Bronchopulmonary Dysplasia Criteria

How to convince a coder -- or a payer -- that an infant has BPD (bronchopulmonary dysplasia) – especially if the NICU docs are throwing around antiquated (but familiar terms) such as CLD (chronic lung disease)?

Consider the 2003 Statement on the Care of the Child with Chronic Lung Disease of Infancy and Childhood published by the American Thoracic Society (Am J Respir Crit Care Med Vol 168. pp 356–396, 2003.)

Abstracted are 3 criteria sets:

1979 Criteria: (Bancalari and coworkers)

(1) supplemental oxygen requirement at 28 days of postnatal life,

(2) persistent abnormalities of the chest radiograph, and

(3) tachypnea in the presence of rales or retractions.

1989 Criteria (Maternal and Child Health Bureau)

1 ) positive-pressure ventilation during the first 2 weeks of life for a minimum of 3 days,

(2) clinical signs of respiratory compromise persisting longer than 28 days of age,

(3) requirement for supplemental oxygen for more than 28 days to maintain a PaO2 above 50 mm Hg, and

(4) chest radiograph with findings characteristic of BPD.

2001 Criteria (Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723–1729.)