Find information on Acute Asthma, also known as an Asthma Attack or Acute Asthmatic Episode. This resource covers clinical documentation, medical coding, healthcare guidelines, and best practices for diagnosing and managing acute asthma exacerbations. Learn about symptoms, treatment, and prevention strategies for improved patient care. This information is relevant for healthcare professionals, including physicians, nurses, and medical coders seeking accurate and reliable resources.
Also known as
Asthma and status asthmaticus
Covers various types of asthma, including acute exacerbations.
Chronic lower respiratory diseases
Includes asthma alongside other chronic respiratory conditions.
Respiratory failure, not elsewhere classified
Relevant if acute asthma leads to severe respiratory compromise.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the asthma attack with status asthmaticus?
Yes
Code J46.21, Status asthmaticus
No
Is there acute exacerbation of asthma?
When to use each related code
| Description |
|---|
| Sudden worsening of asthma symptoms. |
| Long-term, chronic inflammatory airway disease. |
| Asthma triggered by exercise or physical activity. |
Risk of using a generic asthma code (e.g., J45.909) instead of a code specifying acuity (e.g., J45.901 for acute exacerbation), impacting reimbursement and data accuracy. Keywords: Medical coding, ICD-10-CM, J45.901, J45.909, asthma attack, acute asthma, CDI, healthcare compliance
Insufficient documentation of comorbidities (e.g., allergies, infections) contributing to the acute asthma episode, leading to undercoding and inaccurate severity reflection. Keywords: CDI, medical coding audits, risk adjustment, comorbid conditions, asthma exacerbation, healthcare compliance
Failure to identify and code status asthmaticus (J46), a severe form of acute asthma, if present, resulting in significant underpayment and quality of care concerns. Keywords: J46, status asthmaticus, severe asthma, respiratory failure, medical coding errors, CDI, healthcare compliance
Q: What are the key clinical indicators for differentiating acute asthma exacerbation from other respiratory distress presentations in adults?
A: Differentiating acute asthma exacerbation from other causes of respiratory distress like COPD exacerbation, heart failure, or pulmonary embolism requires a careful assessment of clinical indicators. While all may present with dyspnea and wheezing, acute asthma often features a more pronounced expiratory wheeze, a history of atopy or allergies, and a positive response to bronchodilators. Consider factors like reversibility of airflow obstruction with bronchodilator treatment, the presence of pulsus paradoxus (a drop in systolic blood pressure during inspiration), and peak expiratory flow rate (PEFR) measurements. Explore how incorporating bedside lung ultrasound can aid in rapid differentiation and guide management decisions. Also, note the absence of signs like jugular venous distension or unilateral leg swelling, which may suggest alternative diagnoses. Learn more about the utility of arterial blood gas analysis in assessing the severity of respiratory compromise and guiding oxygen therapy.
Q: How do current evidence-based guidelines recommend managing severe acute asthma in hospitalized patients, particularly regarding the use of non-invasive ventilation and systemic corticosteroids?
A: Current guidelines for managing severe acute asthma in hospitalized patients emphasize early intervention with systemic corticosteroids, such as intravenous methylprednisolone, alongside inhaled bronchodilators. In cases of severe airflow obstruction unresponsive to initial therapy, non-invasive ventilation (NIV), particularly continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP), can be considered to improve oxygenation and reduce work of breathing. However, careful monitoring for respiratory fatigue and potential need for intubation is crucial when using NIV. Consider implementing objective measures like PEFR, oxygen saturation, and arterial blood gas analysis to monitor treatment response and adjust management accordingly. Explore the latest research on the role of magnesium sulfate in severe asthma exacerbations and the potential benefits of adding inhaled anticholinergics to the treatment regimen.
Patient presents with an acute asthma exacerbation, also known as an asthma attack or acute asthmatic episode. Symptoms onset began approximately [timeframe] prior to presentation and include [list symptoms e.g., wheezing, shortness of breath, cough, chest tightness]. Patient reports [triggers e.g., exposure to allergens, exercise, respiratory infection]. Medical history significant for [relevant history e.g., asthma diagnosed at age [age], history of intubations, prior hospitalizations for asthma, current medications including dose and frequency]. Physical examination reveals [objective findings e.g., tachypnea, use of accessory muscles, decreased breath sounds, expiratory wheezing]. Pulmonary function testing, if performed, shows [results e.g., decreased FEV1, reduced peak expiratory flow rate]. Severity of exacerbation is assessed as [mild, moderate, or severe] based on clinical presentation and lung function. Differential diagnosis includes bronchiolitis, COPD exacerbation, pneumonia, and upper airway obstruction. Treatment initiated with [medications, dosages, and routes e.g., albuterol nebulizer treatments, systemic corticosteroids, supplemental oxygen]. Patient response to treatment documented as [describe response e.g., improved breath sounds, decreased wheezing, improved oxygen saturation]. Patient education provided regarding asthma management, trigger avoidance, and proper inhaler technique. Follow-up care arranged with [referrals e.g., primary care physician, pulmonologist]. Discharge instructions provided including medication reconciliation and action plan for future exacerbations. ICD-10 code J45.90 (Asthma, unspecified) or J45.21 (Mild intermittent asthma with (acute) exacerbation), if applicable, is considered for this encounter, along with relevant procedure codes for treatments administered. The medical necessity for services rendered is documented and supports the level of care provided.