Pulmonology Coding Alert

Reader Questions:

Unclog Confusion When Coding Bronchitis

Question: If the doctor says "acute exacerbation of chronic bronchitis," wouldn't it be better to use 466.0 (Acute bronchitis)? Isn't 491.21 (Obstructive chronic bronchitis; with [acute] exacerbation) used more for patients with COPD with acute exacerbation? If the doctor doesn't say "obstructive bronchitis" can you make that leap and use 491.21?

Florida Subscriber

Answer: If the patient does not have obstructive chronic bronchitis (491.20) and develops an acute bronchitis, then you should use 466.0. This would be in a patient who does not have airflow limitation on PFT testing but does have the symptoms of chronic bronchitis (cough and chronic sputum production for 3 months, 2 years in a row [491, 491.0 or 491.1]).

-- The answers to the Reader Questions and You Be the Coder were provided and reviewed by Alan L. Plummer, MD, professor of medicine in the division of pulmonary, allergy, and critical care at Emory University School of Medicine in Atlanta; and Carol Pohlig, BSN, RN, CPC, ASC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.