Pulmonology Coding Alert

Question: I have a report where the provider diagnosed the patient with multiple pulmonary nodules in the lungs. Can I assign J84.10 to report the diagnosis?

Florida Subscriber

Answer: No, you shouldn’t assign J84.10 (Pulmonary fibrosis, unspecified) to report pulmonary nodules in the lungs. Pulmonary nodules aren’t fibrosis, so you’ll assign R91.8 (Other nonspecific abnormal finding of lung field) to report the nodules.

In the ICD-10-CM Alphabetic Index, you’ll look for Nodule(s), nodular > lung, solitary > multiple, which directs you to R91.8 that you can verify in the Tabular List. Code R91.8 features additional conditions that a provider may use in their report, such as:

• Lung mass NOS found on diagnostic imaging of lung
• Pulmonary infiltrate NOS
• Shadow, lung

Pulmonary nodules are abnormal growths in the lungs. Patients may have one nodule (solitary) or multiple nodules, and the nodules can grow in one or both of the patient’s lungs. On the other hand, pulmonary fibrosis is a scarring or damaging of the lung tissue. The lung tissue becomes thickened and stiff, which makes it harder for the lungs to function properly.

Code J84.10 is designated for an unspecified pulmonary fibrosis diagnosis. Unless the provider’s report calls out pulmonary fibrosis or a specific pulmonary fibrosis condition, you won’t use a pulmonary fibrosis code for a pulmonary nodules diagnosis.