Chapter 10 - Diseases of the respiratory system (J00-J99) » Chronic lower respiratory diseases (J40-J47) » Mild intermittent asthma with (acute) exacerbation (J45.21) Show YOU AGREE THAT THE INFORMATION PROVIDED ON THIS WEBSITE IS PROVIDED “AS IS”, WITHOUT ANY WARRANTY OF ANY KIND, EXPRESSED OR IMPLIED, INCLUDING WITHOUT LIMITATION WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE, OR NON-INFRINGEMENT OF ANY THIRD-PARTY PATENT, COPYRIGHT, OR ANY OTHER THIRD-PARTY RIGHT. IN NO EVENT SHALL THE CREATORS OF THE WEBSITE OR WASHINGTON UNIVERSITY BE LIABLE FOR ANY DIRECT, INDIRECT, SPECIAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE WEBSITE, THE USE OF THE WEBSITE, OR THIS AGREEMENT, WHETHER IN BREACH OF CONTRACT, TORT OR OTHERWISE, EVEN IF SUCH PARTY IS ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. BackgroundThe International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is a morbidity classification published by the United States for classifying diagnoses and reason for visits in all health care settings. The ICD-10-CM is based on the ICD-10, the statistical classification of disease published by the World Health Organization (WHO). Deaths have been coded using asthma diagnostic codes (ICD-9 Code: 493; or ICD-10 Codes: J45, J46) as the underlying causes of death. However, a clinical modification of the classification for morbidity purposes has been developed by the National Center for Health Statistics (NCHS), the federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10-CM) in the United States. 1 General ChangesThe ICD-10-CM code sets have updated medical terminology and disease classifications, thus ICD-9-CM and ICD-10-CM are vastly different. There are nearly 5 times as many diagnosis codes in ICD-10-CM than in ICD-9-CM. The clinical modification represents significant changes from ICD-9-CM to ICD-10-CM which include:
The new structure will allow further expansion than was possible with ICD-9-CM. The ICD-9-CM to ICD-10-CM conversion will have a significant impact on public health surveillance systems and activities that involve coded clinical data and healthcare utilization data, particularly asthma-related hospital discharge and emergency department visits. 2 Coding Changes
Analysis GuidanceThe transition from ICD-9-CM to ICD-10-CM occurred on October 1, 2015. In 2015, asthma hospitalization and emergency department visits data for the first three quarters of the year were coded as ICD-9-CM (493.0-493.9) and the fourth quarter was coded as ICD-10-CM (J45.0-J45.998). If you received 2015 data with both coding schemes, you will have to differentiate ICD-9-CM and ICD-10-CM records to identify asthma-related hospitalization and emergency department visits. However, if your state coded the complete year (2015) using ICD-9-CM codes, then there will be no change to how data are analyzed and reported. For both scenarios, trend analysis will require a dash or other symbol indicating a coding change. By 2016, the transition should be complete and all related data should be coded using ICD-10-CM codes J45.0-J45.998. The change in definition using ICD-9-CM versus ICD-10-CM may result in a decrease in asthma hospitalizations and emergency department visits. ChallengesThe transition from ICD-9-CM to ICD-10-CM will impact public health surveillance activities, particularly those regarding asthma morbidity and healthcare utilization. A major challenge for asthma surveillance is the difference in coding for asthma. There will also be a lag in data collection to analyze trends. The coding and rule changes between ICD-10-CM and ICD-9-CM will result in discontinuities in the measurement of asthma-related morbidity and healthcare utilization outcomes. A comparability ratio would measure these discontinuities and assist in identifying real changes in morbidity and healthcare utilization. This would be key to understanding the trend in related statistics from 2014 and 2015. 5, 6 To produce this measure, a complete year of 2015 data would need to be coded using ICD-9-CM and ICD-10-CM. A comparability ratio will not be provided by NCHS. Table: ICD-CM coding for Asthma 3, 4
References
Federal and State Contacts and Resources for the ICD-9-CM to ICD-10-CM ConversionCenters for Disease Control and Prevention (CDC) National Center for Environmental Health (NCEH) What is intermittent asthma with exacerbation?A person may experience asthma exacerbations, during which their asthma worsens or new symptoms occur. These exacerbations, also known as asthma attacks, sometimes happen with no warning. The symptoms of asthma exacerbations include coughing, wheezing, chest tightness, and shortness of breath.
What is asthma with acute exacerbation?Acute asthma exacerbations are episodes of worsening asthma symptoms and lung function; they can be the presenting manifestation of asthma or occur in patients with a known asthma diagnosis in response to a "trigger" such as viral upper respiratory infection, allergen, air pollution or other irritant exposure, lack of ...
What does mild intermittent asthma mean?Patients who have symptoms fewer than 2 days per week and fewer than 2 nights per month are classified as having mild intermittent asthma. Those with symptoms more than 2 days per week but less than every day or more than 2 nights per month are considered to have mild persistent asthma.
What is the ICD 10 code for acute asthma?The ICD-CM codes for asthma have changed from 493.00 – 493.99 in ICD-9-CM to J45. 0 – J45. 998 in ICD-10-CM (Table).
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