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ICD-10 Guide
ICD-10 CodesJ45.901

J45.901

Unspecified asthma with (acute) exacerbation

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

Code Description

ICD-10 J45.901 is a billable code used to indicate a diagnosis of unspecified asthma with (acute) exacerbation.

Key Diagnostic Point:

J45.901 refers to unspecified asthma with (acute) exacerbation, a condition characterized by the sudden worsening of asthma symptoms, which can include wheezing, shortness of breath, chest tightness, and coughing. Asthma is a chronic inflammatory disease of the airways, primarily affecting the bronchi and bronchioles, leading to airflow obstruction. The exacerbation may be triggered by various factors such as allergens, respiratory infections, exercise, or environmental pollutants. The disease progression can vary, with some patients experiencing frequent exacerbations that may require hospitalization. Diagnostic considerations include a thorough patient history, physical examination, and pulmonary function tests to assess the severity of asthma and the degree of airflow limitation. It is essential to differentiate between acute exacerbations and stable asthma to provide appropriate management and treatment strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive assessment of symptoms and triggers.
  • Treatment complexity: Management may involve multiple medications and monitoring.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis.
  • Coding specificity: Requires accurate coding to reflect the specific type of asthma and exacerbation.

Audit Risk Factors

  • Common coding errors: Misclassification of asthma severity or exacerbation type.
  • Documentation gaps: Incomplete clinical notes regarding exacerbation triggers and treatment response.
  • Billing challenges: Potential denials if documentation does not clearly support the acute exacerbation.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Allergy and Immunology

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

The clinical significance of J45.901 lies in its association with increased healthcare utilization, including emergency department visits and hospitalizations due to acute asthma exacerbations. Asthma affects millions globally, and its exacerbations can lead to significant morbidity and mortality. Understanding the epidemiology of asthma and its exacerbations is crucial for developing effective public health strategies and quality measures aimed at improving patient outcomes and reducing healthcare costs.

ICD-9 vs ICD-10

The clinical significance of J45.901 lies in its association with increased healthcare utilization, including emergency department visits and hospitalizations due to acute asthma exacerbations. Asthma affects millions globally, and its exacerbations can lead to significant morbidity and mortality. Understanding the epidemiology of asthma and its exacerbations is crucial for developing effective public health strategies and quality measures aimed at improving patient outcomes and reducing healthcare costs.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the medical necessity for the visit and any procedures performed is clearly documented. Common denials may arise from insufficient documentation or failure to demonstrate the acute nature of the exacerbation. Coders should adhere to best practices by ensuring that all relevant clinical information is included in the patient's record to support the claim.

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 J45.901?

J45.901 covers unspecified asthma cases where patients experience acute exacerbations, which may not be linked to a specific trigger or underlying condition. It includes patients with varying degrees of asthma severity who present with sudden worsening of symptoms.

When should J45.901 be used instead of related codes?

J45.901 should be used when the patient's asthma is not specified as mild, moderate, or severe, and when an acute exacerbation is present. It is important to differentiate it from codes that specify the severity or type of asthma.

What documentation supports J45.901?

Documentation should include a detailed account of the patient's asthma history, recent exacerbation events, treatment plans, and response to medications. Clinical notes should clearly indicate the acute nature of the exacerbation and any relevant diagnostic tests performed.