Cardiology Coding Alert

Check out the codes for ‘other’ and ‘unspecified’ options, too.

When the provider documents abnormal results for a cardiovascular test without documenting a specific diagnosis, your ICD-10-CM options will be similar to those you know for ICD-9-CM.

ICD-9-CM Codes

• 794.30, Nonspecific abnormal results of function studies; cardiovascular; abnormal function study, unspecified
• 794.31, Nonspecific abnormal results of function studies; cardiovascular; abnormal electrocardiogram [ECG] [EKG]
• 794.39, Nonspecific abnormal results of function studies; cardiovascular; other

ICD-10-CM Codes

• R94.30, Abnormal result of cardiovascular function study, unspecified
• R94.31, Abnormal electrocardiogram [ECG] [EKG]
• R94.39, Abnormal result of other cardiovascular function study

ICD-9 coding rules: ICD-9 instructions for the 794 range tell you that the codes apply to radioisotope scans and uptake studies as well as scintigraphy. Code 794.31 excludes long QT syndrome, which you should code to 426.82. An inclusion list under “other” code 794.39 offers the hint that abnormal ballistocardiograms, phonocardiograms, and vectorcardiograms are among the tests the code applies to.

ICD-10 changes: Your ICD-10 code options will match almost one-to-one with your ICD-9 options. Also note that the ICD-10 range R94, like ICD-9’s 794, applies to “abnormal results of radionuclide [radioisotope] uptake studies” and “abnormal results of scintigraphy.” R94.31 excludes long QT syndrome, which you’ll code to I45.81. The ICD-10 “other” code has an inclusion list featuring phonocardiogram and vectorcardiogram. Rather than listing ballistocardiograms, ICD-10 lists abnormal electrophysiological intracardiac studies.

Documentation: Your provider’s documentation should not need to change for you to find the appropriate ICD-10 code. As with ICD-9, the provider should document a definitive diagnosis, rather than simply “abnormal results,” when possible.

Coder tips: Keep in mind that inclusion and excludes lists aren’t necessarily exhaustive. In other words, for these codes, the notes help you know which code to use for the listed tests, but there could be unlisted tests that fall under the same codes.

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