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Current RMA Instruments:
|Reasonable Hypothesis SOP||55 of 2013|
|Balance of Probabilities SOP||56 of 2013|
Changes from Previous Instruments:
- ICD-9-CM Codes: 501
- ICD-10-AM Codes: J61
Asbestosis is scarring of the lungs due to the inhalation of large quantities of airborne asbestos fibres over a long period. It is a type of fibrosing interstitial lung disease, but is covered by a stand alone SOP. See further comments below.
Is specific diagnostic evidence required to apply the SOP? – Yes.
The diagnosis of asbestosis needs to be made by a specialist respiratory or general physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
Conditions not covered by SOP
- fibrosing alveolitis, ICD code 516.3
- fibrosing interstitial lung disease, ICD code 516.3
- mesothelioma, ICD code 158.8
- pleural plaque, ICD code 511.0
- pulmonary fibrosis, ICD code 516.3
If, after considering the above information you are unable to apply the SOP, you should then:
- seek medical officer advice about further investigation, or;
- generate a diagnostic report, or;
- re-encode the condition, if appropriate.
The following investigations may be useful in establishing the diagnosis.
- Report from a respiratory physician
If the diagnosis of asbestosis is established by the demonstration of asbestos bodies in the lung on histology, or based on a convincing history of heavy inhalational asbestos exposure, then this SOP applies. If fibrosing interstitial lung disease is present, but a diagnosis of asbestosis cannot be confirmed, then the fibrosing interstitial lung disease SOP applies. That SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.