Wiki Lower Lobe Pneumonia vs. Lobar Pneumonia

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Code: J18.1

Code Name: ICD-10 Code for Lobar pneumonia, unspecified organism

Block: Influenza and pneumonia (J09-J18)

Excludes 2: allergic or eosinophilic pneumonia (J82)
aspiration pneumonia NOS (J69.0)
meconium pneumonia (P24.01)
neonatal aspiration pneumonia (P24.-)
pneumonia due to solids and liquids (J69.-)
congenital pneumonia (P23.9)
lipid pneumonia (J69.1)
rheumatic pneumonia (I00)
ventilator associated pneumonia (J95.851)

Details: Lobar pneumonia, unspecified organism

J18

Code first associated influenza, if applicable (J09.X1, J10.0-, J11.0-)

Excludes1: abscess of lung with pneumonia (J85.1)
aspiration pneumonia due to anesthesia during labor and delivery (O74.0)
aspiration pneumonia due to anesthesia during pregnancy (O29)
aspiration pneumonia due to anesthesia during puerperium (O89.0)
aspiration pneumonia due to solids and liquids (J69.-)
aspiration pneumonia NOS (J69.0)
congenital pneumonia (P23.0)
drug-induced interstitial lung disorder (J70.2-J70.4)
interstitial pneumonia NOS (J84.9)
lipid pneumonia (J69.1)
neonatal aspiration pneumonia (P24.-)
pneumonitis due to external agents (J67-J70)
pneumonitis due to fumes and vapors (J68.0)
usual interstitial pneumonia (J84.17)

Guidelines: Diseases of the respiratory system (J00-J99)
Use additional code, where applicable, to identify:exposure to environmental tobacco smoke (Z77.22)
exposure to tobacco smoke in the perinatal period (P96.81)
history of tobacco use (Z87.891)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)


Note: When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).

Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
smoke inhalation (T59.81-)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
For more details on J18.1 , ICD-10 Code for Lobar pneumonia, unspecified organism , visit: https://coder.aapc.com/icd-10-codes/
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I have a case of some debate. The MD finial Dx was "Left lower lobe pneumonia". In ICD -9 -- yes, I know we aren't using that anymore but hear me out. In ICD-9 there was a coding clinic 1985 March-April page 6 that states:

Question:
Is pneumonia of the right lower lobe the same as lobar pneumonia?

Answer:
No. The diagnosis of right lower lobe pneumonia without further specification as to type of pneumonia or the specific organism involved is coded 486. The entry in the first printing of the Alphabetic Index for Pneumonia, lobe-see Pneumonia, lobar - should be deleted from the Alphabetic Index. lobar pneumonia is a synonym (interchangeable term) for pneumococcal pneumonia, 481.​


Is this something that we are continuing in ICD-10? The only reference I and two of my colleges can find to Lobar pneumonia is in Nelly when Lobar pneumonia is the finial and how to code it with or without mention of infecting organism.

Using AAPCs own ICD-9 to ICD-10 code translator:
486 is J18.9 Pneumonia, unspecified
481 is J13 pneumonia due to Strep and J18.1 Lobar pneumonia, unspecified organism​

How would you code "Left Lower lobe pneumonia" please site reasons and preferably documentation of guideline.

Thanks,
Amanda K. Coder 1 COC, CCA
 

trachelle

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Coding Clinic for Lobar Pneumonia

I realize you posted your question several years ago now. I myself was researching coding Lobar Pneumonia when you had a dx of Lower Lobe Pneumonia and I came across your question. I did end up finding a new coding clinic that addresses this.





Lobar pneumonia

ICD-10-CM/PCS Coding Clinic, Third Quarter ICD-10 2018 Pages: 24 - 25 Effective with discharges: September 24, 2018

Related Information




Question:



When the physician documents "Right upper lobe pneumonia" and the causal organism is not documented, would it be appropriate to assign code J18.1, Lobar pneumonia?



Answer:



Yes. Assign code J18.1, Lobar pneumonia, unspecified organism, for right upper lobe pneumonia when the causal organism is not documented. If the specific organism causing the pneumonia is documented, assign a combination code indicating the specific pneumonia with the responsible organism. If the provider documents that the pneumonia is specific to a lobe, or a similar diagnostic statement for pneumonia affecting one or more lobes of the five lobes of the lung, or part of a lobe, code J18.1 would be assigned when the causal organism is not specified. A diagnosis of "lobar pneumonia" (pneumonia that mentions the affected lobe) or "multilobar pneumonia" (pneumonia affecting more than one lobe) describes the specific site of the pneumonia (rather than a type of pneumonia) and would be coded according to the responsible organism, if known.



The Alphabetic Index supports this advice:



Pneumonia

lobar (disseminated) (double) (interstitial)

J18.1



Additional subentries refer to specific organisms. For example, Pneumonia, lobar, pneumococcal is indexed to code J13, Pneumonia due to Streptococcus pneumonia.
 
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