Obstructive syndrome code according to ICD 10. Coding of chronic bronchitis in ICD

Medicine is constantly looking for new ways to cure various diseases, preventive measures to prevent them, and also tries to do everything possible to ensure that people live long. There are a lot of pathologies in the world, so to make it easier for doctors, a special taxonomy was created, which is called ICD - International Classification of Diseases.

Obstructive bronchitis according to ICD 10 is an inflammation of the respiratory system, which is accompanied by spasm of the bronchi and narrowing of the tubules. Most often, elderly people and young children suffer from pathology, because they have a weakened immune system and are susceptible to various bacterial diseases.

With normal therapy, the prognosis for life is favorable, however, in some cases the disease can result in death. To get rid of obstructive bronchitis, doctors prescribe standard treatment, which includes:

anti-inflammatory drugs;
antibacterial medications;
glucocorticosterone drugs.

When the disease is still at an early stage, you can start using folk recipes in parallel with medications. This can be taking decoctions, herbs, tinctures.

It is also important to be completely calm, so you need to stay in bed, follow a diet, and drink a lot. You definitely need walks in the fresh air and regular ventilation.

Obstructive bronchitis ICD 10 is divided into acute and chronic phases. The acute phase is different in that the symptoms are very severe, but recovery occurs quickly - within a month. The chronic type is accompanied by periodic relapses with deterioration in the patient's health.

Depending on the nature of the pathology, the acute phase is also divided into two types:

Infectious. Occurs due to the penetration of an infectious source into the human body.
The chemical type occurs when vapors of formaldehyde and acetone enter the respiratory tract.
The mixed type is accompanied by the appearance in the body of two of the above types at once.

If the pathology appears as a complication after suffering a disease of the respiratory system, then this process is secondary and is much more difficult to treat. The nature of inflammation in bronchitis can also be divided into purulent and catarrhal.

The disease can occur in different ways, therefore obstructive and non-obstructive types are distinguished. In the second case, the disease is not accompanied by problems with ventilation, so the outcome for the patient’s life is favorable.

ICD code 10 acute bronchitis

Acute obstructive bronchitis code according to ICD 10 - j 20.0, which contains 10 precise diagnoses, differing in the type of causative agent of the disease.

Chronic obstructive bronchitis code according to ICD 10 – j 44.0, while the appearance of the disease after influenza is excluded.

Obstructive bronchitis in children, as described by ICD 10, occurs rapidly and is very similar in symptoms to a cold.

Nature of occurrence

Obstructive bronchitis can appear under the influence of a wide variety of factors:

hypothermia;
weakening of the immune system;
bad habits such as smoking and drinking alcohol;
exposure to toxic and irritating components;
allergic reaction.

Antigens, viruses and microorganisms, when they penetrate a person, are perceived by the body as foreign substances that need to be gotten rid of. Therefore, the body begins to actively produce antibodies designed to identify and destroy foreign bodies that have entered there. Lymphocytes and macrophages actively bind to harmful particles, engulf them, digest them, and then produce memory cells so that the immune system remembers them. The whole process is accompanied by inflammation, sometimes even with a rise in temperature.

In order for immune cells to quickly find the source of the disease, increased blood circulation begins, including to the bronchial mucosa. A large amount of biologically active substances begins to be synthesized. Due to the influx of blood, the mucous membrane begins to expand and acquires a red tint. There is a secretion of mucous secretion from the tissues that line the internal cavity of the bronchi.

This provokes the appearance of a dry cough, which over time begins to turn into a wet one. This happens because the amount of mucus produced increases. If pathogenic bacteria enter the trachea, the disease turns into tracheobronchitis, which has an ICD code of j20.

Symptoms

All pathologies of the respiratory system, and acute obstructive bronchitis, have a similar set of symptoms:

lethargy;
deterioration of general health;
dizziness or headache;
cough;
the appearance of a runny nose;
wheezing, accompanied by noise and whistling;
myalgia;
temperature rise.

