Page 1 of 2 12 LastLast
Results 1 to 10 of 13

clinical pneumonia

  1. #1
    Red face clinical pneumonia
    Medical Coding Books
    Hi can any tell me if I can code a dx of clinical pnuemonia as 486? Some say this is not a dx. Thanks for any help.

  2. #2
    Unfortunately, if the Doctor's don't specify what type of Pneumonia it is, you have no choice but to use the 486. We have the same problem with our Docs.

  3. #3
    I would be comfortable coding 486 as long as he was treating this patient with an antibiotic.

  4. #4
    I do a lot of ER coding and I also have a problem with the doc's writing anything more than pneumonia. Sometimes they will specify LLL or something like that but for the most part, we end up using the 486 code the most.

  5. #5
    Thank you all so much.

    I guess there were issues with the fact the dr. states its "clinical" pna. Some people were saying that clinical means the same as possible and we cant code possible dx. I just think it means the dr. make an educated guess that the pt has pna. ANy thoughts on this?

  6. #6
    Default pneumonia
    LLL is lobar pneumonia and should be coded 481

  7. #7
    Yes, I am aware of that. I was just letting her know that UNLESS they state LLL or another type of pneumonia, to use the 486.

    As far as your question Dawn, I would only code what it documented. I think you are right NOT to code anything that is "possible" or "probable" but if the physician makes that assumption and documents it that way and treats as clinical pneumonia, then you can code it that way. As long as it doesn't state possible. Good luck

  8. #8
    Columbia, MO
    Physicians are allowed to diagnose infective type conditions such as pneumonia, UTI, Strep, Sepis, etc based on the patient's clinical presentation, and they do not require any diagnostic evidence to support the diagnosis. Therefore it looks to me like that is maybe what this physician was taught to write when he renders a clinical assessment of pneumonia without diagnostic support, so I have no problem with the 486 code.
    Debra Mitchell MSPH, CPC-H

  9. #9
    Thank you debra and leslie I feel more comfortable about this now. sometimes you just need a sane mind to agree with you

  10. #10
    Quote Originally Posted by sherryc View Post
    LLL is lobar pneumonia and should be coded 481

    Some one correct me if I am wrong but i believe that when a dr writes LLL this is just indicating the place where the pna is not a dx for lobar pna. The code for lobar pneumonia "481" refers to the "type" of pneumonia, not the "site".


Page 1 of 2 12 LastLast

Similar Threads

  1. Pneumonia with cavitation
    By Hernf in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 11-25-2014, 06:26 AM
  2. Hx Pneumonia
    By jaime9543 in forum Diagnosis Coding
    Replies: 1
    Last Post: 08-19-2012, 07:05 AM
  3. Bibasal pneumonia
    By Gemini18 in forum Diagnosis Coding
    Replies: 0
    Last Post: 09-18-2009, 07:24 AM
  4. Cavitary Pneumonia -would you code
    By Gemini18 in forum Diagnosis Coding
    Replies: 0
    Last Post: 04-22-2009, 01:59 PM
  5. pneumonia
    By NJcoder in forum Diagnosis Coding
    Replies: 1
    Last Post: 11-25-2008, 01:09 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.