Pediatric Coding Alert

Question: One of our asthma patients presented with a little chest tightness and required a Singulair prescription renewal. Does the chest tightness mean I should code this as "exacerbated"?

Georgia Subscriber

Answer: Don't let the extra asthma code options confuse you: When an asthma patient presents with severe wheezing or a recognizable asthma attack, you can report acute exacerbation code 493.02 (Asthma, extrinsic asthma; with [acute] exacerbation). The physician should indicate "wheezing," "status asthmaticus" or "exacerbated asthma" as the patient's chief complaint in the documentation.

In the scenario you describe, however, the patient was not in distress. Therefore, assign a fifth-digit "0" to the code. This visit is a controlled extrinsic asthma visit, so you should report 493.00 and link it to the E/M code.