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v1.0.0
ICD-10 Guide
ICD-10 CodesA37.90

A37.90

Whooping cough, unspecified species without pneumonia

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

Code Description

ICD-10 A37.90 is a billable code used to indicate a diagnosis of whooping cough, unspecified species without pneumonia.

Key Diagnostic Point:

Whooping cough, or pertussis, is a highly contagious bacterial infection caused primarily by Bordetella pertussis. It 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, but it can affect individuals of all ages. The infection typically begins with mild respiratory symptoms, including a runny nose, sneezing, and low-grade fever, which can progress to intense coughing episodes. In cases classified under A37.90, the infection is specified as 'unspecified species,' indicating that the exact strain of Bordetella is not identified, and it is noted that the patient does not have pneumonia, which is a common complication of pertussis. Treatment usually involves antibiotics, such as azithromycin or erythromycin, which are most effective when administered early in the course of the illness. Vaccination remains the most effective preventive measure against whooping cough, with the DTaP vaccine recommended for children and Tdap for adolescents and adults. Monitoring for complications, especially in vulnerable populations, is crucial for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of symptoms
  • Need for accurate documentation of vaccination status
  • Differentiation from other respiratory infections
  • Potential for misclassification with pneumonia-related codes

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to document vaccination history
  • Misuse of unspecified codes leading to potential denials
  • Inconsistent coding practices across different providers

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 respiratory distress.

Billing Considerations

Close monitoring for complications in infants and timely vaccination updates.

Infectious Disease

Documentation Requirements

Comprehensive lab results, culture reports, and treatment response.

Common Clinical Scenarios

Outbreak investigations and management of pertussis cases in adults.

Billing Considerations

Consideration of antibiotic resistance patterns and public health reporting.

Coding Guidelines

Inclusion Criteria

Use A37.90 When
  • According to ICD
  • 10 coding guidelines, A37
  • 90 should be used when the diagnosis of whooping cough is confirmed without pneumonia
  • Coders must ensure that documentation supports the diagnosis and that any relevant symptoms are noted

Exclusion Criteria

Do NOT use A37.90 When
No specific exclusions found.

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 history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should ensure vaccination history is reviewed.

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 accuracy of data collection and epidemiological tracking. A37.90 provides a clear distinction for cases without pneumonia, aiding in public health reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of whooping cough, improving the accuracy of data collection and epidemiological tracking. A37.90 provides a clear distinction for cases without pneumonia, aiding in public health reporting.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of whooping cough, improving the accuracy of data collection and epidemiological tracking. A37.90 provides a clear distinction for cases without pneumonia, aiding in public health reporting.

Resources

Clinical References

  • •
    CDC Pertussis Information

Coding & Billing References

  • •
    CDC Pertussis Information

Frequently Asked Questions

What is the significance of the unspecified species in A37.90?

The unspecified species indicates that the exact strain of Bordetella causing the infection has not been identified, which can occur in clinical practice when laboratory testing is not performed or is inconclusive.