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Pediatric Coding Alert

READER QUESTION:

Use Respiratory Dx for Wheezing

Published on Wed Jan 17, 2007

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


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Answer: The best code for "wheezing" or what pediatricians 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. Pediatricians commonly use the diagnosis of wheezing-associated respiratory illness for children with wheezing not meeting the criteria for a diagnosis of asthma.

An example of WARI is a child with an upper respiratory infection who is having his first episode of associated wheezing, requiring treatment of bronchospasm. This would typically not warrant labeling a child with "asthma," using code 493.02 (Extrinsic asthma; with [acute] exacerbation).
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