Chronic obstructive pulmonary disease, COPD Coding under ICD-10-CM
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. COPD is one of the most common respiratory diseases. COPD affects more men than women, although rates in women are increasing. The main cause of COPD is smoking. The likelihood of developing COPD increases the more you smoke and the longer you?ve been smoking. This is because smoking irritates and inflames the lungs, which results in scarring. Over many years, the inflammation leads to permanent changes in the lung. The walls of the airways thicken and more mucus is produced. Damage to the delicate walls of the air sacs in the lungs causes emphysema and the lungs lose their normal elasticity. The smaller airways also become scarred and narrowed. These changes cause the symptoms of breathlessness, cough and phlegm associated with COPD. Some cases of COPD are caused by fumes, dust, air pollution and genetic disorders, but these are rarer.
Symptoms include:
- Increasing breathlessness when active
- A persistent cough with phlegm
- Frequent chest infections
Diagnosis
It is important that COPD is diagnosed as early as possible so treatment can be used to try to slow down the deterioration of your lungs.
COPD is usually diagnosed after a consultation with your doctor, which may be followed by breathing tests.
Treating COPD
Although the damage that has already occurred to your lungs cannot be reversed, you can slow down the progression of the disease. Stopping smoking is particularly effective at doing this.
Treatments for COPD usually involve relieving the symptoms with medication, for example by using an inhaler to make breathing easier. Pulmonary rehabilitation may also help increase the amount of exercise you are capable of doing.
Surgery is only an option for a small number of people with COPD.
Living with COPD
COPD can affect your life in many ways, but help is available to reduce its impact.
Simple steps such as living in a healthy way, being as active as possible, learning breathing techniques, and taking your medication can help you to reduce the symptoms of COPD.
Financial support and advice about relationships and end of life care is also available for people with COPD.
Can COPD be prevented ?
Although COPD causes about 25,000 deaths a year in the UK, severe COPD can usually be prevented by making changes to your lifestyle.
If you smoke, stopping is the single most effective way to reduce your risk of getting the condition.
ICD-10-CM guidelines for coding COPD
ICD-10 codes J40-J44 will be used to define the various diagnoses of Chronic Obstructive pulmonary disease including all disease entities bronchitis and lung disease. Code J44 will be used for other chronic obstructive pulmonary disease including asthma with chronic, obstructive pulmonary disease, chronic asthmatic obstructive bronchitis, chronic bronchitis with airways obstruction, chronic bronchitis with emphysema and chronic obstructive asthma.
Chronic Obstructive Pulmonary Disease [COPD] and Asthma
1) Acute exacerbation of chronic obstructive bronchitis and asthma. The codes in categories J44 and J45 distinguish between uncomplicated cases and those in acute exacerbation. An acute exacerbation is a worsening or a decompensation of a chronic condition. An acute exacerbation is not equivalent to an infection superimposed on a chronic condition, though an exacerbation may be triggered by an infection.
ICD-10 added a code for a common acute exacerbation that brings a patient with COPD back to seek care ? COPD with acute lower respiratory infection such as acute bronchitis or pneumonia. The specific pneumonia or bronchitis code can be coded in addition.
Codes for COPD ICD-10-CM :
J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection
As with ICD-9, there is an ICD-10 code for COPD with exacerbation, which captures ?decompensated? COPD, without any additional documentation.
J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
Replaces
491.21 Obstructive chronic bronchitis with (acute) exacerbation
493.22 Chronic obstructive asthma with (acute) exacerbation
And of course there is an unspecified option, which no longer questions about whether the COPD is predominantly asthma or predominantly bronchitis ? it?s just COPD.
J44.9 Chronic obstructive pulmonary disease, unspecified
Replaces
491.20 Obstructive chronic bronchitis without exacerbation
493.20 Chronic obstructive asthma, unspecified
496 Chronic airway obstruction, not elsewhere classified
To specify and distinguish between uncomplicated cases and those conditions in acute exacerbation, the ICD-10 codes between J44 and j45 are normally used. Acute exacerbation is not equivalent to an infection superimposed on a chronic condition although it might be triggered by an infection is one worth noting it.