2025 ICD-10-CM code J84.1
(Active) Effective Date: N/A Diseases of the respiratory system - Other interstitial pulmonary diseases with fibrosis 10 Feed
Other interstitial pulmonary diseases with fibrosis.
Medical necessity must be established by demonstrating the clinical signs, symptoms, and diagnostic findings consistent with interstitial lung disease, along with the impact on the patient's respiratory function and overall health.
The physician is responsible for diagnosing the specific interstitial lung disease causing the fibrosis through clinical evaluation, imaging studies (such as chest X-rays and CT scans), pulmonary function tests, and potentially lung biopsy. They also manage the patient's condition, which may involve medications, oxygen therapy, pulmonary rehabilitation, and monitoring disease progression.
In simple words: This code refers to a type of lung disease where the lung tissue becomes scarred and stiff, making it harder to breathe. This scarring is not caused by inhaling harmful substances or radiation.
Other interstitial pulmonary diseases characterized by fibrosis of the lung tissue. This excludes pulmonary fibrosis due to inhalation of chemicals, gases, fumes, or vapors (J68.4), and pulmonary fibrosis following radiation (J70.1).
Example 1: A patient presents with progressive shortness of breath, dry cough, and fatigue. After ruling out other causes, a high-resolution CT scan reveals diffuse interstitial fibrosis. The physician diagnoses the patient with nonspecific interstitial pneumonia (NSIP), which falls under J84.1., A patient with a history of rheumatoid arthritis develops increasing dyspnea. Imaging and pulmonary function tests are consistent with interstitial lung disease related to the underlying autoimmune condition. Since this is distinct from other specific ILDs, it is coded as J84.1., A patient exhibits signs and symptoms of interstitial lung disease, and a lung biopsy confirms the presence of fibrosis. However, the specific type of ILD cannot be definitively determined after extensive workup. In this case, the diagnosis is classified as J84.1.
Documentation should include detailed clinical findings, such as symptoms, physical exam results, pulmonary function tests, imaging studies (chest X-ray, CT scan), and lung biopsy results (if performed). The physician's diagnostic reasoning and justification for classifying the condition as "other" interstitial pulmonary disease with fibrosis should be clearly documented.
** Consider using additional codes to specify underlying conditions or contributing factors.Refer to iFrameAI for the most up-to-date information and coding guidance.
- Specialties:Pulmonology, Internal Medicine, Rheumatology
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Independent Clinic, Federally Qualified Health Center