2025 ICD-10-CM code A37.91
Whooping cough, unspecified species with pneumonia.
Medical necessity is established by the signs, symptoms, and diagnostic confirmation of whooping cough and pneumonia. The medical record should clearly document the severity of symptoms and the need for treatment and any hospital care.
Clinicians should diagnose whooping cough based on symptoms, history, and physical exam. Lab tests (blood and mucus cultures, PCR) and imaging (chest X-ray, CT scan, bronchoscopy) are used for confirmation and to identify complications. Treatment includes antibiotics, and hospitalization might be required for severe cases, especially in infants, to manage breathing difficulties and provide oxygen therapy.
- Certain infectious and parasitic diseases (A00-B99)
- A37 - Whooping coughA37.9 - Whooping cough, unspecified speciesA37.91 - Whooping cough, unspecified species with pneumonia.
In simple words: Whooping cough, also known as pertussis, is a very contagious disease that causes bad coughing spells and difficulty breathing. This code is used when the doctor doesn't know the exact type of bacteria causing it, and the patient also has pneumonia, a lung infection.
Whooping cough (pertussis) is a highly contagious bacterial respiratory disease. This code is used when the provider doesn't specify the species of Bordetella causing the infection, and the patient also has pneumonia.
Example 1: A 2-month-old infant presents with paroxysmal coughing, followed by a "whooping" sound during inhalation. The infant also has a fever and rapid breathing. A chest X-ray confirms pneumonia. The causative Bordetella species is not specified. A37.91 is the appropriate code., A 35-year-old unvaccinated adult experiences a persistent cough for several weeks, worsening to coughing fits and difficulty breathing. A chest x-ray shows signs of pneumonia, and pertussis is confirmed, but further bacterial speciation testing was not performed. A37.91 is the correct code., A 70-year-old individual with a history of respiratory illness presents with a severe cough and shortness of breath. A chest X-ray reveals pneumonia, and laboratory tests are positive for whooping cough, but no particular Bordetella bacteria is identified. The diagnosis is coded as A37.91
Documentation should include signs and symptoms (cough, whooping sound, difficulty breathing, fever, etc.), lab results (culture, PCR), imaging findings (chest X-ray or CT if pneumonia is present), and any complications (apnea, seizures, dehydration).
- Specialties:Infectious Disease, Pediatrics, Pulmonology, Family Medicine, Internal Medicine
- Place of Service:Inpatient Hospital, Office, Home, Skilled Nursing Facility, Public Health Clinic,Telehealth Provided in Patient’s Home,Telehealth Provided Other than in Patient’s Home