The Top Pulmonology ICD-10 Codes You Need to Know For Accurate Billing

Providers across the U.S. are seeing an increasing number of cases related to pulmonary diseases, affecting the lungs and respiratory tract at alarming rates. Whether it’s chronic conditions like COPD or the more acute issues such as pulmonary fibrosis, the demand for accurate diagnosis and coding has never been greater. 

As a pulmonologist, you know that precision is everything. One wrong digit or an ambiguous diagnosis can lead to claim rejections, delayed reimbursements, or even worse—unpaid bills. 

In this guide, we’ll walk you through the top Pulmonology ICD-10 codes you absolutely need to know for accurate billing.

Billable ICD 10 Codes for Pulmonology 

you don’t have to memorize a mountain of codes to get it right. Instead, we’ve broken down the top pulmonology ICD-10 codes into easy-to-follow categories that will not only help you avoid costly billing mistakes but also speed up your claims process.

Whether you’re dealing with lung diseases, respiratory infections, or pulmonary conditions, we’ve got you covered. Let’s uncover these essential codes, organized by category.

1. Lung Disease and Respiratory Disorders

ICD-10 Code for Diseases of the Bronchus, Not Elsewhere Classified

J98.0 – Diseases of bronchus, not elsewhere classified
This code is used for bronchial diseases that don’t fall under the more specific categories like bronchitis or bronchiectasis. It could cover conditions that affect the bronchi but don’t fit neatly into other classifications, such as bronchial tumors, bronchial cysts, or other non-specific bronchial issues that need further clarification or haven’t been fully diagnosed.

ICD-10 Code for Pulmonary Collapse

J98.1 – Pulmonary collapse
This code describes a condition where part of the lung collapses—either completely or partially. Pulmonary collapse can be caused by a variety of factors, including trauma, tumors, or obstructed airways. This is a serious condition that can compromise oxygen exchange and requires immediate medical intervention.

ICD-10 Code for Interstitial Emphysema

J98.2 – Interstitial emphysema
Interstitial emphysema refers to the abnormal accumulation of air within the lung's interstitial spaces, which are located between the lung tissue and the pleura (lining around the lungs). This condition can result from trauma, mechanical ventilation, or certain diseases like chronic obstructive pulmonary disease (COPD). It can severely affect lung function if left untreated.

ICD-10 Code for Compensatory Emphysema

J98.3 – Compensatory emphysema
Compensatory emphysema occurs when one part of the lung becomes overinflated to compensate for reduced lung function elsewhere, often due to lung disease or a surgical removal of part of the lung. This condition is a form of adaptive response in the lungs, but it can lead to long-term breathing difficulties and the need for specialized care.

ICD-10 Code for Other Disorders of the Lung

J98.4 – Other disorders of lung
This is a broad category for lung diseases that do not fall under a more specific diagnosis. It could include conditions like pleural effusion (fluid in the lungs), atelectasis (collapsed lung tissue), or pulmonary sequestration (an abnormal mass of lung tissue that does not connect to the normal lung). It’s a catch-all for miscellaneous lung disorders requiring further investigation.

ICD-10 Code for Diseases of the Mediastinum, Not Elsewhere Classified

J98.5 – Diseases of mediastinum, not elsewhere classified
The mediastinum is the central compartment of the chest, located between the lungs, and it contains vital structures like the heart, trachea, and esophagus. This code is used when a disease or condition affecting the mediastinum cannot be classified into other categories. It may involve conditions such as mediastinal tumors or mediastinal fibrosis.

ICD-10 Code for Disorders of the Diaphragm

J98.6 – Disorders of diaphragm
The diaphragm is the muscle that separates the chest cavity from the abdominal cavity and is essential for breathing. Disorders of the diaphragm, such as paralysis or hernias, can lead to difficulty breathing or even respiratory failure in severe cases. This code captures those diaphragm-related conditions that don’t fit other diagnostic categories.

ICD-10 Code for Other Specified Respiratory Disorders

J98.8 – Other specified respiratory disorders
This code is used when a respiratory disorder is diagnosed but cannot be classified under any specific category. It can cover a wide variety of lung and airway conditions, such as pleural effusion, bronchopulmonary dysplasia, or other lung pathologies that are not as common or have yet to be fully described in existing ICD-10 classifications.

