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

Emphysema/Bronchiectasis and COPD

In previous issues of Coding Clinic (Fourth Quarter 2017 and First Quarter 2019), it was advised to report only code J43.9, Emphysema, unspecified, for a patient with both chronic obstructive pulmonary disease (COPD) and emphysema because emphysema is a specific form of COPD. This Coding Clinic advice further stated that it was not appropriate to report codes from both categories J43, Emphysema, and J44, Other chronic obstructive pulmonary disease, because of the Excludes1 notes at both categories.Effective with the October 1, 2023, updates, the Excludes1 notes found at categories J43 and J44 were changed to Excludes2 notes, which now appears to allow the reporting of codes from both categories, when appropriate. However, when referencing “Disease, lung, obstructive (chronic), with emphysema,” only code J43.9 is provided. Do these Excludes note changes allow the reporting of COPD separately in a patient with emphysema? Please clarify the proper code assignment for COPD in a patient with emphysema. ...

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