When poor bronchial obstruction occurs, the following symptoms occur:

dyspnea;
breathing problems;
the appearance of a blue tint on the skin (cyanosis);
continuous dry cough with periodic exhalation;
fine wheezing;
discharge of sputum or mucus from the nose with a large amount of pus;
breathing accompanied by whistling.

This disease is most active in the autumn-spring period, when all ailments begin to worsen. Newborn children suffer the most from it. At the last stage, the following signs appear:

severe paroxysmal cough that occurs when inhaling;
pain arising behind the sternum, in the place of the diaphragm;
breathing is harsh with pronounced wheezing;
sputum may contain impurities of blood and pus.

Diagnostics

To detect obstructive bronchitis according to ICD 10, the doctor must prescribe a number of diagnostic procedures:

General inspection. The attending physician must listen to the lungs and palpate the throat.
X-ray. On an x-ray, the disease appears as dark spots.
Biochemical and general blood test.
Urinalysis.
Check for external respiration.
Bronchoscopy.
Immunological methods.
Microscopic analysis of sputum, as well as checking it for bacterial flora (bacterial culture).

If there is a suspicion that the patient is beginning to have tracheobronchitis, then a number of additional studies are completed:

Ultrasound examination of the respiratory system.
Spirometry.

Treatment

Treatment of obstructive bronchitis should be comprehensive and based on the nature of the disease. Conservative treatment includes:

Taking medications. Based on the test results and the type of bacterial pathogen, antibacterial drugs are prescribed.
Antiviral medications (if the culprits of the disease are viral particles); antiallergic drugs (if it is allergic in nature); anti-inflammatory, to relieve inflammation; expectorants for better expectoration; mucolytic drugs.
Traditional methods.
Physiotherapeutic procedures.

Inpatient treatment is indicated if the patient is at risk of developing auxiliary diseases or complications.

As an auxiliary aid, folk recipes will be useful to help you recover faster. For treatment you can use:

Compresses that improve blood circulation and are applied to the bronchi area.
Rubbing with warming oils and gels that improve mucus discharge. Such remedies can include badger fat, fir oil, and turpentine ointment.
Taking herbal remedies, which can have very different effects on the body.
Massage procedures are useful.
Inhalation using a nebulizer.
Aeroionotherapy.
Electrophoresis.
Gymnastics.

Prevention of obstructive bronchitis ICD 10

strengthening the immune system;
develop a proper nutrition system;
taking multivitamin complexes;
constant physical activity;
hardening;
stop smoking and drinking alcoholic beverages.

If you ignore treatment or do not follow it properly, then the acute phase turns into chronic. One of the dangerous consequences can be bronchial asthma. Elderly people and young children may experience acute renal or respiratory failure. To learn more about acute obstructive bronchitis according to ICD 10:

The main objective of the International Classification of Diseases, Tenth Revision, developed in 1990, is to create a kind of database that facilitates the systematic registration, analysis and interpretation of information on morbidity, prevalence and mortality from various pathologies. And how is chronic and acute obstructive bronchitis classified: ICD code 10 of these diseases has its own characteristics.

The ICD has found wide application not only in studies by epidemiologists, statisticians and other healthcare representatives, but also at all levels of practical medicine. Using a short alphanumeric code, you can formulate any disease or other health-related problems.

This provides convenience:

Fixations;
Storage;
Extracts;
Discussions;
Analysis of the obtained data.

For example, all respiratory diseases have a code consisting of the letter J and a two-digit number (00-99).

This is interesting. Knowledge of the ICD is also necessary when filling out sick leave. There should not be a direct indication of the diagnosis - the doctor enters only an alphanumeric code, which allows maintaining the confidentiality of the data.

Basics of classification

In medicine, obstructive bronchitis is a disease accompanied by inflammatory damage to the bronchi of medium and small caliber, their hyperreactivity and spasm, as well as progressive impairment of pulmonary ventilation.

Most often, the development of the disease is associated with the action of viruses. The influence of microorganisms such as chlamydia and mycoplasma cannot be ruled out.

Typical symptoms of pathology include:

expiratory shortness of breath (difficulty exhaling);
cough with difficult to clear viscous sputum;
wheezing;
signs of respiratory failure.

Diagnosis of pathology is based on typical complaints, objective status, lung auscultation data, radiography and examination of external respiratory functions.

In treatment, medical instructions provide for the use of:

bronchodilators;
inhalations with corticosteroids;
antispasmodics;
antibiotics;
mucolytics.

The generally accepted classification of bronchitis is its division into acute and chronic. The features of these forms of the disease are described in the sections below and the video in this article.

Pay attention! According to ICD 10, acute obstructive bronchitis belongs to class X (respiratory diseases). The chronic form of the pathology is also classified.

Spicy

Acute bronchial obstruction according to ICD 10 has code J20. In some cases, another number is indicated after the dot - it reflects a specific pathogen.

Table: Classification of acute bronchitis by etiology:

Pay attention! Acute bronchopathy is more often diagnosed in childhood and much less often in adults. This is due to the physiologically increased reactivity of the bronchi inherent in small patients.

As a rule, symptoms of the acute form of the disease develop against the background of an upper respiratory tract infection - nasopharyngitis, sinusitis, adenoiditis. The course of the pathology is acute.

The patient’s body temperature rises (usually no higher than 38-38.5 °C) and the following symptoms develop:

general weakness, fatigue;
decreased appetite;
dry, unproductive cough with difficult to separate viscous sputum;
expiratory dyspnea.

In severe cases, signs of respiratory failure may occur:

initial stage– absence of symptoms of DN at rest; with physical exertion, shortness of breath may increase and respiratory rate may increase;
subcompensated stage– shortness of breath at rest, orthopnea, participation of auxiliary muscles in the act of breathing, cyanosis of the nasolabial triangle, tachycardia and tachypnea;
decompensated stage– forced position of the patient, pronounced cyanosis of the skin and mucous membranes, decreased blood pressure;
terminal stage– the patient’s condition is very serious, possible depression of consciousness up to coma, the appearance of pathological breathing (Cheyne-Stokes, Biota).

Pay attention! Medical assistance for symptoms of respiratory failure should be provided as early as possible. The price of delay is human life.

Diagnosis and treatment of acute forms of inflammation of the respiratory tract of mild to moderate severity are carried out on an outpatient basis. Severe disease is an indication for urgent hospitalization. Therapy in a hospital is also required for young patients in the first year of life, regardless of the severity of the condition.

Chronic

Chronic obstructive bronchitis has code J44 (according to the ICD - other COPD).

This alphanumeric combination encodes:

bronchitis itself;
tracheobronchitis;
emphysematous bronchitis with airway obstruction;
bronchitis with emphysema.

The main factors in the development of chronic inflammation of the bronchi with obstruction are:

smoking (both active and passive);
Work in hazardous industries (for example, in contact with silicon, cadmium);
Unfavorable external environmental conditions, high air pollution.

Pay attention! According to statistics, men—miners, metallurgists, and agricultural workers—are more likely to suffer from this disease.

As with the acute form of the disease, the basis of the clinical picture of bronchitis is cough and shortness of breath. The cough is dry and unproductive.

A small amount of sputum may be produced per day, but it does not bring relief - soreness and discomfort in the chest persist for a long time. General signs of intoxication are slightly expressed: the development of weakness, increased fatigue, and decreased performance is possible. Body temperature in chronic bronchitis, as a rule, remains normal.

Stage I— FEV1 is reduced by no more than 50%. At this stage, the signs of DN are slightly expressed, the patient’s quality of life practically does not suffer. Regular visits to the local physician and preventive measures aimed at reducing the number of exacerbations are indicated. Clinical observation by a pulmonologist is not required.
Stage II- FEV1 is 35-49% of predicted. The patient's quality of life decreases and requires constant supportive treatment and supervision by a pulmonologist.
Stage III— FEV1 less than 35%. A severe form of pathology, characterized by a sharp decrease in tolerance to physical activity and the appearance of signs of respiratory failure at rest. The patient requires regular inpatient and supportive outpatient treatment.

