Pulmonology Coding Alert

What diagnosis can you list as secondary to sarcoidosis?

Sarcoidosis -- cause unknown -- is a disease that results from a type of inflammation of tissues. Often, it starts in the lungs or lymph nodes, but can appear in almost any bodyorgan. When a pulmonologist diagnoses a patient with this condition, you would code ICD-9 135 (Sarcoidosis).

When ICD-9 transitions to ICD-10 on October 1, 2013, the code changes to D86.9 (Sarcoidosis, unspecified). The new code will pertain to the same descriptor as its ICD-9 counterpart, except for the addition of the word "unspecified."

ICD difference: You will observe the same function for the new ICD-10 code as its ICD-9 counterpart to specify a diagnosis.

Coder tips: When coding for sarcoidosis with cardiomyopathy, you will note in your ICD-10 index that the code for 'sarcoidosis, cardiac' is D86.9, with I43 (Cardiomyopathy in diseases classified elsewhere) listed in italics. The italics may be there simply to catch your attention so that you remember not to use I43 as a primary (first-listed) diagnosis. The italicized code may represent a manifestation of another disease which you should code first. Another clue may be a note under I43 that advises you to "code first underlying disease," in this case, sarcoidosis (D86.9).