Top ICD-10-CM Changes for Cardiology in 2017
The FY 2017 updates to ICD-10 is all set to go live on Oct. 1. 2016. About 1,943 new codes and 422 revisions will be added to the updates. Cardiology coding in particular will gains some new codes. Are you feeling a little daunted about having to learn so many new ICD-10 codes? Don’t worry, here’s a primer on top cardiology coding changes in ICD-10.
1. Hypertensive Crisis: Is it an urgency or emergency?
The index of the current version of ICD-10-CM for “urgency, hypertensive,” directs you to the general Hypertension entry at I10. However, there is a difference between hypertensive crisis and plain hypertension. According to the American Heart Association, hypertensive crises can present as hypertensive urgency or as hypertensive emergency. A hypertensive crisis refers to a sudden, severe rise in blood pressure that can be dangerous, which requires early intervention and evaluation of blood pressure elevation as well as organ function.
In hypertensive urgency: the BP is elevated to 180 or higher for the systolic or 110 or higher for the diastolic pressure, without associated organ damage.
In hypertensive emergency: this is a more critical of the two conditions. The BP elevations occur (exceeding 180/110) but the hypertension is always accompanied by symptoms of organ damage.
ICD-10-CM added the following new codes to go along with this accepted hypertensive crisis terminology:
I16.0, Hypertensive urgency
I16.1, Hypertensive emergency
I16.9, Hypertensive crisis, unspecified.
Note: If the documentation doesn’t specify urgency or emergency, one has to report the unspecified code.
2. Coding for Familial Hypercholesterolemia
While coding for familial hypercholesterolemia currently, you have to settle for E78.0 (Pure hypercholesterolemia). However, pure hypercholesterolemia (as opposed to mixed hypercholesterolemia) is an inaccurate way of referring to the genetic condition familial hypercholesterolemia (FH). FH can be associated with other manifestations besides high blood cholesterol, such as yellowish patches of cholesterol deposits under the eyelids. In 2017 ICD-10 updates, code E78.0 has been deleted and the following new codes are added:
- E78.00, Pure hypercholesterolemia, unspecified
- E78.01, Familial hypercholesterolemia.You’d use the new E78.00 in events where the type of hypercholesterolemia was unspecified. Plus, the Oct. 1 version of ICD-10-CM adds a new code for reporting family history of FH:
- Z83.42, Family history of familial hypercholesterolemia.
3. Proposed MI Classification Codes
When it comes to myocardial infarction code, the current ICD-10-CM don’t quite line up with the actual MI classification cardiologists uses. To fix that, the American College of Cardiology and American Heart Association Task Force proposed a change, where the new codes would add inclusion notes to STEMI and NSTEMI codes I21.0 to I21.4, specifying that those codes are appropriate to report type 1, spontaneous, MIs. The proposal would then add a new subcategory for the remaining types of MI, which are types 3, 4a, 4b, 4c, and 5. Note: these new MI codes are still in proposal stage.