AHA Coding Clinic® for ICD-9 - 2006 Issue 2; Ask the Editor

Methotrexate Induced Pneumonitis

A 56-year-old female was admitted with shortness of breath, low-grade fevers and headache. She underwent bronchoscopy with bronchoalveolar lavage. The patient had a history of rheumatoid arthritis and was receiving Methotrexate and Remicade therapy. The physician’s final diagnostic statement listed “Methotrexate induced pneumonitis.” Would code 486, Pneumonia, organism unspecified and the E-code for the causative agent be assigned, even though the medical literature describes this condition as an interstitial pneumonitis? How should this be coded? ...

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