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Q&A: Should COPD or pneumonia be sequenced as the principal diagnosis?

Q: If a patient is admitted with both pneumonia and COPD, does pneumonia need to be coded before the COPD exacerbation? We have been coding COPD exacerbation first based on the advice given in AHA Coding Clinic, Third Quarter 2016, p. 15. Coding Clinic states that, when a patient is admitted with both COPD and pneumonia, the note under code J44.10, COPD with acute lower respiratory infection, instructs the coder to “use additional code to identify the infection.” Based on this, Coding Clinic J44.10 should be sequenced first. Is this correct?

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