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v1.0.0
ICD-10 Guide
ICD-10 CodesJ67.3

J67.3

Suberosis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J67.3 is a billable code used to indicate a diagnosis of suberosis.

Key Diagnostic Point:

J67.3 refers to 'Suberosis,' a form of pneumoconiosis caused by the inhalation of suber (cork dust), which is primarily associated with occupational exposure in industries that process cork. Clinically, patients may present with respiratory symptoms such as chronic cough, dyspnea, and wheezing, which can progress to more severe lung conditions if exposure continues. The anatomy involved includes the lungs, particularly the alveoli and bronchi, where inflammation and fibrosis may occur due to the inhaled particles. Disease progression can lead to chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis, significantly impacting lung function. Diagnostic considerations include a thorough occupational history, pulmonary function tests, imaging studies such as chest X-rays or CT scans, and possibly bronchoscopy with biopsy to assess lung tissue. Early diagnosis and intervention are crucial to prevent irreversible lung damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires occupational history and imaging studies.
  • Treatment complexity: Management may involve avoiding exposure and symptomatic treatment.
  • Documentation requirements: Detailed occupational exposure history and symptomatology must be documented.
  • Coding specificity: Specific to suberosis, differentiating from other pneumoconioses.

Audit Risk Factors

  • Common coding errors: Misclassification with other pneumoconioses.
  • Documentation gaps: Lack of detailed occupational history.
  • Billing challenges: Potential denials due to insufficient evidence of occupational exposure.

Specialty Focus

Medical Specialties

Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Occupational Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Suberosis has significant clinical implications, particularly for workers in industries involving cork processing. The condition can lead to chronic respiratory issues, affecting quality of life and productivity. Understanding the epidemiology of suberosis is crucial for population health, as it highlights the need for preventive measures in occupational settings. Monitoring healthcare utilization patterns related to suberosis can inform public health initiatives aimed at reducing exposure and improving worker safety.

ICD-9 vs ICD-10

Suberosis has significant clinical implications, particularly for workers in industries involving cork processing. The condition can lead to chronic respiratory issues, affecting quality of life and productivity. Understanding the epidemiology of suberosis is crucial for population health, as it highlights the need for preventive measures in occupational settings. Monitoring healthcare utilization patterns related to suberosis can inform public health initiatives aimed at reducing exposure and improving worker safety.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that the services provided are medically necessary. Common denials may arise from insufficient documentation of exposure or failure to provide adequate clinical justification for the diagnosis. Best practices include thorough documentation of all relevant clinical findings and maintaining clear communication with payers regarding the occupational nature of the condition.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J67.3?

J67.3 specifically covers suberosis, which is caused by inhalation of cork dust. It is characterized by respiratory symptoms and lung damage due to occupational exposure.

When should J67.3 be used instead of related codes?

J67.3 should be used when there is clear evidence of occupational exposure to cork dust, differentiating it from other pneumoconioses like asbestosis or silicosis.

What documentation supports J67.3?

Documentation should include a detailed occupational history, evidence of exposure to cork dust, clinical symptoms, and results from pulmonary function tests and imaging studies.