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J84.10
ICD-10-CM
Pulmonary Fibrosis

Find comprehensive information on pulmonary fibrosis diagnosis, including clinical documentation requirements, ICD-10 codes (J84.1), medical coding guidelines, and healthcare resources. Learn about symptoms, treatment options, and prognosis for idiopathic pulmonary fibrosis IPF and other interstitial lung diseases ILD. This resource helps healthcare professionals ensure accurate and complete documentation for pulmonary fibrosis cases.

Also known as

Lung Fibrosis
Interstitial Lung Disease

Diagnosis Snapshot

Key Facts
  • Definition : Scarring and thickening of lung tissue, causing breathing difficulty.
  • Clinical Signs : Shortness of breath, dry cough, fatigue, and weight loss.
  • Common Settings : Outpatient pulmonology clinics, hospitals for acute exacerbations.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC J84.10 Coding
J84.1

Idiopathic pulmonary fibrosis

Scarring of the lungs with unknown cause.

J84.8

Other interstitial pulmonary diseases

Lung diseases affecting the interstitium, excluding IPF.

J84.9

Interstitial pulmonary disease, unspecified

Unspecified disease affecting the lung interstitium.

J70-J98

Diseases of respiratory system

Encompasses various respiratory conditions including fibrosis.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Pulmonary Fibrosis
Idiopathic Pulmonary Fibrosis
Hypersensitivity Pneumonitis

Documentation Best Practices

Documentation Checklist
  • Pulmonary Fibrosis diagnosis documentation checklist:
  • ICD-10-CM code J84.1 for PF confirmation
  • High-resolution CT scan evidence of UIP pattern
  • PFTs showing restrictive pattern, reduced DLCO
  • Exclude alternative diagnoses (e.g., sarcoidosis)
  • Document patient symptoms (e.g., dyspnea, cough)

Coding and Audit Risks

Common Risks
  • Unspecified PF Coding

    Coding pulmonary fibrosis without specific type (e.g., idiopathic) when documented, leading to inaccurate DRG assignment and reimbursement.

  • Comorbidity CDI Capture

    Missing documentation and coding of significant comorbidities impacting PF severity, affecting quality reporting and risk adjustment.

  • Unbundling Diagnostic Tests

    Separate coding of diagnostic tests integral to PF diagnosis (e.g., PFTs, HRCT) when bundled codes exist, triggering compliance issues.

Mitigation Tips

Best Practices
  • ICD-10 J84.1, CDI: Detail fibrosis type/stage for accurate coding.
  • CPT 94010: Document PFTs, FVC, DLCO for reimbursement compliance.
  • HCPCS G0239: Ensure proper O2 therapy documentation for billing.
  • CDI query: 'Specify usual interstitial pneumonia (UIP) pattern if present'.
  • Document patient education on palliative care options for IPF.

Clinical Decision Support

Checklist
  • Verify progressive dyspnea ICD-10 J96.0
  • Confirm bibasilar inspiratory crackles on exam
  • Check PFTs for restrictive pattern FVC lt 80 predicted
  • HRCT scan for UIP pattern or alternative diagnosis
  • Exclude other ILDs sarcoidosis, hypersensitivity pneumonitis

Reimbursement and Quality Metrics

Impact Summary
  • Pulmonary Fibrosis reimbursement hinges on accurate ICD-10-CM (J84.1XX) and CPT coding for procedures like PFTs (94010, 94060) impacting DRG assignment and payment.
  • Coding errors for Pulmonary Fibrosis diagnoses (e.g., unspecified vs. idiopathic) can lead to claim denials, affecting revenue cycle management.
  • Quality metrics for Pulmonary Fibrosis like oxygen saturation monitoring and pulmonary rehabilitation compliance influence value-based reimbursement models.
  • Precise documentation of disease severity (e.g., GAP staging) is crucial for appropriate Pulmonary Fibrosis reimbursement and accurate hospital quality reporting.

Streamline Your Medical Coding

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

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective strategies for differentiating Idiopathic Pulmonary Fibrosis (IPF) from other interstitial lung diseases (ILDs) in clinical practice?

