J43.2
BillableCentrilobular 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 primarily affect the upper portions of the lung units, typically associated with smoking.
Coding Tips
- •Centrilobular emphysema is strongly associated with cigarette smoking; document tobacco use history
- •This type typically affects the upper lobes and apical segments more severely
Clinical Significance
Centrilobular emphysema is the most common form of emphysema, primarily affecting the respiratory bronchioles in the central portion of the acinus with upper-lobe predominance. It is strongly associated with cigarette smoking and is a hallmark finding of smoking-related chronic obstructive pulmonary disease, carrying significant implications for long-term respiratory decline.
Documentation Requirements
- ✓CT imaging demonstrating centrilobular (centriacinar) emphysema pattern, typically upper-lobe predominant
- ✓Pulmonary function testing showing obstructive ventilatory defect
- ✓Smoking history with pack-year calculation
- ✓Current symptom severity: dyspnea scale, exercise tolerance, oxygen requirements
- ✓Treatment plan including bronchodilators, inhaled corticosteroids, smoking cessation, pulmonary rehabilitation
- ✓GOLD stage classification if documented
Commonly Confused Codes
J43.1 — Panlobular emphysema: lower-lobe predominant, associated with alpha-1 antitrypsin deficiencyJ43.9 — Emphysema, unspecified: use only when imaging or documentation does not specify the patternJ44.9 — COPD, unspecified: may be used when emphysema is part of a broader COPD diagnosisJ43.8 — Other emphysema: use for paraseptal or other patterns not classified as centrilobular or panlobular