Cardiology Coding Alert

Plus: Get the latest on the proposed implementation date.

News flash: On April 9, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced a proposed rule that includes a new ICD-10 implementation date: Oct. 1, 2014.

This information about the one-year delay is in the April 9 press release, "New Health Care Law Provisions Cut Red Tape, Save Up to $4.6 Billion," at www.cms.gov/apps/media/press_releases.asp.

If the latest update has increased your motivation to prepare, get things rolling with a look at cardiac arrest coding.

The diagnosis: Cardiac arrest refers to a sudden loss of heart function caused by the heart's electrical system (that is, arrhythmia). Cardiac arrest differs from a heart attack, which results from a blockage that prevents blood from flowing to the heart.

ICD-9-CM Code

• 427.5, Cardiac arrest

ICD-10-CM Codes

• I46.2, Cardiac arrest due to underlying cardiac condition
• I46.8, Cardiac arrest due to other underlying condition
• I46.9, Cardiac arrest, cause unspecified

ICD-9 coding rules: A note with 427.5 lets you know the code is also appropriate for "cardiorespiratory arrest."

ICD-10 changes: ICD-10 provides three cardiac arrest codes. For I46.2 and I46.8, you should "code first" the underlying condition that led to cardiac arrest.

Additionally, ICD-10 lists an "excludes" note with the cardiac arrest codes to ensure you don't report them for cardiogenic shock (R57.0).

Documentation: Work with your physicians to ensure you'll have easy access to documentation of the underlying cause of the cardiac arrest so you may code more accurately.

Coder tips: Not only will you need to know whether the underlying cause is "cardiac" or "other" to choose between I46.2 and I46.8, you'll also need to know the specific underlying condition so you may report it separately.

Remember: When ICD-10-CM goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.