# Help coding - I'm having a bit of an issue with a certain diagnosis



## ohn0disaster (Jul 12, 2010)

I'm having a bit of an issue with a certain diagnosis. The physician states "*chronic bronchial asthma*" as the diagnosis. The code for Bronchial Asthma is 493.90. The code 493.9X also states "Allergic Asthma", "Allergic Bronchitis", and "_Asthmatic Bronchitis_". There is no code for "chronic" bronchial asthma unless I'm supposed to be using the code for Chronic Asthmatic Bronchitis, 493.2X, for Chronic Bronchial Asthma. I'm pretty sure I'm just making this more difficult than it needs to be but I'd appeciate some input regardless.

*Which code should I be using for Chronic Bronchial Asthma, 493.90 or 493.20?*

Thanks in advance!


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## vj_tiwari (Jul 13, 2010)

Hey,

I think 493.9* is the appropriate code for Chronic Bronchial Asthma. {As I follows the ICD 9CM Asthma itself is a chronic disease, bronchial is included in asthma as per index of diseases. And also in Chronic Bronchial Asthma, Asthma is the main term (locate the main term)}. 

B'coz as per defination of Asthma, Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, airflow obstruction, and bronchospasm. Symptoms include wheezing, cough, chest tightness, and shortness of breath.

Although asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary disease as this term refers specifically to combinations of bronchiectasis, chronic bronchitis, and emphysema. Unlike these diseases, the airway obstruction in asthma is usually reversible; however, if left untreated, asthma can result in chronic inflammation of the lungs and irreversible obstruction. In contrast to emphysema, asthma affects the bronchi, not the alveoli.

Whereas Chronic asthmatic bronchitis (493.2*) is the condition in which the airways in the lungs are obstructed due to both persistent asthma and chronic bronchiti. People with this disease generally also have a persistent cough which brings up mucus. Chronic asthmatic bronchitis which also involves emphysema is usually classified under the more general category of COPD.

So, if you observe any coditions or symptoms regarding 493.2* then you can cosider it but not then 493.9* is the correct one. And if you obsevre the tabular list for 493.9* & 493.2* then it's easy for understanding.

Hope this helps! 

VJ.


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