Bronchitis refers to the inflammation of the bronchi and is mainly categorized as acute and chronic bronchitis. If viruses and bacterial infections are the major cause of acute bronchitis, cigarette smoking and air pollution are the causes for chronic bronchitis. Accurate diagnosis of bronchitis is very important to provide appropriate care and treatment at the right time. As ICD-10 is implemented from October 1, 2015, ICD-10 medical coding for bronchitis is a matter of concern for healthcare providers. With increased specificity and complexity, the new system will have a significant impact on medical billing.
Five Documentation Requirements for Bronchitis
The common symptoms of bronchitis are sore throat, headache, cough, runny or stuffy nose, muscle aches and fatigue. When it comes to severe cases, the patient may experience general malaise and chest pain. In the case of a patient with an underlying lung condition such as chronic obstructive pulmonary disease (COPD), there would be dyspnea and cyanosis. As the ICD-10 codes are more specific, your documentation should clearly specify the symptoms and other conditions that will help to choose the most appropriate codes. The five ICD-10 documentation requirements for bronchitis are as follows.
- Type: This refers to the exact type of bronchitis and includes simple, mucopurulent, fibrinous, membranous, purulent, or septic bronchitis.
- Temporal Factors: These are also called parameters, which include acute, chronic, acute on chronic and recurrent.
- Infectious Agents: These may include Mycoplasma pneumoniae, Hemophilus influenzae, Streptococcus, Coxsackie virus, Parainfluenza virus, Respiratory syncytial virus, Rhinovirus, Echovirus and other specified organisms.
- Associated Conditions: These may include tracheitis, tracheobronchitis and bronchospasm. Apart from ICD-10 coding, these conditions should be documented for supporting medical necessity for the services rendered.
- Cause or Contributing Factors: These may include tobacco smoke exposure (occupational or environmental), tobacco dependence, tobacco use, or history of tobacco use. You must assign an additional ICD-10 code to specify this along with the diagnosis code for bronchitis.
ICD-10 Codes for Bronchitis
The bronchitis codes are classified as acute or chronic in ICD-10-CM. Both these types are further divided into more categories.
Acute Bronchitis
- J20: Acute bronchitis
- J20.0: Acute bronchitis due to Mycoplasma pneumoniae
- J20.1: Acute bronchitis due to Hemophilus influenzae
- J20.2: Acute bronchitis due to streptococcus
- J20.3: Acute bronchitis due to coxsackievirus
- J20.4: Acute bronchitis due to parainfluenza virus
- J20.5: Acute bronchitis due to respiratory syncytial virus
- J20.6: Acute bronchitis due to rhinovirus
- J20.7: Acute bronchitis due to echovirus
- J20.8: Acute bronchitis due to other specified organisms
- J20.9: Acute bronchitis, unspecified
Chronic Bronchitis
- J41: Simple and mucopurulent chronic bronchitis
- J41.0: Simple chronic bronchitis
- J41.1: Mucopurulent chronic bronchitis
- J41.8: Mixed simple and mucopurulent chronic bronchitis
- J42: Unspecified chronic bronchitis
Though each subcategory comprises an unspecified code, you must assign the following code if the documentation does not specify a time parameter.
- J40: Bronchitis, not specified as acute or chronic
As the new ICD-10 start date is Oct. 1, 2015, providers must pay closer attention to their documentation practices to ensure accurate documentation and coding for bronchitis and avoid losing reimbursement after ICD-10 implementation. Consider teaming up with professional medical billing and coding experts trained and proficient in the new coding system.
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