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J45.20

Billable

Mild intermittent asthma, uncomplicated

HCC Category Mapping

RxHCCHCC 229COPD and Chronic Bronchitis
0.000

What This Code Means

Asthma that occurs occasionally (a few times per month or less) with mild symptoms and no current breathing problems.

Coding Tips

  • Mild intermittent asthma is the least severe asthma classification; confirm that symptoms occur less than 2 days per week
  • The 'uncomplicated' designation means no acute exacerbation or status asthmaticus is present at the time of coding

Clinical Significance

Mild intermittent asthma, uncomplicated represents the least severe classification of asthma with symptoms occurring less than twice per week and nighttime awakenings less than twice per month. While this does not map to CMS-HCC models for Medicare Advantage, it is relevant in the RxHCC model for prescription drug risk adjustment.

Documentation Requirements

  • Asthma diagnosis explicitly documented by the provider
  • Severity classification: mild intermittent (symptoms ≤2 days/week, nighttime awakenings ≤2x/month)
  • Documentation that the condition is uncomplicated (no current exacerbation or status asthmaticus)
  • Current controller and rescue medication regimen
  • Pulmonary function testing or peak flow measurements if available
  • Trigger identification and asthma action plan

Commonly Confused Codes

Code Hierarchy

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