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Lower Lobe Pneumonia vs. Lobar Pneumonia

  1. Question Lower Lobe Pneumonia vs. Lobar Pneumonia
    Medical Coding Books
    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:

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

    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.

    Amanda K. Coder 1 COC, CCA

  2. Default 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


    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?


    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:


    lobar (disseminated) (double) (interstitial)


    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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