Otolaryngology Coding Alert

READER QUESTIONS:

Use Respiratory Dx for Wheezing

Question: Concerning coding of acute bronchospasm (519.11), when is it appropriate to simply report 786.07 for wheezing?


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Answer: The best code for -wheezing- or what allergists call -wheezing associated respiratory illness- (WARI) is the new five-digit ICD-9 code 519.11  (Acute bronchospasm).

Although 786.07 states -wheezing,- the code refers to stenosis of respiratory passages. Code 519.11 is more specific for bronchospasm.

Allergists commonly use the diagnosis of WARI for patients with wheezing, not meeting the criteria for a diagnosis of asthma. An example of -WARI- is a child with an upper respiratory infection (URI) who is having his first episode of associated wheezing, requiring treatment of bronchospasm. This would typically not warrant labeling a child with -asthma,- using ICD-9 code 493.02 (Extrinsic asthma; with [acute] exacerbation).

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