Cardiology Coding Alert

Question: Should I use ICD-9 code 198.89 (Secondary malignant neoplasm of other specified sites) for malignant ventricular arrhythmia? North Carolina Subscriber Answer: In this case the word "malignant" should be taken in the context of tending to become progressively worse and to result in death. Without further information on the type of arrhythmia (e.g., fibrillation or tachycardia), you should use the general arrhythmia code of 427.9 (Cardiac dysrhythmia, unspecified). Answers to You Be the Coder and Reader Questions were provided by Martha Gerant, CPC, professional coder and reimbursement specialist for Cardiology Services in Olathe, Kan.; Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.; Cynthia Swanson, RN, CPC, a cardiology coding consultant with Seim, Johnson, Sestak and Quist in Omaha, Neb.; Sandy Fuller, CPC, a cardiology coding and reimbursement specialist in Abilene, Texas; and Anne Karl, RHIA, CCS-P, CPC, coding and compliance specialist at St. Paul Heart Clinic in Mendota Heights, Minn.