The goal of therapy for chronic obstructive bronchitis is to slow the progression of the pathological process, reduce the frequency and duration of bronchospasm attacks, and improve the quality of life. The treatment plan is drawn up by the doctor individually depending on the clinical manifestations and instrumental examination data.

Thus, obstructive bronchitis can be classified according to its course, which is reflected in the tenth revision of the ICD, and according to severity. Any form of the disease requires contacting a specialist for timely and comprehensive therapeutic and diagnostic measures.

Chronic bronchitis is assigned to a person if inflammation of the bronchial mucosa does not go away for a long time. According to ICD 10, chronic bronchitis is a lung disease; it has some differences in its course, which are coded J40-J42, J44.

These digital designations are designed for specialists, so that the doctor, at the first glance at the code, can understand what disease he is dealing with.

The main manifestation of chronic inflammation of the bronchi is cough.

Chronic bronchitis is diagnosed if a person suffers from a cough for three months. These episodes are summarized over the course of a year, or if the illness lasts continuously for a specified period of time. This pattern should persist for two years in a row.

If these time intervals do not correspond to the conditions for diagnosis, then coughing episodes are classified as either acute or recurrent bronchitis.

Important: if temporary features were not taken into account, then any prolonged cough would be defined as chronic bronchitis, and a huge number of patients had this diagnosis.

Often situations of prolonged cough are observed in people:

addicted to smoking;
who are forced to work under unfavorable working conditions and heavily polluted air.

How does chronic bronchitis form?

Inflammation exists in the lungs for such a long time that changes and restructuring occur in the structure of the bronchi.
Changes in the bronchi cause airflow problems.
The discharge of secretions from the bronchi becomes difficult.
Local pulmonary immunity decreases.
When an infection occurs, it becomes extremely difficult for the body to recover completely.
The infection continues to develop and inflammation continues to spread.
If the development of the disease is not prevented by therapeutic measures, the disease will transform into chronic obstructive pulmonary disease (COPD). This disease has more severe manifestations and its main problem is not only cough, but also the development of respiratory failure.

Photos and videos in this article will show how the disease is formed.

Classification

Chronic bronchitis code according to ICD 10 refers to the block of chronic respiratory diseases, among them there are several conditions that differ in clinical manifestations, and they also have different codes in this medical reference book.

Table No. 1. Types of pathology and their designations:

Disease code	Type of bronchitis	Characteristics
J40	Not specified as acute or chronic	It has the classic course of acute bronchitis, but is accompanied by very copious sputum production. This code will define an unspecified condition, therefore it may include both acute and chronic bronchitis
J41	Simple and mucopurulent	It occurs with the release of purulent or mucopurulent sputum, and a wet cough. The disease affects the large bronchi
J42	Unspecified	This includes a chronic condition in which the type of course is not determined
J44	Obstructive	The patient has particularly clearly observed wheezing; the condition is more severe than a simple chronic course.

Important: chronic bronchitis can be cured; for this, patients must diligently follow the instructions of the attending physician.

Signs of illness

Chronic inflammation in the bronchi has certain signs of progression, they are described below.

Cough

Cough is the main symptom of most pulmonary diseases. It invariably accompanies the disease and is a symptom that defines the disease.

Cough is divided according to its characteristics:

Wet cough– in which expectoration of mucus occurs. This is considered a protective element, in which the produced sputum is naturally evacuated from the bronchial tree, due to this the lumen of the bronchi remains free and the patient’s breathing is not difficult. It is very important that there is no bronchospasm, which prevents normal coughing up of sputum.
Dry cough otherwise it is called non-productive, since it does not separate sputum and remove it from the body, since it is simply absent in the bronchi. Dry cough is assessed by patients as painful. It often occurs in attacks, makes it difficult for the patient to stop, and causes pain in the abdomen and chest. After an attack, the patient still coughs up a meager lump of mucus.

During chronic bronchitis, a wet cough predominates, since sputum is actively produced in the bronchi.

