Radiology Coding Alert

Question: Documentation shows both COPD and acute bronchitis for a patient. What are my ICD-9 coding options?

Hawaii Subscriber

Answer: When the physician documents acute bronchitis with COPD (chronic obstructive pulmonary disease), ICD-9 official guidelines instruct you to report 491.22 (Obstructive chronic bronchitis, with acute bronchitis).

You don't need to report 466.0 (Acute bronchitis) as an additional code, the guidelines state.

In addition, if the patient has acute bronchitis with COPD with acute exacerbation, you should report only 491.22. "The acute bronchitis included in code 491.22 supersedes the acute exacerbation," the guidelines state.

Definition: "An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection," the ICD-9 official guidelines indicate.

Resource: You can find the guidelines online at www.cdc.gov/nchs/data/icd9/icdguide10.pdf.