J45.9

First it was COPD (KOL), then it was brittle asthma and now I am told that I have asthma bronchiale J45.9. Anyone out there know this one?

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A quick google seems to reveal it is a code for unspecifed ashtma (asthma without an obvious cause) at least that is how I read it.

Bex

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As Bex says, this is the ICD-10 code for 'asthma, unspecified' including 'asthmatic bronchitis NOS' (not otherwise specified) and 'late onset asthma'. See www3.who.int/icd/currentver... for the full ICD-10 coding for asthma.

ICD-10 is the International Classification of Diseases, version 10, a classification of diseases written by the World Health Organisation. It's mainly used for statistical and epidemiological purposes, eg for compiling lists of incidences of asthma in different countries. It's not really intended as a clinical tool, and it's also quite out of date, as it was written in 1990.

In the UK, every time anyone has a hospital admission, the cause of the admission will be recorded as an ICD-10 code - it's usually done by clerical staff in the clinical coding department, and in my experience is often quite startlingly wrong! Increasingly, these codes are being used or will be used as a way of paying the hospital, which is a bit of a worry.

As far as I can see, giving you this label has little practical relevence to your treatment - it's just a way of saying that they are not quite sure what's triggering your asthma, but they don't think it's a specific allergen. Every condition listed in ICD-10 has a 'NOS' (not otherwise specified) catagory for those who don't quite fit into the boxes. ICD-10 does not actually have a classification for brittle asthma, so a lot of the brittle asthmatics on here would probably fit into J45.9 as well, although some would come under the allergic asthma catagory, and there's also a catagory for 'idiosyncratic asthma' which intrigues me...

At the end of the day it's really one for the statisticians to worry about. I wouldn't get too hung up on having an exact label for your condition - it's not likely to have any impact on your treatment. I have been given so many different labels in the past - 'Type I brittle asthma', 'Type II brittle asthma', 'chronic severe asthma', 'chronic steroid dependent asthma' etc - but until they have specific treatments for each specific type, it makes little difference!

Hope this helps,

Em H

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EmilyH - you are quite right in your description. As a health researcher (not quite a statistician yet!!) we tend to only use the first 3 digit code for research purposes, so for asthma include J45 and J46. Asthma is classed as a 'potentialy avoidable' admission in that with good primary care and early intervention admission to hospital should not be necessary!!! As we are all aware, no amount of primary care can make some admissions avoidable though. So asthma is studied quite often and is one of the conditions included in my present research. Primary Care Trusts also use the data to monitor performance.

And Emily you are so correct about clerical errors in coding - whilst sorting some data out a couple of years ago I found a patient coded for an elective cardiac arrest!

anyway - back to writing about statistics (am not a statistician - honest!)

baba