ICD Guidelines Ch. 9 Diseases of the Circulatory System Flashcards
This can ONLY be coded together when the Dr. links the two as due to HTN or implied hypertensive
HTN w/ Heart Disease
When HTN & Heart disease aren’t linked
code them separately
HTN w/ CKD is a cause and effect relationship & whenever documented it’s
coded the smae NOT LINKED
HTN Heart Disease & CKD are coded
when documented
Code the Heart Failure and CKD as
additional codes
Should be 3 codes
A casual relationship can be assumed in a pt. w/ both atherosclerosis & angina
unless documentation indicates the angina is due to something else
AMI happens within
4 Weeks or 28 days
AMI is considered old after
4 weeks or 28 days
Subsequent AMI can be coded when it happens within 4 weeks of the
1st one. The sequencing depends on documentation
Hypertension uses the same code
Essential, Malignant, Benign,
Sequencing 1st- I10
Hypertension in the setting of Heart Disease Dr. DOES NOT have to Link DX
1st- I11
2nd- I50.- or I51.4- I51.9 (specify Heart Failure)
Hypertensive Chronic Kidney Disease Dr. DOES NOT have to LINK DX
1st- I12
2nd- N18 ( To identify the Stage)
Hypertensive Heart & Chronic Kidney Disease Dr. does not have to link DX
1st- I13
2nd- I50 (specify the heart faliure)
3rd- N18 ( to identify the stage)
Dr. MUST specify the DX in Hypertension and
Cerebrovascular disease
Hypertension Cerebrovascular disease
1st- I60- I69
2nd- HTN code
Hypertensive Retinopathy
1st- I10 or H35.0
sequence w/ the reason for the encounter (RFE)
Secondary HTN is do to an underlying condition. Two codes are rquired. One for the cause, and one for the hypertension
1st- I15 or the Underlying condition
sequence w/ the RFE
Elevated blood pressure
ex: white coat syndrome
1st- RO3.0
HTN controlled by therapy
Hypertension controlled
1st- I10-I15
HTN not responding to therapy
Hypertension uncontrolled
1st- I10-I15
Document for HTN crisis, & use a code to identify the type of HTN
1st- I16, I10- I15 (sequence events)
Code pulmonary HTN, Code associated conditions or adverse effects of drugs and toxins.
1st- I27 (other pulmonary HTN)
2nd- I27.1, I27.2- (secondary HTN)
3rd- asociated conditions, or adverse effects of drug/ toxins sequence in reason for encounter
Ch. 15 During pregnancy (gestational HTN or Preclampsia
1st- O13 for gestational HTN and O14 for preclampsia
Atherosclerotic Coronary Artery disease ASHD & Angina
combo code w/ angina pectoris
1st- I25.11 (Native coronary artery) or
I25.7 (bypass grafts)
AMI in ASHD- pt. admitted due to AMI
1st-AMI
2nd-I25.11 (CAD) coronary heart disease
Acute Myocardial infarction
AMI- unspecified
1st-I21.9
The segment is flat, isoelectric section of the EKG, typically it’s elevated
ST Elavation Myocardial infarction (STEMI) -Type 1
STEMI-Type 1
1st- I21.0- I21.2 or I21.3- be sure to specify the site of the infection
The NON ST segment is when the isoelectric section is depressed or below the lead
Non ST Elavation myocardial infarction (NSTEMI)- Type 1
1st-I21.4
If DX as non transmural or subendocardial and the site of the infarction is provided code as
Subendocardial AMI
1st- I21.4
If a type 1 NSTEMI evolves to a STEMI code the
STEMI
If a type 1 STEMI converts to a NSTEMI due to thrombolytic therapy code the
STEMI
ONLY the STEMI and the transmural MI without a dx site
Type 1 AMI- unspecified
Use I22 for subsequent
type 1 AMI
other types of AMI/ Type 3, 4a, 4b, 4c, & 5
1st- I21.A9 (other AMI type)
