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ICD-10 Guide
ICD-10 CodesA37.1

A37.1

Whooping cough due to Bordetella pertussis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A37.1 is a billable code used to indicate a diagnosis of whooping cough due to bordetella pertussis.

Key Diagnostic Point:

Whooping cough, or pertussis, is a highly contagious bacterial infection caused by Bordetella pertussis. It primarily affects the respiratory system and is characterized by severe coughing fits that can lead to a 'whooping' sound during inhalation. The disease is particularly dangerous for infants and young children, who may experience complications such as pneumonia, seizures, and even death. The infection is transmitted through respiratory droplets, making it easily spread in crowded environments. Diagnosis is typically confirmed through clinical evaluation and laboratory tests, including PCR and culture methods. Treatment usually involves antibiotics, such as azithromycin or erythromycin, which are most effective when administered early in the course of the illness. Vaccination is the primary preventive measure, with the DTaP vaccine recommended for children and Tdap for adolescents and adults. The resurgence of whooping cough in recent years has raised concerns about vaccine coverage and the emergence of antibiotic resistance, necessitating ongoing public health efforts to monitor and control the disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of cough-related illnesses
  • Understanding the nuances of vaccination history and its impact on coding
  • Recognizing the potential for complications that may require additional coding
  • Navigating the documentation requirements for both acute and chronic cases

Audit Risk Factors

  • Inadequate documentation of vaccination status
  • Failure to document the severity of symptoms
  • Misclassification of the type of cough or respiratory illness
  • Lack of supporting lab results for diagnosis

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of cough, vaccination status, and any complications.

Common Clinical Scenarios

Infants presenting with severe cough and difficulty breathing.

Billing Considerations

Documentation must clearly indicate the age of the patient and vaccination history.

Infectious Disease

Documentation Requirements

Comprehensive lab results and treatment plans, including antibiotic therapy.

Common Clinical Scenarios

Outbreak investigations and management of pertussis cases.

Billing Considerations

Consideration of antibiotic resistance patterns in treatment.

Coding Guidelines

Inclusion Criteria

Use A37.1 When
  • According to ICD
  • 10 coding guidelines, A37
  • 1 should be used when the diagnosis of whooping cough is confirmed as being due to Bordetella pertussis

Exclusion Criteria

Do NOT use A37.1 When
  • Exclusion criteria include cases where the causative organism is not specified or is due to other pathogens

Related CPT Codes

99213CPT Code

Established patient office visit, level 3

Clinical Scenario

Used for follow-up visits for patients diagnosed with whooping cough.

Documentation Requirements

Document the patient's symptoms, treatment response, and any complications.

Specialty Considerations

Pediatricians should ensure vaccination history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of whooping cough, improving the ability to track outbreaks and manage public health responses. It has also emphasized the importance of accurate documentation of causative organisms.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of whooping cough, improving the ability to track outbreaks and manage public health responses. It has also emphasized the importance of accurate documentation of causative organisms.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of whooping cough, improving the ability to track outbreaks and manage public health responses. It has also emphasized the importance of accurate documentation of causative organisms.

Resources

Clinical References

  • •
    CDC Pertussis Information

Coding & Billing References

  • •
    CDC Pertussis Information

Frequently Asked Questions

What is the primary treatment for whooping cough?

The primary treatment for whooping cough is antibiotics, such as azithromycin or erythromycin, which are most effective when started early in the illness.