COPD ICD 10

Let us learn about COPD ICD 10 code list, guidelines with examples.

COPD:

Chronic obstructive pulmonary disease is an inflammatory disease which blocks airflow and make it difficult to breath. Groups of lung diseases contribute to COPD, most commonly seen combinations are Emphysema and chronic bronchitis.

Cigarette smoking is one of the major risk factor in increasing the number of COPD patients in the world. Other factors include occupational exposure to dusts and chemical, exposure to fumes from burning fuel or rarely any genetic factor (alpha-1-antitrypsin deficiency).

Symptoms and Tests

COPD causes symptoms like shortness of breath, wheezing, chronic cough or chest tightness. Diagnosis of COPD can be done by doing pulmonary function test (PFT), chest X-ray, CT lung or arterial blood gas analysis.

COPD ICD 10 Code list and guidelines

COPD ICD 10 codes and guidelines can be found in chapter 10 of ICD-10-CM manual which is “diseases of the respiratory system”, code range J00 – J99

COPD ICD 10 codes	Description	Guidelines
J44.1	COPD with exacerbation	J44.0 also can be coded if documented in the medical record.
J44.0	COPD with lower respiratory infections	Code also the infection
J44.9	Unspecified COPD	Asthma with specified type can be coded separately.

• As COPD is a group of diseases it is important to see the coding guidelines properly before deciding which code to be assigned.
• Look for the notes – Excludes 1, excludes 2, includes, code also, use additional.
• Excludes 1 note has codes from category J43, J41, J42, J47 and J68.0
• Asthma of specified type (Eg: mild intermittent asthma) should be coded separately along with COPD.
• Disease – Airway – Obstructive = Leads to COPD

Table below shows few combinations of Lung diseases and codes with COPD along with guideline.

Scenario	COPD ICD 10 codes	Guidelines
COPD, Emphysema	J43.9 (Emphysema)	COPD J44.9 is not coded as per excludes 1 note with J43.9
COPD, Emphysema, Acute bronchitis	J43.9, J20.9 (Acute bronchitis)	J44.0 (COPD with lower respiratory infections) is not coded as per excludes 1 note with J43.9
COPD, Emphysema, Pneumonia	J43.9, J18.9 (Pneumonia)	J44.0 (COPD with lower respiratory infections) is not coded as per excludes 1 note with J43.9
COPD, Lobar pneumonia	J44.0, J18.1 (Lobar pneumonia)	J18.1 coded separately as per “code also” note with J44.0
COPD, Mild persistent asthma	J44.9, J45.30 (Mild persistent asthma)	J45.30 coded separately as per “code also” note with J44.9
COPD exacerbation, Mild persistent asthma	J44.1, J44.0, J45.30	Both J44.1 and J44.0 is coded as per excludes 2 notes with J44.1
COPD, Emphysema, Chronic bronchitis	J44.9	Can not code J43.9(emphysema) as it has excludes 1 note for “emphysema with chronic (obstructive) bronchitis (J44.-)
COPD with exacerbation, Emphysema, Chronic bronchitis	J44.1	J43.9 not coded following excludes 1 note with J43.9 for “emphysema with chronic (obstructive) bronchitis (J44.-)
COPD exacerbation,Emphysema	J43.9	As there is no chronic bronchitis we need to follow excludes 1 note with J43.9 and not code COPD

COPD ICD 10 Example 1

77 year old female presents with shortness of breath worse with exertion and cough with yellow sputum. She gets wheezing sometimes. She is an asthma patient and diagnosed with COPD few months back. She is on Anoro for the same. She uses nebulizer 2-3 times a day. Vitals noted temperature of 97.9 F, HR 84 beats per minute, oxygen saturation 96% RA. Examination found wheezing when taking breath, decreased breath sound and no obvious cardiac murmurs.

Chest X-ray and PFT were done. This case is diagnosed as COPD exacerbation.

ICD-10 codes

• 1 (COPD exacerbation)

Note: asthma unspecified J45.909 can not be coded with COPD. Asthma can be coded only if it is specified to which type.

COPD ICD 10 Example 2

Peter, 68 year old male admitted to hospital for cough and dyspnea from past one week. He had visited a nearby clinic and was diagnosed as COPD exacerbation. He started taking azithromycin but not had an improvement even after 3 days. He has a history of hypertension and COPD and takes lisinopril and albuterol inhaler. Review of systems shows productive cough, chills and fever. Vitals noted as temperature 101.2 F, heart rate 89 bpm, respiratory rate 18 bpm, BP 140/86 mm Hg, oxygen saturation 84% RA, 98% on 4L nasal canula. Physical exam shows coarse breath sounds, and wheezing throughout. Chest X-ray showed positive for pneumonia. Sputum culture showed positive for pneumococcus.

Assessment documented as pneumococcal pneumonia, COPD exacerbation.

ICD-10 Codes

• 1 (COPD exacerbation)
• 0 (COPD with respiratory infection)
• J13 (Pneumococcal pneumonia)
• I10 (HTN)

Note: Both J44.1 and J44.0 is coded as per excludes 2 notes with J44.1