The International Classification of Diseases (ICD) is a medical coding system crafted by the World Health Organization (WHO). It serves as the primary foundation for health recording and disease statistics across various levels of care, including primary, secondary, and tertiary care settings, as well as on death certificates to determine causes of mortality.
These meticulously coded clinical terms play a pivotal role in supporting numerous healthcare functions, including payment systems, service planning, quality administration, safety oversight, and health services research. Moreover, the diagnostic framework associated with ICD categories standardizes data collection and facilitates extensive research endeavors. Given the dynamic nature of the medical field, the ICD undergoes periodic revisions to accommodate advancements and changes in healthcare practices.
Many countries now use national variations of ICD-10, each modified to align with their unique healthcare infrastructure.
The most recent update to the US version of the ICD-10-CM now includes codes for:
- Chronic lung allograft dysfunction (code J4A)
- Bronchiolitis obliterans and bronchiolitis obliterans syndrome (code J44.81)
Each of these codes became effective on October 1, 2023, for use in the US to support billing and reimbursement initiatives along with epidemiological tracking.
Chronic lung allograft dysfunction (CLAD) – bronchiolitis obliterans syndrome (BOS), known as CLAD-BOS, is a severe clinical condition which can occur after lung transplantation. It is characterised by airflow restrictions, which are not reversible with inhaled bronchodilators and progressive shortness of breath, and is associated with increased morbidity and mortality.
Lung transplantation surgery is very relevant to pulmonary arterial hypertension as it is the therapeutic option of choice for patients who do not respond to the most powerful treatment. To quote the most recent European Society of Cardiology (ESC) and European Respiratory Society (ERS) clinical guidelines for the diagnosis and treatment of pulmonary hypertension, section 6.3.8. on Lung and heart–lung transplantation:
“Lung transplantation remains an important treatment option for patients with PAH refractory to optimized medical therapy.”
The issuance of these new ICD-10-CM codes for CLAD-BOS and related conditions will support the collection of epidemiological data and track changes in this disease across the US in subsequent years. The coding will greatly facilitate identifying and following the natural course of the disease’s progression in these patients. Even if this coding is only applicable for the US at present it sets an important precedent for the recognition of this disease.
There is currently no approved treatment for BOS. The Zambon Group is supporting a global clinical development plan to evaluate the safety and efficacy of investigational liposomal cyclosporine A for inhalation formulation to treat BOS in patients after lung transplant and after allogeneic hematopoietic stem cell transplantation. The rationale of inhaled therapies is to deliver sufficient concentrations of the drug directly to the site of disease in the lungs while minimizing systemic exposure.
To be followed!
References
What Is ICD-10? American Academy of Professional Coding
2024 ICD-10-CM Codes & Guidelines: Review the Updates Here (yes-himconsulting.com)
ICD-10-CM 2024 Updates: PART – 1 | Practolytics
Photo credit
Dave Braunschweig – Own work, , derived from File: Icd9codeslogo.png, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=76417738