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v1.0.0
ICD-10 Guide
ICD-10 CodesJ92.0

J92.0

Pleural plaque with presence of asbestos

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

Code Description

ICD-10 J92.0 is a billable code used to indicate a diagnosis of pleural plaque with presence of asbestos.

Key Diagnostic Point:

Pleural plaques are localized areas of fibrous thickening on the pleura, commonly associated with asbestos exposure. Clinically, patients may remain asymptomatic for years, but some may experience respiratory symptoms such as cough or dyspnea. The pleura, a double-layered membrane surrounding the lungs, can develop these plaques due to the inflammatory response triggered by asbestos fibers. Disease progression is generally slow, and while pleural plaques themselves are not malignant, they are indicative of asbestos exposure and may signal an increased risk for other asbestos-related diseases, including asbestosis and lung cancer. Diagnosis typically involves imaging studies such as chest X-rays or CT scans, which can reveal characteristic calcified plaques. A thorough occupational history is essential to establish a link between asbestos exposure and the development of pleural plaques. Differential diagnosis may include other pleural diseases, necessitating careful evaluation to confirm the presence of asbestos-related changes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and occupational history
  • Treatment complexity: Generally involves monitoring; no specific treatment for plaques
  • Documentation requirements: Detailed occupational exposure history and imaging results needed
  • Coding specificity: Specific to pleural plaques due to asbestos exposure

Audit Risk Factors

  • Common coding errors: Misidentifying pleural plaques as malignant conditions
  • Documentation gaps: Lack of detailed occupational history or imaging reports
  • Billing challenges: Potential denials if documentation does not clearly establish asbestos exposure

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 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 J92.0 lies in its association with asbestos exposure, which poses a risk for serious respiratory diseases. Understanding the prevalence of pleural plaques can inform public health initiatives aimed at reducing asbestos exposure in occupational settings. Monitoring patients with pleural plaques is crucial for early detection of potential complications, contributing to improved healthcare utilization and outcomes in affected populations.

ICD-9 vs ICD-10

The clinical significance of J92.0 lies in its association with asbestos exposure, which poses a risk for serious respiratory diseases. Understanding the prevalence of pleural plaques can inform public health initiatives aimed at reducing asbestos exposure in occupational settings. Monitoring patients with pleural plaques is crucial for early detection of potential complications, contributing to improved healthcare utilization and outcomes in affected populations.

Reimbursement & Billing Impact

Reimbursement may be affected by the completeness of the occupational history and imaging results. Common denials may arise from insufficient documentation linking the diagnosis to asbestos exposure. Best practices include ensuring that all relevant clinical notes, imaging reports, and occupational histories are included in the patient’s medical record to support the coding and billing process.

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 J92.0?

J92.0 specifically covers pleural plaques resulting from asbestos exposure. It does not include other pleural diseases or conditions not related to asbestos.

When should J92.0 be used instead of related codes?

J92.0 should be used when there is confirmed presence of pleural plaques due to asbestos exposure. If there are additional complications such as pleural effusion, J92.1 may be more appropriate.

What documentation supports J92.0?

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