Cardiology Coding Alert

Check to see whether an ‘abnormal heart beat’ code would be more appropriate.

ICD-10 maps provide a mash-up of abnormal heart beat and cardiac sound options as possible replacements for 785.3. To sort through the confusion, review the hints below, and remember to search the index when it’s time to start using ICD-10 codes on your claims.

ICD-9-CM Code:

785.3, Other abnormal heart sounds

ICD-10-CM Codes:

R00.8, Other abnormalities of heart beat

R00.9, Unspecified abnormalities of heart beat

R01.2, Other cardiac sounds

ICD-9 coding rules: Code 785.3 applies to abnormal heart sounds not described by another code. This may include cardiac dullness (increased or decreased), cardiac friction fremitus, and precordial friction.

ICD-10 changes: ICD-9 to ICD-10 General Equivalency Mappings (GEMs) cross 785.3 to R01.2, which includes cardiac dullness (increased or decreased), cardiac friction fremitus, precordial friction, and split heart sounds.

But the reverse ICD-10 to ICD-9 GEMs also show abnormal heart beat codes R00.8 (other) and R00.9 (unspecified) as possible matches for 785.3. You’ll generally find, however, that diagnoses indexed to R00.8 in ICD-10 are indexed to ICD-9 code 427.89 (Other specified cardiac dysrhythmias), rather than abnormal sounds code 785.3. Some of these diagnoses include alternating pulse, bigeminal pulse, coupled rhythm, gallop rhythm, and pulsus alternans or trigeminy.

Documentation: Because some of these coding options are for "other" diagnoses, your physician needs to be as specific as possible in his documentation. That way, you can search for the particular diagnosis in the index to determine if there’s a more specific code available.

Coder tips: "Other" means the physician documented the type, but ICD-10 doesn’t offer a code specific to the documented type. "Unspecified" means the physician did not document the type of abnormality.

Remember: CMS has finalized the ICD-10 compliance date of Oct. 1, 2014. When ICD-10 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.