2025 ICD-10-CM code J44.1
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Respiratory System Diseases - Chronic lower respiratory diseases (J40-J47) Chapter 10: Diseases of the respiratory system (J00-J99) Feed
Chronic obstructive pulmonary disease (COPD) with acute exacerbation.
Modifiers are not applicable to ICD-10 codes. Modifiers are used with CPT and HCPCS codes.
Medical necessity for treatment of an acute COPD exacerbation is established by the presence of documented worsening symptoms, such as increased dyspnea, cough, or sputum production, which require medical intervention to improve the patient's respiratory status and prevent potential complications, such as respiratory failure.The severity of the exacerbation and the patient's overall clinical presentation will guide the decision regarding appropriate level of care.
The clinical responsibility for a patient with J44.1 includes diagnosis, treatment and management of the acute exacerbation, stabilization of the patient's respiratory status, identifying and treating any underlying infections or contributing factors, and educating the patient on self-management strategies for COPD.This might involve ordering diagnostic tests such as blood work, chest X-rays, pulmonary function tests (PFTs), arterial blood gas analysis (ABG), and providing respiratory treatments like bronchodilators, corticosteroids, and oxygen therapy as clinically indicated.
In simple words: This code describes a sudden worsening of chronic obstructive pulmonary disease (COPD), a long-term lung condition.It means the person's COPD symptoms, like shortness of breath and coughing, have gotten much worse and need extra medical care.
This code is used to classify cases of chronic obstructive pulmonary disease (COPD) that are experiencing an acute worsening or exacerbation of their symptoms.The exacerbation represents a decompensation of the underlying chronic condition and requires additional medical intervention.The unspecified nature of this code indicates that no specific details regarding the type of exacerbation were documented.It encompasses various presentations of acute worsening, such as increased dyspnea, cough, sputum production, or wheezing. This code should be used when an acute exacerbation is documented, even in the absence of an identified infection.
Example 1: A 65-year-old male with a history of COPD presents to the emergency room with increased shortness of breath, increased sputum production, and wheezing.The patient is diagnosed with an acute exacerbation of COPD.Treatment includes oxygen therapy, bronchodilators, and corticosteroids., A 70-year-old female with a long-standing history of COPD is admitted to the hospital for an acute exacerbation of her condition. The patient has increased dyspnea and is found to have a bacterial pneumonia. The physician codes J44.1 along with a code for pneumonia., An 80-year-old male with COPD experiencing an acute exacerbation is seen in the outpatient clinic for management.The patient reports increased cough and shortness of breath with increased sputum production.The physician performs a pulmonary function test (PFT) and modifies the patient's home medication regimen.
Complete documentation should include the patient's history of COPD, details about the acute exacerbation (onset, duration, severity of symptoms), results of any diagnostic tests performed (e.g., PFTs, chest X-ray, ABG, sputum culture), treatments provided, and the patient's response to therapy.Any relevant social determinants of health, such as smoking history and environmental exposures, should be documented.The documentation should clearly support the diagnosis of acute exacerbation.
** The severity of the COPD exacerbation should be documented to support the level of care provided and ensure appropriate reimbursement.Accurate documentation is crucial for appropriate billing and reimbursement, especially when considering potential comorbidities.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and the payer.
- RVU: RVUs are not applicable to ICD-10 codes.Reimbursement for services related to COPD will depend on the specific services provided, the payer, and the place of service.
- 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.
- Specialties:Pulmonology, Internal Medicine, Family Medicine, Emergency Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital, Office, Urgent Care Facility