ICD Code J45.51

ICD code J45.51 is severe persistent asthma with an acute exacerbation, meaning the patient has a long-term, severe form of asthma that is currently experiencing a sudden worsening of symptoms.

1. Patient has a documented diagnosis of asthma classified as severe and persistent.

2. Symptoms are ongoing and include frequent wheezing, coughing, shortness of breath, and chest tightness that occur daily and often at night.

3. Patient requires high-dose inhaled corticosteroids and additional controller medications to maintain symptom control.

4. There is evidence of poor symptom control despite optimal therapy, with frequent use of rescue inhalers.

5. Patient experiences significant limitations in normal activities due to asthma symptoms.

6. There is an acute worsening of asthma symptoms (exacerbation), such as increased shortness of breath, wheezing, coughing, or chest tightness, requiring a change in treatment (e.g., increased medication, systemic corticosteroids, or emergency care).

7. Exacerbation is confirmed by clinical evaluation and may be supported by objective measures such as decreased peak expiratory flow or oxygen saturation.

Relevant CPT codes for ICD-10 code J45.51 include:

- 94010 (Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation)

- 94640 (Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes)

- 99202-99215 (Office or other outpatient evaluation and management services, new or established patient)

- 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular)

- 94664 (Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device)

- 94760 (Noninvasive ear or pulse oximetry for oxygen saturation; single determination)

- 94644 (Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour)

- 94645 (Each additional hour, continuous inhalation treatment with aerosol medication for acute airway obstruction)

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