2025 ICD-10-CM code J43
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Chronic lower respiratory diseases - Emphysema Diseases of the respiratory system Feed
Emphysema is a chronic lung disease characterized by the destruction of alveoli, leading to shortness of breath and difficulty breathing.
Modifiers are not applicable to ICD-10 codes.They are used with CPT and HCPCS codes to further specify the circumstances of a service or procedure.
Medical necessity for the diagnosis and treatment of emphysema is established based on clinical findings such as dyspnea, reduced pulmonary function, and imaging evidence of emphysema.Treatment options should be consistent with severity and the patient's overall health status.
The clinical responsibility for managing a patient with emphysema involves diagnosing the condition, assessing its severity, managing associated symptoms, and providing patient education regarding risk factors, disease progression, and treatment options. This often involves collaboration between pulmonologists, primary care physicians, respiratory therapists, and other healthcare professionals.
In simple words: Emphysema is a lung disease that makes it hard to breathe.Your lungs' tiny air sacs are damaged, making it difficult to get enough oxygen.Smoking is the biggest cause, but it can also be genetic.Treatment focuses on managing symptoms and may include medicine, breathing exercises, and oxygen.
Emphysema is a chronic obstructive pulmonary disease (COPD) characterized by the abnormal enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls without obvious fibrosis. This results in reduced elasticity of the lungs and impaired airflow, leading to symptoms such as shortness of breath, dyspnea on exertion, chronic cough, and wheezing.The most common cause is long-term exposure to cigarette smoke, but other factors such as genetic predisposition (alpha-1-antitrypsin deficiency) and air pollution can contribute.Severity varies widely, and diagnosis involves clinical evaluation, pulmonary function tests, and imaging studies. Treatment options include smoking cessation, bronchodilators, inhaled corticosteroids, pulmonary rehabilitation, and in severe cases, supplemental oxygen and lung volume reduction surgery.
Example 1: A 65-year-old male with a 40-pack-year smoking history presents with progressive shortness of breath, chronic cough, and wheezing. Pulmonary function tests reveal significantly reduced FEV1 and increased total lung capacity, consistent with severe emphysema. Treatment involves bronchodilators, inhaled corticosteroids, and pulmonary rehabilitation., A 70-year-old female with a history of alpha-1-antitrypsin deficiency develops dyspnea and decreased exercise tolerance.Chest CT scan confirms the presence of panlobular emphysema. Treatment involves oxygen therapy and consideration for lung volume reduction surgery., A 50-year-old male with a history of moderate emphysema experiences an acute exacerbation with increased cough, sputum production, and fever.Treatment includes antibiotics, bronchodilators, and supplemental oxygen.
Thorough documentation is crucial for accurate coding.This includes the patient's history (including smoking history, family history, and exposure to environmental factors), physical examination findings, pulmonary function test results (spirometry, DLCO), imaging studies (chest X-ray, CT scan), and treatment plan.
** Accurate coding requires detailed clinical documentation, including patient history, physical examination, diagnostic test results, and treatment plan.Consider using appropriate ICD-10-CM codes to identify any associated conditions such as chronic bronchitis, respiratory infections, or other comorbidities.
- Revenue Code: Revenue codes will vary based on the specific services provided and the payer.Examples might include codes for physician services, respiratory therapy, or diagnostic testing.
- RVU: RVUs are not directly assigned to ICD-10 codes.Reimbursement is determined by the procedures and services provided, which are coded using CPT codes, and the associated RVUs.These values will vary by payer and geographic location.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.Reimbursement is based on the procedures and services provided, which are coded using CPT or HCPCS codes and their associated fee schedules.
- Specialties:Pulmonology, Internal Medicine, Respiratory Therapy
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center, Home Healthcare