ICD 10 Coding Alert

Don’t dither on learning the cardiology-specific ICD-10-CM code updates. There’s information you need to know about diagnoses like hypertension, angina pectoris, microvascular dysfunction, and tachycardia.

Plus, the code updates include a lot of adjustments to parent codes, which means you’ll have more specificity to wield on your cardiology claims.

Converted to Parent

• I20.8 (Other forms of angina pectoris)

New

• I20.81 (Angina pectoris with coronary microvascular dysfunction). This code will also include angina pectoris with coronary microvascular disease.
• I20.89 (Other forms of angina pectoris). This code will also include angina equivalents angina of effort, coronary slow flow syndrome, stable angina, and stenocardia.

Converted to Parent

• I24.8 (Other forms of acute ischemic heart disease)

New

• I24.81 (Acute coronary microvascular dysfunction). This code will include acute (presentation of) coronary microvascular disease.
• I24.89 (Other forms of acute ischemic heart disease)

Converted to Parent

• I47.1 (Supraventricular tachycardia)

New

• I47.10 (Supraventricular tachycardia, unspecified)
• I47.11 (Inappropriate sinus tachycardia, so stated). This code will include IST.
• I47.19 (Other supraventricular tachycardia). This code will include atrial (paroxysmal) tachycardia; atrioventricular [AV] (paroxysmal) tachycardia; atrioventricular re-entrant (nodal) tachycardia [AVNRT] [AVRT]; junctional (paroxysmal) tachycardia; and nodal (paroxysmal) tachycardia.

Analysis: Any time the heart is involved, the most accurate diagnosis code possible is vital toward ensuring the patient receives the care that they need — at that moment and in future interactions with healthcare providers. Providing an ICD-10-CM code that gets past the 4th character and drills deeper with details can only help patients.

Use I1A.0 for Resistant Hypertension

In 2024, you will see a whole new category for hypertension: I1A- (Other hypertension). Under this category, you will gain new code I1A.0 (Resistant hypertension). Code I1A.0 will also include apparent treatment resistant hypertension, treatment resistant hypertension, and true resistant hypertension.

Code first: You will see a Code first note with I1A- instructing you to code first the specific type of existing hypertension, if known, such as essential hypertension (I10) or secondary hypertension (I15.-).

Don’t miss: Per the guidelines, resistant hypertension refers to the blood pressure of a patient with hypertension that remains above goal despite the use of antihypertensive medications. You should sequence a code for the specific type of existing hypertension first if known.

Know These 2 New Microvascular Dysfunction-Related Codes

You will see a couple of new codes related to microvascular dysfunction in 2024. First, you will see I25.85 (Chronic coronary microvascular dysfunction) for chronic coronary microvascular dysfunction. This code will include chronic (presentation of) coronary microvascular disease and coronary microvascular dysfunction NOS.

You will also get new code I21.B (Myocardial infarction with coronary microvascular dysfunction). This code also includes myocardial infarction with coronary microvascular disease, myocardial infarction with coronary microvascular dysfunction, and myocardial infarction with non-obstructive coronary arteries (MINOCA) with microvascular disease.

Don’t miss: According to the 2024 ICD-10-CM Official Guidelines for Coding and Reporting, “Coronary microvascular dysfunction (CMD) is a condition that impacts the microvasculature by restricting microvascular flow and increasing microvascular resistance.”

“As ICD-10-CM keeps adding associated conditions to current categories creating new parent and kid codes, quality of documentation is becoming imperative for capturing the specificity to report these codes accurately,” says Robin Peterson, CPC, CPMA, manager of professional coding and compliance services, Pinnacle Enterprise Risk Consulting Services, LLC in Centennial, Colorado. “As coders, we should make sure providers are familiar with the newly associated conditions to ensure this is captured in their documentation.”

Pay Attention to Revisions

You will also see some revisions in 2024. For example, I25.112 (Atherosclerostic heart disease of native coronary artery with refractory angina pectoris) will see one small change. As you can see, the “s” will change to a “t” in the code descriptor. (Emphasis added).

Several of the aneurysm codes will also see some revisions. (Emphasis added).

• I71.51 (Supraceliac aneurysm of the thoracoabdominal abdominal aorta, ruptured)
• I71.52 (Paravisceral aneurysm of the thoracoabdominal abdominal aorta, ruptured)
• I71.61 (Supraceliac aneurysm of the thoracoabdominal abdominal aorta, without rupture)
• I71.62 (Paravisceral aneurysm of the thoracoabdominal abdominal aorta, without rupture)

As you can see, the above code descriptors will revise “abdominal” to “thoracoabdominal.”