Interstitial Lung Diseases - Stay Updated with ICD-10 and CPT Codes

Interstitial Lung Diseases - Stay Updated with ICD-10 and CPT Codes Interstitial lung disease (ILD) causes inflammation and scarring around the balloon-like air sacs in your lungs, called the alveoli.

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Interstitial lung disease (ILD) is an umbrella term for a large group of lung disorders that cause inflammation and progressive scarring of lung tissue (around the balloon-like air sacs in your lungs, called the alveoli). As oxygen travels through the alveoli into your bloodstream, the associated scarring affects your ability to breathe and get enough oxygen into your bloodstream. Generally, these groups of lung disorders are classified together as they affect the tissue and space around the alveoli (air sacs), called the “interstitium�.Depending on the specific disease, other compartments of the lung, including the airways (trachea, bronchi, and bronchioles), blood vessels, and pleura (outside lining of the lung), may also be affected.If left untreated, these disorders can lead to a series of lifethreatening complications, including - high blood pressure in your lungs (pulmonary hypertension), right-sided heart failure (cor pulmonale) and respiratory failure. Diagnosis of this lung disorder is quite challenging, and there is currently no cure for the same. However, incorporating key lifestyle changes along with medications can help with effective management of the symptoms in the long-run. Pulmonologists or other specialists dealing with lung disorders must make sure that they correctly document all the procedures performed in the patient’s medical records. Outsourcing medical billing and coding tasks to a reliable and established medical billing and coding

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There are many types of interstitial lung disease (ILD), majority of which affect the interstitium.According to the American Thoracic Society, there are more than 200 different lung disorders that affect the interstitium. Some of the common disorders include - interstitial pneumonia, chronic silicosis, siderosis, idiopathic pulmonary fibrosis, sarcoidosis, asbestosis and more. The causes of ILD are several and these include – autoimmune disorders (that damage the lungs and other organs), long-term exposure to toxic or hazardous materials and anti-inflammatory medications and other drugs. In some cases, however, the causes remain unknown.

What Are the Typical Symptoms?

Interstitial lung diseases can vary from one person to another and may depend on the specific potential causes.Symptoms can range from mild to severe. In some cases, symptoms progress slowly, while in other cases they worsen quickly. Most common symptoms include – dry cough and shortness of breath at rest or aggravated by exertion.

As and when these symptoms appear, irreversible lung damage might havealready occurred. Therefore, it is important to consult your physician as soon as you experience serious breathing difficulty. Getting an early and accurate diagnosis will www.outsourcestrategies.com

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help in proper treatment.Exposure to occupational and environmental toxins, habit of smoking, gastroesophageal reflux disease, age, and radiation and chemotherapy are some of the potential risk factors associated with the condition.

Need for Early Diagnosis and Treatment of ILD Making a clear and definitive diagnosis of ILDcan be challenging as a large number of disorders fall into this broad category. In addition, the signs and symptoms can often mimic other types of medical conditions. Certain blood tests may be conducted during the initial stage of diagnosis to detect proteins, antibodies and other markers of autoimmune diseases or inflammatory responses to environmental exposures, (such as those caused by molds or bird protein).

A wide range of other diagnostic imaging tests like Computerized tomography (CT) scan, X-ray and pulmonary function tests (such as Spirometry and diffusion capacity, Oximetry) will be conducted as part of the diagnosis. In addition, lung tissue analysis will be conducted by examining a small amount of lung tissue (biopsy) in a laboratory. The tissue sample may be obtained through procedures like – Bronchoscopy, Bronchoalveolar lavage and surgical biopsy.

There are currently no treatment options that can completely reverse the lung scarring that occurs in interstitial lung.

However, treatment modalities may help improve symptoms www.outsourcestrategies.com

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and slow the progression of scarring, and allow a person to breathe more freely. Pulmonologists may prescribe medications like - corticosteroids (prednisone), pirfenidone (Esbriet) and nintedanib (Ofev) to slow the disease progression.

As gastro esophageal reflux disease is one of the top risk factors for ILD, physicians may prescribe medications including H-2receptor antagonists or proton pump inhibitors such as lansoprazole (Prevacid 24HR), omeprazole (Prilosec OTC) and pantoprazole (protonix) to reduce stomach acid and other symptoms of acid reflux. In addition, oxygen therapy and pulmonary rehabilitation can help patients improve breathing and lung efficiency. Lung transplantation may be considered as a last resort for people with severe interstitial lung disease who haven't benefited from other treatment options.

