Coding for acute bronchitis and comorbidity
The HEDIS® “Avoidance of Antibiotic Treatment” measure includes adults 18 to 64 years old who were diagnosed with uncomplicated acute bronchitis and who were not prescribed an antibiotic. However, as you know, a patient who has a co-morbid condition and/or bacterial infection may require treatment of acute bronchitis with an antibiotic. This makes it critical that you use proper coding when prescribing an antibiotic for these patients. Proper coding will ensure that these members are excluded from the “Avoidance of Antibiotic Treatment” measure.
Use one of these codes to identify acute bronchitis:
|Acute bronchitis||J20.3, J20.4, J20.5, J20.6, J20.7, J20.8, J20.9|
Make sure to add comdes to indentify co-morbid conditions, as applicable:
|Chronic airway obstruction, chronic obstructive asthma|
|Disorders of the immune system|
|Extrinsic allergic alveolitis|
|HIV disease; asymptomatic HIV|
|Other diseases of the respiratory system|
|Pneumoconiosis and other lung disease due to external agents|
Great resources on antibiotic utilization can be found on the CDC website from their GETSMART campaign. Visit cdc.gov/getsmart/campaign-materials/print-materials.html for more information.