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ICD-10 Guide
ICD-10 CodesJ21.8

J21.8

Acute bronchiolitis due to other specified organisms

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

Code Description

ICD-10 J21.8 is a billable code used to indicate a diagnosis of acute bronchiolitis due to other specified organisms.

Key Diagnostic Point:

Acute bronchiolitis due to other specified organisms is a respiratory condition primarily affecting infants and young children, characterized by inflammation of the bronchioles, the small air passages in the lungs. Clinically, it presents with symptoms such as wheezing, coughing, shortness of breath, and respiratory distress. The condition is often triggered by viral infections, but in cases coded as J21.8, the causative organisms may include atypical pathogens such as Mycoplasma pneumoniae or Chlamydia pneumoniae. The anatomy involved includes the bronchioles, which are crucial for air passage and gas exchange. Disease progression can lead to significant respiratory compromise, particularly in vulnerable populations. Diagnosis typically involves a clinical evaluation supported by history, physical examination, and may include imaging or laboratory tests to identify the specific organism responsible. Differential diagnoses include other causes of wheezing and respiratory distress, such as asthma or pneumonia, which must be ruled out to ensure accurate coding and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires identification of specific organisms and differentiation from other respiratory conditions.
  • Treatment complexity: Management may involve supportive care, bronchodilators, or corticosteroids depending on severity.
  • Documentation requirements: Detailed clinical notes are essential to support the diagnosis and code selection.
  • Coding specificity: Requires precise coding to differentiate from other bronchiolitis codes.

Audit Risk Factors

  • Common coding errors: Misidentification of the causative organism can lead to incorrect coding.
  • Documentation gaps: Incomplete clinical notes may hinder accurate code assignment.
  • Billing challenges: Insufficient documentation may result in claim denials or delays.

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

Pulmonology

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

Acute bronchiolitis due to other specified organisms has significant clinical implications, particularly in pediatric populations. It can lead to increased healthcare utilization, including emergency visits and hospitalizations. Understanding the epidemiology of this condition helps in developing preventive strategies and quality measures aimed at reducing incidence rates. Effective management can improve patient outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Acute bronchiolitis due to other specified organisms has significant clinical implications, particularly in pediatric populations. It can lead to increased healthcare utilization, including emergency visits and hospitalizations. Understanding the epidemiology of this condition helps in developing preventive strategies and quality measures aimed at reducing incidence rates. Effective management can improve patient outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis aligns with the services provided. Common denials may arise from insufficient documentation or failure to specify the organism. Best practices include thorough clinical notes and ensuring that all coding guidelines are followed to minimize audit risks and ensure timely payment.

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 J21.8?

J21.8 covers acute bronchiolitis caused by specified organisms other than the common respiratory syncytial virus (RSV), including atypical bacteria such as Mycoplasma pneumoniae and Chlamydia pneumoniae. It is essential to document the specific organism to justify the use of this code.

When should J21.8 be used instead of related codes?

J21.8 should be used when the acute bronchiolitis is confirmed to be due to specified organisms other than RSV. If the causative agent is RSV, J21.0 should be used. Accurate differentiation is crucial for appropriate treatment and billing.

What documentation supports J21.8?

Documentation should include a clear clinical assessment, identification of the specific organism causing the bronchiolitis, and any relevant laboratory or imaging results. Detailed notes on the patient's symptoms and treatment response are also necessary.