J43.1
BillablePanlobular emphysema
HCC Category Mapping
V28HCC 280 — Chronic Obstructive Pulmonary Disease
0.334V24HCC 111 — Chronic Obstructive Pulmonary Disease
0.334ESRDHCC 111 — Chronic Obstructive Pulmonary Disease
0.000RxHCCHCC 229 — COPD and Chronic Bronchitis
0.000What This Code Means
A type of emphysema where the air-filled spaces destroy the entire lung structure uniformly throughout both lungs, leading to progressive breathing difficulty.
Coding Tips
- •Panlobular emphysema typically affects the lower lobes and is commonly associated with alpha-1 antitrypsin deficiency
- •Consider screening for alpha-1 antitrypsin deficiency and coding if present (E88.01)
Clinical Significance
Panlobular emphysema involves destruction of the entire acinus (respiratory bronchiole, alveolar ducts, and alveoli) and predominantly affects the lower lobes. It is classically associated with alpha-1 antitrypsin deficiency and represents a more diffuse and often more severe form of emphysema that significantly impacts respiratory function and patient outcomes.
Documentation Requirements
- ✓CT imaging demonstrating panlobular (panacinar) pattern of emphysema, typically lower-lobe predominant
- ✓Pulmonary function testing showing obstructive pattern with reduced diffusion capacity
- ✓Alpha-1 antitrypsin level testing and results if clinically indicated
- ✓Severity assessment including oxygen requirements and functional limitations
- ✓Treatment plan including bronchodilators, pulmonary rehabilitation, and alpha-1 antitrypsin augmentation therapy if applicable
- ✓Smoking history and cessation status
Commonly Confused Codes
J43.2 — Centrilobular emphysema: affects only the central part of the acinus, upper-lobe predominant, typically smoking-relatedJ43.0 — Unilateral pulmonary emphysema (MacLeod's syndrome): unilateral condition, different etiologyJ43.9 — Emphysema, unspecified: use only when the type of emphysema is not specified in documentationE88.01 — Alpha-1 antitrypsin deficiency: code additionally when this underlying cause is documented