Just as other medical specialties, cardiology is also periodically updated with new diagnosis and procedure codes that increase the challenges of cardiology medical coding. It is crucial for physicians and medical coders to understand these codes, current definitions, and coding rules. This will enable accurate documentation, and the selection and proper sequencing of codes.
Let us for instance, consider the ICD-10 codes for Angina Pectoris. Commonly known as Angina, the condition is the result of inadequate oxygen supply to the heart. It is due to a narrowing of the coronary arteries resulting from arteriosclerosis. Symptoms of angina include chest pain consistent with cardiac pain that usually gets worse with exertion and better with rest or nitrates. Patients may also experience shortness of breath.
For on-time reimbursement, the documentation should indicate the type of angina, associated spasm and symptoms. If the patient has coronary artery disease, this should be documented as the code selection will change to a combination code in ICD-10-CM. Documentation should also indicate whether the patient smokes, has been exposed to smoke, or has a history of smoking.
Angina that occurs at rest is unstable angina. It is caused by poor blood flow through the blood vessels of the heart muscle, and is often a precursor to a myocardial infarction.
- 0 – Unstable angina
As per an article in Medline Plus, about 2% of people with angina have coronary artery spasm. This is a temporary, sudden narrowing of one of the coronary arteries. It can be coded as-
- 1 – Angina pectoris with documented spasm
It is recommended that when documenting atherosclerotic heart disease with angina pectoris, coders should include the cause assumed to be atherosclerosis, stability (stable or unstable angina pectoris), note which artery is involved and whether the artery is native or autologous and graft involvement, whether a bypass graft was involved in the angina pectoris diagnosis; also note the original location of the graft and whether it is autologous or biologic.
Codes for this combination include:
- 701 – Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
- 708 – Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
- 709 – Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
- 110 – Atherosclerotic heart disease of a native coronary artery with unstable angina pectoris
- 710 – Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
Other ICD-10 codes related to Angina Pectoris are:
- 8 – Other forms of angina pectoris
- 9 – Angina pectoris, unspecified
To submit clear and accurate medical claims, physicians can ideally obtain professional support from an established medical billing and coding company.
Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.