Advanced Search

Pulmonology Coding Alert

You Be the Coder:

ICD-9 Coding for COPD/Bronchitis

Published on Wed Jan 28, 2009

Question: A new patient reports to the pulmonologist complaining of shortness of breath and coughing. The pulmonologist performs a level five E/M, then orders a spirometry (the practice owns the spirometry equipment). Based on test results, the physician diagnoses chronic obstructive pulmonary disease (COPD) with acute bronchitis. When choosing ICD-9 codes, should I code the COPD and bronchitis separately?

South Dakota Subscriber

Answer: You should not report 466.0 (Acute bronchitis) for the obstructive chronic bronchitis because the code descriptor for 491.22 specifies acute bronchitis is present in addition to the chronic obstructive bronchitis.

On the claim, report the following:

• 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement[s], with or without maximal voluntary ventilation) for the spirometry

• 491.22 (Obstructive chronic bronchitis; with acute bronchitis) appended to 94010 to represent the COPD

• 99205 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity ...) for the E/M

• 491.22 appended to 99205 to represent the COPD

• Modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) is not required to report a pulmonary function test on the same day as an E/M service, unless the payer specifically requires it.

Other Articles in this issue of

Pulmonology Coding Alert

View All