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ICD-10 Guide
ICD-10 CodesJ84.112

J84.112

Idiopathic pulmonary fibrosis

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

Code Description

ICD-10 J84.112 is a billable code used to indicate a diagnosis of idiopathic pulmonary fibrosis.

Key Diagnostic Point:

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease characterized by the accumulation of scar tissue (fibrosis) in the lungs, leading to a decline in lung function. The etiology of IPF remains unknown, hence the term 'idiopathic.' Clinically, patients typically present with symptoms such as persistent dry cough, dyspnea (shortness of breath), and fatigue. The disease primarily affects the interstitial lung tissue, which is crucial for gas exchange. As the fibrosis progresses, the lungs become increasingly stiff, making it difficult for patients to breathe and leading to respiratory failure. Diagnostic considerations include high-resolution computed tomography (HRCT) scans, which reveal characteristic patterns of lung fibrosis, and pulmonary function tests that demonstrate restrictive lung disease. A multidisciplinary approach is often required for diagnosis, including ruling out other interstitial lung diseases and conducting a thorough clinical evaluation. Early diagnosis and management are crucial as IPF has a poor prognosis, with a median survival of 3-5 years post-diagnosis.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires exclusion of other interstitial lung diseases and often involves advanced imaging and lung biopsies.
  • Treatment complexity: Management includes antifibrotic therapies, oxygen supplementation, and potential lung transplantation.
  • Documentation requirements: Detailed clinical history, imaging results, and functional assessments must be documented.
  • Coding specificity: Accurate coding requires precise identification of idiopathic pulmonary fibrosis versus other lung conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of IPF with other lung diseases.
  • Documentation gaps: Incomplete clinical history or lack of imaging results.
  • Billing challenges: Denials may occur if documentation does not support the severity or specificity of the condition.

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

Internal 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

Idiopathic pulmonary fibrosis significantly impacts patient quality of life and healthcare utilization, as it often leads to frequent hospitalizations and a need for specialized care. The disease is associated with high morbidity and mortality rates, affecting a substantial portion of the population, particularly older adults. Understanding the epidemiology of IPF can help healthcare providers implement effective management strategies and improve patient outcomes through early diagnosis and intervention.

ICD-9 vs ICD-10

Idiopathic pulmonary fibrosis significantly impacts patient quality of life and healthcare utilization, as it often leads to frequent hospitalizations and a need for specialized care. The disease is associated with high morbidity and mortality rates, affecting a substantial portion of the population, particularly older adults. Understanding the epidemiology of IPF can help healthcare providers implement effective management strategies and improve patient outcomes through early diagnosis and intervention.

Reimbursement & Billing Impact

Reimbursement considerations include the use of appropriate CPT codes for diagnostic tests and treatments. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for services rendered. Coders should ensure that all relevant clinical information is included in the patient’s medical record to support the diagnosis and any associated procedures. Best practices include regular audits of coding accuracy and ensuring that documentation aligns with coding guidelines.

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 J84.112?

J84.112 specifically covers idiopathic pulmonary fibrosis, which is characterized by progressive lung scarring without a known cause. It is distinct from other interstitial lung diseases that may have identifiable causes.

When should J84.112 be used instead of related codes?

J84.112 should be used when the diagnosis of idiopathic pulmonary fibrosis is confirmed, particularly when other causes of interstitial lung disease have been ruled out through clinical evaluation and imaging.

What documentation supports J84.112?

Documentation should include a comprehensive clinical history, results from high-resolution CT scans showing typical patterns of fibrosis, pulmonary function test results indicating restrictive lung disease, and any relevant laboratory tests to exclude other conditions.