Dear Cari

Coding and BillingNo Comments

Dear Cari,

I am trying to code the following scenario. Can you provide me some assistance?

A patient presents to the emergency room with SOB. A pulse oximetry reveals a low oxygen saturation. The emergency room physician’s report indicates SOB, hypoxemia, admit. The patient is admitted to inpatient status and the attending physician’s discharge summary documents, bronchitis, acute on chronic, asthma with acute exacerbation and acute respiratory failure. What codes should I assign?

Needing Help in Nebraska

Dear Needing Help,

The correct codes for this scenario are;

518.81, 491.22, 493.22

Codes for SOB and hypoxemia are not assigned because these are integral to the confirmed diagnoses. Chronic bronchitis with asthma is coded as chronic obstructive asthma or chronic asthmatic bronchitis, the 5th digit of 2 specifies with acute exacerbation and Code 491.22 reports acute bronchitis superimposed on chronic obstructive (asthmatic) bronchitis.

Hope that helps!


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