Pulmonology Coding Alert
Don't Let ICD-9 Descriptor Limit Diagnosis Coding
Question: My physician noted that a patient has "acute exacerbation of emphysema." The pulmonologist also said that the patient does not have chronic bronchitis. I don't see a diagnosis code for this. What should I use? As demonstrated with these additional code descriptors, the patient condition is not limited to chronic bronchitis for you to be able to report 491.21.
Alaska Subscriber
Answer: You should report ICD-9 code 491.21 (Obstructive chronic bronchitis, with [acute] exacerbation). Even though the patient may not have chronic bronchitis, 491.21 would be the most appropriate diagnosis code to use since it represents a variety of conditions.
If you look beyond the initial code descriptor for 491.21, you'll see that this ICD-9 code also includes:
• acute exacerbation of chronic obstructive pulmonary disease (COPD)
• decompensated chronic obstructive pulmonary disease (COPD)
• decompensated chronic obstructive pulmonary disease (COPD) with exacerbation
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