Wiki **Please help with this EXACERBATION

ebarker33

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I need help in understanding how to code the following:

1. ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
2. ACUTE BACTERIAL EXACERBATION OF CHRONIC BRONCHITIS.
3. ASTHMA WITH EXACERBATION.

I would code this as 493.22 only. Coworkers would code this as 491.22 & 493.22. I don't understand how you can get acute bronchitis out of exacerbation of chronic bronchitis. Any help would be greatly appreciated. :)
 
chronic bronchitis with acute exacerbation

Can anyone tell me if you use 491.9 or another code? I am leaning towards 491.21. Also are there specific written guidelines for the same? Does anyone use an encoder?

Many thx
Jean Cantien CPC-A
 
The asthma is not specified as 'chronic obstructive," so I would not use 493.2x

I would also not use 491.22 since "acute bronchitis" was never mentioned and 491.21 covers the exacerbation as part of the combo code

I would code:

491.21
493.92
 
Refer to coding clinics/coding guidelines

491.22 and 493.22 is correct. This is clearly addressed in multiple coding clinics as well as in the coding guidelines for chapter 8. This pt has an acute infectious bronchitis. Coding clinic advice states 491.22 would include the exacerbation (491.21). Coding guidelines also specifically state to use 491.22. Asthma is coded as obstructive when documented in the same encounter with COPD.

http://news.aapc.com/dont-let-copd-diagnosis-coding-be-an-endurance-test/

Above link is for an AAPC article which states:

Acute Exacerbation of COPD/ Bronchitis / Asthma

Diagnoses of acute exacerbation of COPD, acute bronchitis, and acute exacerbation of asthma are coded 491.22 and 493.22 Chronic obstructive asthma with (acute) exacerbation (AHA Coding Clinic for ICD-9-CM, third quarter 2006).
 
Agree with 491.22 and 493.22.

I have a coding tips: Pulmonary from BCBS, these are the codes given.

The Healthcare Business Monthly magazine that is sent out by AAPC has a great article in the March 2015 issue on lung diseases. It lists several examples with codes listed. Also references the coding clinic articles.

Hope this helps.
 
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