ICD-10 Coding for Acute Bronchiolitis(J21.0, J21.8, J21.9)
Complete ICD-10-CM coding and documentation guide for Acute Bronchiolitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acute Bronchiolitis
J21Primary Range
Acute Bronchiolitis
This range covers all forms of acute bronchiolitis, including those caused by RSV and other viral agents.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| J21.0 | Acute bronchiolitis due to respiratory syncytial virus | Use when RSV is confirmed by laboratory testing. |
|
| J21.8 | Acute bronchiolitis due to other specified organisms | Use when a non-RSV viral cause is confirmed. |
|
| J21.9 | Acute bronchiolitis, unspecified | Use when the causative organism is not identified. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acute bronchiolitis
Essential facts and insights about Acute Bronchiolitis
Primary ICD-10-CM Codes for acute bronchiolitis
Decision Criteria
clinical Criteria
- RSV confirmed by PCR or antigen test
documentation Criteria
- Detailed note specifying RSV as the cause
Applicable To
- RSV bronchiolitis
Excludes
- Chronic bronchiolitis
Clinical Validation Requirements
- RSV antigen or PCR positive
- Symptoms: wheezing, hypoxia
Code-Specific Risks
- Misuse if RSV is not confirmed
Coding Notes
- Ensure RSV confirmation through lab results before coding.
J21.8 - Acute bronchiolitis due to other specified organisms
Use when a non-RSV viral cause is confirmed.
Applicable To
- Adenoviral bronchiolitis
Excludes
- Chronic bronchiolitis
Clinical Validation Requirements
- Viral panel identifying specific non-RSV organism
Coding Notes
Ensure organism is specified in documentation.
J21.9 - Acute bronchiolitis, unspecified
Use when the causative organism is not identified.
Excludes
- Chronic bronchiolitis
Clinical Validation Requirements
- No specific organism identified
Coding Notes
Use only when no specific organism is identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acute Bronchiolitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J21.0.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims
Mitigation Strategy
Use specific terms like 'RSV bronchiolitis', Include lab results in documentation
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Use J21.0 with confirmatory test result.
Impact
Failure to document the causative organism can lead to audit issues.
Mitigation Strategy
Ensure lab results are included in documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acute Bronchiolitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acute Bronchiolitis
Use these documentation templates to ensure complete and accurate documentation for Acute Bronchiolitis. These templates include all required elements for proper coding and billing.
ED/Hospital Admission for Bronchiolitis
Specialty: PediatricsRequired Elements
- Patient age and symptoms
- Lab results
- Oxygen saturation levels
- Exposure history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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