Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out, and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.
People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma. Occupational asthma is caused by inhaling fumes, gases, dust, or other potentially harmful substances while on the job. Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five. There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.
To classify your asthma severity, your doctor will consider how often you have signs and symptoms and how severe they are. Your doctor will also consider the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments.
Asthma is classified into four general categories:
|Asthma classification||Signs and symptoms|
|Mild intermittent||Mild symptoms up to two days a week and up to two nights a month|
|Mild persistent||Symptoms more than twice a week, but no more than once in a single day|
|Moderate persistent||Symptoms once a day and more than one night a week|
|Severe persistent||Symptoms throughout the day on most days and frequently at night|
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time. Asthma signs and symptoms include shortness of breath, chest tightness or pain, wheezing when exhaling(which is a common sign of asthma in children), trouble sleeping caused by shortness of breath, coughing or wheezing, and coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu. Signs that your asthma is probably worsening include asthma signs and symptoms that are more frequent and bothersome, increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter), the need to use a quick-relief inhaler more often. For some people, allergy induced asthma signs and symptoms flare up in certain situations. Exercise-induced asthma can be triggered by intense exercise, which may be worse when the air is cold and dry. Occupational asthma is triggered by workplace irritants such as chemical fumes, gases, or dust. Allergy-induced asthma is triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander).
There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them. Controller medications are taken daily and include corticosteroids inhaler (fluticasone (Flovent Diskus, Flovent HFA, Arnuity Ellipta), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), flunisolide (Aerobid), beclomethasone (Qvar) and others). Combination inhalers contain an inhaled corticosteroid plus a long-acting beta-agonist (LABA). Combination medications include fluticasone and salmeterol (Advair Diskus, Advair HFA), fluticasone and vilanterol (Breo Ellipta), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera). Anticholinergics are inhaled medications that also help in opening the airways. The medication tiotropium (Spiriva Respimat) is used as maintenance therapy in asthma. Leukotriene modifiers are oral medications that include montelukast (Singulair), zafirlukast (Accolate), and zileuton (Zyflo, Zyflo CR). Quick-relief or rescue medications are used to quickly relax and open the airways and relieve symptoms during an asthma flare-up or are taken before exercising if prescribed. These include short-acting beta-agonists. These inhaled bronchodilator medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). Quick-relief medications do not take the place of controller medications.
The table below includes the most commonly used ICD-10 codes for asthma:
|ICD-10 Chapter||Codes||Code Description|
|10||J45.20||Mild intermittent asthma, uncomplicated|
|10||J45.21||Mild intermittent asthma with (acute) exacerbation|
|10||J45.22||Mild intermittent asthma with status asthmaticus|
|10||J45.30||Mild persistent asthma, uncomplicated|
|10||J45.31||Mild persistent asthma with (acute) exacerbation|
|10||J45.32||Mild persistent asthma with status asthmaticus|
|10||J45.40||Moderate persistent asthma, uncomplicated|
|10||J45.41||Moderate persistent asthma with (acute) exacerbation|
|10||J45.42||Moderate persistent asthma with status asthmaticus|
|10||J45.50||Severe persistent asthma, uncomplicated|
|10||J45.51||Severe persistent asthma with (acute) exacerbation|
|10||J45.52||Severe persistent asthma with status asthmaticus|
|10||J45.901||Unspecified asthma with (acute) exacerbation|
|10||J45.902||Unspecified asthma with status asthmaticus|
|10||J45.909||Unspecified asthma, uncomplicated|
|10||J45.991||Cough variant asthma|
Author: Tonoya Ahmed