Use chronic codes for patients with rhinitis for 12-plus weeks.
Otolaryngology practices could treat patients suffering from a variation of rhinitis types — and since ICD-10 rolled out with its more specific diagnosis codes across the board, choosing the right code for these conditions is nothing to sniff at.
Read on for more information on how to identify the different types of rhinitis, and you’ll know how to fix any diagnosis coding issues before they occur.
I.D. Rhinitis Type First
In basic clinical terms “rhinitis is inflammation of the mucous lining of the nose,” explains Catherine Tinkey, administrator for ENT Medical Services, PC, in Iowa City, Iowa. When it comes to deciding which ICD-10 code to choose for the condition, however, things can get tricky fast.
Here’s a rundown of the types of rhinitis that your otolaryngologist is most likely to treat, along with a quick list of symptoms you might spot in the documentation to confirm the rhinitis type. Use this list to identify the different rhinitis issues you might have to code at your practice:
Definition Vasomotor rhinitis is also known as “nonallergic rhinitis,” explains Lisa Jones, CPC, consultant at 360 Practice Management Solutions in Hollywood, Fla. You’ll report instances of vasomotor rhinitis with J30.0 (Vasomotor rhinitis).
Symptoms of a vasomotor rhinitis sufferer “are similar to an allergic reaction, but the causes differ. [Allergic reactions] cause the nasal linings to swell and cause excessive blood vessel dilation,” says Jones. On the other hand, “the most common cause of nonallergic rhinitis is acute viral infection,” she continues.
Definition: Allergic rhinitis is “an inflammation of the nasal passages caused by allergic reaction to airborne substances,” Tinkey relays. You’ll report allergic rhinitis with codes from the J30.1 (Allergic rhinitis due to pollen) through J30.9 (Allergic rhinitis, unspecified) code set.
“Allergic rhinitis may be seasonal, perennial, or occupational and is the most common type of rhinitis,” Jones explains.
Symptom clues: Allergic rhinitis is systemic, so its symptoms might differ from traditional rhinitis clues. When a patient is suffering from allergic rhinitis, the condition “may be associated with constitutional symptoms such as fatigue, malaise, post nasal drip and headache. It also may be a comorbidity in patients with asthma, eczema, or chronic sinusitis,” says Jones.
Definition: Chronic rhinitis is “a protracted sluggish inflammation of the nasal mucous membrane [and] inflammation of the sinuses for more than 12 weeks,” explains Tinkey. You’ll report chronic rhinitis with J31.0 (Chronic rhinitis).
A patient might have chronic rhinitis if “symptoms include nasal congestion, facial pressure, cough, and thick nasal discharge,” says Jones. Danger zones for chronic rhinitis development include after a patient suffers a cold or during times of ongoing allergic rhinitis symptoms, Jones continues.
Physician Could Use Many Services to Dx Rhinitis
Symptom-wise, most rhinitis sufferers will exhibit similar problems no matter the final diagnosis code. For each rhinitis ICD-10 code, “the symptoms could all be very similar — congestion, post-nasal drip, itchy nose, sneezing,” explains Tinkey. In order to diagnose the specific type of rhinitis the patient has, your provider might need to perform one (or more) of the following services/tests in an office setting:
If your otolaryngologist performs one of the services above, she might be trying to get a definitive rhinitis or perhaps a sinusitis diagnosis.