Take Heed of Patient’s Fancies
Question: A patient arrived at our emergency department (ED) presenting with pain while breathing, a dry cough, chills, and fever. They tested negative for COVID. Chest X-rays showed inflammation of the lungs. They mentioned being worried about the amount of time they were in the ED because they have pet parakeets that need care. After looking at the X-rays, symptoms, and realizing that the patient kept birds in their home, the physician diagnosed them with bird fancier’s lung. How should we report this? Pennsylvania Subscriber Answer: Bird fancier’s lung (J67.2) falls under the J67.- (Hypersensitivity pneumonitis due to organic dust) code family. The parent code, J67.-, carries a symbol that indicates an additional 4th character is required for proper reporting. While this scenario and diagnosis points to bird fancier’s lung, there are several very specific diagnoses in this code family whose hypersensitivity pneumonitis conditions may be the result of environmental factors. These codes include: Other occupational hazards may result in similar conditions: The last ICD-10-CM code of that list, J67.8, also carries additional descriptors, such as cheese-washer’s lung, coffee-worker’s lung, fish-meal worker’s lung, and furrier’s lung. However, if the provider diagnosed the patient with hypersensitivity pneumonitis, but the documentation didn’t appear to specify a concrete reason as to why — or, in this situation, perhaps the patient didn’t randomly mention their pet parakeets — then you would instead choose J67.9 (Hypersensitivity pneumonitis due to unspecified organic dust). Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
