ICD-10 Guide

J05.10

Acute epiglottitis without obstruction

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/06/2025

Code Description

ICD-10 J05.10 is a billable code used to indicate a diagnosis of acute epiglottitis without obstruction.

Key Diagnostic Point:

Acute epiglottitis without obstruction is a serious inflammatory condition affecting the epiglottis, a flap of tissue that sits at the base of the tongue and prevents food from entering the windpipe during swallowing. Clinically, patients may present with sudden onset of fever, sore throat, difficulty swallowing (dysphagia), and stridor, which is a high-pitched wheezing sound indicative of airway obstruction. The condition is most commonly seen in children but can also occur in adults. The disease progression can be rapid, leading to airway compromise, making timely diagnosis and intervention critical. Diagnostic considerations include a thorough clinical evaluation, imaging studies such as lateral neck X-rays, and direct visualization via laryngoscopy. The absence of obstruction in J05.10 indicates that while the epiglottis is inflamed, the airway remains patent, differentiating it from more severe cases requiring immediate airway management. Understanding the anatomy involved and the potential for rapid deterioration is essential for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Diagnostic complexity
Treatment complexity
Documentation requirements
Coding specificity

Audit Risk Factors

Common coding errors include misclassification of severity and failure to document the absence of obstruction.
Documentation gaps may arise if the clinical presentation is not thoroughly recorded.
Billing challenges can occur if the condition is not clearly distinguished from other respiratory infections.

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

Acute epiglottitis, while less common due to vaccination efforts, remains a significant concern in pediatric populations. Its clinical significance lies in the potential for rapid airway compromise, necessitating prompt recognition and treatment. The impact on population health includes the need for emergency interventions and hospitalizations, which can strain healthcare resources. Quality measures focus on timely diagnosis and management to prevent complications, highlighting the importance of awareness among healthcare providers.

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the need for potential airway management. Documentation must support the diagnosis, including clinical findings and any imaging studies performed. Common denials may arise from insufficient documentation or incorrect coding, emphasizing the need for thorough clinical notes and adherence to coding guidelines. Best practices include regular training on coding updates and ensuring that all relevant clinical information is captured in the patient's record.

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 J05.10?

J05.10 specifically covers acute epiglottitis without obstruction, characterized by inflammation of the epiglottis that does not impede airflow. It is important to differentiate this from other respiratory conditions that may present similarly.

When should J05.10 be used instead of related codes?

J05.10 should be used when a patient presents with acute epiglottitis symptoms but without any signs of airway obstruction. If obstruction is present, J05.11 should be selected.

What documentation supports J05.10?

Documentation should include clinical findings such as fever, stridor, and dysphagia, as well as imaging results that confirm the diagnosis of acute epiglottitis without obstruction.

ICD-10 J05.10 is a billable code used to indicate a diagnosis of acute epiglottitis without obstruction.