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ICD-10 Guide
ICD-10 CodesJ84.01

J84.01

Alveolar proteinosis

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

Code Description

ICD-10 J84.01 is a billable code used to indicate a diagnosis of alveolar proteinosis.

Key Diagnostic Point:

Alveolar proteinosis is a rare lung disease characterized by the accumulation of surfactant proteins and lipids within the alveoli, leading to impaired gas exchange and respiratory distress. Clinically, patients may present with symptoms such as progressive dyspnea, cough, and fatigue. The disease primarily affects the lungs, where the alveoli, the tiny air sacs responsible for gas exchange, become filled with a proteinaceous material. This accumulation can result from various causes, including autoimmune disorders, exposure to certain environmental factors, or may be idiopathic in nature. Disease progression can vary, with some patients experiencing acute exacerbations while others may have a more chronic course. Diagnosis typically involves imaging studies such as chest CT scans, which reveal characteristic ground-glass opacities, and bronchoalveolar lavage, where the presence of excess surfactant can be confirmed. Early recognition and management are crucial to prevent complications such as respiratory failure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires specialized imaging and laboratory tests for confirmation.
  • Treatment complexity: Management may involve therapies such as whole lung lavage or immunosuppressive agents.
  • Documentation requirements: Detailed clinical history and diagnostic findings are essential for accurate coding.
  • Coding specificity: Requires precise documentation to differentiate from other interstitial lung diseases.

Audit Risk Factors

  • Common coding errors: Misclassification with other lung diseases.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

Pathology

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

Alveolar proteinosis, while rare, has significant clinical implications for affected individuals, often leading to decreased quality of life and increased healthcare utilization due to frequent hospitalizations. Understanding this condition is crucial for improving population health outcomes, as timely diagnosis and appropriate management can reduce morbidity associated with respiratory failure. Epidemiologically, the condition may be underreported, highlighting the need for increased awareness among healthcare providers.

ICD-9 vs ICD-10

Alveolar proteinosis, while rare, has significant clinical implications for affected individuals, often leading to decreased quality of life and increased healthcare utilization due to frequent hospitalizations. Understanding this condition is crucial for improving population health outcomes, as timely diagnosis and appropriate management can reduce morbidity associated with respiratory failure. Epidemiologically, the condition may be underreported, highlighting the need for increased awareness among healthcare providers.

Reimbursement & Billing Impact

reimbursement challenges include denials due to insufficient documentation or misclassification of the condition. It is essential to use the correct CPT codes for any procedures performed, such as bronchoscopy or lung lavage, to ensure appropriate reimbursement. Regular audits of coding practices can help identify and rectify common billing issues.

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 J84.01?

J84.01 specifically covers idiopathic pulmonary alveolar proteinosis, which is characterized by the accumulation of surfactant in the alveoli. It does not include secondary forms of alveolar proteinosis caused by other underlying conditions.

When should J84.01 be used instead of related codes?

J84.01 should be used when the diagnosis of idiopathic pulmonary alveolar proteinosis is confirmed through clinical evaluation and diagnostic imaging. It should not be used for secondary forms of alveolar proteinosis, which may require different coding.

What documentation supports J84.01?

Documentation for J84.01 should include clinical findings, imaging results showing characteristic patterns, and results from bronchoalveolar lavage that confirm the diagnosis of alveolar proteinosis.