Internal Medicine Coding Alert
Asthma With Croup Requires 5-Digit ICD-9 Code
Question: An established patient with a history of asthma who is now taking Albuterol reports to the internist with a barking cough. The physician performs a level-three E/M service, notes a "croupy-sounding cough" and gives a final diagnosis of asthma. In this scenario, what ICD-9 code (or codes) should I report? Answer: You should choose a diagnosis code that reflects the patient's asthma and the croupy sounds. ICD-9 does contain a diagnosis code that represents both. On the claim, you should report the following: Note: When you look up "Croup, asthmatic" in the ICD-9 index, it instructs you to use 493.9x.
Michigan Subscriber
• 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem-focused history; an expanded problem-focused examination; medical decision-making of low complexity) for the E/M service
• 493.90 (Asthma, unspecified) linked to 99213 to represent the patient's asthma and croup.
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