ICD-10 Coding for Bronchiolitis(J21.0, J21.9)
Complete ICD-10-CM coding and documentation guide for Bronchiolitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Bronchiolitis
J21Primary Range
Acute bronchiolitis
This range includes all codes related to acute bronchiolitis, specifying different viral etiologies.
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 as the causative agent. |
|
| J21.9 | Acute bronchiolitis, unspecified | Use when the causative virus 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 RSV bronchiolitis
Essential facts and insights about Bronchiolitis
Primary ICD-10-CM Codes for bronchiolitis
Decision Criteria
clinical Criteria
- RSV confirmed by PCR test
documentation Criteria
- Documented symptoms of acute bronchiolitis
Applicable To
- RSV bronchiolitis
Excludes
- Chronic bronchiolitis
- Asthma
Clinical Validation Requirements
- Positive RSV PCR test
- Symptoms of wheezing and retractions
Code-Specific Risks
- Requires virologic confirmation
- Incorrect use without lab results
Coding Notes
- Ensure RSV is confirmed through lab testing before using J21.0.
J21.9 - Acute bronchiolitis, unspecified
Use when the causative virus is not identified.
Applicable To
- Viral bronchiolitis without specified virus
Excludes
- Chronic bronchiolitis
- Asthma
Clinical Validation Requirements
- Symptoms of bronchiolitis without identified virus
Coding Notes
Use when no specific viral cause is identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting 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: Missed opportunity to address environmental factors., Regulatory: Non-compliance with documentation standards., Financial: Potential loss of additional reimbursement.
Mitigation Strategy
Always ask about and document exposure to tobacco smoke., Use Z77.22 when exposure is confirmed.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure RSV is confirmed by PCR or antigen test before coding.
Impact
Coding J21.0 without lab confirmation of RSV.
Mitigation Strategy
Ensure lab results are documented before coding.
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 Bronchiolitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Bronchiolitis
Use these documentation templates to ensure complete and accurate documentation for Bronchiolitis. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Bronchiolitis
Specialty: PediatricsRequired Elements
- Chief complaint
- History of present illness
- Physical exam findings
- Lab results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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