Cardiology Coding Alert

Quiz:

Test Your Cardiomyopathy ICD-10-CM Knowledge With a Quick Quiz

Published on Fri Aug 27, 2021

Remember: Code I42.0 also includes congestive cardiomyopathy.

Reporting different diagnoses can be very tricky because ICD-10-CM offers so many different codes based upon specificity. With cardiomyopathy, this is especially true. When you report this condition, you must know what type of cardiomyopathy the patient has, as well as if it was due to another circumstance such as drugs.

Read on to learn more.

First, Define Cardiomyopathy for Clarity

Question 1: What is cardiomyopathy?

Answer 1: Cardiomyopathy is a noninflammatory disease of the heart muscle that makes it difficult for your heart to pump blood throughout your body.

The different types of cardiomyopathies include dilated, hypertrophic, and restrictive.

Don’t miss: “It’s estimated that cardiomyopathy may affect one in five hundred people. Cardiomyopathy may eventually degenerate and cause arrhythmia, valve disorders, or heart failure,” says Robin Peterson, CPC, CPMA, Manager of Professional Coding, Pinnacle Integrated Coding Solutions, LLC. “Often, I see providers document unspecified cardiomyopathy and miss documenting alcoholism, drugs, or underlying causes. It’s important to query your provider and work with educating them on what the documentation needs to provide to code accurately.”

Focus on This Code for Dilated Cardiomyopathy

Question 2: What is dilated cardiomyopathy, and which ICD-10-CM code should I report for this diagnosis?

Answer 2: Dilated cardiomyopathy occurs when the heart muscle stretches, weakness, and becomes enlarged.

You should report code I42.0 (Dilated cardiomyopathy) for dilated cardiomyopathy. This code also includes congestive cardiomyopathy.

Pinpoint Correct Dx for Hypertrophic Cardiomyopathy

Question 3: What is hypertrophic cardiomyopathy, and which ICD-10-CM code should I report for this condition?

Answer 3: With hypertrophic cardiomyopathy, the heart muscle thickens and grows stiffer than normal. This type of cardiomyopathy is often found in young, active people, and it is usually inherited.

You have two codes to look to for hypertrophic cardiomyopathy. They are as follows:

I42.1 (Obstructive hypertrophic cardiomyopathy). Note: This code also includes hypertrophic subaortic stenosis (idiopathic).
I42.2 (Other hypertrophic cardiomyopathy). Note: This code also includes nonobstructive hypertrophic cardiomyopathy.

Rely on This Choice for Congenital Cardiomyopathy

Question 4: What ICD-10-CM code should I report for congenital cardiomyopathy?

Answer 4: You should report I42.4 (Endocardial fibroelastosis) because this code also includes congenital cardiomyopathy and elastomyofibrosis, per the ICD-10-CM manual.

Physician Documents Restrictive Cardiomyopathy? Do This

Question 5: What is restrictive cardiomyopathy, and what ICD-10-CM code should I report for this condition?

Answer 5: With restrictive cardiomyopathy, the ventricles become rigid and don’t have the flexibility to expand as they fill with blood.

You should report code I42.5 (Other restrictive cardiomyopathy) for restrictive cardiomyopathy. This code also includes constrictive cardiomyopathy NOS.

Don’t Forget to Report Presence of Alcoholism

Question 6: What ICD-10-CM should I report for alcoholic cardiomyopathy?

Answer 6: You should report code I42.6 (Alcoholic cardiomyopathy) for alcoholic cardiomyopathy.

Don’t miss: When you report I42.6, you should also code the presence of alcoholism from category F10- (Alcohol related disorders), per ICD-10-CM.

Turn to I42.7 for Cardiomyopathy Due to Drugs

Question 7: What code should I report if my cardiologist documented cardiomyopathy due to drugs and an external agent?

Answer 7: You should report I42.7 (Cardiomyopathy due to drug and external agent) for cardiomyopathy due to drugs and an external agent.

Don’t miss: You should first code the poisoning due to drugs or toxin, if applicable, with codes T36- (Poisoning by, adverse effect of and underdosing of systemic antibiotics) through T65- (Toxic effect of other and unspecified substances), per ICD-10-CM. You should also report an additional code for adverse effect, if applicable, to identify the drug from categories T36- through T50- (Poisoning by, adverse effect of and underdosing of diuretics and other and unspecified drugs, medicaments and biological substances).

Code Underlying Disease First

Question 8: My cardiologist documented “cardiomyopathy in disease classified elsewhere.” How should I handle this situation?

Answer 8: You should check the documentation and query your cardiologist because you need to know exactly what the underlying disease is in this case. You should first code the underlying disease such as E85- (Amyloidosis), E74.0 (Glycogen storage disease), M10- (Gout), or E05.0- (Thyrotoxicosis with diffuse goiter) through E05.9- (Thyrotoxicosis, unspecified). Then, you would report code I43 (Cardiomyopathy in diseases classified elsewhere).

Discover Cardiomyopathy Symptoms

Question 9: What are some symptoms of cardiomyopathy?

Answer 9: Symptoms of cardiomyopathy include the following: