Two codes are necessary to capture the full diagnosis, one code for the Acute Exacerbation of COPD
A group of progressive lung disorders characterized by increasing breathlessness.
To help you feel better, you may want to try the following self-care measures:
Symptoms of Chronic Bronchitis
What is the difference between: Emphysema, COPD, Asthma, and Chronic Bronchitis?
In the meantime, you can also try these tips to ease your cough:
J44. 1 - Chronic obstructive pulmonary disease with (acute) exacerbation. ICD-10-CM.
An exacerbation of chronic bronchitis may be defined as the acute worsening of the clinical symptoms of the disease, i.e. breathlessness, wheezing and cough, associated with sputum production and/or sputum purulence.
9 – Acute Bronchitis, Unspecified. Code J20. 9 is the diagnosis code used for Acute Bronchitis, Unspecified.
9 – Chronic Obstructive Pulmonary Disease, Unspecified. ICD-Code J44. 9 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Chronic obstructive pulmonary disease. This is sometimes referred to as chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD).
This affects airflow to the lungs. Doctors sometimes call this condition emphysema or chronic bronchitis. A person with COPD can experience a period when their symptoms are much worse than usual. This is known as an acute exacerbation.
Exacerbation: A worsening. In medicine, exacerbation may refer to an increase in the severity of a disease or its signs and symptoms. For example, an exacerbation of asthma might occur as a serious effect of air pollution, leading to shortness of breath.
Bronchitis and bronchiolitis Therefore, you'll typically use just two ICD-10 codes: J20. 9 and J21. 9.
To diagnose bronchitis, your doctor will do a physical exam and ask about your medical history and symptoms. The doctor may also order a blood test to look for signs of infection or a chest X-ray to see if your lungs and bronchial tubes look normal and rule out pneumonia.
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.
A patient is documented in the record to have COPD and also has a diagnosis of chronic bronchitis and is on long term medications to help keep the chronic bronchitis from exacerbations. In this case, only code J44.
If the COPD exacerbation is in the setting of COPD with acute bronchitis, both code J44. 0 and code J44. 1 may be reported when appropriate. – Acute bronchitis is not equivalent to acute exacerbation; it is a separate condition.
Remember that codes from the J44. - category cover both chronic obstructive bronchitis and chronic obstructive asthma, so if a patient's diagnosis includes both of those, one code from J44. - will suffice, according to tabular instruction.
If the documentation is unclear as to whether a patient has Acute Bronchitis and an Acute Exacerbation of Asthmatic Bronchitis or just an Acute Exacerbation of Asthmatic Bronchitis, query the physician for clarification. Work with your physicians to help them understand the different descriptions and options in ICD-10-CM.
Under category (J44) (Other Chronic Obstructive Pulmonary Disease) there is a Code also note instructing coders to code the type of Asthma, if applicable (J45.-). In this case, Unspecified Asthma with Acute Exacerbation (J45.901) is added.
If an MD documents Acute Bronchitis and then further specifies it as Acute Asthmatic Bronchitis, a code for Acute Bronchitis (J44.0) is not coded in addition. In this case, the patient does not have Acute Bronchitis, only Acute Asthmatic Bronchitis.
Note: When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
I would agree with your codes. When the diagnosis is both of a lower respiratory tract infection and exacerbation of COPD , both J44.1 and J44.0 are coded, followed by a code for the specific lower respiratory infection, which in your example is the acute bronchitis.