ICD-10 DRG Driven Shifts: COPD with Asthma Exacerbation

Through our work conducting DRG audits, Provident has identified a number of new shifts due to the change from the ICD-9 to ICD-10 codeset. Many of these DRG shifts were due to changes in the Official Coding Guidelines, Indexing, and procedure coding. Below is an example of one of the ICD-10 driven shifts identified.

Case Study: Patient admitted with a COPD exacerbation and asthma exacerbation


DRG Shifts - COPD Exacerbation

  • COPD with asthma exacerbation only required a single code in ICD-9


  • COPD with asthma exacerbation is coded using two separate codes in ICD-10
  • This results in a CC when coded in ICD-10
  • The ICD-10-CM Index instructional notes under J44 Other chronic obstructive pulmonary disease states, “Code also type of asthma, if applicable (J45.-)”


  1. International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM): Tabular Section – Category: J44 – Other chronic pulmonary disease – Code also type of asthma, if applicable (J45.-)

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