2025 ICD-10-CM code A15.5
(Active) Effective Date: N/A Revision Date: N/A Infectious Disease - Tuberculosis Certain infectious and parasitic diseases (A00-B99) Feed
Tuberculosis of the larynx, trachea, and bronchus.
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Medical necessity for the diagnosis and treatment of A15.5 is established by the presence of clinical symptoms and signs consistent with laryngeal, tracheal, or bronchial tuberculosis.Confirmation through laboratory tests, such as positive sputum culture for *M. tuberculosis* and/or histopathological evidence of granulomatous inflammation in tissue biopsies, is essential for supporting the medical necessity of treatment.The severity of symptoms and the potential for airway compromise also justify treatment interventions.In cases of airway obstruction, a tracheostomy may be medically necessary to maintain adequate ventilation.
Diagnosis and treatment of tuberculosis of the larynx, trachea, and bronchus involves various specialists, including pulmonologists, otolaryngologists, and infectious disease specialists.The clinical responsibility includes taking a thorough patient history, performing a physical examination, ordering and interpreting diagnostic tests (e.g., sputum culture, chest x-ray, bronchoscopy), prescribing and monitoring anti-tuberculosis medication, and managing any surgical interventions (such as tracheal resection) if necessary.
In simple words: Tuberculosis (TB) is a bacterial infection that can affect the voice box (larynx), windpipe (trachea), and the large airways in the lungs (bronchi). It spreads through the air when someone with TB coughs or sneezes. Symptoms can include a bad cough, trouble breathing, hoarseness, weight loss, fever, and fatigue.Doctors diagnose TB through tests like X-rays and sputum cultures. Treatment involves taking several medicines for at least six months. In some cases, surgery may be needed.
Tuberculosis (TB) of the larynx, trachea, and bronchus is an infection of the upper respiratory system caused by the bacterium *Mycobacterium tuberculosis*.Transmission occurs through airborne droplets produced by coughing or sneezing.Symptoms may include loss of appetite, breathing difficulties, hoarseness, cough (possibly with mucus or blood), sore throat, fatigue, weight loss, night sweats, mild fever, and general ill health. Diagnosis involves assessing symptoms, medical history, physical examination, and tests such as bronchoscopy, chest X-ray, CT scan of the respiratory system, and a tuberculin skin test.Sputum cultures can confirm the presence of *M. tuberculosis*. Treatment typically involves a six-month or longer course of multiple anti-tuberculosis drugs (e.g., isoniazid, rifampin, ethambutol, and pyrazinamide), often administered under directly observed therapy (DOT).Severe cases may require tracheal resection.
Example 1: A 45-year-old male presents with a two-month history of progressive hoarseness, cough, and hemoptysis.Chest x-ray reveals evidence of active pulmonary tuberculosis, and bronchoscopy shows granulomatous lesions in the larynx and trachea.A sputum culture confirms *M. tuberculosis*.The patient is diagnosed with A15.5 and initiated on a four-drug anti-tuberculosis regimen under DOT., A 60-year-old female with a history of poorly controlled diabetes presents with dysphagia and a persistent cough.Laryngoscopy reveals ulcerative lesions on the vocal cords.Biopsy confirms the presence of caseating granulomas, consistent with tuberculosis.She is diagnosed with A15.5 and started on anti-tuberculosis treatment.Her diabetes management is optimized to support her recovery., A 30-year-old immigrant presents with progressive dyspnea and stridor.Examination reveals severe laryngeal edema and airway obstruction, requiring emergency intubation.A tracheostomy is performed to secure the airway, and subsequent bronchoscopic examination shows characteristic lesions suggestive of tuberculosis.Sputum culture and biopsy confirm the diagnosis of A15.5.The patient undergoes treatment for tuberculosis, with careful monitoring of airway patency and recovery.
Complete patient history including symptoms, risk factors (e.g., exposure to individuals with TB, travel history, immunosuppression), and duration of illness.Results of diagnostic tests such as sputum AFB smear and culture, chest x-ray, CT scan, bronchoscopy with biopsy, tuberculin skin test.Details of treatment plan including medications prescribed, duration of therapy, and response to treatment.Documentation of directly observed therapy (DOT) if applicable.Any surgical procedures performed, such as tracheal resection or tracheostomy.
** The diagnosis of A15.5 requires a high index of suspicion, especially in cases where pulmonary involvement is absent or less prominent.It is important to differentiate this condition from other causes of laryngeal lesions, including malignancy.Clinical correlation with imaging studies and microbiological findings is crucial for accurate coding.
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- Specialties:Pulmonology, Otolaryngology, Infectious Disease
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