A: Differentiating Idiopathic Pulmonary Fibrosis (IPF) from other interstitial lung diseases (ILDs) requires a multidisciplinary approach incorporating clinical features, high-resolution computed tomography (HRCT) patterns, and in some cases, surgical lung biopsy. Specifically, IPF typically presents in older adults with progressive dyspnea and dry cough. HRCT findings often reveal a usual interstitial pneumonia (UIP) pattern characterized by basal and subpleural predominance, reticular opacities, honeycombing, and traction bronchiectasis. Absence of features suggestive of alternative diagnoses (e.g., connective tissue disease, hypersensitivity pneumonitis, drug-induced ILD) further supports an IPF diagnosis. Multidisciplinary discussion (MDD) with pulmonologists, radiologists, and pathologists is crucial for complex cases. When HRCT is inconclusive, surgical lung biopsy may be necessary for definitive diagnosis. Consider implementing a standardized diagnostic algorithm for ILDs to ensure accurate and timely IPF diagnosis. Explore how S10.AI can assist in ILD differential diagnosis.

Q: How can clinicians effectively manage acute exacerbations of IPF in patients, and what are the latest evidence-based treatment recommendations?

A: Acute exacerbations of IPF (AE-IPF) represent a significant challenge in IPF management, marked by rapid worsening of respiratory symptoms and often a poor prognosis. Treatment strategies focus on supportive care, including oxygen therapy, managing comorbidities, and treating potential underlying infections. High-dose corticosteroids are frequently used, although their efficacy remains debated. Consider implementing a prompt evaluation to identify and treat any potentially reversible causes, such as infection. Some studies suggest the use of antifibrotic therapy during stable periods may reduce the risk of AE-IPF, though more research is needed. Emerging evidence suggests a potential role for other therapies such as Nintedanib and Pirfenidone in managing AE-IPF. Learn more about the latest research on AE-IPF management and explore how S10.AI can support clinical decision-making in these critical situations.

Quick Tips

Practical Coding Tips
  • Code J84.118 for idiopathic pulmonary fibrosis
  • Document fibrosis extent for accurate coding
  • Query physician for laterality if unspecified
  • Check for associated conditions like RA, SLE
  • Use combination codes for fibrosis with other lung diseases

Documentation Templates

Patient presents with progressive dyspnea on exertion, a chronic cough often described as dry and hacking, and fatigue.  These symptoms are consistent with the clinical picture of pulmonary fibrosis (PF).  On physical examination, inspiratory crackles or rales were auscultated bilaterally at the lung bases.  Patient reports a history of gradual worsening of breath shortness over the past [timeframe], impacting their activities of daily living.  No fever, chills, or recent infections reported.  Patient denies hemoptysis.  Risk factors for interstitial lung disease (ILD) including environmental exposures (asbestos, silica), connective tissue disease, and family history of pulmonary fibrosis were reviewed.  Patient denies any known exposure to asbestos or silica.  No known family history of ILD.  Connective tissue disease screening is negative.  Pulmonary function tests (PFTs) demonstrate a restrictive pattern, with reduced forced vital capacity (FVC) and total lung capacity (TLC), and a decreased diffusing capacity of the lungs for carbon monoxide (DLCO).  High-resolution computed tomography (HRCT) of the chest reveals  [specific HRCT findings e.g., reticular opacities, honeycombing, traction bronchiectasis] predominantly in the [distribution e.g., lower lobes, peripheral and subpleural regions], consistent with the diagnostic criteria for usual interstitial pneumonia (UIP) pattern.  Based on the clinical presentation, PFTs, and HRCT findings, a diagnosis of idiopathic pulmonary fibrosis (IPF) is suspected.  The patient was counseled on the prognosis and management of IPF, including antifibrotic therapy, pulmonary rehabilitation, and supplemental oxygen as needed.  Referral to a pulmonologist specializing in interstitial lung disease is recommended for further evaluation and confirmation of diagnosis.  Follow-up scheduled in [timeframe] to monitor disease progression and response to therapy. Differential diagnosis includes other interstitial lung diseases such as nonspecific interstitial pneumonia (NSIP) and hypersensitivity pneumonitis.  Further investigation may include a lung biopsy if deemed necessary to confirm the diagnosis and exclude other potential causes of ILD.  ICD-10 code J84.1 (Interstitial pulmonary fibrosis) is assigned.