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v1.0.0
ICD-10 Guide
ICD-10 CodesJ92

J92

Pleural plaque

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

Code Description

ICD-10 J92 is a used to indicate a diagnosis of pleural plaque.

Key Diagnostic Point:

Pleural plaques are localized fibrous thickenings of the pleura, typically associated with asbestos exposure. Clinically, patients may be asymptomatic, but some may experience respiratory symptoms such as cough or dyspnea. The anatomy involved includes the pleura, which is the double-layered membrane surrounding the lungs. Disease progression is generally slow, and while pleural plaques themselves are not malignant, they can indicate an increased risk for other asbestos-related diseases, including lung cancer and mesothelioma. Diagnosis is often made through imaging studies such as chest X-rays or CT scans, which reveal characteristic calcified plaques on the pleura. A thorough occupational history is essential, as exposure to asbestos is the primary risk factor for developing pleural plaques. Differential diagnoses may include other pleural diseases, such as pleural effusion or mesothelioma, necessitating careful evaluation and imaging to confirm the presence of plaques.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and occupational history
  • Treatment complexity: Generally involves monitoring rather than active treatment
  • Documentation requirements: Detailed history of asbestos exposure and imaging results
  • Coding specificity: Requires precise coding to differentiate from other pleural conditions

Audit Risk Factors

  • Common coding errors: Misclassification with other pleural diseases
  • Documentation gaps: Lack of detailed occupational history or imaging reports
  • Billing challenges: Potential denials if documentation does not clearly 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

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 Codes

Child Codes

2 codes
J92.0
Pleural plaque with presence of asbestos
J92.9
Pleural plaque without asbestos

Related CPT Codes

CPT Code

Clinical Scenario

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

Pleural plaques are significant as they indicate past asbestos exposure, which can lead to serious health issues such as lung cancer and mesothelioma. Understanding the prevalence of pleural plaques in populations exposed to asbestos is crucial for public health initiatives. Monitoring and managing patients with pleural plaques can help reduce healthcare utilization and improve outcomes by facilitating early detection of potential malignancies.

ICD-9 vs ICD-10

Pleural plaques are significant as they indicate past asbestos exposure, which can lead to serious health issues such as lung cancer and mesothelioma. Understanding the prevalence of pleural plaques in populations exposed to asbestos is crucial for public health initiatives. Monitoring and managing patients with pleural plaques can help reduce healthcare utilization and improve outcomes by facilitating early detection of potential malignancies.

Reimbursement & Billing Impact

Reimbursement may be affected by the clarity of the documentation supporting the diagnosis. Common denials can occur if the medical necessity is not clearly established, particularly if the documentation does not explicitly connect the diagnosis to the patient's occupational history. Best practices include ensuring that all imaging studies are properly coded and that any related respiratory symptoms are documented to support the diagnosis.

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 J92?

J92 specifically covers pleural plaques resulting from asbestos exposure. It does not include other pleural diseases such as pleural effusions or malignancies.

When should J92 be used instead of related codes?

J92 should be used when there is a confirmed diagnosis of pleural plaques, particularly in patients with a history of asbestos exposure. It is distinct from codes for pleural effusion or other pleural abnormalities.

What documentation supports J92?

Documentation should include a detailed occupational history indicating asbestos exposure, imaging studies showing pleural plaques, and any relevant respiratory symptoms or findings.