In this topic we shall discuss on types of Cough, Cough ICD 10 guidelines along with examples.
Coughing is a common reflex action when we want to release any irritants from our throat or airway. It is normal to cough sometimes. But we need to visit doctor if continuous cough for more than 3 weeks or coughing with any other symptoms like fever, shortness of breath, chest pain, wheezing, yellow or green mucus or blood because these are due to an underlying disease. Cough is not a disease, it is a symptom of some other condition. Acute cough is the one which cures within 3 weeks, but chronic lasts for more than 8 weeks in adult.
Do not get confuse with the term choking. A person coughs with sound. On the other hand when airway is completely blocked there will be no airflow which makes the person to choke without any sound. This needs urgent attention.
Types of cough:
The main two types of cough are dry cough and wet cough.
Dry cough :- Dry cough is one of the common symptom of Covid-19. It does not produce sputum. Some other diseases like asthma and GERD also can produce a dry cough.
Wet cough :- It produces mucus from lungs or sinuses. This occurs in pneumonia, flu, COPD, asthma or bronchitis.
Other few types of cough which can be found in medical record.
Whooping cough :- When coughing it sounds like ‘whoop’, hence it is known as whooping cough. It has another name “pertussis”. This occurs due to bacterial infection.
Croup cough :- Patient will have a barking cough due to viral infection.
Smoker’s cough :- Occurs in long term smokers which is characterized by persistent cough for more than 3 weeks.
Below are few conditions in which cough is a routine symptom.
- Postnasal drip
- Upper respiratory infections – cold, flu
- Lung cancer
Depending on the type of cough and other symptoms, physician will do further testing such as chest X-ray, CT, angiogram, bronchoscopy, Covid-19 PCR etc to find out the definitive diagnosis.
Cough ICD 10 codes and guidelines
- Cough with haemorrhage (bleeding) should be coded as haemoptysis – R04.2
- Choking should be coded as R09.89 (choking sensation)
- Croup cough should be coded as “Croup” J05.0
- Avoid coding unspecified cough R05 when a definitive diagnosis is coded in which cough is a routine symptom
- Do not code J41.0 without diagnosed by physician. Just because patient is a smoker coming with cough can not be assumed and coded as smoker’s cough.
|Cough ICD 10 Code||Description|
-Laryngeal spasmodic cough
|B49||Tea taster’s Cough|
|A37.90||Whooping cough without pneumonia, unspecified species|
Few scenarios on cough
Cough ICD 10 Scenario 1
40 year old Jennifer visits clinic with dry cough, shortness of breath and feverish from past 4 days. She had a business related travel to Australia 2 weeks back. She states she had followed all the precautions of Covid-19 and not had contact with any Covid positive persons. On exam she does not have fever, BP was 125/85 mm Hg. She is alert and oriented with laboured breathing. Physician ordered Covid-19 PCR test. Chest X-ray performed today showed no abnormalities. Physician mentioned in the final assessment – suspected exposure to Covid-19
ICD-10 codes to be coded:
Z20.828 – Contact with or suspected exposure to someone who has positive Covid-19
R05 – Dry cough
R06.02 – SOB
Note : Dry cough is a common symptom of Covid-19. But R05 is coded here as there is no definitive diagnosis of Covid-19.
Cough ICD 10 Scenario 2
A 67 year old man presented to the emergency department with coughing blood from last 2 weeks. He stated he had small streaks of blood in sputum, but today just half an hour before he coughed up a cup of blood. He has no history of pneumonia, kidney disease or any autoimmune disease. He use tobacco. He continued coughing small amount of blood during physical exam. Vitals noted as BP 100/60 mm Hg, heart rate of 112 beats per minute, respiratory rate of 30-35 breaths per minute, oxygen saturation of 93% on a 100% oxygen via high flow face mask. Head and neck exam showed presence of blood in oropharynx and nares. Physician ordered for labs and chest X-ray and admitted the patient for further work up.
ICD-10 codes to be coded:
R04.2 – Hemoptysis
Z72.0 – Tobacco use
Note : Coughing blood is coded as Hemoptysis as per guideline.