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J18.1
ICD-10-CM
Lobar Pneumonia

Learn about lobar pneumonia diagnosis, including clinical documentation requirements, medical coding guidelines (ICD-10-CM J18.1), symptoms, treatment, and prognosis. Find information on pneumonia, lobar consolidation, community-acquired pneumonia, bacterial pneumonia, respiratory infection, chest X-ray findings, and auscultation. This resource provides healthcare professionals with essential information for accurate diagnosis and coding of lobar pneumonia.

Also known as

Lobar Pneumonia
Pneumonia of a Lobe

Diagnosis Snapshot

Key Facts
  • Definition : Lung infection affecting one or more lobes, often caused by bacteria or viruses.
  • Clinical Signs : Cough, fever, chills, shortness of breath, chest pain, rapid breathing.
  • Common Settings : Community-acquired, hospital-acquired, healthcare-associated, ventilator-associated.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC J18.1 Coding
J18.1

Lobar pneumonia, unspecified organism

Pneumonia affecting one or more lobes of the lung, cause unknown.

J12-J18

Pneumonia

Inflammation of the lungs from various causes.

J13

Pneumonia due to Streptococcus pneumoniae

Lung inflammation specifically caused by Streptococcus pneumoniae bacteria.

J15

Bacterial pneumonia, not elsewhere classified

Pneumonia caused by bacteria other than those specifically classified.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the lobar pneumonia bacterial?

  • Yes

    Organism specified?

  • No

    Viral pneumonia?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Lobar Pneumonia
Bronchopneumonia
Community-Acquired Pneumonia

Documentation Best Practices

Documentation Checklist
  • Lobar pneumonia diagnosis documentation checklist:
  • Confirm lobar consolidation on imaging (X-ray/CT)
  • Document symptom onset, duration, and character
  • Specify affected lobe (e.g., right upper lobe)
  • Record physical exam findings (e.g., rales/crackles)
  • Note causative organism if identified (e.g., S. pneumoniae)

Coding and Audit Risks

Common Risks
  • Unspecified Organism

    Coding pneumonia without identifying the causative organism when documented leads to inaccurate severity and treatment reflection.

  • Clinical Validation

    Insufficient clinical indicators like fever, cough, and chest X-ray findings may lead to unsubstantiated lobar pneumonia diagnosis coding.

  • Laterality Miscoding

    Failing to specify right, left, or bilateral involvement when documented can impact quality reporting and reimbursement accuracy.

Mitigation Tips

Best Practices
  • Document symptom onset, duration, type, and severity for accurate ICD-10 coding (J18.1)
  • Capture chest X-ray findings and physical exam details for CDI of lobar pneumonia diagnosis.
  • Ensure documentation supports medical necessity for antibiotic treatment and compliance.
  • Query physician for clarity if documentation lacks specificity for lobar pneumonia diagnosis.
  • Code comorbidities accurately for proper severity reflection and reimbursement.

Clinical Decision Support

Checklist
  • Sudden fever onset documented
  • Cough, chest pain recorded
  • Lung consolidation on CXR confirmed
  • Auscultation findings consistent with lobar pneumonia

Reimbursement and Quality Metrics

Impact Summary
  • Lobar Pneumonia: Diagnosis impacts reimbursement through accurate ICD-10-CM coding (J18.1, J18.2, J18.9) maximizing case mix index.
  • Coding validation and physician documentation integrity crucial for pneumonia severity reporting, impacting DRG assignment and payment.
  • Accurate present on admission (POA) indicator for pneumonia affects quality metrics like hospital-acquired pneumonia (HAP) rates.
  • Timely and specific documentation of antibiotic treatment and response impacts quality reporting and potential value-based payments.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Document lobar consolidation
  • Code J18.1 for pneumonia
  • Specify organism if known
  • Query physician for laterality
  • Review imaging reports

Documentation Templates

Patient presents with symptoms consistent with lobar pneumonia.  Chief complaints include productive cough with rusty or blood-tinged sputum, fever, chills, pleuritic chest pain, dyspnea, and fatigue.  Physical examination reveals diminished breath sounds, crackles, and dullness to percussion over the affected lobe.  Symptoms onset began approximately three days ago.  Patient reports recent upper respiratory infection.  Vital signs demonstrate elevated temperature (102.5 F), tachycardia, and tachypnea.  Chest X-ray confirms consolidation in the right lower lobe, consistent with lobar pneumonia diagnosis.  Differential diagnosis considered bacterial pneumonia, viral pneumonia, and bronchitis.  Based on clinical presentation and imaging findings, the diagnosis of lobar pneumonia is confirmed.  Treatment plan includes antibiotic therapy with ceftriaxone intravenously,  oxygen supplementation as needed,  analgesics for pain management, and antipyretics for fever reduction.  Patient education provided on the importance of medication adherence, hydration, rest, and follow-up care.  Patient advised to return for re-evaluation in one week to assess treatment response and resolution of symptoms.  Medical coding includes ICD-10 code J18.1 for lobar pneumonia, unspecified organism.  CPT codes will be assigned based on specific procedures performed, including chest X-ray and intravenous administration of medication.  Prognosis is generally favorable with appropriate antibiotic treatment and supportive care.  Patient monitoring will include respiratory status, oxygen saturation, temperature, and response to antibiotics.  Potential complications such as pleural effusion, empyema, and sepsis will be monitored closely.