Pulmonology Coding Alert

The fourth digit opens a new world of complications.

If your pulmonology practice gives cessation counseling, you may be regularly using emphysema diagnosis codes to support your reporting. You will have to stay updated for new ICD-10 diagnosis codes that are definitely coming to avoid losing out on hard earned dollars. Good news is that although you will have twice as many codes to choose from, you will have to remember just six codes.

The six new codes will give your claims more detail. Read on to see what code relates to what type of emphysema.

Let Go of Limited ICD-9 Codes

Today, when your provider diagnoses a patient with emphysema, you use an ICD-9 code from 492 (Emphysema) section. You need to code the fourth digit for the type of emphysema as follows:

• 492.0 (Emphysematous bleb) — This type includes a diagnosis of giant bullous emphysema, ruptured emphysematous bleb, tension pneumatocele, and vanishing lung.

• 492.8 (Other emphysema) — includes a diagnosis of emphysema (lung or pulmonary), MacLeod’s syndrome, Swyer-James syndrome, and unilateral hyperlucent lung.

Count the Same Number of Digits

In the future, with ICD-10 codes, instead of 492 codes, you will report a J43 (Emphysema) code. If you have a diagnosis of 492.0, it will be a direct match to code J43.9 (Emphysema, unspecified). If you need a match to 492.8, you will have a choice between four additional codes that describe the type of emphysema formerly included in 492.8:

• J43.0 — Unilateral pulmonary emphysema [MacLeod’s syndrome]

• J43.1 — Panlobular emphysema

• J43.2 — Centrilobular emphysema

• J43.8 — Other emphysema.

Good news: Your physician is likely already documenting the details you’ll need to choose the right code. But if she isn’t, be sure to explain that accurate ICD-10 coding will require very specific details and encourage her to start providing you as much information as possible in her notes.