Internal Medicine Coding Alert
Choose Single ICD-9 Code to Represent Aortic/Mitral Valve Condition
Question: The internist ordered an electrocardiogram for a patient diagnosed with stenosis of the aortic and mitral valves. During the ECG, she took 14 leads. What would be the correct coding for this scenario? Specifically, how many ICD-9 codes should I report to reflect the patient's condition?
Arkansas Subscriber
Answer: You'll use one diagnosis code to represent the stenosis in both valves. When patients have stenosis (or another affliction) in the mitral and aortic valves, you should choose a code from the 396 series (Diseases of mitral and aortic valves) to identify both conditions.
Aortic stenosis does have its own code, 424.1 (Aortic valve disorders). However, under the exclusions section for 424.1, it states that the diagnosis does not include "that of unspecified cause but with mention of diseases of mitral valve (396.0-396.9)."
ICD-9 coding: The proper code for your claim is 396.0 (Mitral valve stenosis and aortic valve stenosis).
CPT coding: Choose from one of these ECG codes, depending on the specifics of the encounter:
• 93000--Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report
• 93005--... tracing only, without interpretation and report
• 93010--... interpretation and report only.
Internal Medicine Coding Alert
- Master Frequency Rules, Risk Categories for Medicare Colonoscopy Screenings
Medicare has specific frequency requirements for average- and high-risk patients
Medicare patients who present to your [...] - Remember 'Rule of Nines' When Calculating Patient's Burned Body Area
When a patient has multiple burns, make sure to include a dx for each one
When [...] - YOU BE THE CODER:
ABPM Readings
Question: Our internist recently performed an ambulatory blood pressure monitoring on a patient with elevated [...] - READER QUESTIONS:
Choose Single ICD-9 Code to Represent Aortic/Mitral Valve Condition
Question: The internist ordered an electrocardiogram for a patient diagnosed with stenosis of the aortic [...] - READER QUESTIONS:
When Internist Removes ED Stitches, Opt for E/M Code
Question: An established patient with three scalp sutures reports to the internist for suture removal. [...] - READER QUESTIONS:
Dermabond/Suture Combo Calls for Wound Care Code
Question: An established Medicare patient reports to the internist after falling from the stairs on [...] - READER QUESTIONS:
Check Payer Policy Before Reporting Bandage Wrap as Strapping
Question: A patient reports with a swollen right index finger that she injured while catching [...] - READER QUESTIONS:
Confirm Physician Involvement, Instrumentation Before Coding Cerumen Removal
Question: If a patient reports to the internist for removal of cerumen (earwax), what code [...] - READER QUESTIONS:
Size Matters When Choosing Devitalized Tissue Removal Code
Question: A patient with a pressure ulcer on his shoulder blades reported to the office, [...] - Correction:
Reflect Phenergan With HCPCS Code J2550, Not J2250
When coding for Phenergan, don’t mix up the “25” with a “22.”
[...]
