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ICD-10 Guide
ICD-10 CodesJ84.09

J84.09

Other alveolar and parieto-alveolar conditions

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

Code Description

ICD-10 J84.09 is a billable code used to indicate a diagnosis of other alveolar and parieto-alveolar conditions.

Key Diagnostic Point:

J84.09 refers to 'Other alveolar and parieto-alveolar conditions,' which encompasses a variety of lung diseases that affect the alveoli, the tiny air sacs in the lungs where gas exchange occurs. These conditions can lead to impaired respiratory function and may present with symptoms such as dyspnea, cough, and chest discomfort. Anatomically, the alveoli are critical for oxygen uptake and carbon dioxide elimination, and any pathological changes can significantly impact overall lung function. Disease progression can vary widely, with some conditions being acute and self-limiting, while others may lead to chronic respiratory failure or pulmonary hypertension. Diagnostic considerations for J84.09 include imaging studies such as chest X-rays or CT scans, pulmonary function tests, and sometimes lung biopsies to ascertain the underlying cause of the alveolar condition. Clinicians must carefully evaluate the patient's history and clinical presentation to differentiate between various alveolar pathologies, which may include conditions like pulmonary fibrosis, alveolar proteinosis, or other interstitial lung diseases.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Varies based on the underlying cause of the alveolar condition.
  • Treatment complexity: Treatment may involve multiple specialties, including pulmonology and radiology.
  • Documentation requirements: Requires thorough documentation of clinical findings and diagnostic tests.
  • Coding specificity: Requires precise coding to differentiate from other respiratory conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of the specific alveolar condition.
  • Documentation gaps: Incomplete clinical notes or lack of diagnostic evidence.
  • Billing challenges: Potential for denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Radiology

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

The clinical significance of J84.09 lies in its association with various lung diseases that can lead to significant morbidity and mortality. Understanding these conditions is crucial for improving population health outcomes, as they can affect a wide range of patients, particularly those with pre-existing respiratory issues. Quality measures related to the management of these conditions can help healthcare providers identify at-risk populations and implement effective interventions, ultimately reducing healthcare utilization and improving patient quality of life.

ICD-9 vs ICD-10

The clinical significance of J84.09 lies in its association with various lung diseases that can lead to significant morbidity and mortality. Understanding these conditions is crucial for improving population health outcomes, as they can affect a wide range of patients, particularly those with pre-existing respiratory issues. Quality measures related to the management of these conditions can help healthcare providers identify at-risk populations and implement effective interventions, ultimately reducing healthcare utilization and improving patient quality of life.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, and it is crucial to understand the specific requirements for each insurance provider. Common denials may arise from insufficient documentation or incorrect coding, so adherence to coding best practices is essential for successful claims processing.

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 J84.09?

J84.09 covers a range of conditions affecting the alveoli, including but not limited to pulmonary alveolar proteinosis, alveolar hemorrhage syndromes, and certain forms of interstitial lung disease that do not have a more specific code.

When should J84.09 be used instead of related codes?

J84.09 should be used when the specific alveolar condition does not fall under more defined categories. It is essential to use this code when the clinical presentation suggests an alveolar issue that is not specifically classified elsewhere.

What documentation supports J84.09?

Documentation should include a detailed clinical history, physical examination findings, results from imaging studies, and any laboratory tests that help establish the diagnosis of an alveolar condition.