Understanding Exacerbation Medical Coding
884 views · Published 1 June 2015 · 6:52 · Indexed 20 September 2026
Channel: CCO Academy · 2015 · Education
Understanding Exacerbation Medical Coding https://www.cco.us/medical-terminology-anatomy-medical-coders-course Q: I need help in understanding how to code the following: These are three diagnoses – the way I took this question. Three diagnoses on one encounter, one patient. The three are: 1. Acute exacerbation of COPD or Chronic Obstructive Pulmonary Disease. 2. Acute bacterial exacerbation of chronic bronchitis. 3. Asthma with exacerbation. Our coder is stating: “I would code this as 493.22 only” which is chronic obstructive asthma with acute exacerbation. She or he, the coder is stating that, “The coworkers would code this with 491.22 and 493.22. I don’t understand how you can get acute bronchitis out of exacerbation of chronic bronchitis. Any help would be greatly appreciated.” A: This can be very confusing – the acute and the chronic – especially when you got a disease process that is so similar. What I did was I took the two codes and just put them up here. So, 493.22 states, “Chronic obstructive asthma; with (acute) exacerbation.” That’s a specific code. You can have chronic obstructive asthma without the acute exacerbation. Then, we have 491.22, “Obstructive chronic bronchitis; with acute bronchitis. The point that I think that will help the coder that is asking this, is understanding a little bit about the disease process. First of all, you might wonder, “Well, how come we’re not coding COPD, because that was the first thing listed?” Actually, when you have these other two diagnoses, if you note down where… this is what you get when you look up – COPD 496. Down here on the bottom it states, “Note: This code is not to be used with any code from categories 491-493.” And both of those other codes are in that range, so we’re not going to code the COPD. We are going to code just for the asthma and the bronchitis. Read more here: https://www.cco.us/understanding-exacerbation-medical-coding-video/
