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ICD-10 Guide
ICD-10 CodesJ05.0

J05.0

Acute obstructive laryngitis [croup]

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J05.0 is a billable code used to indicate a diagnosis of acute obstructive laryngitis [croup].

Key Diagnostic Point:

Acute obstructive laryngitis, commonly known as croup, primarily affects children and is characterized by inflammation of the larynx and subglottic airway. Clinically, it presents with a distinctive barking cough, stridor (a high-pitched wheezing sound), and hoarseness due to the narrowing of the airway. The condition is often viral in origin, with parainfluenza viruses being the most common causative agents. The anatomy involved includes the larynx, trachea, and surrounding soft tissues, which can become edematous, leading to airway obstruction. Disease progression can vary; mild cases may resolve spontaneously, while severe cases can lead to significant respiratory distress requiring immediate medical intervention. Diagnostic considerations include clinical evaluation based on symptoms, history of recent upper respiratory infections, and, in some cases, imaging studies to rule out other causes of stridor. Treatment typically involves corticosteroids to reduce inflammation and, in severe cases, nebulized epinephrine to relieve airway obstruction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical assessment and differentiation from other respiratory conditions.
  • Treatment complexity: May involve outpatient management or hospitalization based on severity.
  • Documentation requirements: Detailed symptomatology and treatment response must be documented.
  • Coding specificity: Requires accurate coding to distinguish from other respiratory conditions such as J06.9 (acute upper respiratory infection, unspecified).

Audit Risk Factors

  • Common coding errors: Misclassification with other respiratory conditions.
  • Documentation gaps: Incomplete records of symptoms or treatment response.
  • Billing challenges: Denials due to lack of specificity or insufficient documentation.

Specialty Focus

Medical Specialties

Pediatrics

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

Croup is a significant cause of respiratory distress in children, impacting population health through increased emergency department visits and hospitalizations. Understanding the epidemiology of croup, including seasonal variations and viral etiologies, is crucial for healthcare providers. Quality measures may focus on timely diagnosis and effective management to reduce complications and improve patient outcomes.

ICD-9 vs ICD-10

Croup is a significant cause of respiratory distress in children, impacting population health through increased emergency department visits and hospitalizations. Understanding the epidemiology of croup, including seasonal variations and viral etiologies, is crucial for healthcare providers. Quality measures may focus on timely diagnosis and effective management to reduce complications and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the setting of care (outpatient vs. inpatient). Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for treatments such as corticosteroids or nebulized epinephrine. Best practices include ensuring that all clinical notes clearly outline the patient's symptoms, treatment rationale, and response to therapy to support the coding and billing process.

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 J05.0?

J05.0 specifically covers acute obstructive laryngitis (croup) caused by viral infections, primarily affecting children. It is characterized by symptoms such as a barking cough, stridor, and hoarseness.

When should J05.0 be used instead of related codes?

J05.0 should be used when the patient presents with classic symptoms of croup, particularly when there is evidence of airway obstruction due to laryngeal inflammation. It is distinct from other upper respiratory infections that do not involve significant laryngeal obstruction.

What documentation supports J05.0?

Documentation should include a detailed account of the patient's symptoms, clinical findings (such as stridor and cough), treatment administered, and any response to treatment. History of recent upper respiratory infections should also be noted.