pulmonary disease (COPD)

• decompensated chronic obstructive pulmonary disease (COPD) with exacerbation.

In other words, the patient's condition is not limited to chronic bronchitis for you to be able to report 491.21.