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Thread: Dyspnea vs. SOB

  1. #1
    Join Date
    Apr 2007
    Location
    JC MO
    Posts
    109

    Question Dyspnea vs. SOB

    I am struggling with this and want your input please. When you look up the word dyspnea in the Index to Diseases, the code provided first is 786.09. When you refer to the tabular list, dyspnea is not mentioned.

    When you look up the definition of dyspnea it leads to short of breath 786.05.

    So tell me why 786.09 is appropriate and 786.05 is not? The definitions (pasted below) are almost identical. I want to understand.

    Main Entry: dys·pnea
    Pronunciation: \ˈdis(p)-nē-ə\
    Function: noun
    Etymology: Latin dyspnoea, from Greek dyspnoia, from dyspnoos short of breath, from dys- + pnein to breathe — more at sneeze
    Date: circa 1681
    : difficult or labored respiration


    intransitive verb
    1 : to draw air into and expel it from the lungs : respire ; broadly : to take in oxygen and give out carbon dioxide through natural processes
    2 : to inhale and exhale freely
    transitive verb
    : to inhale and exhale <breathing fresh air>


    Function: noun
    : difficult or labored respiration

    Function: noun
    1 a : the movement of respiratory gases (as oxygen and carbon dioxide) into and out of the lungs b : a single complete act of breathing <30 respirations per minute>
    2 : the physical and chemical processes (as breathing and diffusion) by which an organism supplies its cells and tissues with the oxygen needed for metabolism and relieves them of the carbon dioxide formed in energy-producing reactions
    M.J.

  2. #2

    Default Dyspnea vs SOB

    MJ

    You are not crazy wondering about these differences. T

    he best explaination I have discovered is this: I do a lot of teaching and this question is frequently asked or I ask it of the attendees. Most nurses think SOB is appropirately called Dyspnea; many physicians believe they are the same; BUT some physicians think of SOB is what you are after running up 3 flights of stairs where as dyspnea is that same labored breathing but without the 3 flights. A patient with dyspnea is SOB to them but has some underlying cause (not the 3 flights).

    Now this is a symantics discussion for sure, but what I always say is when in doubt code the word that the physician wrote down. Because changing SOB to Dyspnea or vice verse results in a different ICD9 code which may cause problems. It is only one 5th digit off but it is different.

    I hope this helps - but yes this is one of those tricky coding areas.
    Jill

    Jill M. Young, CPC, CEDC, CIMC
    Past Member AAPCCA BOD 2007-2011
    Young Medical Consulting, LLC
    East Lansing, Michigan

  3. #3
    Join Date
    Apr 2007
    Posts
    67

    Default

    Quote Originally Posted by Youngmedconsult View Post
    MJ

    You are not crazy wondering about these differences. T

    he best explaination I have discovered is this: I do a lot of teaching and this question is frequently asked or I ask it of the attendees. Most nurses think SOB is appropirately called Dyspnea; many physicians believe they are the same; BUT some physicians think of SOB is what you are after running up 3 flights of stairs where as dyspnea is that same labored breathing but without the 3 flights. A patient with dyspnea is SOB to them but has some underlying cause (not the 3 flights).

    Now this is a symantics discussion for sure, but what I always say is when in doubt code the word that the physician wrote down. Because changing SOB to Dyspnea or vice verse results in a different ICD9 code which may cause problems. It is only one 5th digit off but it is different.

    I hope this helps - but yes this is one of those tricky coding areas.

    It's funny that you say when in doubt code the word that the physician wrote down, because my doctor documented both SOB and dyspnea. In that case, should I code both?

    Thanks.

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