Pulmonology Coding Alert

Question: I’m having trouble understanding how the word “unspecified” differs between diagnosis code descriptors.

Could you please explain how the same word can mean different things?

California Subscriber

Answer: Certainly! According to the ICD-10-CM official guideline, section I.A.9.b, “Codes titled ‘unspecified’ are for use when the information in the medical record is insufficient to assign a more specific code.” This means that if the physician documents a diagnosis but does not provide a precise description of the condition, you’d assign an unspecified code.

For example, in the J34.82- (Nasal valve collapse) code subcategory, the following codes exist:

• J34.8200 (Internal nasal valve collapse, unspecified)
• J34.8210 (External nasal valve collapse, unspecified)
• J34.829 (Nasal valve collapse, unspecified)

Codes J34.820- (Internal nasal valve collapse) and J34.821- (External nasal valve collapse) both require 7^th characters to complete the codes. The 7^th characters 1 and 2 represent static and dynamic conditions, respectively. Using 0 as a 7^th character, as in the codes listed above, indicates an unspecified condition.

You’d assign J34.8200 when the physician issues a diagnosis of internal nasal valve collapse but doesn’t exactly mention whether the condition is static or dynamic — or they do not have enough information to confirm one of those diagnoses. The same logic applies to when a physician documents just external nasal valve collapse in the patient’s record. In that case, you’ll assign J34.8210.

Report J34.829 if the provider documents that the patient is experiencing nasal valve collapse but doesn’t specify internal, external, static, or dynamic.

Mike Shaughnessy, BA, CPC, Development Editor, AAPC