ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)

December 19th, 2023 - Aimee Wilcox

Chronic Obstructive Pulmonary Disease (COPD) is a progressive and persistent inflammatory lung disease resulting in limited airflow. Primary causes of COPD are long-term exposure to irritating gases or particulate matter, most commonly from cigarette smoke. There are multiple factors that can contribute to the development of COPD, such as: 

Smoking (Z87.891, Z72.0, F17.2-): This is the leading cause of COPD. Cigarette smoke contains harmful chemicals that can damage the lungs and airways over time. Pipe, cigar, electronic, and other types of tobacco smoke can also contribute. 

Respiratory Infections: Severe respiratory infections, especially during childhood, can increase the risk of developing COPD later in life, particularly if infections are recurrent or if there is a history of severe pneumonia.

Aging: Development of COPD increases with age, and the disease is more common in individuals over the age of 40.

Environmental Exposure: Long-term exposure to tobacco smoke (Z77.22, Z57.31), harmful gases and particulate matter in the workplace (Z77.0) or at home can contribute to COPD. This includes exposure to industrial dust, chemical fumes, and indoor air pollution.

Genetics: Some genetic factors may predispose individuals to COPD, such as people with a protein deficiency called alpha-1 antitrypsin are at an increased risk of developing COPD, especially if they smoke.

Air Pollution: Prolonged exposure to outdoor air pollution can contribute to the development and progression of COPD. This is particularly relevant in geographic areas with high levels of pollution.

Comorbidities: Other chronic health conditions can impact pulmonary function.

Reporting ICD-10-CM for COPD

The International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM) is a system developed by the World Health Organization (WHO) and modified by the United States for assigning codes to medical diagnoses for reporting to payers and for tracking of conditions and illnesses in general. Chapter 10. Diseases of the Respiratory System, Category J44, contains the following codes for reporting COPD: 

Code Code Description
J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection
J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation
J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome
J44.89 Other specified chronic obstructive pulmonary disease
J44.9 Chronic obstructive pulmonary disease, unspecified

Provider documentation of the diagnosis must match the details included in the code description for the code to be assigned. For example, assign J44.0 when a patient with COPD presents with an acute lower respiratory infection, like an acute bronchitis. If the patient presents with an acute exacerbation of their COPD and chronic bronchitis, then report J44.1 and a code for chronic bronchitis (J42). Be sure to follow the instructional notations and guidelines such as Excludes 1, Excludes 2, Code Also, and Use Additional to ensure coding is complete, and reported at the highest specificity. 

Example: Patient presents with symptoms of shortness of breath and coughing. He is a current, everyday cigarette smoker with COPD, and acute bronchitis. 

Code Assignment: 

J44.0 Chronic obstructive pulmonary disease with acute lower respiratory infection

F17.210 Nicotine dependence, cigarettes, uncomplicated

Codes are not assigned for the symptoms of cough and shortness of breath, as those are common symptoms of both COPD and acute bronchitis, two confirmed diagnoses, and the ICD-10-CM coding guidelines instruct us to not report symptoms when they are explained by a confirmed diagnosis.

Other Specified and Unspecified Codes

Documentation that fails to provide the detail described in another code description should be reported as unspecified; however, if the documentation identifies a specific type of COPD, but there isn’t a code with a description that matches the documented type, report J44.89 for ‘other specified COPD.’ Code J44.81 Bronchiolitis obliterans and bronchiolitis obliterans syndrome is an example of an other ‘specified’ type, so if the documentation does not match that code description, code J44.89 for other specified.

Always consult the most current version of the ICD-10-CM codeset and guidelines, as updates may occur. Additionally, healthcare professionals should use their clinical judgment and adhere to specific coding guidelines when assigning codes for accurate and comprehensive documentation.




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