# Acute illness with systemic symptoms



## sivakumar.s (May 26, 2021)

Hi Everyone,

could you please provide detailed explanation with examples for* "Acute illness with systemic symptoms"?*


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## mullenslemoine@aol.com (May 28, 2021)

Is Asthma, other  (J45.998) & rhinitis (J30.9) considered 1 acute illness with systemic symptoms? No diagnostic testing was done. Would this be a 99214?
Is Asthma, unspecified, uncomplicated (J45.909) & allergic rhinitis (J31.0) considered 1 acute illness with with systemic symptoms? No diagnostic testing done. Would this be a 99214?
Is Asthma w/acute exacerbation (J45.901) & Allergic rhinitis, unspecified (J30.9) considered 1 chronic illness with exacerbation? No diagnostic testing done. Would this be a 99214?


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## natashalage (May 30, 2021)

Hi. I am a new coder so please don't take my input as a rule. For 'Acute illness with systemic symptoms," examples from *E/M Service Guide file* are:
"_Acute illness with systemic symptoms (for example, pyelonephritis, pneumonitis, colitis_.)"
_Asthma w/acute exacerbation and rhinitis_- to me, is Moderate level for Number/Complexity for Problems because the key word is ' exacerbation of chronic illness" falls under Moderate level per E/M table. But it does not mean your entire E/M level is 99214; you will need to level your Data and Risk. If Data and Risk are a Low level, then your E/M is 99213. I know I didn't answer all questions but I am learning together with you and it's so nice when experienced coders share their knowledge with us in this Forum.


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## mullenslemoine@aol.com (Jun 3, 2021)

natashalage said:


> Hi. I am a new coder so please don't take my input as a rule. For 'Acute illness with systemic symptoms," examples from *E/M Service Guide file* are:
> "_Acute illness with systemic symptoms (for example, pyelonephritis, pneumonitis, colitis_.)"
> _Asthma w/acute exacerbation and rhinitis_- to me, is Moderate level for Number/Complexity for Problems because the key word is ' exacerbation of chronic illness" falls under Moderate level per E/M table. But it does not mean your entire E/M level is 99214; you will need to level your Data and Risk. If Data and Risk are a Low level, then your E/M is 99213. I know I didn't answer all questions but I am learning together with you and it's so nice when experienced coders share their knowledge with us in this Forum.


I have several examples I would love to run across you and get your opinion on this new E/M coding. Is data & risk considered as, records from outside reviewed and diagnostic testing and morbidity risk of dx? Also is there an email that I can send you some live examples from the clinic I work at?


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## mullenslemoine@aol.com (Jun 3, 2021)

mullenslemoine@aol.com said:


> I have several examples I would love to run across you and get your opinion on this new E/M coding. Is data & risk considered as, records from outside reviewed and diagnostic testing and morbidity risk of dx? Also is there an email that I can send you some live examples from the clinic I work at?


I think these examples would be great homework exercise to help us both learn together.


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## gchmelewski (Jul 20, 2021)

I have been struggling with this topic as well.  Every time I ask anyone about it even seasoned coders, I don't get a very clear explanation on how to know what falls here.  This is all I have been able to find regarding this.  My providers love to use this when leveling the visit often times giving a 4 over a 3 when used.   There are a few things that stand out to me in the definition.  One it has to have high risk of morbidity ( *when you have a specific illness or condition*) without txt.   What is the difference btw acute illness and minor illness?  I can not find any clinical examples either.  

Acute illness with systemic symptoms: An illness that causes systemic symptoms and has a *high risk of morbidity without treatment*. For systemic general symptoms, such as fever, body aches, or fatigue in a *minor illness* that may be treated to alleviate symptoms, shorten the course of illness, or to prevent complications, see the definitions for self-limited or minor problem or acute, uncomplicated illness or injury. Systemic symptoms may not be general but may be single system. Examples may include pyelonephritis, pneumonitis, or colitis.

Examples may include *acute myocardial infarction*, pulmonary embolus, severe respiratory distress, progressive severe rheumatoid arthritis, psychiatric illness with potential threat to self or others, peritonitis, acute renal failure, or an abrupt change in neurologic status.

Some of my claims are patients that have maybe fever, sore throat, headache and we test for covid.  Providers are many times putting these into that category.  It would be great to get some coders out here to put some good examples of when this can and should be used.


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## tphilpot1975 (Sep 8, 2021)

Good Morning would Pilonidal Cyst be considered Acute ill with systemic symptoms or acute uncomplicated illness?


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## dixiecups (Sep 16, 2021)

I would consider a pilonidal cyst to be an acute uncomplicated illness.   By definition a systemic illness affects the entire body, rather than a single organ or part.  Systemic disorders can include high blood pressure or an infection in the bloodstream. Left untreated, both conditions would affect the body - example untreated hypertension can lead to kidney disease.


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