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Is it appropriate to code Chronic Bronchitis, 491.0 with COPD, 496

Candy Posted Fri 21st of December, 2012 13:29:34 PM

For a patient who has chronic bronchits and COPD, is it appropriate to code the '491.0' with '496'? The explanation in ICD-9 of billing acute bronchitis in a patient with COPD has me second guessing the correct way to bill chronic bronchitis with documented COPD.

SuperCoder Answered Fri 21st of December, 2012 19:44:32 PM

COPD (496) is a general term for many disorders that cause persistent obstruction of bronchial airflow. Covered by 496 are non-specific lung disease, obstructive lung disease and obstructive pulmonary disease. It should not, however, be used when bronchitis, emphysema or asthma applies. These exceptions fall under categories 491.xx (chronic bronchitis; chronic must be specified), which includes 491.0 (simple chronic bronchitis or smoker's cough), 491.1 (mucopurulent chronic bronchitis, persistent inflammation of the bronchi with mucous) and 491.2x (obstructive chronic bronchitis, with or without acute exacerbation), as well as 492.x (emphysema) and 493.xx (asthma; intrinsic, extrinsic, chronic-obstructive or unspecified). The "xs" indicate subcodes and you should not assume that emphysema, for example, can be coded with only three digits instead of four. Missing digits in your diagnosis will cause an automatic rejection of the claim.

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