Wiki Can we code 493.20 & 491.20 together?

[ramanan_kr]

Hi,
The document states Chronic obstructive bronchitis and chronic obstructive asthma are present for this patient.
As per ICD 9, both the codes 493.20 & 491.20 are in the excludes list of each other, does that mean we can code both together if the document supports?
But, COPD is a nonspecific term that
encompasses many different respiratory
conditions that cause progressive damage to
the lungs.
? Such as:
? Bronchitis
? Bronchitis with emphysema
? Emphysema
? Asthma
Does this mean that we have to consider Chronic obstructive asthma as more specific condition and code only 493.20 instead of both the codes?
Please Help

 

[matho07@ymail.com]

I believe 493.20 is the more appropriate code for this. When you index it, Bronchitis >> Asthmatic >> Chronic. it will lead you to above code. Check Tabular, it says Asthma with COPD as well as Chronic Asthmatic Bronchitis

Hope this helps.

 

[ramanan_kr]

Hi ramon_mathoni_villanueva@optum.com - As u said if we Check Tabular, it says Asthma with COPD as well as Chronic Asthmatic Bronchitis, but Chronic obstructive bronchitis is in Excludes list,
The patient has both Chronic obstructive bronchitis and chronic obstructive asthma.. That is where my confusion is

 

[s.haney86]

coding 49320 and 49120 together

I think you should code both of them together. They are in the excludes list of each other so they are separately identifiable diseases. You can have bronchitis without asthma and the asthma without bronchitis. Coding both codes would just be more specific