AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 2; Ask the Editor

COPD, Pneumonia and Bronchiectasis

A 67-year-old patient who presented to the Emergency Department with chest pain was admitted due to bilateral pneumonia, chronic obstructive pulmonary disease (COPD) exacerbation, acute respiratory failure, and sepsis. The patient’s respiratory conditions worsened overnight, and the patient expired the following day. The provider documented bilateral pneumonia secondary to severe COPD with chronic bronchiectasis as a secondary diagnosis.When referencing “Disease, lung, obstructive (chronic), with, bronchiectasis” in the Alphabetic Index, only code J47.9, Bronchiectasis, uncomplicated, is provided. However, the Excludes2 note at category J44, Other chronic obstructive pulmonary disease, lists bronchiectasis (J47.-), which indicates that both conditions (COPD and bronchiectasis) may be reported, when appropriate.Is it appropriate to report codes for COPD and bronchiectasis when both conditions meet reporting requirements? What is the appropriate code assignment for COPD exacerbation with pneumonia in a patient with chronic bronchiectasis? ...

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