COPD ICD-10 CM coding guide for Medical coders

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COPD ICD-10 CM Coding information

This is a very frequently coded ICD 10 code in respiratory system. This disease is very dangerous can lead to death as well. I am talking about Chronic Obstructive Pulmonary Disease (COPD). Also, there are multiple combination codes with COPD in diagnosis coding. For ICD 10 medical coders, it is very important to know about the COPD ICD-10 CM and related codes. Most of the times the medical coders make errors while coding a combination code of asthma with COPD, bronchitis with COPD or COPD with or without exacerbation. So, today we will checkout the list of ICD 10 codes used with COPD.

Applicable stages (or types)
There are two main types of COPD:

Chronic bronchitis
Emphysema

Chronic bronchitis is defined by a long-term cough with mucus. Emphysema is defined by a destruction of the lungs over time. Many people with COPD have a combination of both conditions.

Symptoms
In general, signs and symptoms of COPD can vary, depending on which lung disease (i.e., emphysema or chronic bronchitis) is most prominent. Those with COPD will likely experience exacerbations during which symptoms suddenly become much worse. Symptoms of emphysema include shortness of breath, wheezing, and chest tightness. Symptoms of chronic bronchitis include a chronic cough that produces yellowish sputum, shortness of breath, frequent respiratory infections, and the need to clear one’s throat early in the morning.

Category for ICD-10 CM code for COPD

The main category containing mainly CODP codes are J44. In this category, you will find all the ICD 10 codes of COPD. Let us check them below.

J44 Other chronic obstructive pulmonary disease

Includes: asthma with chronic obstructive pulmonary disease chronic asthmatic (obstructive) bronchitis

Code also type of asthma, if applicable (J45.-)

Use additional code to identify:

exposure to environmental tobacco smoke (Z77.22)

history of tobacco dependence (Z87.891)

occupational exposure to environmental tobacco smoke (Z57.31)

tobacco dependence (F17.-)

tobacco use (Z72.0)

Excludes1: bronchiectasis (J47.-)

chronic bronchitis NOS (J42)

chronic simple and mucopurulent bronchitis (J41.-)

chronic tracheitis (J42)

chronic tracheobronchitis (J42)

emphysema without chronic bronchitis (J43.-)

Excludes2: lung diseases due to external agents (J60-J70)

J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection

Use additional code to identify the infection

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation

Decompensated COPD

Decompensated COPD with (acute) exacerbation

Excludes2: chronic obstructive pulmonary disease [COPD] with acute bronchitis (J44.0)

J44.9 Chronic obstructive pulmonary disease, unspecified

Chronic obstructive airway disease NOS Chronic obstructive lung disease NOS

Related COPD ICD 10 Synonyms Include:

Chronic Obstructive Lung Disease (COLD)
Chronic Obstructive Airway Disease (COAD)
Asthma, chronic obstructive pulmonary disease (COPD
Asthma, chronic obstructive without status asthmaticus
Asthmatic bronchitis
Bronchiolitis fibrosa obliterans
Chronic asthmatic bronchitis
Chronic bronchitis, obstructive
Chronic obstructive airway disease with asthma
Chronic obstructive asthma
Chronic obstructive lung disease
Chronic Obstructive Pulmonary Disease (COPD)
Emphysematous bronchitis
Mild chronic obstructive pulmonary disease
Moderate chronic obstructive pulmonary disease
Severe chronic obstructive pulmonary disease
Airways obstruction irreversible

Related ICD 10 codes for COPD in Index

ICD 10 code for COPD in Asthma index

Asthma, asthmatic (bronchial) (catarrh) (spasmodic) J45.909

– with

– – chronic obstructive bronchitis J44.9

– – – with

– – – – acute lower respiratory infection J44.0

– – – – exacerbation (acute) J44.1

– – chronic obstructive pulmonary disease J44.9

– – – with

– – – – acute lower respiratory infection J44.0

– – – – exacerbation (acute) J44.1

– – exacerbation (acute) J45.901

Diagnosis code for COPD in Bronchiolitis index

Bronchiolitis (acute) (infective) (subacute) J21.9

– with

– – bronchospasm or obstruction J21.9

– – influenza, flu or grippe -see Influenza, with, respiratory manifestations NEC – chemical (chronic) J68.4

– – acute J68.0

– chronic (fibrosing) (obliterative) J44.9

Diagnosis code for COPD in Bronchitis index

Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous) J40

– with

– – influenza, flu or grippe -see Influenza, with, respiratory manifestations NEC

