tci Part B Insider - 2011 Issue 32

Reader Question: Let Physicians Know That Vague Diagnoses Won't Fly

Question: My physician documented "multilobar pneumonia." Which ICD-9 code should I report?Answer: When coding for pneumonia, you should be able to identify the specific type, and code based on the causal organism. The Coding Clinic emphasizes that the term "lobar pneumonia" is, in fact, outdated as it codes only to 481 (Pneumococcal pneumonia [streptococcus pneumoniae pneumonia]), whereas other organisms may be involved. For instance, lobar pneumonia and pneumonia of the right lower lobe are not the same.You would code Pneumonia of the right lower lobe without specification with 486 (Pneumonia organism unspecified), while lobar pneumonia is...

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