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v1.0.0
ICD-10 Guide
ICD-10 CodesR06.03

R06.03

Acute respiratory distress

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

Code Description

ICD-10 R06.03 is a billable code used to indicate a diagnosis of acute respiratory distress.

Key Diagnostic Point:

Acute respiratory distress is characterized by a sudden onset of respiratory failure, often manifesting as severe shortness of breath, hypoxemia, and increased work of breathing. Patients may present with tachypnea, use of accessory muscles for breathing, and cyanosis. This condition can arise from various underlying causes, including pneumonia, pulmonary embolism, acute respiratory distress syndrome (ARDS), and exacerbations of chronic obstructive pulmonary disease (COPD). Clinical evaluation typically involves a thorough history and physical examination, along with imaging studies such as chest X-rays or CT scans, and laboratory tests including arterial blood gases (ABGs) to assess oxygenation and carbon dioxide levels. The urgency of the condition necessitates prompt identification and management of the underlying cause, as well as supportive care, which may include supplemental oxygen or mechanical ventilation. Accurate coding of acute respiratory distress requires careful documentation of the clinical findings and the context in which the symptoms arise.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to acute respiratory distress.
  • Need for precise documentation of clinical findings.
  • Differentiation from chronic respiratory conditions.
  • Potential overlap with other respiratory codes.

Audit Risk Factors

  • Inadequate documentation of the acute nature of the distress.
  • Failure to specify the underlying cause of respiratory distress.
  • Misclassification of acute respiratory distress as chronic.
  • Lack of supporting lab results or imaging studies.

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed history of present illness, physical exam findings, and results of diagnostic tests.

Common Clinical Scenarios

Patients presenting with acute exacerbations of chronic conditions or new onset respiratory symptoms.

Billing Considerations

Ensure clarity in distinguishing between acute and chronic respiratory issues.

Emergency Medicine

Documentation Requirements

Immediate assessment findings, interventions performed, and response to treatment.

Common Clinical Scenarios

Patients arriving with acute shortness of breath, often requiring rapid intervention.

Billing Considerations

Document the urgency and severity of the condition to support the acute coding.

Coding Guidelines

Inclusion Criteria

Use R06.03 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code reflects the acute nature of the respiratory distress and is supported by clinical documentation

Exclusion Criteria

Do NOT use R06.03 When
No specific exclusions found.

Related CPT Codes

94640CPT Code

Pressurized inhalation treatment

Clinical Scenario

Used in conjunction with acute respiratory distress management.

Documentation Requirements

Document the indication for treatment and response.

Specialty Considerations

Emergency medicine may require rapid documentation due to the acute nature.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of acute respiratory conditions, 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 acute respiratory conditions, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 respiratory distress and chronic respiratory failure?

Acute respiratory distress is characterized by a sudden onset of respiratory failure, often requiring immediate intervention, while chronic respiratory failure is a long-term condition that may not require acute treatment.