Help with coding question

Unknown
in CDI Talk Archive
Can anyone help me with the following question. Can we code COPD and
pulmonary fibrosis together. If we can, please let me know where the
references for this would be located.



Thanks,

Patti



Patti Stewart BSN,RN

Clinical Documentation Specialist

Mercy Medical Center

1301 15th Ave. West

Williston, ND 58801

pattistewart@catholichealth.net

Comments

  • Unknown
    edited May 2016
    In ICD-9-CM for COPD go to:
    Disease
    Pulmonary
    Obstructive (chronic)
    It takes you to 496 chronic airway obstruction NEC
    There is a note:
    NOTE: this code is not to be used with any code from categories 491-493
    And Exludes:
    COPD with
    -allergic alveolitis
    -asthma
    -bronchiectasis
    -bronchitis
    -decompensated
    -emphysema

    For pulmonary fibrosis go to:
    Fibrosis
    Pulmonary (chronic)
    Takes you to 414 postinflammatory pulmonary fibrosis

    I do not see any notes or excludes for using the two together.


    Charlene Thiry RN, BSN, CPC, CCDS
    Clinical Documentation Specialist
    Quality Resources
    Menorah Medical Center
    5721 W. 119th Street | Overland Park, Kansas 66209
    Charlene.Thiry@hcahealthcare.com
  • david.smithdavid.smith
    edited May 2016
    I can find nothing to prohibit the coding of both conditions. You
    probably won't find anything that specifically states that you can code
    both together, but if there is no coding rule or guideline against it
    then you should be OK. I would assume the fibrosis can be the cause of
    the airflow obstruction, but even then I would still code both out. It
    seems like the underlying process is different in both; Fibrosis is more
    of a scarring of the tissue and COPD is more of an inflammation of the
    tissue.
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