ICD-10 Coding and Documentation for Asthma

Approximately 300 million people around the world are affected by asthma, a chronic respiratory condition with its prevalence increasing by 50% every decade. An estimated 10% of North America’s population have asthma and even today, it is underdiagnosed and undertreated.

In order to document asthma conditions for further reference and for reimbursement purposes, pulmonologists and immunologists should use appropriate ICD-10 codes. Relying on medical billing services for comprehensive documentation and accurate coding of asthma can contribute towards effective patient care and timely reimbursement.

ICD-10 Classification for Asthma

ICD-10 has classified asthma under the code block: J45, which also contains sub-classification of the different types and severity of asthma. The most important codes in this category are:

1. J45.2 – Mild intermittent asthma
2. J45.3 – Mild persistent asthma
3. J45.4 – Moderate persistent asthma
4. J45.5 – Severe persistent asthma
5. J45.9 – Other and unspecified asthma

Code Definition and Requisite Documentation

Each asthma code is classified based on complications, severity and frequency that require specific medical documentation for appropriate care and reimbursement.

1. Mild Intermittent Asthma (J45.2)

• Symptoms occur less than twice a week and at night, less than twice a month.
• Documentation should include frequency and triggers, like allergens or exercise.

2. Mild Persistent Asthma (J45.3)

• Symptoms occur more than twice a week but not daily, with mild restrictions on daily activities.
• Documentation should include the symptom frequency, prescribed medication, and any environmental triggers.

3. Moderate Persistent Asthma (J45.4)

• Symptoms occur daily that may impact daily activities, with attacks twice or more per week.
• Documentation should mention frequency of symptoms, medication use and effects on the quality of life.

4. Severe Persistent Asthma (J45.5)

• Symptoms occur consistently with frequent exacerbations and limited physical activity.
• Documentation should include detailed information on treatment plans, response to medications, and emergency interventions.

4. 4. Unspecified Asthma (J45.909):

This code can be used when there is lack of proper information to classify the asthma severity.

Coding for Asthma with Complications

There are instances where patients can have asthma with complications which require precise coding to ensure proper treatment is imparted. And, there are two categories into which they are classified:

Coding to Identify Causes for Asthma

Risk factors for asthma include smoking, having allergic conditions, family history of allergies or asthma, being overweight, and exposure to secondhand smoke.

Significance of Accurate Documentation

Healthcare providers should ensure transparent and accurate documentation, which is vital for coding asthma under ICD-10. Below are the important parameters providers must include:

• The type and severity
• Frequency and triggers
• Response to treatment/medications
• Instances of emergency medical interventions/hospitalizations

Today, healthcare facilities/providers rely on medical billing outsourcing companies for precise & efficient medical coding. An expert team of medical coders can streamline the entire process from documentation and coding to claim submission and reimbursement. This minimizes any risk of errors, thereby ensuring compliance and timely reimbursements. By utilizing medical coding and billing services, healthcare professionals can save a lot of time, ease administrative burdens, and focus on delivering dedicated patient care.

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Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.
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