Cardiology Coding Alert

New codes won't free you from needing to track payer preferences.

When ICD-10-CM replaces ICD-9-CM on Oct. 1, 2013, you may find that even those codes that correspond directly to one another have slightly different definitions. As an example, take a look at the codes for preoperative cardiovascular exams.

ICD-9-CM: V72.81, Preoperative cardiovascular exam

ICD-10-CM: Z01.810, Encounter for preprocedural cardiovascular examination

The codes above apply when a patient has an exam related to the cardiovascular system (such as SPECT, ECG, or venogram) to evaluate the patient's health status and ability to undergo a more involved procedure (such as an invasive surgery).

ICD-10 changes: ICD-10 makes a small change to the code's descriptor, so that the main definition is "encounter for preprocedural cardiovascular examination." An inclusion note for the Z01.81- range tells you those codes apply to encounters for preoperative exams and those for radiological and imaging examinations as part of preprocedural examination.

Coder tips: One of the main challenges of using V72.81 correctly is applying payer rules on coding for preprocedural exams. For example, a payer may require you to report V72.81 as well as codes for the condition that prompted the evaluation and the condition connected to the expected procedure. Be sure to keep an eye on payer policies for similar rules when ICD-10-related policies become available.

Remember: When ICD-10-CM goes into effect on Oct. 1, 2013, 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.