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FAQ:Pneumonia and Lack of Organisms

Published on 

Tuesday, November 6, 2018

 | RAC Information 
 | FAQ 

Q:

Do you code Pneumonia, nos (J18.9) when a physician documents “Right Upper Lobe Pneumonia” and no causal organism is identified?




A:

No.  Effective with discharges September 24, 2018, Right Upper Lobe Pneumonia is coded to Lobar Pneumonia, unspecified organism (J18.1).  If the physician documents that Pneumonia is specified in one  or more lobes, code to Lobar Pneumonia or Multi-lobar Pneumonia, depending on how many lobes are affected.  Remember, the right-side has three lobes and the left-side has two lobes. By coding Lobar Pneumonia, we are coding the specific site of the Pneumonia instead of the type of Pneumonia.  Of course, if an organism is identified as causing the Pneumonia, code to the type of Pneumonia instead.  Please refer to the Coding Clinic listed below for the full update.  

Resource:  Coding Clinic for ICD-10-CM/PCS, Third Quarter 2018:  Page 24 

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This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.