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Pulmonology Coding Alert

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Don't Miss Out on Fifth Digit Asthma Diagnosis

Published on Mon Jan 25, 2010

Question: Do I need a fifth digit when reporting 493.xx (Asthma)? Michigan Subscriber Answer: You should use a fifth digit subclassification when reporting asthma diagnosis. Your claim would likely get rejected by payers as incomplete if you submit with only four digits. How-to: Assign the fourth digit based on the asthma category: • 493.0x -- Extrinsic asthma • 493.1x -- Intrinsic asthma • 493.2x -- Chronic obstructive asthma • 493.8x -- Other forms of asthma • 493.9x -- Asthma, unspecified. Then, choose the asthma's current state from any of the appropriate fifth digit: • 0 -- unspecified • 1 -- with status asthmaticus • 2 -- with (acute) exacerbation. Clue: Code 493.x0 when the patient's asthma is controlled. A fifth digit of "1" means the patient has status asthmaticus, a medical emergency that is usually treated in the ER. You should assign a "2" when something has caused the condition to exacerbate. Important: The fifth digit is for [...]
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