ICD-10 Codes for Reporting Five Common Pulmonary Diseases

by | Published on Mar 26, 2020 | Resources | 0 comments

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Pulmonary diseases are one of the most commonly reported health issues in the United States, and the pulmonary medical specialty focuses on the prevention, diagnosis, and treatment of conditions that affect the lungs and respiratory tract. These diseases affect any organ inside your body that is associated with the breathing process. It may cause trouble to airways, nasal cavities, larynx, throat, lung tissues, windpipe, bronchioles or circulation of blood in and out of your lungs. Presence of fungal, viral or bacterial infections, excessive exposure to smoke and other toxic materials, low immune functioning, adverse climatic conditions, intolerable air pollution and inappropriate development of lungs during childhood/before are some of the common reasons that can cause pulmonary diseases. Symptoms of pulmonary diseases depend on the type of diseases and the severity of infection a person suffers and may generally include – breathing issues (like wheezing or shortness of breath), continuous cough (may also be accompanied by mucus), tightness or uneasiness in the chest area, throat ache (due to soreness and inflammation), blood with a cough, and swelling in the toes and fingers due to improper breathing. Patients who experience any of the above symptoms need to immediately consult a medical professional who can provide correct treatment. Treatment for these conditions may generally include medications, use of respiratory assistance and possible surgery to prevent further complications. Proper documentation is necessary to justify medical necessity and selection of medical codes for billing. Relying on the services of a professional pulmonary medical billing company can help in accurate and timely claim submission for appropriate reimbursement.

Here discussed are the top five pulmonary conditions and their related ICD-10 codes –

Acute respiratory distress syndrome (ARDS) – This condition occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream, which deprives your organs of the oxygen they need to function. Severe shortness of breath is one of the main symptoms of ARDS. There is no specific test to identify ARDS. Diagnosis is normally based on a physical exam, chest X-ray and oxygen levels. The ICD-10 code for reporting this condition is –

  • J80 – Acute respiratory distress syndrome

Asthma – Asthma is a condition that can cause breathing difficulty and trigger coughing, wheezing and shortness of breath. It can make your airways narrow and produce extra mucus. Asthma cannot be cured fully but its symptoms can be controlled effectively. Exposure to various irritants and substances that activate allergies (allergens) can trigger signs and symptoms of asthma. These signs and symptoms vary from person to person and include – shortness of breath, chest tightness or pain, trouble sleeping (caused by shortness of breath, coughing or wheezing), a whistling or wheezing sound when exhaling, and coughing and wheezing attacks (worsened by a respiratory virus, such as a cold or the flu). Long-term control and prevention are the key steps in stopping asthma attacks before they begin. Treatment modalities involve recognizing the triggers and taking adequate steps to avoid them. In case of an asthma flare-up, physicians may prescribe a quick-relief inhaler, such as albuterol. Other medications include – oral and intravenous corticosteroids, leukotriene modifiers, Ipratropium (Atrovent), theophylline and short-acting beta agonists.
Related ICD-10 codes include –

J45 – Asthma

J45.2 – Mild intermittent asthma

  • J45.20 – Mild intermittent asthma, uncomplicated
  • J45.21 – Mild intermittent asthma, with (acute) exacerbation
  • J45.22 – Mild intermittent asthma, with status asthmaticus

J45.3 – Mild persistent asthma

  • J45.30 – Mild persistent asthma, uncomplicated
  • J45.31 – Mild persistent asthma, with (acute) exacerbation
  • J45.32 – Mild persistent asthma, with status asthmaticus

J45.4 – Moderate persistent asthma

  • J45.40 – Moderate persistent asthma, uncomplicated
  • J45.41 – Moderate persistent asthma, with (acute) exacerbation
  • J45.42 – Moderate persistent asthma, with status asthmaticus

J45.5 – Severe persistent asthma

  • J45.50 – Severe persistent asthma, uncomplicated
  • J45.51 – Severe persistent asthma, with (acute) exacerbation
  • J45.52 – Severe persistent asthma, with status asthmaticus

