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ICD-10 training: A physician's guide to coding for heart disease

Ischemic heart diseaseClick to view full imageIschemic heart disease is reported in ICD-10-CM with categories I20-I25. This includes angina pectoris, myocardial infarction, current complications following myocardial infarction, and chronic ischemic heart disease. Physicians and coders need to understand how the organization of codes, current definitions, and coding rules have changed. This will enable the provision of accurate documentation, and the selection and proper sequencing of codes.

This article provides a quick, but important, look at the major differences in reporting ischemic heart disease in ICD-10-CM in comparison with ICD-9-CM.

The provision of many more codes in ICD-10-CM as well as changes in definitions require the coder and the physician to understand the rules for code selection and sequencing, and the documentation specificity required to prevent delays in claim submission, rejection, and revenue loss.

Atherosclerotic coronary artery disease

Coronary atherosclerosis codes in ICD-9-CM are found in subcategory 414.0.

Code selection is by type of vessel or graft: unspecified whether native or grafted vessel, native coronary artery, autologous vein bypass graft, arterial bypass graft, nonautologous biological bypass graft, unspecified type of bypass graft, or native artery or bypass graft of a transplanted heart. Codes for angina pectoris are reported in addition to coronary atherosclerosis codes when both conditions are present.

In ICD-10-CM, there is an assumed causal relationship in a patient with both coronary atherosclerosis and angina pectoris. ICD-10-CM provides combination codes for these two conditions that are selected when both are documented in the patient, unless the documentation specifically states that the angina pectoris is due to some other condition or disease process besides the atherosclerosis.


Next: ICD-10-CM codes differentiated by subcategories

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