Cardiology Coding Alert

Hint: Report I47.1 for paroxysmal supraventricular tachycardia.

To ethically maximize your cardiology practice's bottom line, you need to know the appropriate ICD-10 codes for common cardiology conditions. Take this coding challenge to see how your ICD-10 know-how measures up.

Search Your Coding Options for Orthostatic Hypotension

Question 1: What ICD-10 code should you report for orthostatic hypotension?

Answer 1: The correct code for orthostatic hypotension is I95.1 (Orthostatic hypotension).

Orthostatic hypotension definition: "Orthostatic hypotension (aka postural) relates to a drop in blood pressure when patients go from sitting to standing," says Julie Graham, BA, CPC, CCC, consultant at JG Cardiology and CT Consulting in Dallas, Texas. "Thisreading is in comparison to their blood pressure while sitting."

Caution: The physician must specifically document "orthostatic hypotension," along with the patient's vitals, for you to correctly report I95.1 (Orthostatic hypotension), according to Graham. Code I95.1 is indicated for both postural and orthostatic (chronic) hypotension.

Mari Robinson, CPC, CPMA, CRC, CCC, compliance analyst of chronic conditions at Riverside Medical Group in Newport News, Virginia, emphasizes the importance of documenting the specific type of hypotension.

"A coder must be able to determine from the provider's note whether it is orthostatic hypotension or hypotension," Robinson says. "If the provider does not document orthostatic, then do not code orthostatic hypotension."

Know the Lowdown on Paroxysmal Supraventricular Tachycardia

Question 2: How would you report paroxysmal supraventricular tachycardia?

Answer 2: The correct ICD-10 code in this case is I47.1 (Supraventricular tachycardia).

Included conditions for I47.1 are as follows:

• Atrial (paroxysmal) tachycardia
• Atrioventricular [AV] (paroxysmal) tachycardia
• Atrioventricular re-entrant (nodal) tachycardia [AVNRT] [AVRT]
• Junctional (paroxysmal) tachycardia
• Nodal (paroxysmal) tachycardia.

Paroxysmal supraventricular tachycardia definition: Supraventricular tachycardia refers to a faster than normal heart rate that originates in the atria or the atrioventricular node. Paroxysmal means the rapid heart rate happens occasionally.

Don't miss: A code first note instructs you to sequence tachycardia complicating the following conditions first, followed by I47.1:

• O00.0 (Abdominal pregnancy) through O07 (Failed attempted termination of pregnancy)
• O08 (Complications following ectopic and molar pregnancy)
• O75.4 (Other complications of obstetric surgery and procedures).

Search Your Coding Option for Chronic Diastolic Congestive Heart Failure

Question 3: How should you report chronic diastolic congestive heart failure?

Answer 3: The proper code in this case is I50.32 (Chronic diastolic (congestive) heart failure).

Don't miss: There are several important notes you should remember for I50- (Heart failure).

First, a "code first" note for category I50- tells you to sequence the following underlying conditions first, followed by I50.32:

• O00.0 through O07
• O08
• I11.0 (Hypertensive heart disease with heart failure)
• I13.- (Hypertensive heart and chronic kidney disease)
• I97.13- (Postprocedural heart failure)
• O75.4 (Other complications of obstetric surgery and procedures)
• I09.81 (Rheumatic heart failure).

Code also: A "code also" note for I50.32 tells you to also code I50.84 (End stage heart failure) along with I50.32, if applicable.