J44.0
BillableChronic obstructive pulmonary disease with (acute) lower respiratory infection
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 chronic lung disease (COPD) that is currently worsened by an acute infection in the lower airways such as bronchitis or pneumonia.
Coding Tips
- •This code requires documentation of both COPD and an acute lower respiratory infection; identify the specific infection organism if documented
- •Do not use this code if the infection is only in the upper respiratory tract
Clinical Significance
Chronic obstructive pulmonary disease with acute lower respiratory infection represents a COPD patient experiencing a concurrent acute infection such as pneumonia or acute bronchitis. This combination significantly increases morbidity, hospitalization risk, and mortality, making accurate capture critical for reflecting true patient acuity in risk adjustment.
Documentation Requirements
- ✓Established diagnosis of COPD (chronic obstructive pulmonary disease)
- ✓Documentation of an acute lower respiratory infection (pneumonia, acute bronchitis) occurring concurrently
- ✓The specific acute infection should be identified and coded separately (e.g., J13-J18 for pneumonia, J20.x for acute bronchitis)
- ✓Clinical presentation: increased dyspnea, fever, purulent sputum, new infiltrate on imaging
- ✓Treatment plan for both the underlying COPD and the acute infection
- ✓Severity indicators: oxygen requirements, hospitalization, respiratory failure
Code Also
- to identify the infection
Commonly Confused Codes
J44.1 — COPD with acute exacerbation: use when COPD worsens without a documented infection; J44.0 requires documented infectionJ44.9 — COPD, unspecified: does not capture the acute component; never use when an acute infection is documentedJ18.9 — Pneumonia, unspecified: code additionally to identify the infection; J44.0 alone does not specify the typeJ20.9 — Acute bronchitis, unspecified: code additionally if this is the acute lower respiratory infection
Code Hierarchy
└J44Other chronic obstructive pulmonary disease└J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection
└J44.0Chronic obstructive pulmonary disease with (acute) lower respiratory infection