Q: How is renovascular hypertension coded? Is it classified to category I12?
A: No, renovascular hypertension is classified to category I15 rather than I12. It is not the same as hypertensive CKD.
Q: Which stage of heart failure isn't coded using the heart failure code? Is it stage A, B, C, or D?
A: Stage A heart failure is assigned code Z91.89, Other specified personal risk factors, not elsewhere classified. All other stages of heart failure are assigned codes from category I50. Refer to the CM index for proper reporting.
Q: A patient presented with type 2 AMI 3 weeks after STEMI. What is the type 2 MI code?
A: I21.A1, There is only one code for type 2 AMI, even if it occurs within 4 weeks of another type.
Q: If the patient has aortic stenosis and mitral insufficiency, the default code is for rheumatic heart disease. If the patient also has CHF, can we assume it’s rheumatic heart failure and assign a code for rheumatic heart failure?
A: No, there is no assumed link between heart failure and rheumatic heart disease. The key to combination coding is how the conditions are indexed. Under the index entry “Insufficiency; mitral,” the subterm “with” is indented immediately beneath the subterm “mitral,” and the subsequent subterm “with; aortic valve disease,” indicates an assumed link between the aortic stenosis and mitral insufficiency. Guideline I.A.15. gives instruction on the use of “with” in the index and tabular listing. When indexing “Failure; heart,” the term “rheumatic” is not indented under the subterm “with,” indicating that an assumed causal relationship does not exist. Query the provider to determine if the patient’s heart failure is rheumatic when aortic and mitral valve disease are both present.
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Kristi also performs DRG and APC audits and is known for her vast knowledge on coding vascular interventional radiology procedures. Kristi has an extensive background in coding education and consulting and is a national speakers on topics related to ICD-10 and CPT coding as well as code-based reimbursement.