Disclosures: Kuwahara reports serving as a CMS fellow and previously served as a fellow at the Association of Asian Pacific Community Health Organizations. Disclosures: Kuwahara reports serving as a CMS fellow and previously served as a fellow at the Association of Asian Pacific Community Health Organizations.
Tests may include:
chronic obstructive pulmonary disease [COPD] with acute bronchitis ICD-10-CM Diagnosis Code J44.0 Chronic obstructive pulmonary disease with (acute) lower respiratory infection
Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. These two conditions usually occur together and can vary in severity among individuals with COPD. As per AHA Coding Clinic, COPD is a chronic and lifelong condition.
Note: Code J44. 0 includes a note that says “use additional code to identify infection.” The infection has been identified as acute bronchitis (J20. 9) so this code should be added in addition to the others. Note: There is an exclusion note under J44* (COPD) for emphysema without chronic bronchitis.
Table 1ICD-9-CM CodeDescription492.8Other emphysema493.22Chronic obstructive asthma with acute exacerbation496Chronic airway obstruction, not elsewhere classified518.81Acute respiratory failure12 more rows
ICD-9 Code Transition: 466.0 9 is the diagnosis code used for Acute Bronchitis, Unspecified. Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. Acute bronchitis is more severe and can become chronic and progress to pneumonia.
Chronic bronchitis (CB) is closely associated with the frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbation. However, little is known about the impact of CB on COPD exacerbations, severe and non-severe, and on recovery from an exacerbation.
VICC agrees with the clinical advice that bronchiectasis and COPD are two separate diseases. A code can be assigned for each condition depending on the documentation in the medical record. In the scenario cited, J47 Bronchiectasis is assigned.
9 Chronic obstructive pulmonary disease, unspecified.
ICD-10 code: J44. 1 Chronic obstructive pulmonary disease with acute exacerbation, unspecified.
496 - Chronic airway obstruction, not elsewhere classified. ICD-10-CM.
J40: Bronchitis, not specified as acute or chronic.
9: Acute bronchitis, unspecified.
Bronchitis is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may be either acute or chronic.
0 is coded first, followed by the code for pneumonia, and assigned to DRG 190 COPD with MCC. AECOPD and Pneumonia: When a patient has both pneumonia and acute exacerbation of COPD, it is appropriate to assign both codes J44. 0 [COPD with acute lower respiratory infection] and J44. 1 [COPD with (acute) exacerbation].
J44. 9, Chronic obstructive pulmonary disease, unspecified and J45. 40, Moderate persistent asthma, uncomplicated. Codes will be dependent upon the specificity of the COPD and asthma documented.
Exacerbations of chronic obstructive pulmonary disease (COPD) are episodes of worsening of symptoms, leading to substantial morbidity and mortality. COPD exacerbations are associated with increased airway and systemic inflammation and physiological changes, especially the development of hyperinflation.
A diagnosis of COPD and acute bronchitis is classified to code 491.22. It is not necessary to assign code 466.0 (acute bronchitis) with 491.22. Code 491.22 is also assigned if the physician documents acute bronchitis with COPD exacerbation. However, if acute bronchitis is not mentioned with the COPD exacerbation, then code 491.21 is assigned (AHA Coding Clinic for ICD-9-CM, 2008, fourth quarter, pages 241-244).
Asthma with COPD is classified to code 493.2x. However, all coding directives in the Tabular List and index need to be reviewed to ensure appropriate code assignment. A fifth-digit sub classification is needed to identify the presence of status asthmaticus or exacerbation.
Exacerbation is defined as a decompensation of a chronic condition. It is also defined as an increased severity of asthma symptoms, such as wheezing and shortness of breath. Although an infection can trigger it, an exacerbation is not the same as an infection superimposed on a chronic condition. Status asthmaticus is a continuous obstructive asthmatic state unrelieved after initial therapy measures.
Chronic obstructive pulmonary disease is a chronic bronchitis alpha-1 antitrypsin deficiency that is a genetic form of emphysema. The disease is most of the time characterized by the narrowing or obstruction of airflow and interference that hinders normal breathing. The primary risk factor for chronic obstructive pulmonary disease is smoking or second hand smoking, heredity and air pollution.
When the acute exacerbation of COPD is clearly identified, it is the condition that will be designated as the principal diagnosis. (AHA Coding Clinic for ICD-9-CM, 1988, third quarter, pages 5-6).
Coding and sequencing for COPD are dependent on the physician documentation in the medical record and application of the Official Coding Guidelines for inpatient care.
491.22 is a legacy non-billable code used to specify a medical diagnosis of obstructive chronic bronchitis with acute bronchitis. This code was replaced on September 30, 2015 by its ICD-10 equivalent.
The inflamed bronchi produce a lot of mucus. This leads to cough and difficulty getting air in and out of the lungs. Cigarette smoking is the most common cause. Breathing in other fumes and dusts over a long period of time may also cause chronic bronchitis. Treatment will help your symptoms, but chronic bronchitis is a long-term condition that keeps coming back or never goes away completely.
NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus, as well as shortness of breath, wheezing, and chest tightness. There are two main types of bronchitis: acute and chronic.
NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD.
A disease of chronic diffuse irreversible airflow obstruction. Subcategories of copd include chronic bronchitis and pulmonary emphysema.
Signs and symptoms include shortness of breath, wheezing, productive cough, and chest tightness. The two main types of chronic obstructive pulmonary disease are chronic obstructive bronchitis and emphysema. A disease of chronic diffuse irreversible airflow obstruction. Subcategories of copd include chronic bronchitis and pulmonary emphysema.
A chronic and progressive lung disorder characterized by the loss of elasticity of the bronchial tree and the air sacs, destruction of the air sacs wall, thickening of the bronchial wall, and mucous accumulation in the bronchial tree.
The 2022 edition of ICD-10-CM J44.9 became effective on October 1, 2021.
Chronic obstructive pulmonary disease includes chronic bronchitis, in which the bronchi (large air passages) are inflamed and scarred, and emphysema, in which the alveoli (tiny air sacs) are damaged. It develops over many years and is usually caused by cigarette smoking.