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2025 ICD-10-CM code J43.9

Emphysema, unspecified.

When a respiratory condition is described as occurring in more than one site and is not specifically indexed, classify to the lower anatomic site. For example, tracheobronchitis should be coded as bronchitis (J40).

Medical necessity for services related to emphysema is established by the presence of signs, symptoms, and diagnostic findings consistent with the condition. The severity of the disease and its impact on the patient's respiratory function should be documented.

Diagnosis and management of emphysema, including assessment of severity, evaluation of respiratory function, and implementation of appropriate treatment strategies.

IMPORTANT:Use more specific codes (J43.0-J43.8) if the type of emphysema is documented. Do not use J43.9 with J44.- (COPD).If both emphysema and chronic bronchitis are present, use J44.- and code also the type of emphysema if applicable (J43.-).Consider additional codes to identify exposure to tobacco smoke or history of tobacco dependence.

In simple words: This code refers to a lung condition called emphysema where the type is not specified.

Emphysema, unspecified. This code is used when the type of emphysema is not documented or specified in the medical record. It encompasses various forms of emphysema where the specific anatomical distribution or pattern (e.g., panlobular, centrilobular) is not identified.

Example 1: A patient presents with shortness of breath and a history of smoking. Imaging reveals emphysema, but the type is not specified in the report. J43.9 is used., A patient with long-standing respiratory issues is admitted for an exacerbation. The discharge summary mentions emphysema without further detail. J43.9 is appropriate in this case., A patient's medical record mentions "lung disease consistent with emphysema" but does not provide more specific information regarding subtype. Assign J43.9.

Documentation should include evidence supporting the diagnosis of emphysema, such as:-Clinical findings (e.g., shortness of breath, wheezing, reduced breath sounds)-Pulmonary function test results showing obstructive pattern-Imaging studies (e.g., chest X-ray, CT scan) demonstrating characteristic changesIf available, documentation about the type of emphysema should be included to allow for more specific coding.

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