– – obstruction (airway) (lung) J44.9

Diagnosis code for COPD in disease index

Disease, diseased -see also Syndrome

– absorbent system I87.8

– acid-peptic K30

– Acosta’s T70.29

– Adams-Stokes (-Morgagni) (syncope with heart block) I45.9

– Addison’s anemia (pernicious) D51.0

– adenoids (and tonsils) J35.9

– adrenal (capsule) (cortex) (gland) (medullary) E27.9

– – hyperfunction E27.0

– – specified NEC E27.8

– ainhum L94.6

– airway

– – obstructive, chronic J44.9

Diagnosis code COPD in dyspnea index

Dyspnea (nocturnal) (paroxysmal) R06.00

– asthmatic (bronchial) J45.909

– – with

– – – exacerbation (acute) J45.901

– – – bronchitis J45.909

– – – – with

– – – – – exacerbation (acute) J45.901

– – – – – status asthmaticus J45.902

– – – – chronic J44.9

Read also: ICD 10 coding tips for HIV

Diagnosis code for COPD In Obstipation index

Obstipation -see Constipation Obstruction, obstructed, obstructive

– airway J98.8

– – with

– – – allergic alveolitis J67.9

– – – asthma J45.909

– – – – with

– – – – – exacerbation (acute) J45.901

– – – – – status asthmaticus J45.902

– – – bronchiectasis J47.9

– – – – with

– – – – – exacerbation (acute) J47.1

– – – – – lower respiratory infection J47.0

– – – bronchitis (chronic) J44.9

ICD-10 is required for use by physicians and healthcare providers under the Health Insurance Portability & Accountability Act (HIPAA) and will replace all ICD-9 code sets.

Documentation and coding
Documentation should reflect the stage of the lung disease for accurate coding. Review the documentation to see whether background information reveals that the patient has acute bronchitis v. acute exacerbation of chronic bronchitis, stable COPD, or other chronic lung disease. Review the clinical documentation carefully as there are situations where the COPD patient also will have acute respiratory failure upon admission even though he or she did not require intubation or mechanical ventilation.

Treatment
There is no cure for COPD; however, those with the condition can relieve symptoms with the following treatment methods:

Smoking cessation
Use of inhalers to open the airways
Use of inhaled steroids to reduce lung inflammation
Antibiotics to reduce symptom flare ups
At-home oxygen therapy
Pulmonary rehabilitation to learn to breath differently and maintain muscle strength in the lungs
Surgery to remove parts of the diseased lung (for patients with emphysema)
Lung transplant (for severe cases)

Many codes for COPD are found in category J44 (other COPD) in Chapter 10 of ICD-10-CM for respiratory system conditions. This category includes codes for COPD with acute lower respiratory infection, acute exacerbation, or unspecified. COPD is commonly documented and coded with other respiratory illnesses.

Emphysema describes the destruction of the walls and elastic fibers of the alveoli. Codes from category J43 are used to classify emphysema codes. When both emphysema and COPD are reported, only a code from category J43 should be used, as emphysema is a type of COPD.

Take note that there is a lengthy list of diagnoses under the Excludes1 list for J43. “If the more specific codes listed are documented, they would be assigned instead of a code from J43.”

Another type of COPD, chronic bronchitis, occurs when there is long-term inflammation of the breathing tubes (bronchi). Chronic bronchitis patients have a persistent cough that lasts three or more years.

If a patient has chronic bronchitis and is not suffering from an acute exacerbation, a code from category J44 for COPD would be reported. “Code J44.1 [COPD with acute exacerbation] would be used if the patient is suffering from an acute COPD exacerbation.”

When coding for COPD (emphysema or chronic bronchitis), coders should use additional ICD-10-CM codes to report any of the following:

Exposure to environmental tobacco smoke (Z77.22)
History of tobacco dependence (Z87.891)
Occupational exposure to environmental tobacco smoke (Z57.31)
Tobacco dependence (F17.-)
Tobacco use (Z72.0)

COPD patients also commonly present with asthma, as both conditions are brought on by inflammation and structural alterations of the airways. Asthma describes diffuse airway inflammation that makes it very difficult to breathe. It may be triggered by a variety of stimuli such as household and environmental allergens, infections, and cigarette smoke. An asthma attack or exacerbation causes the bronchial tubes to spasm and constrict.

When reporting asthmatic conditions with COPD, an additional code from category J45 should be reported when the type of asthma is specified in the documentation. For example, COPD and moderate persistent asthma would be reported as follows:

J44.9, COPD, unspecified
J45.40, moderate persistent asthma, uncomplicated

If asthma is documented without any further specificity of the type of asthma, only COPD would be reported. Unspecified asthma is not a specific type of asthma, and therefore, would not be reported. If asthma type is not specified, the medical coder must query the physician.

However, if the unspecified asthma is documented to be in exacerbation, it would be coded in addition to the COPD. Exacerbation of unspecified asthma does not describe a type of asthma, but does provide additional specificity regarding the asthma being in acute exacerbation.

Now, I hope you will easily code COPD icd 10 whenever you come across with any of it combination code. Do share this post if you liked it.