Pulmonology Coding Alert

Question:My pulmonologist documents both COPD and acute bronchitis for a patient who presented in our office. What are my ICD-9 coding options? Could you also give me some pointers on reporting COPD?Hawaii SubscriberAnswer:Bronchitis is a common condition that patients with COPD have. In this case, you should report 491.22 (Obstructive chronic bronchitis, with acute bronchitis). You don't have to additionally report 466.0 (Acute bronchitis) for the obstructive chronic bronchitis since the code descriptor for 491.22 specifies acute bronchitis.Tip: If your physician documents that a patient has acute bronchitis with COPD which is causing an acute exacerbation, for your coding purposes, the bronchitis supercedes the exacerbation. Therefore, you should still report 491.22. If, however, the documentation states that the patient has COPD with acute exacerbation, but doesn't mention acute bronchitis, report 491.21 (Obstructive chronic bronchitis, with[ acute] exacerbation).Exception: If your pulmonologist diagnoses COPD and there are no other manifestations or conditions, [...]