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ICD-10 Guide
ICD-10 CodesA37.01

A37.01

Whooping cough due to Bordetella pertussis with pneumonia

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

Code Description

ICD-10 A37.01 is a billable code used to indicate a diagnosis of whooping cough due to bordetella pertussis with pneumonia.

Key Diagnostic Point:

Whooping cough, or pertussis, is a highly contagious respiratory disease caused by the bacterium Bordetella pertussis. It is characterized by severe coughing fits that can lead to difficulty breathing, vomiting, and exhaustion. When pertussis is complicated by pneumonia, it can lead to significant morbidity, particularly in infants and young children. The pneumonia associated with whooping cough is typically a result of the infection spreading to the lungs, leading to inflammation and consolidation. Symptoms of pneumonia may include fever, chills, cough, and difficulty breathing. Diagnosis is primarily based on clinical presentation and can be confirmed through laboratory tests such as PCR or culture of nasopharyngeal secretions. Treatment typically involves antibiotics, such as azithromycin or erythromycin, which are most effective when administered early in the course of the disease. Supportive care, including hydration and oxygen therapy, may also be necessary, especially in severe cases. Vaccination with the DTaP vaccine is crucial for prevention, particularly in vulnerable populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between whooping cough and other respiratory infections
  • Identifying pneumonia as a complication of whooping cough
  • Understanding the nuances of coding for bacterial infections
  • Documentation requirements for confirming the causative organism

Audit Risk Factors

  • Inadequate documentation of pneumonia as a complication
  • Failure to specify the causative organism
  • Misclassification of the severity of the infection
  • Lack of clarity in the clinical notes regarding treatment

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on symptoms, laboratory results, and treatment plans.

Common Clinical Scenarios

Infants presenting with severe cough and respiratory distress.

Billing Considerations

Documentation must clearly indicate the age of the patient and vaccination status.

Infectious Disease

Documentation Requirements

Comprehensive lab results, including culture and sensitivity testing.

Common Clinical Scenarios

Patients with atypical presentations of pneumonia or recurrent respiratory infections.

Billing Considerations

Focus on the identification of the pathogen and resistance patterns.

Coding Guidelines

Inclusion Criteria

Use A37.01 When
  • According to ICD
  • 10 guidelines, A37
  • 01 should be used when there is a confirmed diagnosis of whooping cough due to Bordetella pertussis with pneumonia
  • Coders must ensure that documentation supports the diagnosis and that pneumonia is clearly indicated as a complication

Exclusion Criteria

Do NOT use A37.01 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

Documentation must include the patient's history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should ensure vaccination history is included.

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 and its complications, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of whooping cough and its complications, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Pertussis Information

Coding & Billing References

  • •
    CDC Pertussis Information

Frequently Asked Questions

What are the common symptoms of whooping cough?

Common symptoms include severe coughing fits, a 'whooping' sound during inhalation, vomiting after coughing, and exhaustion. In infants, symptoms may also include apnea.