Documenting Pericarditis – A Common Inflammatory Heart Condition

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A common inflammatory condition of the heart, Pericarditis is the inflammation of the pericardium – a thin, two-layered sac that surrounds your heart. The swelling can lead to sharp pain as the affected pericardial layers rub together causing irritation. Pericarditis is an inflammatory condition, usually acute, coming on suddenly, and lasting from a few days to a few weeks. However, when symptoms develop more gradually or persist, it is considered chronic. Both types of pericarditis can disrupt your heart’s normal rhythm or function. Most cases of this condition are mild and usually improve on their own. On the other hand, treatment modalities for severe cases may include medications and rarely surgery. Early diagnosis and treatment may help reduce the risk of long-term complications of pericarditis. Physicians can rely on outsourced medical billing and coding services to report pericarditis diagnosis and treatment on their medical claims using the correct medical codes.

Reports suggest that about five percent of people who go to the emergency room for chest pain have pericarditis. It is estimated that about 15 – 30 percent of people with pericarditis will have it more than once. The exact cause of pericarditis is often hard to determine, but viral infections are thought to be responsible for 80 to 90 percent of cases. The condition can develop weeks after a major heart attack (due to the irritation of the underlying damaged heart muscle) and also after a heart surgery. Other related causes include – systemic inflammatory disorders (like rheumatoid arthritis or lupus), trauma, kidney failure, parasite, radiotherapy and use of certain medications such as penicillin, warfarin, and phenytoin.

Types of Pericarditis and Symptoms

Pericarditis can be classified into different types, depending on the pattern of symptoms and how long these symptoms last. Acute pericarditis usually lasts less than three weeks. Incessant pericarditis is continuous and lasts about four to six weeks but less than three months. Recurrent pericarditis, on the other hand lasts for about four to six weeks after an episode of acute pericarditis with a symptom-free interval in between. However, the condition is considered chronic if symptoms last longer than three months. Common symptoms include –

  • Sharp pain in the chest (sometimes central, other times to the left, that may decrease in intensity when sitting up and leaning forward)
  • Swelling of the abdomen or legs
  • Shortness of breath, especially when reclining
  • Palpitations
  • Pain in the shoulder
  • Minor fever
  • General weakness
  • Cough

Symptoms, in most cases are very similar to a heart attack. It is imperative to seek medical attention if the patient experiences any pain in the chest. If left untreated, the condition can get worse and lead to several complications like – cardiac tamponade (too much fluid builds up in the pericardium) and constrictive pericarditis (a permanent thickening and scarring of the pericardium).

Diagnosing and Treating Pericarditis Symptoms

Cardiologists or other specialists will begin the diagnosis by analyzing the complete medical history of the patient and asking questions about the chest pain and other related symptoms. Physician will perform a detailed physical examination (to check the heart sounds), as part of their initial evaluation. They will check for the characteristic noise of pericarditis (also called a pericardial rub.), which is made when the pericardial layers rub against each other.

Physicians may also perform tests to determine whether the patient has suffered a heart attack, whether fluid has collected in the pericardial sac or whether there are signs of inflammation. Blood tests may also be done to determine if a bacterial or other type of infection is present. Other diagnostic imaging tests include – Electrocardiogram (ECG), Echocardiogram, Cardiac magnetic resonance imaging (MRI), Computerized tomography (CT) and Chest X-ray.

Treatment for pericarditis depends on the cause as well as the severity. Mild cases may often get better on their own without treatment. Medications like pain relievers (such as aspirin or ibuprofen, Advil, Motrin IB), Colchicine (Colcrys, Mitigare) and Corticosteroids may be prescribed to reduce the inflammation and swelling associated with the condition. If the physician suspects cardiac tamponade (a dangerous complication due to fluid buildup around the heart), patients will require hospitalization. If cardiac tamponade is present, physicians may recommend procedures like pericardiocentesis or pericardiectomy to relieve fluid buildup.

Cardiologists or other specialists providing treatment (that involves diagnosis, screening and other tests) for pericarditis patients must carefully document the diagnosis using the right medical codes. Billing and coding services offered by experienced medical billing companies can help these physicians ensure the correct codes for their medical billing purposes. ICD-10 codes for pericarditis –

  • I30 Acute pericarditis
    • I30.0 Acute nonspecific idiopathic pericarditis
    • I30.1 Infective pericarditis
    • I30.8 Other forms of acute pericarditis
    • I30.9 Acute pericarditis, unspecified
  • I31 Other diseases of pericardium
    • I31.0 Chronic adhesive pericarditis
    • I31.1 Chronic constrictive pericarditis
    • I31.2 Hemopericardium, not elsewhere classified
    • I31.3 Pericardial effusion (non-inflammatory)
    • I31.4 Cardiac tamponade
    • I31.8 Other specified diseases of pericardium
    • I31.9 Disease of pericardium, unspecified
  • I32 Pericarditis in diseases classified elsewhere

In most cases, mild cases of pericarditis can be effectively managed by consuming over-the-counter medications and taking adequate body rest. During the recovery stage, patients need to avoid strenuous physical activity as these can trigger pericarditis symptoms.

As clinicians face the challenges of treating and preventing pericarditis, they can depend on an experienced medical billing and coding company for submitting claims on time and getting correct reimbursement without any delay.

Natalie Tornese

Holding a CPC certification from the American Academy of Professional Coders (AAPC), Natalie is a seasoned professional actively managing medical billing, medical coding, verification, and authorization services at OSI.

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