Radiology medical coding involves the use of relevant diagnosis and procedure codes to bill the procedure correctly. The relevant ICD-10 and CPT codes to document different types of interstitial lung diseases (ILD) include – ICD – 10 Codes J84 - Other interstitial pulmonary diseases J84.0 - Alveolar and parieto-alveolar conditions  J84.01 - Alveolar proteinosis  J84.02 - Pulmonary alveolar microlithiasis www.outsourcestrategies.com

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 J84.03 - Idiopathic pulmonary hemosiderosis  J84.09 - Other alveolar and parieto-alveolar conditions J84.1 - Other interstitial pulmonary diseases with fibrosis  J84.10 - Pulmonary fibrosis, unspecified J84.11 - Idiopathic interstitial pneumonia  J84.111 - Idiopathic interstitial pneumonia, not otherwise specified  J84.112 - Idiopathic pulmonary fibrosis  J84.113 - Idiopathic non-specific interstitial pneumonitis  J84.114 - Acute interstitial pneumonitis  J84.115 - Respiratory bronchiolitis interstitial lung disease  J84.116 - Cryptogenic organizing pneumonia  J84.117 - Desquamative interstitial pneumonia J84.17 - Other interstitial pulmonary diseases with fibrosis, in diseases classified elsewhere J84.2 - Lymphoid interstitial pneumonia J84.8 - Other specified interstitial pulmonary diseases  J84.81 - Lymphangioleiomyomatosis

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 J84.82 - Adult pulmonary Langerhans cell histiocytosis  J84.83 - Surfactant mutations of the lung J84.84 - Other interstitial lung diseases of childhood  J84.841 - Neuroendocrine cell hyperplasia of infancy  J84.842 - Pulmonary interstitial glycogenosis  J84.843 - Alveolar misalignment

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 J84.848 - Other interstitial lung diseases of childhood J84.89 - Other specified interstitial pulmonary diseases J84.9 - Interstitial pulmonary disease, unspecified CPT Codes  94010 - Spirometry Complete, includes graphic record total and timed vital capacity, expiratory flow rate measurement(s) with or without maximal voluntary ventilation (94010 should not be reported with 94150, 94200, 94375, 94728)  94011 - Measurement of spirometry forced expiratory flows in an infant or child through 2 years of age

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 94012 - Measurement of spirometry forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age  94013 - Measurement of lung volumes (i.e., functional residual capacity (FRC); forced vital capacity (FVC), and expiratory reserve volume (ERV) in an infant or child through 2 years of age  94014 - Patient-initiated spirometry recording per 30 day period of time; includes reinforced education, transmission of spirometry tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health professional  94015 - [Patient-initiated spirometry] recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)  94016 - [Patient-initiated spirometry] review and interpretation only by a physician or other qualified health professional  94060 - Bronchodilation Responsiveness, spirometry as in 94010, pre- and post bronchodilator administration.

(94060 should not be reported with 94150, 94200, 94375,

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94640, and 94728. For prolonged exercise test for bronchospasm with pre- and post-spirometry use 94620)  94070 - Bronchspasm provocation evaluation, multiple spirometric determination as in 94010, with administered agents (eg. antigen(s), cold air, methacholine)  94150 - Vital capacity, total (separate procedure) (Do not report in conjunction with 94010, 94060, 94728)  94200 - Maximum breathing capacity, maximum voluntary ventilation. (Do not report in conjunction with 94010, 94060).  94250 - Expired gas collection, quantitative, single procedure (separate procedure).  94375 - Respiratory flow volume loop (Do not report in conjunction with 94010, 94060, 94728)  94400 - Breathing response to CO2 (CO2 response curve).  94450 - Breathing response to hypoxia (hypoxia response curve) (For high altitude simulation test (HAST) see 94452, 94453).  94452 - High altitude simulation test (HAST) with interpretation and report by a physician or other qualified health professional (Do not report in conjunction with 94453, 94760, 94761) www.outsourcestrategies.com

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 94453 – (HAST) with supplemental oxygen titration (Do not report in conjunction with 94452, 94760, 94761).  94620 - Pulmonary stress test simple.  94621 - Pulmonary stress test, complex (including measurement if CO2 production, O2 uptake, and electrocardiographic recordings).  94680 - Oxygen uptake, expired gas analysis, rest and exercise, direct, simple  94681 - [Oxygen uptake] including CO2 output, percentage oxygen extracted.  94690 - [Oxygen uptake] rest, indirect (separate procedure)  94726 - Plethysmography for determination of lung volumes and when performed, airway resistance (Do not report in conjunction with 94727)  94727 - Gas dilution or washout for determination of lung volumes, and when performed distribution of ventilation and closing volume (Do not report in conjunction with 94726)  94728 - Airway resistance by impulse oscillometry (Do not report in conjunction with 94010, 94060, 94070, 94375, 94726). www.outsourcestrategies.com

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 94729 - Diffusing capacity (Must be reported in conjunction with 94010, 94060, 94070, 94375, 94726, 94727 or 94728).

Living with chronic interstitial lung disease is really challenging.

Getting actively involved in treatment programs and staying as healthy as possible are essential to living with ILD. Eating a balanced healthy diet, quitting the habit of smoking and getting vaccinated (to prevent respiratory infections) can help reduce the complications associated with ILD and prevent its symptoms in the long-run.

Medical coding for various lung disorders can be difficult. With all the complexities involved, the support of a reliable medical billing and coding outsourcing company can assist in timely medical billing and claims submission for optimal reimbursement.

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