Other Chronic
Respiratory
Diseases
Description - ICD-10-CM
J44.-
Other chronic obstructive pulmonary diseases
 Asthma with COPD
 Chronic bronchitis:
 Asthmatic (obstructive)/emphysema tous
w/ airway obstruction, emphysema
 Chronic obstructive:
 Asthma/bronchitis/tracheobronchitis
J44.0 COPD w/ acute lower respiratory infection;
such as acute bronchitis or pneumonia.
Use additional code to identify the infection.
J44.1 COPD w/ acute exacerbation, unspecified.
Excludes 2: COPD w/ acute bronchitis (J44.0)
J44.9 COPD, unspecified
 Chronic obstructive
 Airway disease NOS
 Lung disease NOS
J47.-
Bronchiectasis
J47.0  Bronchiectasis w/ac. lower resp.infection
J47.1  Bronchiectasis with (acute) exacerbation
J47.9  Bronchiectasis, uncomplicated
Reporting Tobacco Exposure
I. The documentation must be precise in order to find evidence
of whether the patient had exposure to second-hand smoke, a
history of tobacco use, or current use or dependence.
II. Several "use additional code" notes are included related to
tobacco exposure and use:
Tobacco Exposure and Use
Exposure to environmental tobacco smoke
Z77.22
P96.81
Z87.891
Z57.31
(F17.-)
Z72.0
Exposure to tobacco smoke in the perinatal period
Personal history of nicotine dependence
Occupational exposure to environmental tobacco
smoke
Nicotine dependence
Tobacco use
III. When use, abuse or dependence of the same substance are
documented, only one code should be used to report it. To
determine which to choose, the ICD-10-CM Official Guidelines for Coding and Reporting for Chapter 5 contain a hierarchy to follow:
IV. To establish if the patient meets the criteria for use or dependence, the type of tobacco used should be documented
as well. Under tobacco dependence (F17.-), there are the
following options:
V.
Code
Nicotine Dependence
F17.20F17.21F17.22F17.22-
unspecified
cigarettes
chewing tobacco
other tobacco product
Each code also involves a 6th character to further specify
the type of dependence:
6th Character
0
1
3
8
9
Type of Dependence
uncomplicated
in remission
w/ withdrawal
w/ other nicotine-induced disorders
w/ unspecified nicotine-induced
disorders
Coding Examples

Patient has mild asthma that recurs once or twice a week, but
does not impede physical activity
ICD-10-DM: Mild intermittent asthma, uncomplicated
(J45.20)

Patient with chronic laryngitis. This patient is a long-time,
dependent tobacco user who smokes cigarettes
ICD-10-DM: Chronic laryngitis (J37.0) and F17.210
(nicotine dependence, cigarettes, uncomplicated)

Patient visits the Doctors with acute bronchitis and COPD.
ICD-10-DM: COPD with acute bronchitis (J44.0)
highlight-icd10cm-respiratory-changes
 www.copdfoundation.org/pdfs/ICD%20Reference%20Codes.pdf
 CMS. 2011 ICD-10-PCS Code Tables and Index.
www.cms.gov/ICD10/11b_2011_ICD10PCS.asp
 CMS. 2011 ICD-10-PCS Reference Manual. www.cms.gov/ICD10
 National Center for Health Statistics. International Classification of
Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).
www.cdc.gov/nchs/icd/icd10cm.htm
Abuse
 use and abuse
 www.livescience.com/44105-respiratory-system-surprising-facts.html
 abuse and dependence
 www.acdis.org
 use, abuse and dependence
ICD-10-CM
 www.justcoding.com/302030/asthma-specificity-and-tobacco-use-
If Documented
 use and dependence
(J00-J99)
References
Assign Only the Code for
Dependence
COPD and other
Diseases of the
Respiratory
System
July 2016
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue
Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark
of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are
registered marks of the Blue Cross Association.
Disorders of the Respiratory System found on
ICD-10-CM are included in the codes J00-J99 and
identify conditions such as asthma, pneumonia, and
chronic obstructive pulmonary disease.
II. The 4th character indicates the severity & the 5th one identify
whether status asthmaticus or exacerbation is present
J40
Asthma
Description - ICD-10-CM
J45
Asthma
• Allergic:
 Bronchitis NOS
 Rhinitis with asthma
• Atopic asthma
• Extrinsic allergic asthma
• Hay fever with asthma
• Predominantly allergic asthma
Mild intermittent asthma
Uncomplicated
with (acute) exacerbation
with status asthmaticus
Mild persistent asthma
Uncomplicated
with (acute) exacerbation
with status asthmaticus
Moderate persistent
Uncomplicated
with (acute) exacerbation
with status asthmaticus
Reporting Respiratory Conditions



