Cardiomyopathy Documentation with Accurate ICD-10-Codes

Hi everybody and welcome to our podcast series. My name is Meghann Kiernan and I’m a Senior Solutions Manager with Outsource Strategies International. Today I’ll be discussing with you how to document cardiomyopathy with accurate ICD-10 codes. First, let me tell you a little bit about cardiomyopathy. Cardiomyopathy is a progressive disease of the myocardium or heart muscle that makes it harder for the heart to pump blood to the rest of the body. This is a lifelong serious condition which can lead to heart failure. Often, the exact cause of this condition is unknown as it can be the result of other conditions or passed on from a parent. This is often the case when the disease occurs in children. Types of cardiomyopathy include – Arrhythmogenic right ventricular dysplasia, Hypertrophic, Dilated and Restrictive cardiomyopathy. Diagnosis by an expert cardiologist is crucial for reducing the associated symptoms and effectively treating the different types of cardiomyopathy.

What are the Symptoms of Cardiomyopathy?

Generally, there might not be any signs or symptoms in the early stages of this heart condition. However, as the disease advances, several signs and symptoms appear including –

• Breathlessness with exertion or even at rest
• Swelling of the legs, ankles and feet
• Chest pain
• Heart palpitations
• Fatigue and dizziness
• High blood pressure, and
• Coughing while lying down

If left untreated, the signs and symptoms tend to get worse. In some people, the condition worsens quickly, whereas in others it might not worsen for a long time.

How Do We Diagnose and Treat Cardiomyopathy?

Initial diagnosis of this includes a detailed physical examination wherein the physicians will enquire about the personal and family medical history and ask about the typical symptoms which the patients face (for instance, whether exercise brings on your symptoms). Several imaging tests such as chest X-ray, Echocardiogram, Electrocardiogram (ECG), Cardiac catheterization, Treadmill stress test and Cardiac MRI and CT scan will be conducted. In addition, blood tests and other genetic screening will be performed.

Treatment modalities for this condition will vary and depend on the type of cardiomyopathy you have. Prominent treatment modalities include Medications, Radiofrequency ablation, septal ablation and surgically implanted devices (such as Implantable, Ventricular assist device (VAD) and Pacemaker. Severe cardiomyopathies may prove difficult to control or treat with medication, diet, or other nonsurgical interventions. In such situations, surgical procedures such as septal myectomy and heart transplant may be a considered as a final option.

Let’s talk about how to code cardiomyopathy. Cardiology medical coding involves the use of specific ICD-10 codes to document any such conditions, including cardiomyopathy. ICD-10 codes used to indicate a diagnosis of cardiomyopathy for reimbursement purposes includes code I42.0 to I43. For the whole list of the coding discussed in this podcast, please refer to the transcript below.

I hope this helps. But always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thanks for joining me and stay tuned for my next podcast.