J84.03

Billable

Idiopathic pulmonary hemosiderosis

HCC Category Mapping

V28HCC 280 — Chronic Obstructive Pulmonary Disease

0.334

V24HCC 112 — Fibrosis of Lung and Other Chronic Lung Disorders

0.268

ESRDHCC 112 — Fibrosis of Lung and Other Chronic Lung Disorders

0.000

RxHCCHCC 227 — Sarcoidosis, Pulmonary Alveolar Disorders

0.000

What This Code Means

A rare lung disease where iron deposits accumulate in the lungs, causing bleeding and scarring of lung tissue.

Coding Tips

•Distinguish between primary and secondary idiopathic pulmonary hemosiderosis
•Document any associated conditions such as vasculitis or immune disorders

Clinical Significance

Idiopathic pulmonary hemosiderosis is a rare condition of unknown etiology characterized by recurrent diffuse alveolar hemorrhage leading to iron deposition in the lungs. It is significant for risk adjustment because it causes chronic respiratory impairment, recurrent hemoptysis, and iron deficiency anemia, requiring ongoing management and monitoring.

Documentation Requirements

✓Documentation of recurrent episodes of diffuse alveolar hemorrhage
✓Iron-laden macrophages (hemosiderin-laden macrophages) in BAL or lung biopsy
✓Chest imaging showing diffuse bilateral infiltrates during hemorrhage episodes
✓Iron studies showing iron deficiency anemia from pulmonary blood loss
✓Exclusion of secondary causes of pulmonary hemorrhage (vasculitis, Goodpasture syndrome, anticoagulation, coagulopathy)
✓Pulmonary function test results
✓Treatment plan including iron supplementation and immunosuppressive therapy if used

Excludes 1 — Do NOT code together

acute idiopathic pulmonary hemorrhage in infants [AIPHI] (R04.81)

Code First

underlying disease, such as:
disorders of iron metabolism (E83.1-)

Commonly Confused Codes

R04.89 (Hemorrhage from other sites in respiratory passages) — symptom code for hemoptysis, not the underlying disease J84.01 (Alveolar proteinosis) — different alveolar filling disease M31.0 (Hypersensitivity angiitis / Goodpasture syndrome) — autoimmune cause of pulmonary hemorrhage with renal involvement D50.0 (Iron deficiency anemia secondary to blood loss) — code additionally for the anemia component

Code Hierarchy

└J84Other interstitial pulmonary diseases └J84.0Alveolar and parieto-alveolar conditions └J84.03Idiopathic pulmonary hemosiderosis

└J84.03Idiopathic pulmonary hemosiderosis