Know the Pneumonia Diagnosis Difference

Do you know the difference between 'lobar pneumonia' and 'lobular pneumonia'? When there's no further clarification from the physician, is code 481 (Pneumococcal pneumonia [Streptococcus pneumoniae pneumonia]), which includes lobar pneumonia, organism unspecified, the right code assignment for both "lobar pneumonia" and "multilobar pneumonia?" When should you report 481 versus 485?

A patient with lobar pneumonia has pneumonia that impacts a large and continuous area of the lobe of a lung. A patient who's diagnosed with lobular pneumonia, or bronchopneumonia, has an acute inflammation of the walls of his bronchioles, affecting many small areas of his lung tissue rather than the large area affected by lobar pneumonia.

One more distinction between 481 and 485 is the cause. Code 481 is for pneumonia in which the causative agent happens to be pneumococci. Compared to this, code 485, "Bronchopneumonia, organism unspecified" is an unspecified code used in situations where the causative agent isn't mentioned.

Multilobar pneumonia impacts more than one lobe of your patient's lungs and is a more serious illness than lobar pneumonia. Absent any additional details about your patient's pneumonia, you'd list 481 for either lobar or multilobar pneumonia. But then the most spot on code for pneumonia of any type should be determined by the physician, in part based on the casual organism.

You will list 485 (Bronchopneumonia, organism unspecified) when your patient has lobular pneumonia, however you're unable to figure out the causative organism.