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2025 ICD-10-CM code R09.1

Pleurisy. Inflammation of the pleura, the lining of the lung.

Do not code pleurisy with effusion (J90) with code R09.1. Code the underlying condition if known.

Medical necessity for treatment of pleurisy is established by the presence of signs and symptoms, such as chest pain, difficulty breathing, and cough. The severity of the symptoms and the underlying cause will determine the appropriate level of care.

In simple words: Pleurisy is when the membrane around your lungs becomes inflamed, causing pain when you breathe.

Pleurisy is an inflammation of the pleura, the lining of the lung. When the parietal pleura is involved, there is pleuritic chest pain.It may occur as either an acute or a chronic process.

Example 1: A patient presents with sharp, stabbing chest pain that worsens with breathing or coughing. After examination and review of imaging studies, the physician diagnoses pleurisy., A patient with pneumonia develops pleuritic chest pain.The physician diagnoses pleurisy as a complication of the pneumonia., A patient with a history of lupus develops pleurisy as a manifestation of their autoimmune disease. The physician documents pleurisy in the medical record.

Documentation should include the location, quality, and severity of the pain, as well as any associated symptoms. Physical exam findings, imaging results, and other diagnostic test results should also be documented to support the diagnosis of pleurisy.If associated with another condition, this should be clearly documented.

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