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ICD-10 Coding for Respiratory Syncytial Virus Bronchitis(J20.5, J21.0)

Complete ICD-10-CM coding and documentation guide for Respiratory Syncytial Virus Bronchitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

RSV BronchitisAcute Bronchitis due to RSV

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Related ICD-10 Code Ranges

Complete code families applicable to Respiratory Syncytial Virus Bronchitis

J20-J22Primary Range

Other acute lower respiratory infections

This range includes codes for acute bronchitis and bronchiolitis, specifically J20.5 for RSV bronchitis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
J20.5Acute bronchitis due to respiratory syncytial virusUse for patients with confirmed RSV infection presenting with acute bronchitis symptoms.
  • Positive RSV test (PCR or antigen)
  • Symptoms of acute bronchitis (cough, wheezing)
J21.0Acute bronchiolitis due to respiratory syncytial virusUse for infants and young children with RSV-confirmed bronchiolitis.
  • Patient under 2 years
  • Symptoms of bronchiolitis (wheezing, retractions)

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 bronchitis

Essential facts and insights about Respiratory Syncytial Virus Bronchitis

The ICD-10 code for RSV bronchitis is J20.5, used for acute bronchitis due to respiratory syncytial virus.

Primary ICD-10-CM Codes for respiratory syncytial virus bronchitis

J20.5
Acute bronchitis due to respiratory syncytial virus
Billable Code

Decision Criteria

clinical Criteria

  • Patient over 2 years with acute bronchitis symptoms and positive RSV test

coding Criteria

  • Do not use B97.4 with J20.5

Applicable To

  • Acute bronchitis confirmed by RSV

Excludes

  • Chronic bronchitis (J44.-)
  • Bronchiolitis due to RSV (J21.0)

Clinical Validation Requirements

  • Positive RSV test (PCR or antigen)
  • Symptoms of acute bronchitis (cough, wheezing)

Code-Specific Risks

  • Confusion with bronchiolitis in infants
  • Unnecessary use of B97.4

Coding Notes

  • Ensure documentation specifies 'acute' and confirms RSV via testing.
View Full Code Details

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acute bronchiolitis due to respiratory syncytial virus

J21.0
Use J21.0 for patients under 2 years with bronchiolitis symptoms.

Acute bronchitis due to respiratory syncytial virus

J20.5
Use J20.5 for patients over 2 years with bronchitis symptoms.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Respiratory Syncytial Virus Bronchitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code J20.5.

Impact

Clinical: May lead to inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or reduced reimbursement.

Mitigation Strategy

Always specify 'acute' in the diagnosis., Ensure RSV confirmation through testing.

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data reporting.

Mitigation Strategy

Use J20.5 for RSV bronchitis in patients over 2 years.

Impact

Using J21.0 for patients over 2 years can trigger audits.

Mitigation Strategy

Verify patient age and symptoms 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 Respiratory Syncytial Virus Bronchitis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Respiratory Syncytial Virus Bronchitis

Use these documentation templates to ensure complete and accurate documentation for Respiratory Syncytial Virus Bronchitis. These templates include all required elements for proper coding and billing.

Pediatric ED visit for RSV bronchitis

Specialty: Pediatrics

Required Elements

  • History of present illness
  • Physical examination findings
  • Laboratory test results
  • Assessment and plan

Example Documentation

**HPI:** 4 y/o F with 7-day history of barking cough, yellow sputum, +RSV PCR. Denied retractions/cyanosis. **PE:** - Resp: Wheezes bilateral, no retractions - SpO2: 95% RA **Labs:** RSV PCR+ (CT: 18) **A/P:** Acute bronchitis due to RSV (J20.5). Discharge with albuterol PRN.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Bronchitis, RSV suspected
Good Documentation Example
Acute bronchitis confirmed by RSV PCR (CT value: 22). Patient exhibits productive cough with wheezing, no hypoxemia.
Explanation
The good example specifies the type of bronchitis, confirms RSV with a test, and provides detailed symptoms.

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