Pulmonology Coding Alert

Know how to report a cancelled procedure.

Patients can develop several respiratory complications because of procedures. At times, the complications are easily identified and coded from the provider’s documentation, and other times, you may need to do more digging to find the right codes.

Pulmonology Coding Alert gathered three different scenarios to assess your respiratory complications coding skills. Read through the scenarios below and see if you know the answers!

Code a Cancelled Procedure Due to Complications

Question 1: A 65-year-old patient with a history of severe emphysema and chronic respiratory failure presents to the hospital for a scheduled bronchoscopy procedure. The patient has been experiencing worsening dyspnea and increased sputum production over the past few weeks.

During the procedure, the patient develops sudden severe respiratory distress, with rapidly deteriorating oxygen saturation levels. The physician immediately halts the procedure, and the patient is transferred to the intensive care unit (ICU) for further management.

On arrival in the ICU, the patient requires immediate intubation and initiation of mechanical ventilation due to acute respiratory failure. Her arterial blood gas analysis shows severe hypoxemia and hypercapnia. After reviewing chest X-rays, the provider diagnoses the patient with acute postprocedural respiratory failure.

What ICD-10-CM code(s) would you assign for this encounter?

Validate Your VAP Code Choice

Question 2: A 75-year-old patient is admitted to the ICU with severe respiratory distress. The patient has a history of chronic obstructive pulmonary disease (COPD) and requires immediate intubation and mechanical ventilation due to an acute exacerbation of the underlying COPD.

Clinicians initially stabilized the patient, but the patient’s condition becomes complicated during the ICU stay. They develop high fever, purulent sputum production, and worsening hypoxemia. Chest X-rays show infiltrates in both lungs. A pulmonologist performs a bronchoalveolar lavage (BAL) and reviews the results. The provider diagnoses the patient with ventilator-associated pneumonia (VAP) as a complication of mechanical ventilation.

What code(s) would you assign for the patient’s diagnosis?

Identify This Transfusion-Related Diagnosis

Question 3: A 68-year-old patient presents to the emergency department (ED) complaining of sudden onset shortness of breath, cough, and chest discomfort. The patient has a history of anemia and received a packed red blood cell transfusion at an outpatient clinic earlier in the day.

The ED physician orders chest X-rays, arterial blood gas analysis, and a complete blood count (CBC). The physician reviews the results of the tests, and based on the symptoms and recent transfusion, the physician diagnoses the patient with transfusion-associated dyspnea (TAD).

What code(s) would you assign for the patient’s diagnosis?

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