ICD-10 Guide

J04.3

Supraglottitis, unspecified

BILLABLE STATUSNo

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/06/2025

Code Description

ICD-10 J04.3 is a used to indicate a diagnosis of supraglottitis, unspecified.

Key Diagnostic Point:

Supraglottitis, unspecified, refers to the inflammation of the supraglottic region of the larynx, which is located above the vocal cords. This condition can lead to significant respiratory distress due to swelling and obstruction of the airway. Clinically, patients may present with symptoms such as sore throat, difficulty swallowing, hoarseness, and stridor, which is a high-pitched wheezing sound indicative of airway obstruction. The anatomy involved includes the epiglottis and surrounding structures, which play a crucial role in protecting the airway during swallowing. Disease progression can vary; in some cases, it may resolve with appropriate treatment, while in others, it can lead to severe airway compromise requiring emergency intervention. Diagnostic considerations include a thorough clinical evaluation, laryngoscopy, and imaging studies if necessary to assess the extent of inflammation and rule out other conditions such as epiglottitis or laryngeal abscess. Prompt diagnosis and management are essential to prevent complications such as respiratory failure.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Diagnostic complexity: Requires clinical evaluation and possibly imaging.
Treatment complexity: May involve outpatient management or emergency interventions.
Documentation requirements: Detailed clinical notes and symptom descriptions are necessary.
Coding specificity: Requires accurate coding to differentiate from related conditions.

Audit Risk Factors

Common coding errors: Misclassification with other upper respiratory conditions.
Documentation gaps: Incomplete symptom descriptions or lack of diagnostic testing.
Billing challenges: Potential denials if documentation does not support the severity of the condition.

Specialty Focus

Medical Specialties

Otolaryngology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Emergency Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Supraglottitis can significantly impact patient health, leading to potential airway obstruction and respiratory failure if not promptly addressed. It is essential for healthcare providers to recognize the signs and symptoms early to facilitate timely intervention. The condition may affect various populations, particularly children and immunocompromised individuals, highlighting the need for awareness and preventive measures in community health initiatives.

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the necessity for emergency services if applicable. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical details are captured in the medical record to support the diagnosis and any associated procedures performed.

Resources

Clinical References

•
ICD-10 Official Guidelines for J00-J99
•
Clinical Documentation Requirements

Coding & Billing References

•
ICD-10 Official Guidelines for J00-J99
•
Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J04.3?

J04.3 covers cases of supraglottitis that are not specified as acute or chronic. It may include cases with varying degrees of inflammation and symptoms but does not specify the underlying cause.

When should J04.3 be used instead of related codes?

J04.3 should be used when the supraglottitis is not further specified or when the clinical presentation does not meet the criteria for other specific codes such as J04.0 or J04.1.

What documentation supports J04.3?

Documentation should include a detailed history of symptoms, physical examination findings, any diagnostic tests performed, and the clinical rationale for the diagnosis of supraglottitis.

ICD-10 J04.3 is a used to indicate a diagnosis of supraglottitis, unspecified.