Experts from 11 UK professional societies (the Joint British Societies or JBS) and charities engaged in cardiovascular disease (CVD) prevention have developed a new risk calculator named ‘JBS3’, that can tell the real age of an individual’s heart. It is developed on the basis of available scientific evidence and assumptions where no evidence is available. This calculator estimates the ‘heart age’ of individuals and the years they can be expected to live without developing CVD. The tool is a part of JBS guidelines on CVD prevention and its ultimate aim is to empower individuals to reduce their risk of CVD.
Though risk calculators for CVD is nothing new, JBS opines that current prevention strategies focus only on high short term risk (within the next 10 years) of a heart attack or stroke. But, the JBS3 calculator can evaluate the risk of heart disease and stroke throughout one’s life and in the short term. In addition to this, it shows the benefits that people will experience if they make vital changes in their lifestyle (for example, stopping smoking, reducing cholesterol levels). The tool also shows the effects on people if delaying these changes.
The benefits of JBS3 unlike other risk calculators (Framingham risk calculator) available for years are:
- Easy online access
- Provides what is regarded as an accurate risk assessment of experiencing a serious CVD event including heart attack or stroke
- Useful for younger adults who could be on the route to stroke or heart attack owing to unhealthy lifestyle choices, despite having low short-term risk of CVD
Cardiovascular Diseases – Symptoms, Diagnosis and Treatment
Heart diseases are among the most serious health problems in the United States. The recent statistical update of the American Heart Association shows that cardiovascular disease is a leading health problem in the country. As per the statistics, approximately 84 million people experience some form of CVD in the U.S. which cause around 2,200 deaths a day with one death every 40 seconds on an average. The percentage breakdown attributable to death due to cardiovascular disease in United States during 2010 is as follows:
- Coronary Heart Disease – 48.2%
- Stroke – 16.4%
- High Blood Pressure – 8.0%
- Heart Failure – 7.3%
- Diseases of the Arteries – 3.4%
- Others – 16.7%
The direct and indirect costs associated with cardiovascular disease and stroke is estimated to be $315.4 billion in U.S. during 2010 and this figure is increasing each year. Let’s take a look at the symptoms, diagnosis and treatment of CVD.
Even though each type of CVD event typically has different symptoms, many of them have similar symptoms. Call the doctor if you or someone related to you is regularly experiencing any of the symptoms given below as it can be a warning sign for CVD.
- A fast heart rate (more than 100 beats per minute)
- A new, irregular heart beat
- Chest pain or discomfort while doing an activity that goes away after taking rest
- Breathing difficulty during regular activities as well as on rest
- A respiratory infection or cough becomes worse
- Change in sleep patterns
- Constant dizziness or lightheadedness
- Loss of appetite or nausea
- Extreme fatigue
- Restlessness or confusion
Physicians diagnose cardiovascular diseases using an array of laboratory tests and imaging studies. Blood tests, stress testing, EKG/ECG, chest X-ray and cardiac MRI are some of the common tests. The primary step of diagnosis is analyzing the medical and family histories of the patients, risk factors and conducting physical examination. Then, these findings are coordinated with the results from tests and procedures.
Physicians providing treatment for CVD have to ensure proper medical documentation incorporating appropriate diagnosis and procedure codes to report various CAD events. This is important from the point of view of medical billing and coding for medical claim submission and reimbursement.
There are Major Cardiovascular Diseases (Major CVD) and Total Cardiovascular Diseases (Total CVD). The former type is commonly reported by the National Center for Health Statistics (NCHS). The latter type typically comprises all ‘Diseases of the Circulatory System’.
Commonly Used Cardiovascular Diagnosis Codes for Diseases of the Circulatory System
- 390-392: Acute Rheumatic Fever
- 393-398: Chronic Rheumatic Heart Disease
- 401-405: Hypertensive Disease
- 410-414: Ischemic Heart Disease
- 415-417: Diseases of Pulmonary Circulation
- 420-429: Other Forms of Heart Disease
- 430-438: Cerebrovascular Disease
- 440-449: Diseases of Arteries, Arterioles, and Capillaries
- 451-459: Diseases of Veins and Lymphatics, And Other Diseases of Circulatory System
ICD-10 based diagnostic coding for Cardiology specifically circulatory system involves an extensive number of codes ranging from I00 to I99.
The treatment options for CVD include cardiac procedures and surgeries (for example, angioplasty, by-pass surgery), placing implantable devices (e.g. pacemaker) and cardiac medication (e.g. anticoagulants, antiplatelet agents). Physicians advise the best treatment combination depending on the severity of CAD. Physicians providing the treatment can use appropriate CPT codes on their medical claims to specify treatment procedures and receive reimbursement from payers. It is very important to check whether the CPT codes used are valid currently as AMA may add new codes, delete older codes and revise existing codes. Here are some examples of revised cardiovascular codes.
- 33222: Revision or relocation of skin pocket for pacemaker
- 33223: Revision of skin pocket for cardioverter-defribrillator
- 33222: Relocation of skin pocket for pacemaker
- 33223: Relocation of skin pocket for cardioverter-defibrillator
JBS3 calculator is specifically designed to help healthcare professionals identify and communicate the CVD risk to the people whose risk in the next 10 years is low, but who may develop high risk over their lifetime. Both health professionals and patients can thus better understand cumulative lifetime risk of CVDs and take effective measures to lower it.