Asthma and Patient Engagement: An ICD-10 Marriage

Few relationships in health care equal or trump the intimacy between a health condition and patient engagement than that which will apply to asthma in the wake of the ICD-10-CM transition. The primary reasons are the following:

The impending ICD-10-CM coding system coincides with the current international asthma classification system – a system devised by an expert panel of the National Heart Lung and Blood Institute (NHLBI) in 2007.
The new coding system takes into account the meaningful involvement of patients in the treatment of their asthma.

The current ICD-9 diagnosis coding system has three main codes for asthma based on whether or not the asthma is allergic, nonallergic or a mixture of asthma and COPD. The new coding system will be totally different though. Its codes will focus primarily on the frequency and severity of asthma symptoms.

The current asthma classification system rates symptom frequency as intermittent or persistent. Intermittent means that symptoms occur two or fewer days per week. Persistent has three subcategories. They are mild, moderate and severe. Mild means symptoms occur greater than two days per week. Moderate means they occur daily. Severe means they occur throughout the day.

The classification system grades symptom severity based on the following:

The number of times per week symptoms cause awakening at nighttime
The number of times per day a short acting inhaler (rescue medication) has to be used to relieve symptoms
The degree to which symptoms interfere with normal activities of daily living

The current asthma classification system also uses some other variables to classify the disease. But the frequency and severity criteria make it a suitable companion of the ICD -10-CM coding system whose main codes for asthma signify:

Mild intermittent asthma
Mild persistent asthma
Moderate persistent asthma
Severe persistent asthma

The patient engagement which brings about the asthma/ICD-10-CM marriage is involvement of patients in their disease management in ways that help health care providers choose the most appropriate ICD-10-CM codes pertaining to their health care. The lion’s share of that involvement will be patient record-keeping. Much of the record-keeping should pertain to the frequency and severity of symptoms as well as some of the other criteria utilized by the international classification system.

One such criterion is lung function. The volume of air expelled with a maximal effort following a maximal deep breath (forced vital capacity or FVC) and the volume of air expelled in one second with maximal effort following a maximal deep breath (forced expiratory volume in one second or FEV1) are the measurements used in classifying asthma based on lung function. A professional performs these measurements in a laboratory setting. Therefore it is not a patient engagement activity. But there is an alternative lung function measurement which patients can perform with a handheld device at home. As such, it is a patient engagement activity. The measurement is peak flow rate, which is the maximum speed at which a person can exhale air after taking the deepest breath possible. The device which performs the measurement is a peak flow meter.

Measurement of peak flow rates is not an official part of the asthma classification system but the system implies that it is an alternative. Additionally, many health care providers are of the same opinion. At any rate, it is a patient engagement activity which can help anchor the marriage between asthma and ICD-10-CM.

Sharing recorded asthma symptom and lung function information with your health care provider will not only promote a happy ICD-10-CM marriage. It can serve as an impetus for a healthier asthma patient.

Natural Remedies To Treat Asthma

Asthma is very common nowadays. It is basically a condition in which a person’s airway becomes swollen and produces extra mucus, which makes breathing difficult. Some of the common signs of identifying the condition are frequently short of breath, coughing, especially while doing exercise, difficulty in breathing normally, chest tightness, wheezing, etc. All its symptoms are very serious and can be deadly if you left them untreated. So, make sure you consult the doctor as soon as you experience any of the above symptoms. You can take the proper medication as per recommended by your doctor, but to get relief from its symptoms, here are some natural remedies you can try. So, take a look and make sure you take professional assistance before opting for any of the below-mentioned technique.

Garlic And Onion: Onions are rich in anti-inflammatory property that fight against any allergy and garlic stimulate the excretory organ that strengthens your lungs. Therefore, it is considered as the best and effective ways to treat the Asthma naturally.
Flaxseeds: Another thing you need to add to your diet to manage the Asthma symptoms is flaxseeds. These are loaded with omega 3 fatty acids and prove to be very effective in treating this deadly disease naturally.
Vitamin C: Foods that are rich in Vitamin C like Guava, Green Peppers, Orange, Papaya, Strawberries, etc. lessens the spasms of a bronchial passage, which reduce wheezing and shortness of breathing. Therefore, it is highly recommended for all Asthma patients to include vitamin C in their diet.
Turmeric: This is something that is available in every kitchen and it helps to cure the asthma symptoms due to the presence of curcumin in it, which ensure better air flow. Make sure you consult the expert before adding to your diet the right way to see only the positive effects.
Magnesium: Foods like Chocolate, Cashew, Banana, Figs, etc. are high in magnesium that relaxes the muscles of the respiratory tract and help you manage the symptoms of asthma.

These are some of the natural remedies that help you manage the symptoms of asthma. Therefore, you should include it in your diet. Also, make sure you take expert assistance before including any of the above remedies, as the usage and quantity of usage may be varied as per your condition. Don’t leave the condition untreated, take the proper medication and cure the condition naturally, so you can live a healthier and happier like before.

An Explanation Of The Term Asthma Pathophysiology

Pathophysiology is the study of what is abnormal, or what causes normal physiological processes to be disturbed. Asthma is a chronic inflammatory problem of the lungs and bronchioles which is characterized by reversible bronchospasm that often result from an exaggerated response to a variety of stimuli. This is the pathophysiological response which the lungs take when assaulted by an allergen.

What does all this mean? Well in the first place it means that asthma is not all in the mind and that it cannot be outgrown. It also means that it is a serious disease but is that you cannot catch it from someone else who has it. The pathophysiological changes resulted inflammation and symptoms such as coughing, wheezing and shortness of breath.

There are actually two types of asthma-extrinsic and intrinsic. An asthmatic who suffers from extrinsic asthma will have difficulty with allergic and immune responses. These individuals are often classified as being atopic, meaning that they have difficulty with IgE responses. Individuals who have asthmatic attacks from intrinsic factors means that they do not have an immune response but rather an allergic response to either aspirin or specific types of infections.

The more common of the two are those individuals who suffer from extrinsic asthma, or that which is immune mediated. In these cases the lungs of the individual becomes inflamed and the bronchial tubes become hyper responsive to allergens. The inflammation in the airway is an important part of the pathology and the underlying process which derives and maintains the inflammatory process.

The inflammation will activate the release of mast cells, eosinophils and macrophages in the airway. These substances increase the amount of mucus secretion present in the airways.

Therefore an individual with asthma struggles with two individual responses in the bronchi and bronchioles which results in decreased air exchange in the lungs, coughing, wheezing and shortness of breath. In the first instance the lungs become inflamed or swollen from the allergic response to an inhaled substance. The inflammation alone is enough to cause difficulty breathing, wheezing and shortness of breath.

Combined with the inflammation is the increased mucus production caused by the body’s response to the allergen inside the lungs. This increased mucus production also causes shortness of breath and wheezing but it also induces coughing to clear the mucus.

This complex interaction between inflammatory cells, mediators and tissues in the airway cause injury to the epithelium and prolonged contraction of the smooth muscle. The lungs continue to secrete mucus, swell and change the involuntary control of breathing. These inflamed airways become more narrow and obstructed which causes hyper-responsiveness and results in narrowing when the stimulus is introduced.

Individuals who suffer from extrinsic asthma can be triggered by a viral respiratory infections, pollen or mold, tobacco smoke, cold air or even exercise. Most individuals must determine their particular triggers in order to avoid them and thus prevent an asthmatic attack.

This airway obstruction can develop suddenly or gradually and will cause very real physical symptoms that can range from mild to life-threatening. Although stress has been known to increase the severity of the symptoms, asthma is not a condition which is psychologically based. But, like all other physical conditions, stress will increase the severity of the body’s reaction to the disease.