Cough itself is a reflex reaction that occurs in response to the stimulation of numerous receptors located in the mucous membrane of the bronchi and trachea. Impulses from the receptor apparatus rush to the brain, to a special cough center. The brain reacts to impulses and causes the respiratory muscles to contract - this is how a cough occurs.

There is one problem in the nature of cough - the uneven distribution of receptors in the tissues of the bronchi of different sizes:

a large number of receptors are located in large bronchi and trachea;
There are practically no receptors in the small bronchi.

In such a situation, if inflammation occurs in small pulmonary structures, then complete blockage occurs quite quickly. A cough does not occur, even in the presence of sputum, the lungs do not provide air movement - bronchial obstruction develops.

Important: it is possible to determine that the cause of the problem is the small bronchi during forced exhalation; if wheezing is heard, then their patency is impaired.

Dyspnea

If chronic bronchitis passes without bronchial obstruction, then shortness of breath does not occur.

It occurs in people in the following cases:

if an exacerbation occurs, ICD 10 code is J44, the disease is active and symptoms are rapidly increasing;
if the inflammatory process continues for a very long time, for more than one year, it can be considered a sluggish disease, patients in this case do not even notice the moment when the disease returned to them;
if a person is a smoker or has a seasonal reaction to changing weather in the form of a cough;
when a person suffers from an obstructive form of the disease, then shortness of breath forms from the very beginning;
may occur along with a cough during physical exertion, even with ordinary bronchitis at the initial stage; with further development of the disease, the syndrome increases - symptoms develop in the patient even with minimal activity;
in severe cases, shortness of breath begins even at rest.

Sputum separation

Important: if a person has difficult working conditions - severe air pollution, then the color of the sputum will vary; among miners, the sputum may be black.

The amount of sputum may vary depending on the stage of the disease and its type.

Table No. 2. How sputum is actively produced under various conditions:

Important: pronounced purulent sputum indicates strong microbial activity, which requires serious treatment.

Wheezing

The occurrence of wheezing is associated with difficulty in normal air movement. Sputum located in the bronchi interferes with the normal movement of air - turbulences are formed, which cause sounds.

By the nature of the sounds you can tell what stage the disease is in:

when the disease is in remission, dry wheezing is heard;
If the disease is progressing and sputum is produced, the wheezing becomes moist.

The higher the tone of the wheeze, the smaller the bronchi suffer from obstruction. Such wheezing can be heard even at a distance from the patient.

Bleeding during coughing

The discharge of blood during coughing is not a typical symptom of chronic bronchitis. Such cases arise only when the disease has a very long course.

Important: coughing up blood is a sign of deterioration and complications in the patient.

Blood can appear in different ways:

If, after a long bout of coughing, you notice streaks of blood or the sputum has a brown tint, then this fact is not a cause for great concern, but requires mandatory consultation with a specialist.
If the blood after a cough is bright red and is released in significant quantities, then this indicates a pronounced pathological change in the bronchial mucosa or the development of hemorrhagic bronchitis. The worst reason for the release of a significant amount of blood is the patient’s oncological status.

Signs of asthma

They occur when chronic bronchitis is accompanied by significant obstruction; it is formed for the following reasons:

the inflammatory process has been going on for a long time, as a result the bronchi narrow and cease to respond adequately, becoming rigid;
obstruction may occur due to bronchospasm.

Asthmatic syndrome in chronic bronchitis has the following symptoms:

a complex of shortness of breath occurs - pressure in the chest, a feeling that there is not enough air;
significantly difficult exhalation;
the condition increases or renews when the patient comes into contact with tobacco smoke, room dust, or changes in ambient temperature, especially during a sharp cold snap or frost;
night cough.

This set of complaints can occur at any stage of the disease. If the disease is not treated, then asthmatic cough occurs not only at night, it appears both in the morning and during the day.

Cyanosis

Occurs only in complicated forms of pathology.

