Acute on Chronic Sinusitis


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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