ICD-10 Code for Respiratory Disorder, Unspecified

J98.9 – Respiratory disorder, unspecified
As the catch-all code for respiratory conditions, this code is used when a specific diagnosis cannot be made at the time of billing. It can include cases where the patient is experiencing respiratory symptoms but further diagnostic tests are required, or the condition has not yet been fully identified.

2. Pulmonary Fibrosis

Pulmonary fibrosis refers to the scarring of lung tissue, which can arise from a variety of causes, such as autoimmune diseases, environmental exposures, or idiopathic causes (without known origin). This condition often requires more detailed coding based on the type.

• ICD-10 Code for Pulmonary Fibrosis (Unspecified):

  • J84.10 – Pulmonary fibrosis, unspecified

    • Use this code when pulmonary fibrosis is diagnosed, but the exact type or cause remains unclear.

• ICD-10 Codes for Specific Pulmonary Fibrosis Types:

  • J84.11 – Idiopathic pulmonary fibrosis (IPF)

    • For cases where no specific cause can be identified, but the fibrosis is considered idiopathic.

  • J84.17 – Other interstitial pulmonary diseases, including idiopathic interstitial pneumonia

    • This covers pulmonary fibrosis linked to interstitial lung diseases or specific interstitial pneumonia types.

3. Parainfluenza (Respiratory Infections)

The codes can range from general upper respiratory infections to pneumonia directly caused by the parainfluenza virus.

ICD-10 Code for Parainfluenza Infection (General Upper Respiratory Infection)

J06.9 – Acute upper respiratory infection, unspecified

This general code is used when a parainfluenza infection causes an upper respiratory infection (URI), but the specific virus (like parainfluenza) is not identified or confirmed in the diagnosis. It's a catch-all for viral URIs where the exact pathogen is unclear or unspecified.

Use this code when there’s a general URI diagnosis without confirmation that parainfluenza is the exact viral agent.

ICD-10 Code for Parainfluenza Virus as a Cause of Disease (Non-Pneumonia)

B97.4 – Parainfluenza virus as the cause of diseases classified elsewhere

This code is used when parainfluenza is identified as the causative agent for another respiratory condition. For example, it can be used for bronchitis, croup, or other respiratory diseases caused by parainfluenza. It doesn’t specify a disease like pneumonia; it simply links the virus to a respiratory illness that’s categorized elsewhere.

Use this code when the virus is the identified cause of a disease that doesn’t specifically fall under the category of pneumonia or upper respiratory infection.

ICD-10 Code for Parainfluenza Virus Pneumonia (Specific Disease Diagnosis)

J12.2 – Parainfluenza virus pneumonia

J12.2 is the most specific code used when parainfluenza is confirmed to be the cause of pneumonia. It identifies both the causative agent (parainfluenza virus) and the disease (pneumonia), which helps eliminate ambiguity. This code is ideal for cases where the patient has parainfluenza viral pneumonia—a diagnosis directly linked to the virus.

Use this code when a confirmed diagnosis of pneumonia caused by parainfluenza is made. This is a more accurate and specific diagnosis compared to the other codes mentioned.

Shortness of Breath (Dyspnea)

Shortness of breath, or dyspnea, is one of the most common symptoms encountered in clinical practice, particularly in respiratory conditions such as COPD, asthma, heart failure, and even anxiety disorders

ICD-10 Codes for Dyspnea

R06.00 – Dyspnea, unspecified

This code is used when shortness of breath is reported, but the underlying cause has not yet been identified or clarified. It’s a catch-all code for dyspnea when further diagnostic work is needed to determine if the symptom is due to respiratory conditions, cardiac issues, or anxiety.

Use this code when the cause of shortness of breath is unclear or if the physician has not yet pinpointed the specific diagnosis.

Additional Codes for Specific Types of Dyspnea

R06.01 – Orthopnea

Orthopnea refers to shortness of breath that occurs when a patient is lying flat, often relieved when the patient sits or stands. This condition is commonly associated with heart failure and other cardiac or respiratory disorders.

Use this code when a patient specifically reports dyspnea while lying down, often in the context of left-sided heart failure or severe chronic obstructive pulmonary disease (COPD).

R06.02 – Shortness of breath

This code is used when a patient reports shortness of breath as a general symptom, but no further clarification is given as to whether it’s related to acute or chronic conditions. It's used for situations where the patient is having difficulty breathing but without specific detail on the type of dyspnea.

Use this code when the general complaint of dyspnea is noted, but further information is needed to differentiate between chronic and acute symptoms.

