Cardiology Coding Alert

Concentrate on numerous parent, new ‘kid’ codes.

The ICD-10-CM 2024 code additions, deletions, and revisions are out. The 2024 addendum includes about 500 new codes, with another 30 or so revised codes. These new options will include codes for hypertension, angina pectoris, microvascular dysfunction, and tachycardia, to name a few.

Now is the perfect time to familiarize yourself with the new code list, which will take effect on Oct. 1, 2023.

Meet the Parents: Converted Codes Get New ‘Kids’

In 2024, you will see some cardiology-related ICD-10-CM codes where the new codes rely on an existing code for their taxonomy. These already existing codes have been converted to parent codes. When a code is converted to a parent code, it expands the coding possibilities under that particular diagnosis code by adding new codes with greater specificity below it.

Converted to Parent

• I20.8 (Other forms of angina pectoris)

New

• I20.81 (Angina pectoris with coronary microvascular dysfunction). This code will also include angina pectoris with coronary microvascular disease.
• I20.89 (Other forms of angina pectoris). This code will also include angina equivalent angina of effort, coronary slow flow syndrome, stable angina, and stenocardia.

Converted to Parent

• I24.8 (Other forms of acute ischemic heart disease)

New

• I24.81 (Acute coronary microvascular dysfunction). This code will include acute (presentation of) coronary microvascular disease.
• I24.89 (Other forms of acute ischemic heart disease)

Converted to Parent

• I47.1 (Supraventricular tachycardia)

New

• I47.10 (Supraventricular tachycardia, unspecified)
• I47.11 (Inappropriate sinus tachycardia, so stated). This code will include IST.
• I47.19 (Other supraventricular tachycardia). This code will include atrial (paroxysmal) tachycardia; atrioventricular [AV] (paroxysmal) tachycardia; atrioventricular re-entrant (nodal) tachycardia [AVNRT] [AVRT]; junctional (paroxysmal) tachycardia; and nodal (paroxysmal) tachycardia.

Analysis: Any time the heart is involved, the most accurate diagnosis code possible is vital toward ensuring the patient receives the care that they need — at that moment and in future interactions with healthcare providers. Providing an ICD-10-CM code that gets past the 4th character and drills deeper with details can only help patients.

Report I1A.0 for Resistant Hypertension

In 2024, you will see a whole new category for hypertension —I1A- (Other hypertension). Under this category, you will gain new code I1A.0 (Resistant hypertension). Code I1A.0 will also include apparent treatment resistant hypertension, treatment resistant hypertension, and true resistant hypertension.

Code first: You will see a Code first note with I1A- instructing you to code first the specific type of existing hypertension, if known, such as essential hypertension (I10) or secondary hypertension (I15.-).

Don’t miss: Per the guidelines, resistant hypertension refers to the blood pressure of a patient with hypertension that remains above goal despite the use of antihypertensive medications. You should sequence a code for the specific type of existing hypertension first if known.

Focus on 2 New Microvascular Dysfunction-Related Codes

You will see a couple of new codes related to microvascular dysfunction in 2024. First, you will see I25.85 (Chronic coronary microvascular dysfunction) for chronic coronary microvascular dysfunction. This code will include chronic (presentation of) coronary microvascular disease and coronary microvascular dysfunction NOS.

You will also get new code I21.B (Myocardial infarction with coronary microvascular dysfunction). This code also includes myocardial infarction with coronary microvascular disease, myocardial infarction with coronary microvascular dysfunction, and myocardial infarction with non-obstructive coronary arteries (MINOCA) with microvascular disease.

Don’t miss: According to the 2024 ICD-10-CM Official Guidelines for Coding and Reporting, “Coronary microvascular dysfunction (CMD) is a condition that impacts the microvasculature by restricting microvascular flow and increasing microvascular resistance.”