# Allergic Rhinitis/Asthma



## francotti@aol.com (Jun 11, 2013)

Good Day everyone,

I need some assistance please if provider documents allergic rhinitis with asthma is it two seperate codes 477.9 and 493.90 or is it a combination 493.00.


Thanks in Advance
Colin


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## kvangoor (Jun 11, 2013)

I believe it is one code 493.00


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## slshields (Jun 11, 2013)

*Use Guideline*

I would follow the guideline useage for "with"  and select the apporiate code(s)


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## tharal (Jun 11, 2013)

493.00 will use

Thara L CPC H


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## mitchellde (Jun 12, 2013)

the physician states allergic rhinitis with asthma  there is nothing about whether the asthma is intrinsic or extrinsic.  the allergic rhinitis can tric trigger attacks in both forms of asthma, with no further specification I feel you should code the allergic rhinitis and code the asthma as unspecified.


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## tharal (Jun 12, 2013)

When we go with the main term in alphabetic index asthma with rhinitis, allergic we will get 493.0x and the main term rhinitis with asthma also leads to 493.0x. Here as states the provider clearly documented the condition 'allergic rhinitis with asthma', hence can we go with the index in this case or it is necessary to query intrinsic or extrinsic (variable terms) to code as 493.0x?

Thanks
Thara L CPC H


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## francotti@aol.com (Jun 12, 2013)

*Thanks*

Thanks to everyone on your feedback it was definitely helpful in coding my visit.


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## Aardvark (Jul 15, 2014)

When you look up Asthma in the Index, and follow it down to "with rhinitis, allergic" it refers you to a combination code of 493.00. So basically if the doctor is coding Asthma 493.90 and also Allergic Rhinitis (477.xx), then you would use the combo code 493.00 and drop the 477.xx Allergic Rhinitis, because the addition of "allergic rhinitis" (477.xx) makes the asthma "extrinsic'. Extrinsic asthma means there is an allergen, such as pollen, pet dander and mold, etc., that is triggering the asthma. In contrast, Intrinsic Asthma means asthma symptoms are triggered by factors not related to allergies, such as laughing, coughing, contact with chemicals like cleaning agents and cigarette smoke, exercising, etc. Even if the physician is coding 493.00 Extrinsic Asthma and also Allergic Rhinitis then again, you would use the combo code 493.00 and drop the Allergic Rhinitis. If however, the physician uses the phrase "Allergic Asthma" (493.90) without stating 'Allergic Rhinitis' then the only way you would be able to use a combo code of 493.00, would be if he actually stated the allergen that was causing it to be allergic asthma within the documentation. Just remember, for it to be considered Extrinsic, there has to be an allergen or the phrase "allergic rhinitis" stated within the documentation.


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## Jean Cantieni (Apr 14, 2015)

*asthma and allergic rhinitis*

I there a formal reference for this combo code? A written guideline, etc...?

Thx
Jean Cantieni, CPC-A


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