Understanding Pneumonia ICD-10 Codes for Accurate Billing

by | Last updated May 11, 2023 | Published on May 10, 2023 | Medical Billing

Pneumonia ICD-10 Codes for Accurate Billing
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Pneumonia is an infection that can impact one or both lungs. It is a leading cause of death among children and the elderly. The condition is caused by bacteria, viruses, or fungi, and can inflame the air sacs (alveoli) in the lungs, leading to coughing and breathing difficulties. Pneumonia can be classified as community-acquired (CAP), health care-associated (HCAP), hospital-acquired (HAP), or ventilator-associated (VAP). The severity of pneumonia symptoms can vary depending on several factors, including the type of germ that caused the infection and the patient’s age and overall health. Some common symptoms of pneumonia include chest pain while breathing or coughing, breathlessness, loss of appetite, fatigue, and nausea. Additionally, some patients may experience vomiting, diarrhea, or other gastrointestinal symptoms. Proper medical coding for pneumonia is crucial for appropriate reimbursement for physicians, as the type of pneumonia and its causal factor must be accurately documented in the medical record.

To assign the most accurate codes, specialists should document the type and etiology of pneumonia. Pulmonary medical billing can be challenging. Pneumonia can be caused by a bacterial, viral or fungal infection and the correct cause has to be documented using the appropriate code. AAPC-certified coders who specialize in providing pulmonary medical coding services can assist infectious disease specialists in accurately reporting this condition and optimizing reimbursement.

Learn Pneumonia ICD-10 Codes

Learn Pneumonia ICD-10 Codes

  • J12 Viral pneumonia, not elsewhere classified
    • 0 Adenoviral pneumonia
    • 1 Respiratory syncytial virus pneumonia
    • 2 Parainfluenza virus pneumonia
    • 3 Human metapneumovirus pneumonia
    • 8 Other viral pneumonia
    • 9 Viral pneumonia, unspecified
  • J13 Pneumonia due to Streptococcus pneumonia
  • J14 Pneumonia due to Hemophilus influenza
  • J15 Bacterial pneumonia, not elsewhere classified
  • J16 Pneumonia due to other infectious organisms, not elsewhere classified
    • 0 Chlamydial pneumonia
    • 8 Pneumonia due to other specified infectious organisms
  • J17 Pneumonia in diseases classified elsewhere
  • J18 Pneumonia, unspecified organism
    • 0 Bronchopneumonia, unspecified organism
    • 1 Lobar pneumonia, unspecified organism

The primary objective of treating this pulmonary condition is to cure the infection, and the nature of treatment will depend on several factors, including the type of pneumonia, its severity, and the patient’s overall health. Common treatment modalities include medications such as antibiotics and pain relievers like aspirin, ibuprofen (Advil, Motrin IB, others), and acetaminophen (Tylenol, others). It is essential to seek timely treatment, as untreated pneumonia can lead to complications, especially in people with weakened immune systems or chronic conditions like diabetes.

Infectious disease specialists can rely on professional hands for accurate pulmonary medical coding services, which will optimize their reimbursement.

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Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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