Radiology Coding Alert

Look for a one-to-one match for coal and asbestos.

While ICD-10 will offer you some direct matches for pneumoconiosis, you will be mistaken if you believe it applies to all causative dusts. Here is a layout of new and extended coding options for pneumoconiosis that you can implement later this year.

What is pneumoconiosis? Pneumoconiosis is a lung disease caused by inhalation of various types of dust particles. “Pneumoconiosis is a lung disease caused by breathing in air contaminated with particles of dust such as coal, kaolin, asbestos and talc,” says Christy Hembree, CPC, Team Leader, Summit Radiology Services, Cartersville, GA. “It is generally an occupational disease and affects people who are exposed to the contaminated air for prolonged periods of time.”

You Have Some Simple Direct Maps

You have a one-to-one match for coal worker’s pneumoconiosis. The ICD-9 code 500 (Coal workers’ pneumoconiosis) maps to J60 (Coal worker’s pneumoconiosis) in ICD-10.

Note: Coal worker’s pneumoconiosis is also called anthracosilicosis, anthracosis, black lung disease, coal workers’ lung, and miners’ asthma. You can look for any of these terms in the clinical note.

Like coal worker’s pneumoconiosis, there is a direct match for asbestosis in ICD-10. In ICD-9, you report code 501 (Asbestosis) and in ICD-10, you will report code J61 (Pneumoconiosis due to asbestos and other mineral fibers).

What is new in ICD-10? The descriptor of code J61 in ICD-10 specifies that the code applies to pneumoconiosis due to asbestos and also to that caused by other mineral fibers.

Differentiate Silica and Talc in ICD-10

For pneumoconiosis due to silica and silicates, you submit ICD-9 code 502 (Pneumoconiosis due to other silica or silicates). This code also applies to pneumoconiosis due to talc.

Remember: You have a common code for the simple, massive, and complicated silicosis. You do not differentiate silicosis for complications or extent of fibrosis.

ICD-10 Options: When the ICD-10 is implemented later this year, you choose from code J62.8 (Pneumoconiosis due to other dust containing silica) or J62.0 (Pneumoconiosis due to talc dust), depending upon whether the pneumoconiosis is due to silica or talc.

How is talc different from silica? Talc is a term for rocks and minerals which include silicates. Talc is essentially hydrous magnesium silicate. Talc is formed by geological modification of rocks. Most often, talc is formed by alteration of dolomite in the presence of excess silica.

Get Specific for Inorganic Dust Pneumoconiosis

When reporting pneumoconiosis in ICD-10, you will need to be specific as to which dust was the cause of pneumoconiosis. This is because the single ICD-9 code 503 (Pneumoconiosis due to other inorganic dust) maps to seven codes in ICD-10.

ICD-9 option: You report code 503 for aluminosis, bauxite fibrosis, and graphite fibrosis of lung. You also report this code for berylliosis, siderosis, and stannosis. “In ICD-9, a single diagnosis code 503 represents pneumoconiosis due to aluminosis, bauxite fibrosis, berylliosis, graphite fibrosis (of lung), siderosis, or stannosis,” says Hembree. “In ICD-10 these all are multiple options with their separate codes for these.”

ICD-10 options: You look out for specific codes for each of the conditions. You choose from the following codes:

• J63.0, Aluminosis (of lung)
  
• J63.1, Bauxite fibrosis (of lung)
  
• J63.2, Berylliosis
  
• J63.3, Graphite fibrosis (of lung)
  
• J63.4, Siderosis
  
• J63.5, Stannosis
  
• J63.6, Pneumoconiosis due to other specified inorganic dusts.
  

Do Not Miss Any Options

When you submit the pneumoconiosis codes in ICD-10, you may need to still extend your options by looking out for more specific possibilities. In ICD-9, you report code 504 (Pneumonopathy due to inhalation of other dust) for byssinosis, cannabinosis, and flax-dressers’ disease. “Byssinosis and cannabinosis are identified by a single code in ICD-9 but ICD-10 offers separate codes,” Hembree says.

In ICD-10, you have more definitive options for these conditions. These include the following:

• J66.0, Byssinosis
  
• J66.1, Flax-dressers’ disease
  
• J66.2, Cannabinosis
  

When your physician documents pneumopathy due to any other organic dusts, ICD-10 offers you an option to report code J66.8 (Airway disease due to other specific organic dusts). “You may use J66.8 when the dust type is given but not identified in ICD-10,” Hembree says.