COPD coding
Hello, quick question.. if the documentation states "acute on chronic COPD" with no documentation of "exacerbation" or "decompensated" is it still ok to code "copd with acute exacerbation" J441.. Following the pathway in the encoder it gives you the option of exacerbation or with lower respiratory infection. Is it ok to assume "acute on chronic COPD" is references an acute exacerbation or decompensated clinical picture. The body of the record supports and exacerbation - just the verbiage is missing. thanks.