Pulmonology Coding Alert

Don't forget to code first underlying infection.

Pulmonary embolism is a sudden blockage in a lung artery. To diagnose or rule out this condition, the pulmonologist would usually order a ventilation/ perfusion study. When billing for pulmonary embolism, you would code ICD-9 415.1x (Pulmonary embolism and infarction). Subcategory codes for 415.1x include:

• 415.11 -- Iatrogenic pulmonary embolism and infarction
• 415.12 -- Septic pulmonary embolism
• 415.19 -- Other pulmonary embolism and infarction.

ICD difference: When ICD-9 transitions to ICD-10 on October 1, 2013, the code 415.12 will change to I26.90 (Septic pulmonary embolism without acute cor pulmonale). This new code will pertain to the same descriptor as its ICD-9 counterpart, except for the added term for specificity: "without acute cor pulmonale."

Coder tips: In ICD-10 when billing for I26.90, you will code first underlying infection, such as septicemia (A40.9-A41.9). Septic pulmonary embolism is an uncommon disorder that generally presents with an insidious onset of fever (R50.9, Fever unspecified), cough (R05), and hemoptysis (R04.2, Hemoptysis; R04.9; Hemorrhage from respiratory passages unspecified).