Pneumothorax is a condition which occurs when air leaks into the space between your lungs and the chest wall – called the pleural space. This buildup of air puts pressure on the lungs, so it cannot expand as much as it normally does when a person takes breath. The leaked air pushes on the outside of your lungs and makes it collapse. Also called lung collapse, the condition can be caused by a blunt or penetrating chest injury, ruptured air blisters, mechanical ventilation, certain medical procedures or lung damage from many types of underlying diseases (including COPD, cystic fibrosis and pneumonia). The condition can be either a complete lung collapse or a collapse of only a portion of the lung. If there is only a small amount of air trapped in the pleural space, the condition can heal on its own if there have been no further complications. On the other hand, more serious cases that involve larger volumes of air could become fatal if left untreated. Physicians providing treatment for this lung condition can rely on medical billing companies to meet their claim submission concerns.

Generally, men are far more likely to develop pneumothorax than women. It is more likely to develop in people between the age group of 20 – 40 years, particularly among tall and underweight people. Some of the common risk factors include – smoking, genetics, lung diseases, mechanical ventilation and previous cases of pneumothorax.

Types of Pneumothorax

Pneumothorax is generally categorized into different types which include the following –

  • Traumatic pneumothorax – This type is often the result of an injury (sports injuries, car accidents, and punctures or stab wounds) that damages the chest wall and pleural space. Certain medical procedures like inserting a catheter into a vein in the chest or taking a sample of lung tissue may also lead to traumatic pneumothorax.
  • Non-traumatic pneumothorax – This type of pneumothorax occurs spontaneously, which is why it is also referred to as spontaneous pneumothorax. There are two major types of non-traumatic pneumothorax – primary and secondary.
    • Primary spontaneous pneumothorax (PSP) – The direct cause of PSP is unknown. The condition occurs when the person has no known history of lung disease. The most important risk factor associated with PSP is smoking tobacco. According to a review in the medical journal BMJ, men who smoke tobacco are 22 times more likely to develop PSP than non-smokers. Women who smoke tobacco are nine times more likely than nonsmokers to develop PSP. If treated promptly, PSP is usually not fatal.
    • Secondary spontaneous pneumothorax (SSP) – SSP is caused by a variety of lung diseases like – chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, thoracic endometriosis, lung infections such as tuberculosis, and certain forms of pneumonia.
  • Tension pneumothorax – This is caused by a leak in the pleural space. As a person inhales, the air leaks into the pleural space and becomes trapped. It cannot be released during an exhale. This leads to increased air pressure in the pleural space.

People who have had one pneumothorax can have another, typically within one to two years of the first. In some cases, air may continue to leak if the opening in the lung won’t close. Surgery may be required to close the air leak, in such critical cases.

Symptoms, Diagnosis and Treatment

Initially, the symptoms of the condition may hardly be noticeable. However, as the condition progresses several mild to life-threatening symptoms may occur which include – shortness of breath, chest pain (which may be more severe on one side of the chest), sharp pain when inhaling, rapid breathing, pressure in the chest that gets worse over time, loss of consciousness or coma, confusion or dizziness, and blue discoloration of the skin or lips.

As there are a variety of causes and symptoms associated with the condition, diagnosing the same can be difficult. Physicians will examine patients to check for abnormal sounds or listen to their breathing through a stethoscope. They may conduct a detailed review about previous medical history and ask questions about smoking habits and family history of lung disorders. Imaging tests like chest X-ray, CT scan and ultrasound may be performed to view the size and severity of the pneumothorax.

Treatment of pneumothorax aims to relieve the pressure on your lungs, allowing it to re-expand. Top treatment modalities include – observation, needle aspiration, chest tube insertion, nonsurgical repair or surgery. Inserting a small tube between the ribs or under the collarbone help to release the gas that has built up, which slowly decompresses the lungs. Physicians may also prescribe various medications to numb pain, help remove toxins, or prevent infection in the body. In some rare cases, surgery may be necessary.

ICD-10 Codes for Pneumothorax

Medical billing services offered by reputable service providers can help physicians use the right ICD-10 codes for their medical billing process. ICD-10 codes for diagnosing different types of pneumothorax –

  • J93 – Pneumothorax and air leak
  • J93.0 – Spontaneous tension pneumothorax
  • J93.1 – Other spontaneous pneumothorax
    • J93.11 – Primary spontaneous pneumothorax
    • J93.12 – Secondary spontaneous pneumothorax
  • J93.8 – Other pneumothorax and air leak
    • J93.81 – Chronic pneumothorax
    • J93.82 – Other air leak
    • J93.83 – Other pneumothorax
  • J93.9 – Pneumothorax, unspecified

Pneumothorax may be life-threatening in certain situations and hence should not be taken lightly. It is important to consult a physician soon after the symptoms develop. Most cases can be treated with prompt medical intervention.

Pulmonary medical billing and coding for pneumothorax can be complex. Billing and coding services provided by AAPC-certified coders can help pulmonologists optimize reimbursement for the services they offer.