ICD-10 Coding for Bronchopneumonia(J18.0, J13)
Complete ICD-10-CM coding and documentation guide for Bronchopneumonia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bronchopneumonia
J12-J18Primary Range
Pneumonia due to various organisms
This range includes codes for different types of pneumonia, including bronchopneumonia, based on the causative organism.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J18.0 | Bronchopneumonia, unspecified organism | Use when bronchopneumonia is confirmed but the organism is unidentified. |
|
| J13 | Pneumonia due to Streptococcus pneumoniae | Use when Streptococcus pneumoniae is identified as the causative organism. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for bronchopneumonia
Essential facts and insights about Bronchopneumonia
Primary ICD-10-CM Codes for bronchopneumonia
Decision Criteria
clinical Criteria
- Presence of patchy infiltrates on CXR and clinical symptoms of pneumonia.
Applicable To
- Bronchopneumonia NOS
Excludes
- Pneumonia due to specified organisms (J12-J16)
Clinical Validation Requirements
- Fever, productive cough, and CXR showing patchy bilateral infiltrates
- Absence of identified organism in cultures
Code-Specific Risks
- Risk of under-coding if organism is identified but not documented.
Coding Notes
- Ensure documentation specifies 'bronchopneumonia' to avoid defaulting to J18.9.
J13 - Pneumonia due to Streptococcus pneumoniae
Use when Streptococcus pneumoniae is identified as the causative organism.
Applicable To
- Pneumonia due to pneumococcus
Excludes
- Pneumonia due to other specified bacteria (J14-J16)
Clinical Validation Requirements
- Positive sputum culture for Streptococcus pneumoniae
- Gram-positive cocci in clusters on sputum stain
Coding Notes
Document the organism and confirmatory test results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute respiratory failure
J96.0-Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Bronchopneumonia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J18.0.
Impact
Clinical: May lead to inappropriate treatment choices., Regulatory: Non-compliance with coding standards., Financial: Potential loss in reimbursement due to lower DRG.
Mitigation Strategy
Educate clinicians on documentation requirements., Implement checklists for pneumonia documentation.
Impact
Reimbursement: May result in lower DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation specifies 'bronchopneumonia' to use J18.0.
Impact
Failure to document identified organisms can lead to audit discrepancies.
Mitigation Strategy
Implement mandatory fields in EHR for organism documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Bronchopneumonia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bronchopneumonia
Use these documentation templates to ensure complete and accurate documentation for Bronchopneumonia. These templates include all required elements for proper coding and billing.
Bronchopneumonia with unspecified organism
Specialty: PulmonologyRequired Elements
- Patient demographics
- Clinical symptoms
- Radiographic findings
- Microbiological test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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