COPD, Emphysema, Pneumonia
In your opinion, does the coding clinic below preclude assigning J44.0 (COPD with acute lower respiratory tract infection) in a patient with COPD and emphysema admitted with pneumonia? Or is J43.9 the correct assignment?
Coding Clinic 4Q 2017, p77
Question: A patient diagnosed with emphysema presented with an acute exacerbation of chronic obstructive pulmonary disease (COPD). How is a final diagnosis of COPD exacerbation with emphysema coded? Both codes have mutually exclusive Excludes1 notes, so we are unsure which code is appropriate.
Answer: Assign code J43.9, Emphysema, unspecified. Emphysema without mention of chronic bronchitis is classified to category J43, Emphysema. COPD is not synonymous with chronic bronchitis. So “COPD exacerbation with emphysema” is assigned code J43.9, because “COPD” does not automatically mean the patient has chronic bronchitis. Emphysema is a type of COPD