Pulmonology Coding Alert
Append Modifier 91 for Repeat Tests
Question: I have a medical report where the pulmonologist listed the patient’s diagnosis as “chronic obstructive pulmonary disease (COPD), type A.” I understand there are four stages of COPD, but I’ve yet to come across type A, type B, etc. Should I use an emphysema code to report the diagnosis? New Mexico Subscriber Answer: In your case, you’re better off querying the provider as to what they mean by COPD, type A. You should never assume a condition, like emphysema, based on unclear documentation. COPD and emphysema have different codes and are different conditions. At the same time, the ICD-10-CM code set Alphabetic Index doesn’t include type A, type B, etc. under Disease > Pulmonary > Chronic obstructive. If the provider does mean the patient has emphysema by documenting the diagnosis as “COPD, type A,” then this could be a valuable opportunity to have a productive conversation about improving clinical documentation practices or the provider may explain that the COPD diagnosis is correct. As the documentation currently stands, the type A COPD documented diagnosis will be coded as J44.9 (Chronic obstructive pulmonary disease, unspecified).
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