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COPD Codes

H3... Chronic obstructive pulmonary disease
H31.. Chronic bronchitis
H310. Simple chronic bronchitis
H3100 Chronic catarrhal bronchitis
H310z Simple chronic bronchitis NOS
H311. Mucopurulent chronic bronchitis
H3110 Purulent chronic bronchitis
H3111 Fetid chronic bronchitis
H311z Mucopurulent chronic bronchitis NOS
H312. Obstructive chronic bronchitis
H3120 Chronic asthmatic bronchitis
H3121 Emphysematous bronchitis
H3123 Bronchiolitis obliterans
H312z Obstructive chronic bronchitis NOS
H313. Mixed simple and mucopurulent chronic bronchitis
H31y. Other chronic bronchitis
H31y1 Chronic tracheobronchitis
H31yz Other chronic bronchitis NOS
H31z. Chronic bronchitis NOS
H32.. Emphysema
H320. Chronic bullous emphysema
H3200 Segmental bullous emphysema
H3201 Zonal bullous emphysema
H3202 Giant bullous emphysema
H3203 Bullous emphysema with collapse
H320z Chronic bullous emphysema NOS
H321. Panlobular emphysema
H322. Centrilobular emphysema
H32y. Other emphysema
H32y0 Acute vesicular emphysema
H32y1 Atrophic (senile) emphysema
H32y2 MacLeod's unilateral emphysema
H32yz Other emphysema NOS
H32z. Emphysema NOS
H36.. Mild chronic obstructive pulmonary disease
H37.. Moderate chronic obstructive pulmonary disease
H38.. Severe chronic obstructive pulmonary disease
H39.. Very severe chronic obstructive pulmonary disease
H3A.. End stage chronic obstructive airways disease
H3y.. Other specified chronic obstructive airways disease
H3y0. Chronic obstructive pulmonary disease with acute lower respiratory infection
H3y1. Chronic obstructive pulmonary disease with acute exacerbation, unspecified
H3z.. Chronic obstructive airways disease NOS
H5832 Eosinophilic bronchitis(v26)
 

Exclusion codes (Every 12 months)

9h5.. Exception reporting: COPD quality indicators
9h51. Excepted from COPD quality indicators: Patient unsuitable
9h52. Excepted from COPD quality indicators: Informed dissent

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COPD 001.1 Rational

A diagnosis of COPD is considered in any patient who has symptoms of persistent cough, sputum production, or dyspnoea and/or a history of exposure to risk factors for the disease. The diagnosis is confirmed by post bronchodilator spirometry.

See COPD002.1

Where patients have a long-standing diagnosis of COPD and the clinical picture is clear, it would not be essential to confirm the diagnosis by spirometry in order to enter the patient onto the register. However, where there is doubt about the diagnosis practices may wish to carry out post bronchodilator spirometry for confirmation.

NICE clinical guideline 101 recommended a change to the diagnostic threshold for COPD in 2010 (see table 2).

Table 2: Gradation of severity of airflow obstruction

NICE clinical guideline 12 (2004)
ATS/ERS(43) 2004
GOLD 2008(44)
NICE clinical guideline 101 (2010)
Post-bronchodilator FEV1/FVC
FEV1 % predicted
Severity of airflow obstruction
Post-bronchodilator
Post-bronchodilator
Post-bronchodilator
< 0.7
=>80%
Mild
Stage 1 Mild
Stage 1 Mild*
< 0.7
5079%
Mild
Moderate
Stage 2 Moderate
Stage 2 Moderate
< 0.7
3049%
Moderate
Severe
Stage 3 Severe
Stage 3 Severe
< 0.7
< 30%
Severe
Very Severe
Stage 4 Very severe**
Stage 4 Very severe**

*Symptoms should be present to diagnose COPD in people with mild airflow obstruction (see recommendation 1.1.1.1).

**Or FEV1 (Forced expiratory volume in one second) < 50% with respiratory failure.

COPD 001.2 Reporting and verification

See indicator wording for requirement criteria.

Where patients have co-existing COPD and asthma they will be included on both disease registers. Approximately 15 per cent of patients with COPD will also have asthma.

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Prepared By Jean Keenan