Pulmonology Coding Alert

Reader Question:

Stretch CF Code Up To Fifth Digit When Pneumonia Is Involved

Question: The physician orders a direct sputum acid-fast stain and culture for mycobacteria for a patient with CF showing pulmonary exacerbation. Which cystic fibrosis code should you report?New Jersey SubscriberAnswer: Keep in mind that a cystic fibrosis (CF) diagnosis includes different ICD-9 codes (277.00-277.09). In this case, consider that many CF patients develop pneumonia, so you should use 277.02 (Cystic fibrosis with pulmonary manifestations) since the physician clearly stated "pulmonary exacerbation" in the narrative description.
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