Pulmonology Coding Alert

Question: The physician diagnosed a six-month-old patient with croup. The mom describes the cough as seal-like barking and reports that the baby's symptoms are worse at night. The patient also has a family history of asthma. Does the family history mean I should code asthmatic croup, rather than croup?

Answer: You should not code asthmatic croup or cough-variant asthma (493.8, Other specified asthma) in this case. Croup and asthmatic croup are two different things. The regular croup that young children get that sounds, as the mother in your case describes, like a seal barking and worsens at night is regular croup (464.4). Documentation should state "asthmatic croup" before you can use 493.8.