J44.9 is a billable diagnosis code used to specify a medical diagnosis of chronic obstructive pulmonary disease, unspecified. The code J44.9 is valid during the fiscal year 2022 from October 01, 2021 through September 30, 2022 for the submission of HIPAA-covered transactions.
The ICD-10-CM code J44.9 might also be used to specify conditions or terms like airways obstruction irreversible, asthma with irreversible airway obstruction, asthma-chronic obstructive pulmonary disease overlap syndrome, asthmatic bronchitis, chronic asthmatic bronchitis , chronic bronchiolitis, etc.
Unspecified diagnosis codes like J44.9 are acceptable when clinical information is unknown or not available about a particular condition. Although a more specific code is preferable, unspecified codes should be used when such codes most accurately reflect what is known about a patient's condition. Specific diagnosis codes should not be used if not supported by the patient's medical record.
The code J44.9 is linked to some Quality Measures as part of Medicare's Quality Payment Program (QPP). When this code is used as part of a patient's medical record the following Quality Measures might apply: Chronic Obstructive Pulmonary Disease (copd): Long-acting Inhaled Bronchodilator Therapy.
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to the code J44.9:
Inclusion TermsInclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- Chronic obstructive airway disease NOS
- Chronic obstructive lung disease NOS
Type 2 ExcludesType 2 Excludes
A type 2 excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
Entries in the Index to Diseases and Injuries with references to J44.9
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for the code J44.9 are found in the index:
- - Asthma, asthmatic (bronchial) (catarrh) (spasmodic) - J45.909
- - Bronchiolitis (acute) (infective) (subacute) - J21.9
- - Bronchitis (diffuse) (fibrinous) (hypostatic) (infective) (membranous) - J40
- - with
- - obstruction (airway) (lung) - J44.9
- - asthmatic - J45.9
- - chronic - J44.9
- - chronic - J42
- - emphysematous (obstructive) - J44.9
- - obliterans (chronic) - J44.9
- - obstructive (chronic) (diffuse) - J44.9
- - with
- - Disease, diseased - See Also: Syndrome;
- - Dyspnea (nocturnal) (paroxysmal) - R06.00
- - Obstruction, obstructed, obstructive
- - Vanishing lung - J44.9
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Airways obstruction irreversible
- Asthma with irreversible airway obstruction
- Asthma-chronic obstructive pulmonary disease overlap syndrome
- Asthmatic bronchitis
- Chronic asthmatic bronchitis
- Chronic bronchiolitis
- Chronic obliterative bronchiolitis
- Chronic obstructive lung disease
- Chronic obstructive pulmonary disease monitoring due
- Emphysematous bronchitis
- End stage chronic obstructive airways disease
- Mild chronic obstructive pulmonary disease
- Moderate chronic obstructive pulmonary disease
- Obliterative bronchiolitis
- Obstruction of bronchus
- Pulmonary hypertension due to chronic obstructive pulmonary disease
- Pulmonary hypertension due to lung disease and/or hypoxia
- Pulmonary hypertension due to pulmonary disease with mixed restrictive and obstructive pattern
- Pulmonary hypertension due to pulmonary disease with mixed restrictive and obstructive patterns
- Severe chronic obstructive pulmonary disease
- Subacute obliterative bronchiolitis
- Tension pneumatocele
- PULMONARY DISEASE CHRONIC OBSTRUCTIVE-. a disease of chronic diffuse irreversible airflow obstruction. subcategories of copd include chronic bronchitis and pulmonary emphysema.
Diagnostic Related Groups - MS-DRG Mapping
|MS-DRG||MS-DRG Title||MCD||Relative Weight|
|190||CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC||04||1.1239|
|191||CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC||04||0.8831|
|192||CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC||04||0.6949|
The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.
Convert J44.9 to ICD-9 Code
The General Equivalency Mapping (GEM) crosswalk indicates an approximate mapping between the ICD-10 code J44.9 its ICD-9 equivalent. The approximate mapping means there is not an exact match between the ICD-10 code and the ICD-9 code and the mapped code is not a precise representation of the original code.
