ICD-10 Codes for Reporting COPD and Asthma

Hello and welcome to our podcast series.

My name Is Meghann Drella and I am a Senior Solutions Manager here at Outsource Strategies International. Today I will be discussing documenting and coding Chronic Obstructive Pulmonary Disease and Asthma in ICD-10.

Distinguishing between COPD and asthma has significant implications for management and life expectancy, as well as for submitting accurate claims. With temperatures turning cooler, individuals with pulmonary diseases such as COPD and asthma face risk of exacerbation of their condition. As COPD and asthma have common features, differentiating them can be complicated, according to the American Academy of Family Physicians. Practices also need to ensure accurate and up-to-date coding and proper documentation to ensure quality care and appropriate reimbursement, and to also avoid risk of audit.

Asthma is a chronic disease of the airways. The condition causes the bronchial tubes to become swollen or inflamed, restricting air supply to and from the lungs. Asthma is caused by a combination of environmental and hereditary factors. Asthma triggers differ from person to person and include: pollen, dust mites, mold, pet hair, respiratory infections, physical activity, cold air, smoke, certain medications, some preservatives in foods and beverages, stress, and gastroesophageal reflux disease. According to the Centers for Disease Control and Management, 1 in 13 people in the U.S. have asthma. More than 25 million Americans have asthma and it is the leading chronic disease in children.

COPD

COPD is a major cause of disability and a leading cause of death in the United States. This chronic lung disease is characterized by obstructed airflow from the lungs. Smoking is the most common cause of COPD. According to the Mayo Clinic, 20 to 30 percent of people who smoke on a regular basis develop COPD. The disease can also be the result of a genetic disorder. COPD can be made worse by exposure to environmental pollutants. Emphysema and chronic bronchitis are the two most common types of COPD. According to the AAFP, in 2010, COPD was the primary diagnosis in 10.3 million physician office visits, 1.5 million emergency department (ED) visits, and 699,000 hospital discharges. The American Lung Association (ALA) estimates that there may be as many as 24 million American adults living with COPD.

Both asthma and COPD are treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions.

Distinguishing between COPD and asthma can have significant implications for management and life expectancy. As these conditions have many common features, the AAFP recommends that an approach that focuses on the features that can correctly distinguish asthma from COPD. To diagnose asthma or COPD, physicians need to perform a careful history that considers age, symptoms, history, social and occupational risk factors, and response to treatment.

ICD-10 classifies diseases that fall under COPD to category J44.

This category includes the following: asthma with chronic obstructive pulmonary disease; chronic asthmatic bronchitis; chronic bronchitis with airways obstruction. When coding asthma, an additional code should be used to identify exposure to environmental tobacco smoke.

Each condition would need to be documented as exacerbated in order to code to this specificity. If one of these conditions is documented as exacerbated, this does not automatically imply that the other condition is also exacerbated. Physicians need to focus on accurate chart documentation and diagnosis reporting for these pulmonary conditions.

I hope this helps but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you for joining me and stay tuned for my next podcast!