Pediatric Coding Alert

Question: Which is the correct diagnosis code for reactive airway disease (RAD)?

Answer:  Your best bet for reporting RAD is typically 493.90 (Asthma, unspecified; unspecified). That’s because the ICD-9 manual does not contain the term in its alphabetical listing. And although ICD-9 doesn’t specifically direct you to 493.90 for RAD, ICD-9 considers RAD and asthma as the same diagnosis. You also won’t see RAD in your ICD-10 manual—it says “see asthma” when you look up “Reactive airway disease” in the alphabetical index. Code 493.90 crosswalks to J45.909 (Unspecified asthma, uncomplicated) under ICD-10. 

If the pediatrician writes “RAD” as the diagnosis and you’re unclear about which code to use, you should ask the physician, because he may prefer to describe the symptoms if he doesn’t want to go so far as to say the patient has asthma. Options in this category include wheezing (786.07) or shortness of breath (786.05). Under ICD-10, you’ll report R06.2, Wheezing, or R06.02, Shortness of breath, as appropriate.

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