J45.9 – Other and unspecified asthma

  • J45.90 – Unspecified asthma
    • J45.901 – Unspecified asthma, with (acute) exacerbation
    • J45.902 – Unspecified asthma, with status asthmaticus
    • J45.909 – Unspecified asthma, uncomplicated
  • J45.99 – Other asthma
    • J45.990 – Exercise induced bronchospasm
    • J45.991 – Cough variant asthma
    • J45.998 – Other asthma

Chronic obstructive pulmonary disease (COPD) – Regarded as a group of progressive lung diseases, chronic obstructive pulmonary diseases (COPD) cause obstructed airflow from the lungs. The condition is generally caused by long-term exposure to irritating gases, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Common symptoms include – breathing difficulty, cough, mucus (sputum) production and wheezing. Diagnosis of this condition may begin with a detailed review of symptoms and exposure to lung irritants (especially cigarette smoke). Imaging tests like lung (pulmonary) function tests, chest X-ray, CT scan and arterial blood gas analysis will be performed. Treatment modalities include medications and lung therapies like oxygen therapy and pulmonary rehabilitation program. ICD-10 codes for diagnosing COPD include –

  • J44 – Other chronic obstructive pulmonary disease
  • J44.0 – Chronic obstructive pulmonary disease with acute lower respiratory infection
  • J44.1 – Chronic obstructive pulmonary disease with (acute) exacerbation
  • J44.9 – Chronic obstructive pulmonary disease, unspecified

Bronchitis – This is an inflammation of the lining of the bronchial tubes, which carry air to and from your lungs. Bronchitis may be either acute or chronic. Acute bronchitis is often a common condition, which usually improves within a week to 10 days without lasting effects. Chronic bronchitis, on the other hand, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. Symptoms may include – cough, production of mucus (sputum), fatigue, shortness of breath and chest discomfort. Diagnosis of this condition may involve a physical exam along with other tests like sputum tests, pulmonary function tests and chest X-ray. Treatment may involve medications and other pulmonary rehabilitation therapies. ICD-10 codes include –

  • J40 – Bronchitis, not specified as acute or chronic
  • J41 – Simple and mucopurulent chronic bronchitis
    • J41.0 – Simple chronic bronchitis
    • J41.1 – Mucopurulent chronic bronchitis
    • J41.8 – Mixed simple and mucopurulent chronic bronchitis
  • J42 – Unspecified chronic bronchitis

Bronchiectasis – Bronchiectasis occurs when the airways of the lungs become abnormally widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection. The condition is fairly common among people aged 75 years and older, but it can also happen to younger people. The risk of getting this condition increases with age. Bronchiectasis is generally caused by cystic fibrosis (CF) – a genetic condition that results in long-lasting lung infections and reduced ability to breathe. Symptoms include – coughing that results in a lot of mucus, chest pain or tightness, wheezing or making whistling noises when breathing, frequent respiratory infections, fatigue, and weight loss. Treatment for bronchiectasis include – breathing exercises, chest physiotherapy, pulmonary rehabilitation, antibiotics to prevent and treat infection, and medications to thin mucus. ICD-10 codes for diagnosing bronchiectasis include –

  • J47 – Bronchiectasis
  • J47.0 – Bronchiectasis with acute lower respiratory infection
  • J47.1 – Bronchiectasis with (acute) exacerbation
  • J47.9 – Bronchiectasis, uncomplicated

Most of the pulmonary diseases are preventable. The risks of suffering the above-mentioned pulmonary conditions can be reduced to a great extent by taking adequate preventive measures like – stopping the habit of smoking, avoiding exposure to pollutants that can damage your lungs, preventing the occurrence of infections and working with chemicals, dust and fumes.

Healthcare providers need to be well-informed about the highly specific ICD-10 codes to report common pulmonary diseases. Utilizing the services of a reliable medical billing and coding company can help physicians ensure accurate claim submission and optimal reimbursement.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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