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v1.0.0
ICD-10 Guide
ICD-10 CodesR05.1

R05.1

Acute cough

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R05.1 is a billable code used to indicate a diagnosis of acute cough.

Key Diagnostic Point:

Acute cough is defined as a sudden onset of coughing that lasts less than three weeks. It can be a symptom of various underlying conditions, including infections, allergies, or irritants. Acute cough is often associated with other symptoms such as fever, sputum production, or wheezing, which can help in determining the underlying cause. Common causes include viral infections like the common cold or influenza, bacterial infections such as pneumonia or bronchitis, and environmental factors like smoke or allergens. The clinical approach to acute cough typically involves a thorough history and physical examination, focusing on the duration, characteristics of the cough, and associated symptoms. Laboratory findings may include sputum analysis or chest X-rays if pneumonia is suspected. Accurate coding requires careful documentation of the cough's characteristics and any associated symptoms to ensure appropriate treatment and billing.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying causes
  • Need for detailed patient history
  • Differentiation from chronic cough
  • Documentation of associated symptoms

Audit Risk Factors

  • Inadequate documentation of cough characteristics
  • Failure to note associated symptoms
  • Misclassification of acute vs. chronic cough
  • Lack of supporting lab findings

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including duration and characteristics of cough, associated symptoms, and any relevant medical history.

Common Clinical Scenarios

Patients presenting with acute cough due to viral infections, exacerbations of chronic conditions, or allergic reactions.

Billing Considerations

Consideration of comorbidities that may complicate the diagnosis and treatment of acute cough.

Emergency Medicine

Documentation Requirements

Acute care documentation must include vital signs, immediate assessment findings, and any interventions performed.

Common Clinical Scenarios

Patients presenting with acute cough in the context of respiratory distress or severe infections.

Billing Considerations

Rapid assessment and documentation are crucial due to the potential for serious underlying conditions.

Coding Guidelines

Inclusion Criteria

Use R05.1 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the code reflects the acute nature of the cough and any associated symptoms or findings

Exclusion Criteria

Do NOT use R05.1 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 with acute cough.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Internal medicine providers should ensure comprehensive documentation to support the visit level.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acute cough, improving the ability to capture the nuances of patient presentations and associated conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of acute cough, improving the ability to capture the nuances of patient presentations and associated conditions.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of acute cough, improving the ability to capture the nuances of patient presentations and associated conditions.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What is the difference between acute cough and chronic cough?

Acute cough lasts less than three weeks and is often associated with infections or irritants, while chronic cough persists for more than eight weeks and may indicate underlying chronic conditions.