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Home/Diagnosis/ICD-10 Coding for Pleural Effusion

ICD-10 Coding for Pleural Effusion

J91.8
J90
J91.0

Complete ICD-10-CM coding and documentation guide for icd-10 coding for pleural effusion includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
Fluid in the chest
Pleural fluid accumulation
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Key Information: ICD-10 Coding for Pleural Effusion

Essential facts and insights about ICD-10 Coding for Pleural Effusion

Use ICD-10 code J91.8 for pleural effusion in conditions classified elsewhere, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

Pleural effusion in conditions classified elsewhere

Billable Code
J91.8
Billable

Diagnostic Criteria

clinical:
  • • Thoracentesis or specific imaging ordered
documentation:
  • • Effusion attributed to a specific condition

Applicable To

  • • Pleural effusion due to CHF
  • • Pleural effusion post-CABG

Important Notes

  • • Ensure documentation specifies the relationship between the effusion and the underlying condition.

Pleural effusion, not elsewhere classified

Billable Code
J90
Billable

Diagnostic Criteria

clinical:
  • • No identifiable etiology after workup

Applicable To

  • • Idiopathic pleural effusion

Important Notes

  • • Ensure no underlying cause is documented before using this code.

Malignant pleural effusion

Billable Code
J91.0
Billable

Diagnostic Criteria

clinical:
  • • Cytology-confirmed malignancy in pleural fluid

Applicable To

  • • Pleural effusion due to malignancy

Important Notes

  • • Ensure cytology reports are linked to the encounter.
Ancillary Codes

Additional codes that may be used with this diagnosis

I50.9

Heart failure, unspecified

Use alongside J91.8 when pleural effusion is due to CHF.

C34.90

Malignant neoplasm of unspecified part of bronchus or lung

Use alongside J91.0 when the primary site is lung.

Frequently Asked Questions

When is pleural effusion coded with CHF?

Pleural effusion is coded with CHF when there is documented intervention such as thoracentesis or specific imaging ordered to assess the effusion.

How to document malignant pleural effusions?

Document malignant pleural effusions by confirming malignant cells in pleural fluid and linking cytology reports to the encounter.

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