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Thread: Coding question for Endstage COPD

  1. #1
    Join Date
    Apr 2007
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    Question Coding question for Endstage COPD

    What is the correct way to code Endstage COPD: 496 ????
    Thanks,

    Sherry

  2. #2
    Join Date
    Apr 2007
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    Capital Coders
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    130

    Default

    Hi Sherry!

    Yes, 496 is the only code to use. Unfortunately, they don't have a separate code for end stage COPD. However, talk to your docs - sometimes there's something else going on there.

    For example: they may have asthma or bronchitis along with the COPD which would point you to other more specific codes to use. I've worked with Pulmonary/Critical Care/Sleep Medicine docs for the past 8+ years and I'm always asking them for more information - which normally leads me to other more specific code ranges. In the event that COPD is all you have to go on, then yes, the 496 would be appropriate to use.

    Hope this helps! Janet
    Janet L. Dunkerley, CPC, CPC-I, CMC
    Certified PMCC Instructor
    AAPC-CA Board of Directors 2007-2010
    Board Secretary 2007-2009
    2008 Region 3 Networker of the Year
    Founder Capital Coders, Columbia SC

  3. #3

    Default

    I would go with 491.20 Emphysema with chronic bronchitis. Any other takers?

  4. #4
    Join Date
    Apr 2007
    Location
    Kokomo, IN
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    769

    Default Endstage COPD

    Quote Originally Posted by afahmi View Post
    I would go with 491.20 Emphysema with chronic bronchitis. Any other takers?
    I agree with Janet, I would code 496 unless the Dr can give you more information. Yes, COPD is a combination of emphysema and bronchitis, but, unless the Dr wants to give him more specific info, COPD is all he can go with. My opinion!

  5. #5

    Default

    Quote Originally Posted by Anna Weaver View Post
    I agree with Janet, I would code 496 unless the Dr can give you more information. Yes, COPD is a combination of emphysema and bronchitis, but, unless the Dr wants to give him more specific info, COPD is all he can go with. My opinion!
    I just verified with a pulmonologist, and a good acquaintance of mine, according to his opinion the term End Stage COPD unto itself implies that the patient has severe form of Emphysema that requires constant oxygen cylinder.

    So if it is just COPD I will go with 496. But if in the documentation it says ESCOPD, then shouldn't we make sure that the diagnosis code correctly depicts patient state?


    Azim

  6. #6

    Default

    Quote Originally Posted by Anna Weaver View Post
    I agree with Janet, I would code 496 unless the Dr can give you more information. Yes, COPD is a combination of emphysema and bronchitis, but, unless the Dr wants to give him more specific info, COPD is all he can go with. My opinion!
    I just verified with a pulmonologist, and a good acquaintance of mine, according to his opinion the term End Stage COPD unto itself implies that the patient has severe form of Emphysema that requires constant oxygen cylinder.

    So if it is just COPD I will go with 496. But if in the documentation it says ESCOPD, then shouldn't we make sure that the diagnosis code correctly depicts patient state?


    Azim

  7. #7
    Join Date
    Apr 2007
    Location
    Kokomo, IN
    Posts
    769

    Default escopd

    Quote Originally Posted by afahmi View Post
    I just verified with a pulmonologist, and a good acquaintance of mine, according to his opinion the term End Stage COPD unto itself implies that the patient has severe form of Emphysema that requires constant oxygen cylinder.

    So if it is just COPD I will go with 496. But if in the documentation it says ESCOPD, then shouldn't we make sure that the diagnosis code correctly depicts patient state?


    Azim
    Absolutely, I agree. However, we should make sure that the diagnosis code correctly reflects the documentation. Therefore, the Dr. must give more information. If not, we can't assume anything, even if we know.

  8. #8
    Join Date
    Apr 2007
    Location
    Chennai
    Posts
    32

    Lightbulb Copd

    Hi sherry,
    COPD is general term for Emphysema, chronic bronchitis, asthma so we should code for COPD go to physician documentation only in document sayes COPD 496 is only code for this, so its correct way to code COPD.

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