Pulmonology Coding Alert

Question: A 46-year-old patient with a history of smoking visited our office and saw the pulmonologist for an E/M service. The patient is currently on albuterol to control their moderate persistent asthma. The patient presented with complaints of coughing, runny nose, low-grade fever, and a strange sound when inhaling. After a physical examination and testing, the physician diagnosed the patient with tracheobronchitis due to Bordetella bronchiseptica with pneumonia.

Can you point me in the direction of the correct diagnosis codes?

Florida Subscriber

Answer: You’ll assign only A37.81 (Whooping cough due to other Bordetella species with pneumonia) to report the provider’s diagnosis of tracheobronchitis due to Bordetella with pneumonia.

Tracheobronchitis is listed under the “T” diagnoses of the ICD-10-CM Alphabetic Index even though “bronchitis” is in the term. You’ll then follow the indentations along Tracheobronchitis > due to > Bordetella bronchiseptica > with pneumonia. You can then verify the code in the Tabular List.

At the same time, if you search the ICD-10-CM Alphabetic Index for whooping cough, you can follow the indentations along Whooping cough > with pneumonia > due to Bordetella > bronchiseptica, which also leads you to A37.81.

Tracheobronchitis is an inflammation of the bronchi. This is typically caused by a bacterial or viral infection, but irritants such as such as cigarette smoke can also inflame the bronchi. Pertussis, or whooping cough, is a contagious respiratory system infection. The patient may suffer from a sharp cough then while inhaling the patient will produce a high-pitched sound, which sounds like a “whoop.” Both respiratory illnesses are similar, yet distinct. In your situation, the Bordetella bronchiseptica and pneumonia are the factors that connect the whooping cough and tracheobronchitis to A37.81.

If the provider confirmed a diagnosis of tracheobronchitis — without the Bordetella and pneumonia — then you’d look to the bronchitis codes in the ICD-10-CM code set.