Pulmonology Coding Alert

Question: Our physicians treat several patients with chronic obstructive pulmonary disease (COPD). The diagnosis coding for COPD confuses me: What separates the different COPD ICD-9 codes?North Carolina SubscriberAnswer: The correct code will depend on whether or not the patient had a specified exacerbation along with the COPD.Report 491.21 (Obstructive chronic bronchitis; with [acute] exacerbation) for patients diagnosed with COPD who have had an exacerbation.Report 491.20 (Obstructive chronic bronchitis; without exacerbation) for patients diagnosed with COPD classified as obstructive "bronchitis" by the physician in the documentation/medical record, but without an exacerbation.When the COPD is not otherwise specified, report 496 (Chronic airway obstruction, not elsewhere classified).-- Answers to You Be the Coder and Reader Questions were answered/reviewed by Alan L. Plummer, MD, professor of medicine, Division of Pulmonary, Allergy, and Critical Care at Emory University School of Medicine in Atlanta; and Carol Pohlig, BSN, RN, CPC, ACS, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.