With obstruction, there is a lack of oxygen supply of such strength that cyanosis of one of two types is formed:

acrocyanosis– limbs turn blue, as well as the ears and tip of the nose;
diffuse cyanosis– the skin turns blue over the entire surface.

Cyanosis indicates that the bronchi have forever lost the ability to fully ensure air movement. So the air does not have the opportunity to saturate the blood with oxygen and take in the products of respiratory activity. The blood becomes poor, does not saturate tissues and cells with oxygen, and hypoxia occurs.

Symptoms of impaired removal of carbon dioxide, which is concentrated in the lumens of the alveoli and in the blood, with cyanosis will be as follows:

the patient's sleep will be disturbed, insomnia may occur;
headaches;
dizziness;
sweating;
weakness.

If hypoxia is not eliminated for a long time, the following symptoms that are not typical for breathing problems occur:

the nail plates change, taking on the appearance of a watch glass;
the finger phalanges lengthen, becoming like drumsticks.

The International Classification of Diseases is a reference book for medical professionals; specialists rely on it when prescribing the correct treatment. It is currently in its tenth revision, which is why it is called ICD-10. According to the ICD, chronic bronchitis refers to diseases of the lower parts of the lung and has various types of course.

Only a pulmonologist can properly cure the disease; it is impossible to defeat it on your own. The price of self-medication is a rapid deterioration of the condition, up to a threat to the patient’s life.

It is very important to treat the disease under the guidance of a doctor, based on data about the specific type, this guarantees recovery and the absence of complications.

Medicine is constantly searching for new methods of treating diseases, preventing them and creating conditions for extending people’s lives. Without systematizing all previously acquired knowledge, it would be very difficult to move forward in this direction. The method for taking into account all knowledge and statistical data is the ICD - International Classification of Diseases. This document is the basis for the classification of diseases in healthcare. The data is periodically reviewed, supplemented and clarified.

The current ICD is the tenth edition, the transition to which was carried out in Russia in 1999.

What is a disease?

One of the most common diseases, bronchitis, is also located in the ICD. This disease occurs in every second inhabitant of our planet; people of different ages suffer from it, but children and the elderly are most susceptible. The symptoms are well known - a cough that gradually turns from dry to wet, increased body temperature, general weakness, increased sweating.

Regardless of the conditions of occurrence, the code for chronic bronchitis according to ICD 10 is always located in the class of diseases of the respiratory system and the heading of chronic pathologies of the lower respiratory tract.

The items in this section also have divisions, in most cases specifying the morphological type of respiratory pathology. The etiological factor in this case is important only in clinical classifications.

Encoding options:

J40 is an inflammatory process in the bronchi, which for a number of reasons cannot be considered acute, but it is also difficult to classify it as chronic (allergic obstructive inflammation, pathologies caused by chemicals and asthmatic forms of the disease are excluded from the category);
J41 – this code contains simple bronchitis, as well as a disease of a mucous and purulent nature (the category is divided into both types of pathological process and includes a mixed version of the disease);
J42 – a form of pathology of an unspecified nature;
J44 – other types of obstructive pathology of the respiratory system with a protracted course.

Separately in ICD 10 chronic bronchitis has code J45.9 in case of asthmatic lesion. The diagnosis of asthma is made by exclusion in the presence of several attacks of obstruction during the year, which are tied to the same factor and are relieved by bronchodilators.

Features of the disease

Unlike ordinary acute or obstructive bronchitis, this type of inflammatory process is not always associated with an infectious agent. Risk factors for the disease are bad habits, working in hazardous industries, and living in unsatisfactory social conditions.

There are mild, moderate and severe forms of pathology, which is not reflected in the international classification of diseases. The severity of the process is determined depending on the breathing disorder and morphological changes in the bronchi and alveoli.

Chronic bronchitis in ICD 10 is established without a precise indication of the etiological factor, since it has less influence on the prescription of treatment.

The same medications are used for all forms, but in the case of a specific cause of inflammation, its effect on the body should be limited as much as possible. For example, quit smoking or change jobs that involve the entry of small particles of dust, sand and other substances into the bronchi.