Pulmonology Coding Alert

Question: Concerning the coding of acute bronchospasm (519.11), when is it appropriate to simply report 786.07 for wheezing? Wisconsin Subscriber Answer: The best code for wheezing that the physician finds on physical examination, or what physicians call wheezing-associated respiratory illness (WARI), is 519.11 (Acute bronchospasm). Code 786.07 (Wheezing) can be used when the patient complains of wheezing, but the pulmonologist does not find wheezing during the physical examination. Code 519.11 is more specific for bronchospasm. Physicians use the diagnosis of WARI for patients who don't meet the criteria for a diagnosis of asthma. An example of WARI is a child with an upper respiratory infection (URI) who has her first episode of associated wheezing and requires treatment of bronchospasm. This would typically not warrant labeling a child with "asthma," using ICD-9 code 493.02 (Extrinsic asthma; with [acute] exacerbation), but would warrant using 519.11.