J44.1

Billable

Chronic obstructive pulmonary disease with (acute) exacerbation

HCC Category Mapping

V28HCC 280 — Chronic Obstructive Pulmonary Disease

0.334

V24HCC 111 — Chronic Obstructive Pulmonary Disease

0.334

ESRDHCC 111 — Chronic Obstructive Pulmonary Disease

0.000

RxHCCHCC 229 — COPD and Chronic Bronchitis

0.000

What This Code Means

A chronic lung disease (COPD) that is currently experiencing a sudden worsening of symptoms such as increased shortness of breath or coughing.

Coding Tips

•Exacerbation must be documented as acute worsening; look for terms like 'acute exacerbation,' 'flare-up,' or 'decompensation'
•Distinguish between exacerbation (J44.1) and infection (J44.0); exacerbation does not require an identified infection

Clinical Significance

Chronic obstructive pulmonary disease with acute exacerbation represents a worsening of baseline COPD symptoms beyond normal day-to-day variation, requiring a change in treatment. Acute exacerbations are the leading cause of COPD-related hospitalizations and are associated with accelerated decline in lung function and increased mortality risk.

Documentation Requirements

✓Established diagnosis of COPD (chronic obstructive pulmonary disease)
✓Clear documentation of acute exacerbation: worsening dyspnea, increased sputum volume or purulence, increased cough
✓Provider must use terms indicating acute worsening: 'exacerbation,' 'flare,' 'acute worsening,' or equivalent clinical language
✓Change in treatment from baseline: increased bronchodilators, systemic steroids, antibiotics, hospitalization
✓Severity assessment: respiratory distress level, oxygen requirements, need for ventilatory support
✓Baseline COPD severity for comparison

Excludes 2 — Not included here, may code separately

chronic obstructive pulmonary disease [COPD] with acute bronchitis (J44.0)
lung diseases due to external agents (J60-J70)

Commonly Confused Codes

J44.0 — COPD with acute lower respiratory infection: use when a specific infection (pneumonia, acute bronchitis) is identified as the cause J44.9 — COPD, unspecified: use for stable COPD without acute exacerbation or infection J44.89 — Other specified COPD: use for specified COPD presentations not captured by J44.0 or J44.1 J96.x — Respiratory failure: code additionally when exacerbation leads to respiratory failure

Code Hierarchy

└J44Other chronic obstructive pulmonary disease └J44.1Chronic obstructive pulmonary disease with (acute) exacerbation

└J44.1Chronic obstructive pulmonary disease with (acute) exacerbation