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J45.909
ICD-10-CM
Persistent Asthma

Learn about persistent asthma diagnosis, including clinical documentation requirements, ICD-10-CM codes (J45.2, J45.3, J45.4, J45.5), medical coding guidelines, and severity assessment (mild, moderate, severe) for accurate healthcare reporting. Find information on managing persistent asthma, long-term control medications, and best practices for documenting exacerbations and symptom control in electronic health records. Understand the difference between intermittent and persistent asthma for proper diagnosis coding and improved patient care.

Also known as

Chronic Asthma
Long-term Asthma

Diagnosis Snapshot

Key Facts
  • Definition : Chronic airway inflammation causing recurring breathing problems.
  • Clinical Signs : Wheezing, shortness of breath, chest tightness, coughing (especially at night or early morning).
  • Common Settings : Primary care clinics, pulmonologist offices, urgent care, emergency rooms.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC J45.909 Coding
J45-J45

Asthma

Covers all types of asthma, including persistent.

J45.2-J45.2

Mild persistent asthma

Specifies mild persistent asthma severity.

J45.3-J45.3

Moderate persistent asthma

Specifies moderate persistent asthma severity.

J45.4-J45.4

Severe persistent asthma

Specifies severe persistent asthma severity.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is asthma confirmed?

  • Yes

    Is it persistent?

  • No

    Rule out other diagnoses

Code Comparison

Related Codes Comparison

When to use each related code

Description
Persistent asthma: Continual symptoms.
Intermittent asthma: Occasional symptoms.
Exercise-induced bronchoconstriction: Asthma with exercise.

Documentation Best Practices

Documentation Checklist
  • Persistent asthma diagnosis requires documented impairment.
  • Document asthma symptoms frequency and severity.
  • Include FEV1 or PEF measurements and % predicted.
  • Specify asthma control level (well, partly, uncontrolled).
  • Note medication usage and response to treatment.

Coding and Audit Risks

Common Risks
  • Unconfirmed Severity

    Coding asthma as persistent without documented impairment, airflow limitation, or medication use based on symptoms alone.

  • Status Asthmaticus

    Miscoding acute exacerbations requiring hospitalization as persistent asthma instead of status asthmaticus (J46).

  • Comorbidity Confusion

    Incorrectly coding COPD or other respiratory conditions as persistent asthma without proper diagnostic workup.

Mitigation Tips

Best Practices
  • Document asthma control level per NAEPP guidelines (ICD-10 J45.xx)
  • Confirm persistent asthma with spirometry (CPT 94010, 94060) for accurate CDI
  • Assess medication adherence and inhaler technique for optimized management (E/M Codes)
  • Document comorbidities like GERD or rhinitis impacting asthma (ICD-10)
  • Regularly review and update Asthma Action Plan for improved patient outcomes (HCC)

Clinical Decision Support

Checklist
  • Confirm ≥12 months of asthma symptoms
  • Verify episodic airflow obstruction or bronchospasm
  • Document exclusion of alternative diagnoses (ICD-10 J45.xx)
  • Check spirometry for reversible airflow limitation (FEV1/FVC improvement)
  • Correlate symptoms with triggers, severity, and impairment (GINA)

Reimbursement and Quality Metrics

Impact Summary
  • Persistent Asthma: ICD-10 J45.2, accurate coding maximizes reimbursement.
  • Quality metrics: Asthma control assessment, medication adherence impact reporting.
  • Optimize documentation: Severity, exacerbations, improve HCC coding, risk adjustment.
  • Reduce denials: Proper coding, supporting documentation, timely filing crucial.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Document persistent symptoms
  • Code asthma severity level
  • Check exacerbation frequency
  • Include control medication use
  • Note spirometry results

Documentation Templates

Patient presents with persistent asthma, characterized by chronic airway inflammation and reversible airflow obstruction.  Symptoms, including wheezing, shortness of breath (dyspnea), chest tightness, and cough, are reported as occurring frequently, often daily, and may interfere with sleep and daily activities.  Patient reports a history of recurrent exacerbations requiring oral corticosteroids or emergency room visits within the past year.  Pulmonary function testing (PFTs), including FEV1 and FVC measurements, demonstrates evidence of airflow limitation consistent with persistent asthma.  Severity is classified as [mild, moderate, or severe] persistent asthma based on symptom frequency, nighttime awakenings, lung function impairment (FEV1 percent predicted), and interference with normal activity.  Differential diagnoses considered include chronic obstructive pulmonary disease (COPD), bronchitis, vocal cord dysfunction, and upper airway obstruction.  Asthma control is currently deemed [well-controlled, not well-controlled, or very poorly controlled].  Treatment plan includes inhaled corticosteroids (ICS) as controller medication, with the addition of a long-acting beta-agonist (LABA) as needed.  Short-acting beta-agonists (SABAs) are prescribed for quick relief of acute symptoms.  Patient education provided on asthma triggers, medication adherence, proper inhaler technique, and asthma action plan.  Follow-up scheduled to assess treatment response, adjust medications as necessary, and monitor asthma control.  ICD-10 code J45.41 (persistent asthma) is assigned.  Medical billing codes for services rendered will be documented appropriately.