Chronic lung disease

lnsavage10@yahoo.comlnsavage10@yahoo.com
edited June 2016 in Pediatrics

My pediatricians LOVE to document chronic lung disease (I'm sure none of you have this issue :))I am trying to come up with a list of more specific terms to discuss with them in an effort to obtain better documentation. What are terms that you all use? I have BPD, chronic lung disease of prematurity, CF, interstitial lung disease..... I feel like there are others that I may be missing.


Leah Savage, RN, MSN, CCDS

Kosair Children's Hospital

Louisville, KY

leah.savage@nortonhealthcare.org

Comments

  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    Leah,

    Are these patient's mostly ex-preemies or do the MD's just use chronic lung disease as a catch all Dx?

    Jeff

  • lnsavage10@yahoo.comlnsavage10@yahoo.com
    Chronic lung disease for everyone. I have asked them to use chronic lung disease of prematurity (P279) when it is for lung disease d/t prematurity.
  • acbuckle@gundersenhealth.orgacbuckle@gundersenhealth.org
    I have also had difficultly with documentation of this diagnosis. Some providers feel the BPD and chronic lung disease of prematurity are synonymous diagnoses, while others feel they are not. The P27.9 (I am told by our lead hospital coder) cannot be used when a provider documents chronic lung disease of prematurity. I have been trying to get our providers to say bronchopulmonary dysplasia when applicable.  
  • jackietouch@aol.comjackietouch@aol.com
    We have gone around and around on this one as well. There is an excellent reference from the American Thoracic Society that provides an in-depth review of chronic lung disease of infancy. BPD is not exactly the same as chronic lung disease of prematurity: It is one type of chronic lung disease of infancy. We try to have our physicians document BPD if the infant meets clinical criteria for BPD (we use the criteria in Up to Date), otherwise we clarify for CLD of prematurity and our coders accept this diagnosis (after we had one of our pulmonologists speak to our task force group re: the diagnosis and clinical meaning of the term). 

    Reference:
    American Thoracic Society (2003).  Statement on the care of the child with chronic lung disease of infancy and childhood. American Journal of Respiratory Critical Care Medicine, 168, 356-396. doi 10.1164/rccm.168.3.356

    Hope this helps!
    Jackie Touch
  • klabofish@mwph.orgklabofish@mwph.org
    Our physicians have fought us about this as well.  They now write CLD/BPD in their notes. 
  • wachirajwachiraj

    Working with the NICU docs, this is the consensus I have received. "BPD and CLD can be used interchangeably". They say BPD is an old term for CLD.

    Uptodate defines BPD as, " Bronchopulmonary dysplasia (BPD), also known as neonatal chronic lung disease (CLD), is an important cause of respiratory illness in preterm newborns that results in significant morbidity and mortality"

  • vbica@nemours.orgvbica@nemours.org

    There is another pediatric lung disease that can be made more specific as well,  'restrictive lung disease', normally in a child with neuromuscular disease like SMA 1 or DMD.  Also seen in spastic quadriplegic cerebral palsy kids with severe thoracolumbar curves.  many times a cause for 'chronic respiratory failure'....

  • jackietouch@aol.comjackietouch@aol.com
    vbica@nemours.org said:

    There is another pediatric lung disease that can be made more specific as well,  'restrictive lung disease', normally in a child with neuromuscular disease like SMA 1 or DMD.  Also seen in spastic quadriplegic cerebral palsy kids with severe thoracolumbar curves.  many times a cause for 'chronic respiratory failure'....

    How do you capture this one? We end up using J984 when restrictive lung disease is documented (same code we use for CLD that is not due to prematurity or arising during perinatal period). I wish there were a more descriptive one....

    Jackie Touch
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