R06.03 – Acute respiratory distress

This code applies when a patient experiences acute respiratory distress, which is often associated with more severe conditions like pneumonia, pulmonary embolism, asthma attacks, or acute heart failure. Acute respiratory distress requires immediate medical attention, and this code helps to specify the severity of the patient's symptoms.

Use this code when a patient is experiencing severe shortness of breath that is sudden and potentially life-threatening.

R06.09 – Other forms of dyspnea

This code is used when the type of dyspnea is not covered by the above codes but still requires documentation. This can include persistent or episodic shortness of breath that does not neatly fit into categories like orthopnea, acute respiratory distress, or unspecified dyspnea.

Use this code when a patient presents with atypical or non-specific forms of dyspnea, and further investigation is necessary to determine the exact cause.

Hypoxemia (Low Oxygen Levels)

Hypoxemia is a condition where there is insufficient oxygen in the blood, often seen in patients with chronic lung diseases such as COPD or asthma. Properly coding hypoxemia is critical for accurate reimbursement.

ICD-10 Code for Hypoxemia

R09.02 – Hypoxemia

This is the primary code used to indicate low oxygen levels in the blood, regardless of the underlying cause, such as respiratory failure, lung diseases, or circulatory issues.

Lung Mass / Pulmonary Nodules

Lung masses and pulmonary nodules are often discovered incidentally and require specific coding to ensure proper billing. Differentiating between benign and malignant nodules can impact treatment decisions.

ICD-10 Code for Lung Mass (Unspecified):

R91.8 – Other nonspecific abnormal finding of lung

When a mass or abnormality is identified in the lungs but is not further specified, this is the appropriate code to use.

ICD-10 Code for Solitary Pulmonary Nodule:

R91.1 – Solitary pulmonary nodule

This code is used when a single abnormal mass is found in the lung, which may require further evaluation to rule out malignancy.

Pulmonary Hypertension

Pulmonary hypertension refers to high blood pressure in the pulmonary arteries, often secondary to heart or lung disease. Proper coding for this condition is important for accurate diagnosis and treatment.

ICD-10 Code for Primary Pulmonary Hypertension:

I27.0 – Primary pulmonary hypertension

This code is used when pulmonary hypertension arises without a clear underlying cause.

Pulmonary Edema

Pulmonary edema is characterized by fluid buildup in the lungs, often due to heart failure, and it requires careful differentiation between its acute or chronic forms.

ICD-10 Code for Acute Pulmonary Edema

J81.0 – Acute pulmonary edema

Use this code for cases of sudden fluid accumulation in the lungs, often presenting with severe shortness of breath and requiring immediate intervention. You will report J81.0 as ICD 10  for Pulmonary congestion 

Rhinovirus (Common Cold)

Rhinovirus is a leading cause of the common cold, causing congestion, coughing, and sneezing. Coding this condition properly ensures that upper respiratory infections are billed accurately.

ICD-10 Code for Rhinovirus Infection (Common Cold):

J00 – Acute nasopharyngitis (common cold), unspecified

This code is used when rhinovirus or another virus causes a typical cold with congestion and sore throat symptoms.

Wheezing

Wheezing is a common symptom of asthma and bronchitis, marked by a high-pitched whistling sound during breathing. Proper coding helps to differentiate between different causes of wheezing.

ICD-10 Code for Wheezing

R06.2 – Wheezing

This code is used to describe any condition causing wheezing, regardless of the underlying diagnosis.

Cough

Coughing can be caused by infections, allergies, or chronic conditions like asthma and COPD. Proper coding helps determine the underlying cause and treatment options.

ICD-10 Code for Cough

R05 – Cough

This is the general code for any cough, whether acute or chronic, when the specific cause is unknown or not diagnosed.

ICD-10 Code for Persistent Cough:

R05.1 – Acute persistent cough

This code is for coughs that last for an extended period but don’t meet the criteria for other specific diagnostic codes.

Final Words

By familiarizing yourself with the key ICD-10 codes we’ve outlined, you can avoid the costly errors that often arise from ambiguous diagnoses and improve the overall efficiency of your billing process. Whether it's parainfluenza, hypoxemia, or wheezing,or any type of pulmonology disease each code plays an important role in guiding treatment and ensuring you’re properly compensated for your care.

For healthcare providers looking to streamline their billing, consider partnering with HMS. Their specialized pulmonology medical billing services ensure accuracy, reduce claim rejections, and optimize your revenue cycle.