Chronic Bronchitis Medical Billing Claims

If your medical billing claims for patients who present and are diagnosed with chronic bronchitis are getting denied payment by the carrier; take a very close look at the code you’re using to report this condition. One of the biggest reasons chronic bronchitis isn’t paid on a claim is because it is reported as a general chronic code using 491.9, Unspecified chronic bronchitis. The trick is to forego choosing the 491.9 as the ICD-9 will lead you to do. Instead look for the diagnosis of the possible cause of the chronic bronchitis such as chronic asthma which has its own specific code.

If procedures were performed on the patient, note in detail what services were performed and the medical necessity for doing such – this will help validate your medical billing claim of chronic bronchitis. In some cases the coding 491.2(Obstructive chronic bronchitis; with [acute] exacerbation) appears in the diagnosis definition may be more accurate.

If you can’t find the additional information necessary to choose a specific 491.xx code; have a meeting with the physicians and let them understand the terms they use on their notes may be limiting their medical reimbursements. If they can be more detailed in their terms on common procedures such as this, no one will reap greater rewards than the practice itself. The more specific your medical billing claim is, the more likely it is to be reimbursed by the carrier.

View all Articles by: Melissa Clark, CCS-P