by Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
November 8th, 2018
Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections:
Acute rheumatic fever (I00-I02)
Chronic rheumatic heart diseases (I05-I09)
Hypertensive diseases (I10-I16)
Ischemic heart diseases (I20-I25)
Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)
Other forms of heart disease (I30-I52)
Cerebrovascular diseases (I60-I69)
Diseases of arteries, arterioles
Diseases of veins, lymphatic vessels and lymph nodes not elsewhere classified (I80-I89)
Other and unspecified disorders of the circulatory system (I95-I99)
Symptoms and signs involving the circulatory and respiratory systems are reported with R00-R09. It is important to always consider the most specific code if there is more than just signs or symptoms. Use codes from this section for conditions which no diagnosis classifiable elsewhere is recorded.
For example, abnormalities of Heart Rhythm are reported with R00.0 through R00.9, but if there is a more specific code that describes the condition such as I49.02 Ventricular Flutter, then you must use the more specific code. Watch for ICD-10-CM code notes to direct you to the correct sequencing if there are specific rules such as when you view I49.2 Ventricular Flutter, you are directed to CODE FIRST: cardiac arrhythmia complicating: abortion or ectopic or molar pregnancy (O00-O07, O08.8) obstetric surgery and procedures (O75.4).
Cardiac Arrhythmia is coded with I49.01 through I49.9. Coding guidelines require to CODE FIRST applicable cardiac arrhythmia complicating: abortion or ectopic or molar pregnancy (O00- 07, O08.8) obstetric surgery and procedures (O75.4).
Chest Pain is coded from I20.0 to I2.9 “Angina”. If there is a presence of hypertension it must be coded in addition to chest pain with codes I10-I16. In addition, you are required to code and relationship to tobacco such as History of tobacco dependence Z87.891, you must also code any exposure, dependence or use.
An external cause code is required to report infections, diseases or other health conditions due to an external source such as a heart attack during a strenuous activity.
When there are combination codes available and multiple disorders are documented, always assign the combination code. For example I08.1 Rheumatic disorders of both mitral and tricuspid valves.
Review the ICD-10-CM coding guidelines for additional instructional notes and rules for coding.