COPD-Grrrrr!

[fritzta]

I am doing outpatient coding and am a bit confused by COPD. Here's the scenario:

Assesment:
Acute Bronchitis
Chronic lung disease (COPD) with bronchial asthma component

I was coding 466.0 for the acute Bronchitis and 493.20 for the Asthma with COPD, in this particular case nothing was listed as an acute exacerbation, which I know changes things. I think at the beginning of the ICD-9 it says that acute bronchitis IS an exacerbation of COPD and that code 491.22 shouldbe used since it includes the Bronchitis. But where does that leave the asthma. In this particular scenario the provider listed the two separtely. Does a relationship have to be established to go with the COPD rule for code 491.22?

[fritzta]

Never mind, says it right there in BLACK AND WHITE not to use 466.0 with 493.20! Is there a diagnosis code for pregnancy brain or late effect of pregnancy, or something like that