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v1.0.0
ICD-10 Guide
ICD-10 CodesJ98.1

J98.1

Pulmonary collapse

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

Code Description

ICD-10 J98.1 is a used to indicate a diagnosis of pulmonary collapse.

Key Diagnostic Point:

Pulmonary collapse, also known as atelectasis, refers to the partial or complete collapse of the lung or a section of the lung. This condition can occur due to various factors, including obstruction of the airways, pleural effusion, or external compression. Clinically, patients may present with symptoms such as dyspnea, cough, and chest pain, which can vary in severity depending on the extent of lung involvement. The anatomy involved primarily includes the alveoli and bronchi, where the collapse can prevent adequate gas exchange. Disease progression can lead to complications such as pneumonia or respiratory failure if not addressed promptly. Diagnostic considerations include imaging studies like chest X-rays or CT scans, which can reveal areas of lung collapse, and pulmonary function tests to assess the impact on respiratory function. Early identification and management are crucial to prevent further respiratory complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate; requires imaging and clinical correlation.
  • Treatment complexity: Varies; may involve bronchoscopy or chest tube placement.
  • Documentation requirements: Detailed documentation of symptoms, imaging findings, and treatment plans is necessary.
  • Coding specificity: Requires accurate identification of the cause of collapse for proper coding.

Audit Risk Factors

  • Common coding errors: Misidentification of the cause of collapse.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history and treatment.
  • Billing challenges: Potential denials if the 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

Emergency 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

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Documentation Requirements

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

Pulmonary collapse has significant clinical implications, as it can lead to decreased lung function and increased healthcare utilization due to complications like pneumonia. Understanding the epidemiology of atelectasis is essential, as it can affect various populations, particularly those with underlying lung conditions or post-operative patients. Quality measures may include monitoring rates of atelectasis in hospitalized patients, emphasizing the importance of preventive strategies and early intervention.

ICD-9 vs ICD-10

Pulmonary collapse has significant clinical implications, as it can lead to decreased lung function and increased healthcare utilization due to complications like pneumonia. Understanding the epidemiology of atelectasis is essential, as it can affect various populations, particularly those with underlying lung conditions or post-operative patients. Quality measures may include monitoring rates of atelectasis in hospitalized patients, emphasizing the importance of preventive strategies and early intervention.

Reimbursement & Billing Impact

Reimbursement considerations include the need for imaging studies and potential interventions such as bronchoscopy or chest tube placement. Common denials may arise if the documentation does not clearly support the diagnosis or if the treatment provided is not adequately justified. Coders should ensure that all relevant clinical information is captured to facilitate appropriate reimbursement and minimize the risk of audits.

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 J98.1?

J98.1 covers pulmonary collapse due to various causes, including obstructive atelectasis, compressive atelectasis, and post-surgical atelectasis. Each case should be evaluated based on the underlying etiology.

When should J98.1 be used instead of related codes?

J98.1 should be used when the primary diagnosis is pulmonary collapse, particularly when it is the main reason for the patient's symptoms or when it significantly impacts treatment decisions.

What documentation supports J98.1?

Documentation should include clinical findings, imaging results indicating lung collapse, treatment interventions, and any underlying conditions contributing to the atelectasis.