2025 ICD-10-CM code J92.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Respiratory System Diseases - Other diseases of the pleura Diseases of the respiratory system (J00-J99) Feed
Pleural plaque with the presence of asbestos.
Modifiers are not applicable to ICD-10-CM codes, including J92.0.Modifiers are used with procedural codes (CPT and HCPCS).
Medical necessity for coding J92.0 is established by the presence of pleural plaques confirmed by imaging, along with a documented history of asbestos exposure.The absence of either of these components would render the code inappropriate.
The clinical responsibility lies primarily with the pulmonologist or physician specializing in respiratory diseases.The physician's role involves obtaining a thorough patient history, performing a physical examination, interpreting imaging results (chest X-rays, CT scans), and confirming the diagnosis of pleural plaques and asbestos exposure. They will also need to advise the patient on the appropriate management strategy, considering potential future health risks.
In simple words: This code describes a condition called pleural plaques caused by asbestos exposure. Pleural plaques are thickened areas on the outer lining of the lungs. They usually don't cause symptoms, but they are a sign that someone has been exposed to asbestos.
J92.0, in the ICD-10-CM coding system, specifies pleural plaques in association with asbestos exposure.Pleural plaques are circumscribed fibrous thickenings on the parietal pleura, often bilateral, and a hallmark of asbestos exposure. While typically asymptomatic and not impacting lung function, they represent a significant finding indicating prior asbestos exposure.The code necessitates documentation of both the pleural plaques and confirmation of asbestos exposure through appropriate diagnostic methods.
Example 1: A 60-year-old male patient, a former asbestos insulator, presents with a persistent cough. A chest X-ray reveals bilateral pleural plaques.A medical history reveals a 30-year occupational history involving asbestos exposure. J92.0 is coded to capture the asbestos-related pleural plaques., A 75-year-old female patient, previously employed in a shipyard, undergoes a routine chest CT scan which shows multiple pleural plaques.The patient has no respiratory symptoms but confirms a history of exposure to asbestos dust in the shipyard where she worked. J92.0 is used along with additional codes (if applicable) for the imaging studies performed., A 55-year-old male patient who worked in demolition, presents for a follow-up appointment. He had a previous asbestos exposure assessment and now shows new pleural plaques on his chest X-ray.J92.0 is assigned to record the newly developed pleural plaques in connection with prior asbestos exposure.
** Always ensure thorough and accurate documentation supporting the diagnosis and linking the pleural plaques to asbestos exposure.The presence of associated symptoms or complications will require additional coding to reflect the full clinical picture.
- Revenue Code: Revenue codes will vary depending on the healthcare setting and the specific services provided. Consult your facility's revenue code mapping for appropriate selection.
- RVU: RVUs are not directly associated with ICD-10 codes. Reimbursement for services related to the diagnosis (J92.0) would depend on the procedures and services performed, which would use CPT or HCPCS codes with their associated RVUs.
- Global Days: Not applicable; this is a diagnostic code.
- Payment Status: Active
- Modifier TC rule: Not applicable to diagnostic codes.
- Fee Schedule: Not applicable to ICD codes.Fee schedules are associated with procedural codes and vary by payer.
- Specialties:Pulmonology, Occupational Medicine, Radiology
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital