Cardiology Coding Alert
Get Ready for New Aortic Aneurysm, Atherosclerosis Diagnoses
Hint: You’ll see new code I20.2 for refractory angina pectoris. The Centers for Medicare & Medicaid Services (CMS) recently released the new ICD-10-CM 2023 codes. Not only will you gain 22 new aortic aneurysm codes, but you will also see eight new atherosclerosis codes and four new dissection of aorta codes. Learn more about how to prep your cardiology practice for these codes, which will go into effect Oct. 1, 2022. Explore New Aortic Aneurysm Choices In 2023, you will gain the following new thoracic, abdominal, and thoracoabdominal aortic aneurysm codes: Thoracic aortic aneurysm: Abdominal aortic aneurysm: Thoracoabdominal aortic aneurysm: Ruptured aneurysm: As you can see, the new aortic aneurysm codes are distinguished between whether there was a rupture or not. Codes I71.10 through I71.13, I71.30 through I71.33, and I71.50 through I71.52 will offer more specificity when the patient has a ruptured aortic aneurysm. No rupture: On the other hand, codes I71.20 through I71.23, I71.40 through I71.43, and I71.60 through I71.62 will offer more specificity when the patient has an aortic aneurysm without a rupture. As we prepare to implement the new ICD-10-CM changes on October 1, there are a few things to be ready to address, says Robin Peterson, CPC, CPMA, manager of professional coding services, Pinnacle Integrated Coding Solutions, LLC in Centennial, Colorado. First, review current documentation for each of the expanded categories. As your providers are currently documenting, would the verbiage support the level of specificity required to report the new codes? If not, meet with your providers to provide the new codes available to increase their awareness on the expansion of the code selection for each category. “You will also address the detail that is needed to support the highest level of specificity,” Peterson adds. “Also remember, the current EHR templates providers are using may require updates. And lastly, any internal billing or charge systems will need to make the new codes available as of October 1, 2022.” Observe New Chronic Ischemic Disease Codes You will also see the following new atherosclerosis codes under current category I25- (Chronic ischemic heart disease): Don’t miss: The above codes were added because of brand-new angina pectoris code I20.2 (Refractory angina pectoris), which you will also see in 2023. Now, you will have specific combination atherosclerosis and refractory angina pectoris codes to choose from. Notice New Ventricular Tachycardia Codes You will also see the following new ventricular tachycardia codes: Don’t miss: Several coding notes will accompany code I47.21, including a Code also note, which specifies to also report I45.81 (Long QT syndrome), if applicable. Another coding note tells you to report an additional code for adverse effect, to identify the drug from codes T36- (Poisoning by, adverse effect of an underdosing of systemic antibiotics) through T50- (Poisoning by, adverse effect of an underdosing of diuretics and other and unspecified drugs, medicaments and biological substances), if applicable. Highlight Dissection of Aorta Codes You will also gain the following new dissection of aorta codes in 2023: Don’t miss: The I71- (Aortic aneurysm and dissection) codes will get a new Code first, if applicable note. You should first code syphilitic aortic aneurysm (A52.01) or traumatic aortic aneurysm (S25.09, S35.09), per ICD-10-CM. Don’t Forget These Miscellaneous New Codes ICD-10-CM 2023 also added several miscellaneous new codes including nonrheumatic valve disorder codes I34.81 (Nonrheumatic mitral (valve) annulus calcification) and I34.89 (Other nonrheumatic mitral valve disorders); pericardial effusion codes I31.31 (Malignant pericardial effusion in diseases classified elsewhere) and I31.39 (Other pericardial effusion (noninflammatory)); and antineutrophilic cytoplasmic antibody code I77.82 (Antineutrophilic cytoplasmic antibody [ANCA] vasculitis). Don’t miss: Code I31- (Other diseases of the pericardium) will also experience some coding note changes. For example, an Excludes1 note “malignant pericardial effusion (I31.31)” will be added to code I31.2 (Hemopericardium, not elsewhere classified). Also, code I31.3 (Pericardial effusion (noninflammatory) currently includes the diagnosis chylopericardium, but that will change in 2023 when chylopericardium becomes an included diagnosis for new code I31.39. Additionally, new code I31.31 will gain a coding note that instructs you to code first the underlying neoplasm from neoplasm categories C00- through D49-.
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