ICD-10 Coding for Pertussis(A37.01, A37.00)
Complete ICD-10-CM coding and documentation guide for Pertussis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pertussis
A37.0-A37.9Primary Range
Whooping cough due to Bordetella pertussis
This range covers all forms of pertussis, including with and without pneumonia, and is the primary range for coding pertussis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A37.01 | Whooping cough due to Bordetella pertussis with pneumonia | Use when pertussis is confirmed with pneumonia present. |
|
| A37.00 | Whooping cough due to Bordetella pertussis without pneumonia | Use when pertussis is confirmed and no pneumonia is present. |
|
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 pertussis with pneumonia
Essential facts and insights about Pertussis
Primary ICD-10-CM Codes for pertussis
Decision Criteria
clinical Criteria
- Presence of pneumonia confirmed by imaging
Applicable To
- Pertussis with pneumonia
Excludes
- Pneumonia without pertussis
Clinical Validation Requirements
- Paroxysmal cough with whoop
- Radiographic evidence of pneumonia
- Bordetella pertussis confirmed via PCR
Code-Specific Risks
- Misclassification if pneumonia is not documented
Coding Notes
- Ensure pneumonia is confirmed via imaging before using this code.
A37.00 - Whooping cough due to Bordetella pertussis without pneumonia
Use when pertussis is confirmed and no pneumonia is present.
Applicable To
- Pertussis without respiratory complications
Excludes
- Pertussis with pneumonia
Clinical Validation Requirements
- Paroxysmal cough with whoop
- Bordetella pertussis confirmed via PCR or serology
Coding Notes
Ensure no pneumonia is documented before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for immunization
Z23Differential 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 Pertussis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A37.01.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Use lab tests to confirm Bordetella pertussis, Document all clinical findings
Impact
Reimbursement: Incorrect DRG assignment may affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify pneumonia with imaging before coding.
Impact
Using A37.01 without imaging confirmation.
Mitigation Strategy
Require imaging confirmation 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 Pertussis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pertussis
Use these documentation templates to ensure complete and accurate documentation for Pertussis. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Suspected Pertussis
Specialty: Emergency MedicineRequired Elements
- Onset date of symptoms
- Cough characteristics
- Lab results
- Imaging findings
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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