Wiki ICD 10 Acute respiratory failure, acute infectious bronchitis with acute exac of COPD

[Cindy Elliott]

Our group is struggling with multiple interpretations on how to code the below scenario for I10 and hoping you can share your expertise opinion.
Q:
This 75 year old female was brought to the ER with severe difficulty in breathing. She was intubated and started on mechanical ventilation and admitted. Diagnoses for this patient: Acute respiratory failure, acute infectious bronchitis with acute exacerbation of COPD.

The J44.1 and J44.0 kind of leads you around in circles. J44.1 has an excludes 2 note -COPD with acute bronchitis (J44.0) then J44.0 says Use additional code to identify the infection
1. Is it appropriate to code the J02.9- Acute bronchitis, unspecified, when the description of acute bronchitis is within the description of the J44.1?
2. Should both J44.0 and J44.1 be coded?

A: Based on our groups interpretation
J96.00- Acute respiratory failure, unspecified whether with hypoxia or hypercapnia

J44.0- Chronic obstructive pulmonary disease with acute lower respiratory infection
Use additional code to identify the infection
J20.9- Acute bronchitis, unspecified

J44.1- Chronic obstructive pulmonary disease with (acute) exacerbation

Any help or guidance would be appreciated
Thank You
Cindy

 

[LFARDENCPC]

according to the guidelines you would code J20.9 with both the J44.0 and J44.1; The J20 code would normally indicate the infection; if it is not documented you would use the J20.9.
"An Acute exacerbation is a worsening or a decompensation of a chronic condition. An acute Exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection..."
Read the chapter specific guidelines to help clarify your position. Hope this helps.