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Outpatient Facility Coding Alert

Reader Question:

Nebulizer Usage Helps Determine Asthma Diagnosis

Published on Thu May 19, 2016 Print Friendly and PDF PDF

Question: How will you code asthma in ICD-10?

Ohio Subscriber

Answer: The codes from ICD-9 family 493 crosswalk in ICD-10 to J45 (Asthma). In order to assign the best code, follow the severity of the symptoms and the necessity of nebulizer treatment determine the correct diagnosis code. This is consistent with the current national asthma treatment guidelines determined by The National Heart, Lung and Blood Institute.

Focus on the asthma’s severity, based on the following four states:

  • Mild intermittent
  • Mild persistent
  • Moderate persistent
  • Severe persistent.

Pay attention to your physician’s note to assess the severity of the condition as this is necessary for accurate reporting. J45 expands, based on severity, into the following five code sets as described in the guidelines:

  • J45.2 – Mild intermittent asthma
  • J45.3 – Mild persistent asthma
  • J45.4 – Moderate persistent asthma
  • J45.5 – Severe persistent asthma
  • J45.9 – Other and unspecified asthma.

All of the above-mentioned codes further expand based on the asthma state into uncomplicated, acute exacerbation, and status asthmaticus. For example, J45.2 expands into the following three subsets:

  • J45.20 – Mild intermittent asthma, uncomplicated
  • J45.21 – Mild intermittent asthma with (acute) exacerbation
  • J45.22 – Mild intermittent asthma with status asthmaticus.

Bottom line: As with many conditions, the more thoroughly your physician documents the patient’s condition, the more accurate your ICD-10 diagnosis will be.

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