Pulmonology Coding Alert

Question: My pulmonologist documented "multilobar pneumonia." What ICD-9 code should I report?

Arizona Subscriber

Answer: When coding for pneumonia, you should be able to identify the specific type, and code based on the causal organism. The Coding Clinic emphasizes that the term "lobar pneumonia" is, in fact, outdated as it codes only to 481 (Pneumococcal pneumonia [streptococcus pneumoniae pneumonia]), whereas other organisms may be involved. For instance, lobar pneumonia and pneumonia of the right lower lobe are not the same.

You would code Pneumonia of the right lower lobe without specification with 486 (Pneumonia organism unspecified), while lobar pneumonia is associated with pneumococcal pneumonia, 481. (See Coding Clinic, March-April 1985, page 6.)

Important: If the pulmonologist uses nonspecific language, for instance 'healthcare-associated pneumonia' or 'nosocomial pneumonia,' you should clarify with him the specific bacterial type of the pneumonia.