# COPD exacerbation and Asthma exacerbation



## tharal (Nov 22, 2013)

Hi,

Help needed to clarify a coding scenario!

Patient has COPD Exacerbation and Asthma Exacerbation...When we take code for copd in book we will get a subterm exacerbation which leads to 491.21
another subterm with asthma 493.2x and in tabular list we will get 493.22 for obstructive asthma-with exacerbation.

Can we add both for this scenario to fully describe the condition because the first code only saying copd exacerbation and the second code saying asthma exacerbation with copd...


Thanks in advance for any help

Thara L CPC H


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## devinmajor14 (Nov 22, 2013)

I would code COPD w/ asthma excerbation (acute). 493.22


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## tharal (Nov 25, 2013)

If COPD with exacerbated with Asthma, how it will go Devin? need your help..

Thara L CPC H


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## devinmajor14 (Nov 26, 2013)

493.20 for COPD w/ asthma 

493.22 for COPD w/ asthma (acute) excerbation

Double check me, but this is how I've been coding these conditions in the ER with no problems.


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## tharal (Nov 26, 2013)

Thanks Devin,  it's very confusing nowadays...
I was using 491.21 for copd exacerbation and 493.22 for asthma exacerbation with copd. If Copd exacerbation with asthma documents I am coding 491.21 and 493.20. The book leads us like that, separate entry for copd with asthma and with exacerbation. In 493.22 the fifth digits indicates asthma exacerbation only but I agree it's the combination code for Asthma with COPD. the fifth digit exacerbation is confusing...whether its asthma exacerbation or copd exacerbation. One more thing there is a coding clinic for COPD  exacerbation with Asthma exacerbation and acute bronchitis.

Acute Exacerbation of COPD and Asthma with Acute Bronchitis

Coding Clinic, Third Quarter 2006 Page 18:
Effective with Discharges: September 30, 2006

Question:

What is the appropriate code assignment for acute exacerbation of COPD, acute bronchitis and acute exacerbation of asthma?  

Answer:

Assign code 491.22, Obstructive chronic bronchitis, with acute bronchitis, and code 493.22, Chronic obstructive asthma with (acute) exacerbation, for acute exacerbation of COPD, acute bronchitis and acute exacerbation of asthma.


This coding clinic also confusing me...

Kindly bear some time to resolve this issue...

Thara L CPC H


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## tharal (Nov 28, 2013)

Thanks Devin, it's very confusing nowadays...
I was using 491.21 for copd exacerbation and 493.22 for asthma exacerbation with copd. If Copd exacerbation with asthma documents I am coding 491.21 and 493.20. The book leads us like that, separate entry for copd with asthma and with exacerbation. In 493.22 the fifth digits indicates asthma exacerbation only but I agree it's the combination code for Asthma with COPD. the fifth digit exacerbation is confusing...whether its asthma exacerbation or copd exacerbation. One more thing there is a coding clinic for COPD exacerbation with Asthma exacerbation and acute bronchitis.

Acute Exacerbation of COPD and Asthma with Acute Bronchitis

Coding Clinic, Third Quarter 2006 Page 18:
Effective with Discharges: September 30, 2006

Question:

What is the appropriate code assignment for acute exacerbation of COPD, acute bronchitis and acute exacerbation of asthma? 

Answer:

Assign code 491.22, Obstructive chronic bronchitis, with acute bronchitis, and code 493.22, Chronic obstructive asthma with (acute) exacerbation, for acute exacerbation of COPD, acute bronchitis and acute exacerbation of asthma.


This coding clinic also confusing me...

Kindly bear some time to resolve this issue...

Thara L CPC H


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