1) COPD is a chronic lung disease causing breathing difficulties due to obstructed airflow. It encompasses conditions like emphysema and chronic bronchitis. 2) Coding COPD accurately is complex as it can involve multiple associated conditions. The document provides guidance on correctly coding COPD and related diagnoses like asthma according to ICD-10 guidelines. 3) Factors influencing COPD like smoking, occupational exposures, and genetics are also addressed in terms of appropriate ICD codes.

1. Coding for
COPD
–An Overview
COPD is a chronic lung
condition that obstructs
the airways, causing
breathing difficulty. This
article discusses in detail
about coding COPD
condition.
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2. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease
that causes obstructed airflow from the lungs, causing difficulty in breathing. Emphysema
and chronic bronchitis are the two most common types of COPD and in most cases people
develop both these conditions. Common symptoms include breathing difficulty, cough,
mucus (sputum) production, chest tightness and wheezing. Even though there is no cure
for this life-threatening disease, regular and timely screening and diagnosis can help in
early detection of COPD symptoms and better disease management, before any major loss of
lung function occurs. Medical coding for COPD is a complex process, as several other
associated conditions fall under this disease category. Hiring the services of a reputable
medical coding company enables pulmonary specialists to ensure correct coding of COPD
and save valuable time that can be invested in patient care.
Smoking is the primary cause/risk factor for COPD. However, long term exposure to
chemical irritants – such as lung pollution, chemical fumes or dust may also contribute to
this chronic lung disorder. To diagnose this condition, physicians / pulmonary specialists
will review your signs and symptoms, discuss your family and medical history and discuss
any kind of exposure that you have had to lung irritants – especially cigarette smoking.
Several diagnostic tests such as lung (pulmonary) function tests, chest X-rays, CT scan and
arterial blood gas analysis will be conducted to accurately diagnose this condition.
How to Code for COPD?
While coding diagnoses of chronic obstructive pulmonary disease and its associated
conditions such as emphysema, chronic bronchitis, acute bronchitis, chronic asthmatic
bronchitis and acute asthmatic bronchitis, it is important to understand the coding
consequences because the presence of two or more of these conditions may make these
tasks complicated and create errors. Therefore, it is crucial to check whether the condition
is acute, chronic or in acute exacerbation.
The ICD-10 guidelines specify – “If the same condition is described as both acute (sub-
acute) and chronic and separate sub-entries do exist in the alphabetic index at the same
indention level, code both and sequence the acute (sub-acute) code first.”
If a definitive diagnosis of COPD is not made, it is recommended to code only the symptoms.
In coding, if patients have COPD and asthma documented, without any further specificity of
the type of asthma, only COPD would be reported.
COPD
When COPD is confirmed, code - J44 would be reported.
 J44 - Other chronic obstructive pulmonary disease

3.  J44.0 - Chronic obstructive pulmonary disease (COPD), with acute lower
respiratory infection and pneumonia
 J44.1 - Chronic obstructive pulmonary disease with (acute) exacerbation
 J44.9 - Chronic obstructive pulmonary disease, unspecified
Asthma
If any type of asthma is applicable, use J45 as well as a Z code to identify any documented
factors influencing the patient’s health status.
 J45 - Asthma
 J45.2 - Mild intermittent asthma
 J45.3 - Mild persistent asthma
 J45.4 - Moderate persistent asthma
 J45.5 - Severe persistent asthma
 J45.9 - Other and unspecified asthma
 J45.99 - Other asthma
Occupational/Environmental Factors
Cigarette smoking is regarded as one of the leading causes of COPD. However, one out of
six people diagnosed with this lung disorder has never smoked. As discussed above, long
term exposure to environmental or occupational chemical irritants or genetics can be
other risk factors.
 Z57.2 - Occupational exposure to dust
 Z57.31 - Occupational exposure to environmental tobacco smoke
 Z77.22 - Contact with and (suspected) exposure to environmental tobacco smoke
(acute) (chronic)
COPD and Emphysema
COPD and Emphysema covers smoking history, chest CT results to identify the type of
emphysema (whether - centrilobular, septal).
 J43 - Emphysema
 J43.1 - Panlobular emphysema
 J43.2 - Centrilobular emphysema
 J43.8 - Other emphysema

4. COPD with Acute Bronchitis
 J20- Acute bronchitis
 J40 - Bronchitis, not specified as acute or chronic
 J41- Simple and mucopurulent chronic bronchitis
 J41.0 - Simple chronic bronchitis
Accurate medical coding on medical claims is important to ensure correct and on-time
documentation and reimbursement. Outsourcing pulmonary medical billing and coding
services can relieve pulmonary specialists from the hassles of medical coding, and enable
them to focus on providing dedicated patient care.