Report Pulmonary Hypertension Due to Bronchiectasis
Question: A 75-year-old patient presented to the emergency department (ED) with shortness of breath, fatigue, and dizziness. The patient has bronchiectasis. After a history and physical examination, the provider performed an echocardiogram and a cardiologist performed a right heart catheterization. A pulmonologist reviewed the results and diagnosed the patient with pulmonary hypertension due to an acute exacerbation of bronchiectasis. What diagnosis codes should I report? Montana Subscriber Answer: You will need two ICD-10-CM codes to report the patient’s diagnosis. According to the ICD-10-CM Official Guidelines, Section I.C.9.a.11, “The sequencing [of the codes] is based on the reason for the encounter.” In the case you presented, the shortness of breath, fatigue, and dizziness are symptoms of pulmonary hypertension. Start by searching the Alphabetic Index for Hypertension > pulmonary > due to > lung diseases and hypoxia, and then turn to the Tabular List to verify I27.23 (Pulmonary hypertension due to lung diseases and hypoxia). Code I27.23 features a Code also note instructing you to assign a code for the associated lung disease if there is one. In this case, the bronchiectasis is documented as the cause of the pulmonary hypertension. Under parent code J47.- (Bronchiectasis), you’ll find J47.1 (Bronchiectasis with (acute) exacerbation). Additionally, if the patient has a history of, dependence on or exposure to tobacco, you’ll use the appropriate code to identify that information. Mike Shaughnessy, BA, CPC, Development Editor, AAPC
