Pleurisy
ICD-10 R09.1 is a billable code used to indicate a diagnosis of pleurisy.
Pleurisy, also known as pleuritis, is an inflammatory condition affecting the pleura, the double-layered membrane surrounding the lungs. Patients typically present with sharp chest pain that worsens with breathing, coughing, or sneezing, often described as a stabbing sensation. Other symptoms may include shortness of breath, a dry cough, and pleuritic rub heard upon auscultation. The inflammation can be caused by various factors, including viral infections, bacterial infections, autoimmune diseases, or exposure to certain chemicals. Diagnostic approaches often involve imaging studies such as chest X-rays or CT scans to assess for pleural effusion or other underlying conditions. Laboratory tests may include blood tests to identify infection or inflammation markers. Accurate diagnosis is crucial as pleurisy can be a symptom of more serious conditions such as pneumonia or pulmonary embolism.
Detailed history of present illness, including onset, duration, and character of symptoms, as well as any relevant past medical history.
Patients presenting with chest pain and respiratory symptoms, often requiring differential diagnosis from pneumonia or pulmonary embolism.
Ensure documentation reflects the clinical rationale for pleurisy diagnosis and any associated conditions.
Acute care documentation must include vital signs, initial assessment findings, and any immediate interventions performed.
Patients with acute chest pain presenting to the emergency department, requiring rapid assessment and potential imaging.
Consider the need for immediate diagnostic imaging and the urgency of treatment in acute presentations.
Used when imaging is required to assess for pleurisy or related conditions.
Document the reason for the chest X-ray and findings.
Ensure that the imaging is justified based on clinical presentation.
Common causes of pleurisy include viral infections, bacterial infections, autoimmune diseases, and exposure to irritants. It can also occur following trauma or surgery.
Diagnosis typically involves a thorough clinical history, physical examination, imaging studies such as chest X-rays or CT scans, and laboratory tests to identify any underlying infections or inflammatory processes.
