Fibrosing Interstitial Lung Disease H010
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7
Rulebase for fibrosing interstitial lung disease
<h5><strong>Current RMA Instruments</strong></h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2021/430bb7523a/085.pdf" target="_blank">Reasonable Hypothesis SOP</a></address></td><td>85 of 2021</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2021/bfb521d2ac/086.pdf" target="_blank">Balance of Probabilities SOP</a></address></td><td>86 of 2021</td></tr></tbody></table><h5><strong>Changes from previous Instruments</strong></h5><p><drupal-media data-entity-type="media" data-entity-uuid="f4625a31-baec-4a65-8609-7d5f66391dc9" data-view-mode="wysiwyg"></drupal-media></p><h5><strong>ICD Coding</strong></h5><ul><li>ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3</li><li>ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1</li></ul><h5>Brief description</h5><p>This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.</p><h5>Confirming the diagnosis</h5><p>This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.</p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Acute interstitial pneumonia</li><li>Berylliosis</li><li>Coal worker’s pneumoconiosis</li><li>Diffuse (interstitial) pulmonary fibrosis</li><li>Drug-induced interstitial pneumonitis</li><li>Fibrosing alveolitis (idiopathic or cryptogenic)</li><li>Hamman-Rich syndrome</li><li>Idiopathic pulmonary fibrosis</li><li>Lymphoid interstitial pneumonia</li><li>Non-specific interstitial pneumonia</li><li>Radiation fibrosis</li><li>Silicosis (chronic)</li></ul><h5><strong>Conditions that may be covered by SOP</strong></h5><ul><li>Usual interstitial pneumonia</li></ul><h5><strong>Conditions not covered by SOP</strong></h5><ul><li>Asthma*</li><li>Bronchiectasis*</li><li>Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia</li><li>Chronic bronchitis* - chronic obstructive pulmonary disease SOP</li><li>Chronic obstructive pulmonary disease*</li><li>Desquamative interstitial pneumonia<span><sup>#</sup></span></li><li>Eosinophilic pneumonia<span><sup>#</sup></span></li><li>Emphysema* - chronic obstructive pulmonary disease SOP</li><li>Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)</li><li>Histiocytosis (X)<span><sup>#</sup></span></li><li>Hypersensitivity pneumonitis*</li><li>Other organising pneumonia<span><sup>#</sup></span> (excl BOOP)</li><li>Pleural plaque*</li><li>Pulmonary alveolar proteinosis<span><sup>#</sup></span></li><li>Pulmonary Langerhan’s cell histiocytosis<span><sup>#</sup></span></li><li>Pulmonary manifestations of systemic diseases:<ul><li>Sarcoidosis*</li><li>Amyloidosis*</li><li>Rheumatoid arthritis*</li><li>Systemic lupus erythematosus*,</li><li>Scleroderma / Systemic sclerosis*</li><li>Polymyositis<span><sup>#</sup></span></li><li>Sjögren’s disease<span><sup>#</sup></span></li></ul></li><li>Respiratory bronchiolitis associated interstitial lung disease<span><sup>#</sup></span></li></ul><p>* another SOP applies</p><p><sup><span># </span></sup>non-SOP condition</p><h5>Comments</h5><p>Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.</p><h5>Clinical onset</h5><p>The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.</p><h5>Clinical worsening</h5><p>The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.</p><p> </p>
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease
A course of therapeutic radiation to the region of the chest
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/course-therapeutic-radiation-region-chest
A drug from the specified list
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/drug-specified-list
Acute respiratory distress syndrome
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/acute-respiratory-distress-syndrome
Acute silicosis
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/acute-silicosis
An intravenous injection of a talc-containing drug
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/intravenous-injection-talc-containing-drug
Atomic radiation
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/atomic-radiation
Chronic or recurrent diffuse alveolar haemorrhage
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/chronic-or-recurrent-diffuse-alveolar-haemorrhage
Evidence of sensitisation to beryllium
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/evidence-sensitisation-beryllium
Exogenous lipoid pneumonitis
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/exogenous-lipoid-pneumonitis
Inhaling beryllium dust or fumes
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-beryllium-dust-or-fumes
Inhaling mustard gas
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-mustard-gas
Inhaling respirable coal dust in an enclosed space
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-respirable-coal-dust-enclosed-space
Inhaling respirable crystalline silica dust in an enclosed space
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-respirable-crystalline-silica-dust-enclosed-space