Codes for reporting diseases of the respiratory system feature relatively minor variations. Most of the changes involve
understanding the anatomic terms that newly specific codes
include, as well as, the new general structure and rules of
ICD-10-CM codes.
The ICD-10-CM Official Guidelines give instructions for
coding acute exacerbation of chronic obstructive bronchitis
and asthma, acute respiratory failure and influenza due to
avian virus, as well as, some extra instructions added for the
diagnosis of Ventilator Assisted Pneumonia (VAP).
Some codes have been expanded requiring to:
Use additional code to identify
1. The infectious agent
2. The virus
3. Other conditions such as tobacco use or exposure
Code first
J45.-
J45.2
J45.20
J45.21
J45.22
J45.3
J45.30
J45.31
J45.32
J45.4
J45.40
J45.41
J45.42
1. Any associated lung abscess
2. The underlying disease


The codes in categories J44 and J45 differentiate between
uncomplicated cases and those in acute exacerbation. An
acute exacerbation (deteriorating or decompensation of a
chronic condition), is not equal to an infection superimposed
on a chronic condition; however an exacerbation may be
generated by an infection. (Guideline I.C.10.a.1, Acute Exacerbation of Chronic Obstructive Bronchitis & Asthma).
At the beginning of Chapter for the Respiratory System,
appears the instructional guideline: “… when a respiratory
condition is described as occurring in more than one site & is
not specifically indexed, it should be classified to the lower
anatomic site.” For example, tracheobronchitis is classified
to bronchitis using code J40, bronchitis, not specified as
acute or chronic.
Asthma
I. In order to code asthma correctly, the physician must document the severity of the asthma and/or describe the frequency. Terms used to define asthma have been enhanced to reflect the current clinical classification. These terms include:
1. Intermittent asthma which is defined as less than or
equal to two occurrences per week
2. Persistent asthma which includes 3 levels of severity:
 Mild: more than two times per week
 Moderate: daily and may restrict physical activity
 Severe: throughout the day with recurrent severe
attacks limiting the ability to breathe
Bronchitis
J41.-
J42
Bronchitis, not specified as acute or chronic
• Bronchitis:
 NOS
 Catarrhal
 with tracheitis NOS
• Tracheobronchitis NOS
Simple & mucopurulent chronic bronchitis
J41.0 Simple chronic bronchitis
J41.1 Mucopurulent chronic bronchitis
Mixed simple & mucopurulent chronic
J41.8 bronchitis
Unspecified chronic bronchitis:
• Chronic:
 Bronchitis NOS
 Tracheitis
 Tracheobronchitis
Emphysema
Description - ICD-10-CM
J43
Emphysema
J43.0
Severe persistent
J45.5
J45.50 Uncomplicated
J45.51 with (acute) exacerbation
J45.52 with status asthmaticus
Other and unspecified asthma
J45.9
Unspecified:
• Asthmatic bronchitis NOS
J45.90• Childhood asthma NOS
• Late onset asthma
J45.909 Unspecified asthma, uncomplicated
Unilateral pulmonary emphysema
[MacLeod’s syndrome]
• Swyer-James syndrome
• Unilateral emphysema
• Unilateral hyperlucent lung
• Unilateral pulmonary artery functional
hypoplasia
• Unilateral transparency of lung
J43.1
Panlobular emphysema
• Panacinar emphysema
J43.2
Centrilobular emphysema
J43.8
Other emphysema
J43.9
Emphysema, unspecified
• Emphysema (lung) (pulmonary):
 NOS
 Bullous
 Vesicular
• Emphysematous bleb
J45.901 Unspecified asthma with (acute) exacerbation
J45.902 Unspecified asthma with status asthmaticus
Description - ICD-10-CM
Respiratory Failure
Terms Added
J96
Description - ICD-10-CM
Hypercapnia
J96.01
(excess carbon dioxide)
Acute respiratory failure
with hypoxia
Hypoxia
(oxygen deficient)
Chronic respiratory failure
with hypercapnia
J96.12
Although ICD-10-CM contains unspecified codes, their
use is discouraged if the assignment of these codes is
not due to lack of clinical documentation. Select the
most specific ICD-10-CM code based on clinical
documentation.