Treating

• Mild intermittent asthma sufferers will only use an inhaler occasionally.Image by Flickr.com, courtesy of Christian Guthier
  
  There is no daily treatment for mild intermittent asthma. An inhaler may be prescribed for use as needed.
  
  

Reviewing Documentation

• When reviewing documentation for the presence of mild intermittent asthma, look for terms such as mild, intermittent, occasional, few night time exacerbations, and asymptomatic.
  
  In addition, pulmonary function tests may show "FEV1 or PEF >80% predicted, and PEF Variability <20%."
  
  

Looking Up the Code

• In the ICD-9-CM book index (or on the medical coding software), look up the term "asthma."
  
  Because there is currently no specific ICD-9-CM code for mild intermittent asthma, the diagnosis codes to unspecified asthma (493.9x). That will change with the incoming ICD-10 codes where the code for mild intermittent asthma is currently slated as J45.2x.
  
  

Determining the Fifth Digit

• Current fifth-digit code assignments for asthma include:
  0: "without mention of status asthmaticus or acute exacerbation"
  1: "with status asthmaticus"
  2: "with acute exacerbation"
  
  Physician documentation should be reviewed for the appropriate condition code assignment.
  
  

Assigning the Final ICD-9-CM Code (2009)

• If there is an acute exacerbation of the mild intermittent asthma, assign ICD-9-CM code 493.92.
  
  If the mild intermittent asthma is being listed as a secondary diagnosis (and not acute), assign the code 493.90.