AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Quarter 3; Correction Notice
Lobar Pneumonia
Coding Clinic, Third Quarter 2018, pages 24-25, advised to assign code J18.1 , Lobar pneumonia, unspecified organism, when the provider documents pneumonia of the “right upper lobe” and the causal organism is not documented. After further review by our clinical experts, the Coding Clinic Editorial Advisory Board is rescinding previously published advice about lobar pneumonia. Lobar pneumonia should only be coded when the provider specifically documents “lobar pneumonia” and a causal organism is not specified. Lobar pneumonia is a clinical diagnosis and typically involves consolidation of one or more lobes of the lung, meaning there is consolidation...
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Article Overview
This short Coding Clinic update addresses how lobar pneumonia is discussed in documentation and why a prior recommendation was rescinded. It is relevant to coders, CDI staff, and clinicians who review pneumonia documentation and coding references. The article focuses on the relationship between provider documentation, clinical terminology, and ICD-10-CM coding guidance.
Why This Topic Matters
Pneumonia documentation is commonly reviewed for specificity, and this update changes how a previously published Coding Clinic recommendation should be interpreted. It helps reduce coding inconsistency by clarifying the scope of the term as used in clinical documentation and coding references.
What You Will Learn
- How this Coding Clinic update changes prior guidance related to lobar pneumonia
- What kinds of documentation the article discusses in relation to pneumonia coding
- Why clinical terminology and imaging language may not align for coding purposes
- How the article frames the use of ICD-10-CM guidance for pneumonia documentation
Who Should Read This
- Medical coders
- Clinical documentation improvement specialists
- Coding educators
- Physicians and other providers
- Health information management professionals
Codes Discussed
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