Advanced Search

Pulmonology Coding Alert

Reader Question:

Pneumonia Diagnosis Coding: Never Leave Your Medical Language Vague

Published on Thu Aug 18, 2011

Question: My pulmonologist documented "multilobar pneumonia." What ICD-9 code should I report?Arizona SubscriberAnswer: When coding for pneumonia, you should be able to identify the specific type, and code based on the causal organism. The Coding Clinic emphasizes that the term "lobar pneumonia" is, in fact, outdated as it codes only to 481 (Pneumococcal pneumonia [streptococcus pneumoniae pneumonia]), whereas other organisms may be involved. For instance, lobar pneumonia and pneumonia of the right lower lobe are not the same.You would code Pneumonia of the right lower lobe without specification with 486 (Pneumonia organism unspecified), while lobar pneumonia is associated with pneumococcal pneumonia, 481. (See Coding Clinic, March-April 1985, page 6.)Important: If the pulmonologist uses nonspecific language, for instance 'healthcare-associated pneumonia' or 'nosocomial pneumonia,' you should clarify with him the specific bacterial type of the pneumonia.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Pulmonology Coding Alert

View All