Infarct, Myocardial (acute) (with stated duration of 4 weeks or less) (I21.3) NOTE FROM MANUAL Note-Use the following fifth-digit subclassification with category 410:Ģ - subsequent episode without recurrence Infarct, Myocardial (acute or with a stated duration of 8 weeks or less) (with Hypertension) (410.9x) In addition, there are no specific codes for Postoperative Fibrillation or Postoperative Flutter in the alpha index.Ĭongestive Heart Failure (compensated) (decompensated) (428.0)Ĭongestive Heart Failure (compensated) (decompensated) (I50.9)Ĭombined with Systolic (congestive) (I50.40)Ĭombined with Diastolic (congestive) (I50.40) NOTE FROM AUTHOR Attention: There are specific descriptions for Atrial Fibrillation and Atrial Flutter in I-10. one code in I-10Ītrial Fibrillation (established) (paroxysmal) (427.31)Ītrial Fibrillation or Auricular (established) (I48.91) NOTE FROM AUTHOR Attention: Two codes in I-9 vs. ICD-10-CM codes would be I97.89 (other post-procedural complications and disorders of the circulatory system, not elsewhere classified) and I48.0 (paroxysmal atrial fibrillation) based on the instructional note to use an additional code to specify the disorder.For the I-10 Corner this week, we are discussing a few of the specific coding differences for cardiac diagnoses and conditions in ICD-9-CM and ICD-10-CM.Īngina Pectoris with Atherosclerotic Heart Disease (ASHD):Īngina with ASHD, Unspecified-see Arteriosclerosis, Coronary (artery), Unspecified (I20.9) Now, let’s assume that the provider documented that the “post-operative course is complicated by paroxysmal atrial fibrillation requiring amiodarone drip.” This would code: Fibrillation > atrial > postoperative complication > paroxysmal. The ICD-10-CM code would be I48.0 (paroxysmal atrial fibrillation). This would code: Fibrillation> atrial > paroxysmal. Let’s assume documentation of post-operative paroxysmal atrial fibrillation. The physician has to specifically document that the post-operative atrial fibrillation is a complication of the procedure. ICD-9-CM coding allowed for post-operative atrial fibrillation to be coded as a complication, with supporting language in the Coding Clinic published for the fourth quarter of 2013. In these instances, the provider should be queried for clarification that the post-operative atrial fibrillation was, in fact, a complication. Some will agree that it is a complication, while others will say it is an expected outcome of the cardiac procedure. One area that varies among physicians is post-operative atrial fibrillation following cardiac surgery. On the other hand, if the post-operative atrial fibrillation required treatment, either with medications or defibrillation, this condition should be considered a complication. Next, if a patient develops atrial fibrillation post-operatively, what was the outcome? If the patient had several beats of atrial fibrillation noted on cardiac monitoring that resolved on its own without treatment, this should not be considered a complication. First, does the patient have a history of atrial fibrillation that is currently being treated? If so, then post-operative atrial fibrillation is not a complication of surgery and was present on admission. Determining whether or not to view post-operative atrial fibrillation as a complication has several defining factors.
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