Quality Payment Program Measures
When code J44.9 is part of the patient's diagnoses the following Quality Measures apply and affect reimbursement. The objective of Medicare's Quality Measures is to improve patient care by making it more: effective, safe, efficient, patient-centered and equitable.
|Quality Measure||Description||Quality Domain||Measure Type||High Priority||Submission Methods|
|Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy||Percentage of patients aged 18 years and older with a diagnosis of COPD (FEV1/FVC < 70%) and who have an FEV1 less than 60% predicted and have symptoms who were prescribed a long-acting inhaled bronchodilator.||Effective Clinical Care||Process||NO||Claims, Registry|
Information for Patients
What is COPD (chronic obstructive pulmonary disease)?
COPD (chronic obstructive pulmonary disease) is a group of lung diseases that make it hard to breathe and get worse over time.
Normally, the airways and air sacs in your lungs are elastic or stretchy. When you breathe in, the airways bring air to the air sacs. The air sacs fill up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out. If you have COPD, less air flows in and out of your airways because of one or more problems:
- The airways and air sacs in your lungs become less elastic
- The walls between many of the air sacs are destroyed
- The walls of the airways become thick and inflamed
- The airways make more mucus than usual and can become clogged
What are the types of COPD (chronic obstructive pulmonary disease)?
COPD includes two main types:
- Emphysema affects the air sacs in your lungs, as well as the walls between them. They become damaged and are less elastic.
- Chronic bronchitis, in which the lining of your airways is constantly irritated and inflamed. This causes the lining to swell and make mucus.
Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.
What causes COPD (chronic obstructive pulmonary disease)?
The cause of COPD is usually long-term exposure to irritants that damage your lungs and airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause COPD, especially if you inhale them.
Exposure to other inhaled irritants can contribute to COPD. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.
Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing COPD.
Who is at risk for COPD (chronic obstructive pulmonary disease)?
The risk factors for COPD include
- Smoking. This the main risk factor. Up to 75% of people who have COPD smoke or used to smoke.
- Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace
- Age. Most people who have COPD are at least 40 years old when their symptoms begin.
- Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get COPD are more likely to get it if they have a family history of COPD.
- Asthma. People who have asthma have more risk of developing COPD than people who don’t have asthma. But most people with asthma will not get COPD.
What are the symptoms of COPD (chronic obstructive pulmonary disease)?
At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include
- Frequent coughing or a cough that produces a lot mucus
- A whistling or squeaky sound when you breathe
- Shortness of breath, especially with physical activity
- Tightness in your chest
Some people with COPD get frequent respiratory infections such as colds and the flu. In severe cases, COPD can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.
How is COPD (chronic obstructive pulmonary disease) diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- A family history
- Various tests, such as lung function tests, a chest x-ray or CT scan, and blood tests
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.
What are the treatments for COPD (chronic obstructive pulmonary disease)?
There is no cure for COPD. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include
- Lifestyle changes, such as
- Quitting smoking if you are a smoker. This is the most important step you can take to treat COPD.
- Avoiding secondhand smoke and places where you might breathe in other lung irritants
- Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
- Medicines, such as
- Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
- Vaccines for the flu and pneumococcal pneumonia, since people with COPD are at higher risk for serious problems from these diseases
- Antibiotics if you get a bacterial or viral lung infection
- Oxygen therapy, if you have severe COPD and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
- Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
- An exercise program
- Disease management training
- Nutritional counseling
- Psychological counseling
- Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines:
- For COPD that is mainly related to emphysema, there are surgeries that
- Remove damaged lung tissue
- Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
- For severe COPD, some people may need lung transplant
- For COPD that is mainly related to emphysema, there are surgeries that
If you have COPD, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.
Can COPD (chronic obstructive pulmonary disease) be prevented?
Since smoking causes most cases of COPD, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.
NIH: National Heart, Lung, and Blood Institute
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