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Otolaryngology Coding Alert

READER QUESTIONS:

Pay Attention to ICD-9 Descriptor Notations

Published on Thu May 28, 2009

Question: My physician saw a patient with "acute exacerbation of emphysema." In his documentation, he also noted that the patient does not have chronic bronchitis. What diagnosis code should I apply in this situation? Alaska Subscriber Answer: Look to 491.21 (Obstructive chronic bronchitis; with [acute] exacerbation). Even though the patient may not have chronic bronchitis, you should report 491.21 anyway. This diagnosis code represents a variety of conditions. For instance, if you look beyond the initial code descriptor for 491.21 in your ICD-9 manual, you'll see that this ICD-9 code also includes: • acute exacerbation of chronic obstructive pulmonary disease (COPD) • decompensated chronic obstructive pulmonary disease (COPD) • decompensated chronic obstructive pulmonary disease (COPD) with exacerbation. In other words, the patient's condition is not limited to chronic bronchitis for you to be able to report 491.21.
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