Wiki Acute on Chronic Sinusitis

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Code: j32.9
Chronic sinusitis, unspecified
Sinusitis (chronic) NOS
Parent Code Notes: J32
Excludes2: acute sinusitis (J01.-)
Includes: sinus abscess
sinus empyema
sinus infection
sinus suppuration
Use additional code to identify:
exposure to environmental tobacco smoke (Z77.22)
exposure to tobacco smoke in the perinatal period (P96.81)
history of tobacco dependence (Z87.891)
infectious agent (B95-B97)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)

Category Notes
Other diseases of upper respiratory tract (J30-J39)

Coding Guidelines
Diseases of the respiratory system (J00-J99)
Note: When a respiratory condition is described as occurring in more than one site and is not specifically indexed, it should be classified to the lower anatomic site (e.g. tracheobronchitis to bronchitis in J40).
Use additional code, where applicable, to identify:
exposure to environmental tobacco smoke (Z77.22)
exposure to tobacco smoke in the perinatal period (P96.81)
history of tobacco dependence (Z87.891)
occupational exposure to environmental tobacco smoke (Z57.31)
tobacco dependence (F17.-)
tobacco use (Z72.0)
Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
smoke inhalation (T59.81-)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
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chaimz

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Hello fellow coders,

Dr. documents "Acute on Chronic Sinusitis". I looked at the guidelines, and the only one was Section I.B.8 which states "If the same condition is described as both acute (subacute) and chronic, and separate subentries exist in the Alphabetic Index at the same indentation level, code both and sequence the acute (subacute) code first.

If I'm understanding it correctly, Acute Sinusitis is not at the same indentation level as Chronic Sinusitis within the index, so I only code Acute Sinusitis?

But then looking at the chapter specific guidelines, acute sinusitis (j01.90), excludes 1 note states chronic sinusitis (j32.9), but chapter specific guidelines for j32.9 state j01.- is an excludes 2.

So does that mean code j32.9 first, then j01.90?

Thanks in advance,

Chaim Zeitz, CPC
 
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