Transcript Understanding ICD-9-CM Coding Mary Jo

Understanding ICD-9-CM Coding
Mary Jo Bowie MS, RHIA, RHIT
Regina Schaffer AAS, RHIA, CPC
Diseases of the
Respiratory System
CHAPTER
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Respiratory System
• Exchanges oxygen and carbon dioxide
• Structures include
– Nose/mouth
– Lungs
– Bronchi
– Trachea
– Larynx
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or posted to a publicly accessible website, in whole or in part.
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Coding for Respiratory System
• 460–519 category codes
• Neoplastic disease and some major
infectious diseases are found in other
chapters of ICD-9-CM
• Provider documentation guides
code assignment
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or posted to a publicly accessible website, in whole or in part.
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Respiratory
Infections/Diseases
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•
•
•
•
•
Pharyngitis
Bronchitis
Emphysema
Sinusitis
Pneumonia
Legionnaires’ Disease
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Pharyngitis
•
•
•
•
Sore throat
Determine whether acute or chronic
Determine whether due to infection
Infections that cause pharyngitis would
be coded instead of two separate codes
– Specifically, coxsackievirus, flu, or
streptococcus
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Bronchitis
•
•
•
•
Determine whether acute or chronic
Acute is classified to code 466.0
Chronic is classified to code 491 series
Chronic bronchitis with other lung diseases
should be researched to determine whether
one or two codes are necessary
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Other Diseases of the Upper
Respiratory Tract
• Category codes 470–478
• Chronic inflammatory diseases
• Conditions that affect accessory
structures of the respiratory system,
such as sinus cavities and middle ear
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Acute and Chronic
• Acute conditions occur, are treated,
and subside
• Chronic conditions are treated over long
periods of time; some are lifelong
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Pneumonia
• Many types
• Cause should be documented
• Documentation is key due to the types
and causes
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Types of Pneumonia Coded
within ICD-9-CM
•
•
•
•
•
Viral
Pneumococcal
Other bacterial
Due to other specified organism
In “Infectious Diseases Classified
Elsewhere”
• Bronchopneumonia
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Category Codes 492–493
• Emphysema—decrease in number of
alveoli in bronchus
– Category code 492
• Asthma—stricture of the airway
– Category code 493
– Fourth and fifth digits required
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Chronic Obstructive
Pulmonary Disease
• COPD–496 category
• Decrease in airflow of lungs
• When combined with asthma, important
to read instructional notations
• Fifth digit assignment
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or posted to a publicly accessible website, in whole or in part.
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Status Asthmaticus
• Severe asthmatic attack that does not
respond to treatment
• Documentation must support this diagnosis
• Sequenced first; supersedes any type of
COPD including acute exacerbations
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Other Lung Diseases
• Asbestosis—exposure to asbestos
• Empyema—infection in pleural cavity
• Pleurisy—inflammation of
thoracic cavity
• Respiratory failure—severe interruption
of oxygen/carbon dioxide flow
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or posted to a publicly accessible website, in whole or in part.
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