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ICD-10 Guide
ICD-10 CodesJ67.5

J67.5

Mushroom-worker's lung

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

Code Description

ICD-10 J67.5 is a billable code used to indicate a diagnosis of mushroom-worker's lung.

Key Diagnostic Point:

Mushroom-worker's lung, classified under the category of hypersensitivity pneumonitis, is a respiratory condition resulting from prolonged exposure to organic dust, particularly from mushroom cultivation. Clinically, patients may present with symptoms such as cough, dyspnea, and chest tightness, often exacerbated by continued exposure to the allergen. The condition primarily affects the alveoli and bronchioles, leading to inflammation and potential fibrosis if exposure persists. Disease progression can vary; acute episodes may resolve with avoidance of the allergen, while chronic exposure can lead to irreversible lung damage. Diagnostic considerations include a thorough occupational history, pulmonary function tests, and imaging studies such as chest X-rays or CT scans to assess lung involvement. Serological tests may also be employed to identify specific IgG antibodies against mushroom antigens, aiding in diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires detailed occupational history and specific tests.
  • Treatment complexity: Involves avoidance of allergens and potential corticosteroid therapy.
  • Documentation requirements: Must include detailed patient history and symptomatology.
  • Coding specificity: Specific to occupational exposure, necessitating precise coding.

Audit Risk Factors

  • Common coding errors: Misclassification with other respiratory conditions.
  • Documentation gaps: Incomplete occupational history or lack of symptom detail.
  • 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Mushroom-worker's lung has significant clinical implications, particularly in populations engaged in agricultural work. The condition can lead to chronic respiratory issues, impacting quality of life and work productivity. Understanding the epidemiology of this condition helps in implementing preventive measures in occupational health settings. Quality measures may include monitoring lung function in at-risk populations and ensuring compliance with safety regulations to minimize exposure to harmful allergens.

ICD-9 vs ICD-10

Mushroom-worker's lung has significant clinical implications, particularly in populations engaged in agricultural work. The condition can lead to chronic respiratory issues, impacting quality of life and work productivity. Understanding the epidemiology of this condition helps in implementing preventive measures in occupational health settings. Quality measures may include monitoring lung function in at-risk populations and ensuring compliance with safety regulations to minimize exposure to harmful allergens.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity for thorough documentation to support the diagnosis and treatment plan. Common denials may arise from insufficient evidence linking the condition to occupational exposure, so it is crucial to include detailed notes on the patient's work history and any relevant diagnostic tests performed. Best practices include ensuring that all documentation aligns with the coding guidelines and that the medical necessity for treatments is clearly established.

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 J67.5?

J67.5 specifically covers hypersensitivity pneumonitis due to exposure to mushroom dust, characterized by immune-mediated lung inflammation. It is important to differentiate it from other forms of hypersensitivity pneumonitis caused by different organic dusts.

When should J67.5 be used instead of related codes?

J67.5 should be used when the patient's respiratory condition is directly linked to occupational exposure to mushroom dust, as opposed to other organic dusts or non-occupational causes of lung disease.

What documentation supports J67.5?

Documentation should include a detailed occupational history, evidence of exposure to mushroom dust, clinical symptoms, results from pulmonary function tests, and any imaging studies that support the diagnosis of mushroom-worker's lung.