AHA Coding Clinic® for ICD-9 - 1992 Fourth Quarter; New/Revised Codes
Heart Murmurs
Heart murmurs are abnormal physical findings (i.e., signs) which "result from vibrations set up in the bloodstream and the surrounding heart and great vessels as a result of turbulent blood flow, the formation of eddies, and cavitation (bubble formation as a result of sudden decrease in pressure)." They may indicate pathology or they may be innocent. A murmur by itself is not a diagnosis. If a murmur is pathologic, it must be further defined as to the underlying etiology. The ICD-9-CM index directs coders to "see Endocarditis" when they attempt to code diastolic, systolic, tricuspid, or valvular...
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Article Overview
This article explains heart murmurs as physical findings and reviews the broad clinical categories of systolic, diastolic, and continuous murmurs. It is relevant to coders and clinical documentation staff who need to understand how murmurs may reflect underlying disease processes and why additional clarification may be needed when the record is incomplete. The article also discusses older ICD-9-CM indexing guidance and the importance of tracing a murmur to its cause rather than coding the finding in isolation.
Why This Topic Matters
Heart murmurs are common findings that can represent either benign variants or signs of underlying disease, so accurate documentation review is important for correct diagnosis coding and record clarification.
Article Sections
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Heart Murmurs
Defines heart murmurs as physical findings and introduces the relationship between the finding and possible underlying conditions. It also notes older ICD-9-CM indexing guidance related to murmurs.
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Systolic Murmurs
Reviews the broad clinical categories and causes associated with systolic murmurs, including congenital, structural, and systemic conditions.
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Diastolic Murmurs
Summarizes the major clinical categories and potential causes associated with diastolic murmurs, including congenital, rheumatic, and acquired conditions.
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Continuous Murmurs
Describes continuous murmurs as a general category and outlines the broad types of conditions associated with them.
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Documentation and Coding Considerations
Addresses the need to identify the underlying cause when a murmur is documented and emphasizes clarification when the record is not specific.
What You Will Learn
- How heart murmurs are categorized at a high level
- Why murmur documentation may require review of an underlying diagnosis
- What broad conditions are associated with different murmur patterns
- Why clarification may be needed when the medical record is incomplete
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation specialists
- Physicians and other documentation providers
- Revenue cycle staff
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