A21.2

HCC Category Mapping

What This Code Means

Pulmonary tularemia is a serious lung infection caused by the bacterium Francisella tularensis, typically acquired through inhalation of contaminated air or dust. This form of the disease affects the lungs and respiratory system and can cause severe pneumonia-like symptoms.

Coding Tips

• •Verify the documentation specifies pulmonary involvement; other forms of tularemia (ulceroglandular, oculoglandular, typhoidal) have different codes
• •This is a reportable disease in most jurisdictions; ensure proper documentation of exposure source (animal contact, tick bite, contaminated water) for epidemiological tracking

Clinical Significance

Pulmonary tularemia is a severe pneumonic infection caused by Francisella tularensis, often acquired through inhalation of contaminated aerosols or as a complication of other tularemia forms. It is a CDC Category A bioterrorism agent with significant mortality if untreated, requiring specific antibiotic therapy (aminoglycosides or doxycycline).

Documentation Requirements

• ✓Laboratory evidence of Francisella tularensis (serology with 4-fold titer rise, culture, or PCR)
• ✓Chest imaging showing pneumonia, hilar lymphadenopathy, or pleural effusion
• ✓Exposure history (tick/deerfly bites, rabbit/rodent contact, laboratory exposure, aerosolized exposure)
• ✓Clinical presentation with respiratory symptoms in the context of tularemia diagnosis
• ✓Public health notification as a nationally notifiable disease

Commonly Confused Codes