Inhaling respirable crystalline silica dust in an open environment
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-respirable-crystalline-silica-dust-open-environment
Inhaling respirable hard metal or diamond-cobalt dust
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-respirable-hard-metal-or-diamond-cobalt-dust
Inhaling toxic gases or fumes
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/inhaling-toxic-gases-or-fumes
Iodine therapy
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/iodine-therapy
Ionising radiation
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/ionising-radiation
No appropriate clinical management for fibrosing interstitial lung disease
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/no-appropriate-clinical-management-fibrosing-interstitial-lung-disease
Paraquat poisoning
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/paraquat-poisoning
Treatment with a cytotoxic agent
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/treatment-cytotoxic-agent
Tropical pulmonary eosinophilia
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/tropical-pulmonary-eosinophilia
Yttrium therapy
Current RMA Instruments
| Reasonable Hypothesis SOP | 85 of 2021 |
| Balance of Probabilities SOP | 86 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 500, 502.1, 502.2, 503, 506.4, 508.1, 508.8, 515, 516.3
- ICD-10-AM Codes: J60, J62.8, J64, J68.4, J70.1, J70.8, J84.1
Brief description
This SOP covers idiopathic fibrosing alveolitis and a range of other lung diseases that feature chronic inflammation and fibrosis. This SOP does not cover fibrosis associated with systemic disease and has a number of other exclusions. Asbestosis is a form of fibrosing interstitial lung disease, but there is a separate SOP for asbestosis that should be applied if that diagnosis is confirmed (see comments below). Note carefully the included and excluded conditions, detailed below, before applying this SOP. The terminology can be confusing – seek medical advice if in doubt.
Confirming the diagnosis
This diagnosis is complex and should be made by a specialist respiratory physician. High resolution CT / MRI scanning or lung biopsy is usually required.
Additional diagnoses covered by SOP
- Acute interstitial pneumonia
- Berylliosis
- Coal worker’s pneumoconiosis
- Diffuse (interstitial) pulmonary fibrosis
- Drug-induced interstitial pneumonitis
- Fibrosing alveolitis (idiopathic or cryptogenic)
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Lymphoid interstitial pneumonia
- Non-specific interstitial pneumonia
- Radiation fibrosis
- Silicosis (chronic)
Conditions that may be covered by SOP
- Usual interstitial pneumonia
Conditions not covered by SOP
- Asthma*
- Bronchiectasis*
- Bronchiolitis obliterans organising pneumonia* / cryptogenic organising pneumonia
- Chronic bronchitis* - chronic obstructive pulmonary disease SOP
- Chronic obstructive pulmonary disease*
- Desquamative interstitial pneumonia#
- Eosinophilic pneumonia#
- Emphysema* - chronic obstructive pulmonary disease SOP
- Extrinsic allergic alveolitis* (hypersensitivity pneumonitis SOP)
- Histiocytosis (X)#
- Hypersensitivity pneumonitis*
- Other organising pneumonia# (excl BOOP)
- Pleural plaque*
- Pulmonary alveolar proteinosis#
- Pulmonary Langerhan’s cell histiocytosis#
- Pulmonary manifestations of systemic diseases:
- Sarcoidosis*
- Amyloidosis*
- Rheumatoid arthritis*
- Systemic lupus erythematosus*,
- Scleroderma / Systemic sclerosis*
- Polymyositis#
- Sjögren’s disease#
- Respiratory bronchiolitis associated interstitial lung disease#
* another SOP applies
# non-SOP condition
Comments
Asbestosis can present with a similar clinical picture to other forms of fibrosing interstitial lung disease and with very similar findings on radiology. If the diagnosis of asbestosis is established by the demonstration of a diagnostic number of asbestos bodies in the lung on histology or cytology, or based on a convincing history of heavy inhalational asbestos exposure, then the asbestosis 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. The fibrosing interstitial lung disease SOP has factors for asbestos exposure, so effectively, asbestos-related fibrosing interstitial lung disease is covered by both SOPs.
Clinical onset
The condition usually presents with gradual onset of shortness of breath on exertion (dyspnoea) and a non-productive cough, generally in someone of middle age or older. The condition may also be found incidentally on imaging. Pinpointing clinical onset based on dyspnoea may be difficult and imprecise.
Clinical worsening
The usual course for the condition is a gradual decline in lung function and worsening symptoms. Evidence of progression or acceleration beyond the usual course would be required for clinical worsening to apply.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/e-g/fibrosing-interstitial-lung-disease-h010-j60j628j64j684j7/rulebase-fibrosing-interstitial-lung-disease/yttrium-therapy