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    17061845512024-01-25_17_39_09_MedicalCoding_ICD_10_2024-Part-2

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    mo.azeem1996

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    Chapter 9: Diseases of the Circulatory System (100-199) Chapter-Specific Coding Guidelines LC 9. Chapter: Diseases of the Circulatory System (100-199) 1. Hypertension ‘The clasicaton presumes causal relationship between hypertension and heat involvement and between hypertension and kidney Involvement asthe two condtions re inked by the termi the ‘Alphabetic Index These conditions shouldbe coded a related even in ‘he absence of provider documentation ext inking ther, ones he Gocumentaton clearly states the cndltions are untlted For hypertension and conitions not special linked by relational terms Such 2th "asocoted with ore ton the claselfction, poner Aocumentaton must ink the conditons order to code thern as relied 1) Hypertension with Heart Disease Hypertension wth heart conditions clasied to'50- 0814-1517, 15189,1519, are assigned toa code from category i, Hypertensive heart disease, Use adstional codel) rom category 50, Hear fale, to raentiy te spe) of heart alr in those patent wth hea alr ‘The same heart conditions (50, '51.41517, 51.6, 51.9 with hypertension are coded separatly Ite provider has documented they ae unrelated tthe hypertension, Sequence according to the ‘crcumstonces of the adnson/encounter. 2) Hypertensive Chronic Kidney Oiseate Assign codes tram category 12, Hypertensive chvonk kidney esos, ‘wen both hypertension and a condtion lassable to category NI ‘Chronic kidney seas (CKD) are present. CKD should not be code as hyportensiveifthe provide ineates the CKD isnot related to the hypertension ‘The appropriate code fom category N18 shouldbe used asa secondary code with code om category 12 o ident the stage of| Chronic dney dsease, See Section 1.14 Cvoni kney dase a patient has hypertensive cron kidney disease and acute renal flue the acute renal aur shoul aso be coded Sequence ‘secon to the creumstances ofthe admbson/encounter 13) Hypertensive Heart and Chronic Kidney Disease ‘Assign codes from combination categaryI1, Hypertensive heart land ehvonie kidney disease, when theres hypertension with both heart and kidney involvement. hear flue preset assign an ational code rom category 150 identify the type of hea allure, ‘The appropiate code fom category N'8, Chronic kidney seat shouldbe used as a secondary code witha code om category 130 det the stage of ehronicKdney disease, See Section (C4. Chron ney dase, The codes in category 13, Hypertensive heat and chronic kidney ‘seat, ae combination codes that include hypertension heat ‘isease and chronic kidney dsease The Includes nate at 13 species thatthe condtlons includ at 11 and 12 ae included together in 13. fa patient has hypertersion heart disease and even kidney ‘seas, then a code For 13 shouldbe used not inldual codes for hypertension heart sense and chronic kidney deat or codes fom morn, For patient wth both acute renal failure and chronic kidney disease, ‘the acute renal ale should also be coded. Sequence according tothe ‘reumstanees ofthe admssion/encounte, 4) Hypertensive Cerebrovascular Disease For hypertensive cerebrovascular disease frst assion the appropriate code from categories 60469, flowed bythe appropriate hypertension Sod, 5) Hypertensive Retinopathy Subcategory H350, Background retnopathy ad retinal vascular ‘changes should be used along with s code fam categories 10 — 113, in the Hypertensive diseases section to induc the steric hypertension. The Sequencing is based on the reason for the encounter. 20241CD-10-CM 6) Hypertension, Secondary Secondary hypertension i due to an underying canton Two codes are required one to ienty the underyng etclogy and one frm ‘atgory 5 to entity the hypertension. Sequencing of codes i, ‘etermined by the reatan for admision/encounter. 17) Hypertension, Transent Assign code R030, Elevated blood pressure reading without dagnosis of hypertension unless patient hasan established dagnost of hypertension. Asign code O13., Gestational [resnancy induced) hypertension without signer protemura, or O14, Pre-ecampsl, fortvansient hypertension of pregnancy. 18) Hypertension, Controlled ‘This diagnostic statement usual fest an exiting sate of hyperension under contol by therapy. Asign the appropriate code ‘tom categories 1115, Hypertensive disease, 9) Hypertension, Uncontrolled Uncontrolled hypertension may refer to untreated hypertension or hypertension net responding to current therapeutic regimen, nether case, assgn the pproprate cade fom categories 10115, Hypertensive ‘dseases ‘10}ypertensive Criss ‘Assign a code from category 16, Hypertensive criss, for documented bypertensve urgency, ypertensv emergeny or nspectes Inypertensive cs, Code aso any idee hypertensive cease (10- 118) Te sequencing is based on the reason forthe encoun ‘1)Pulmonary Hypertension Pulmonary hypertension is cased to category 127, Other pulmonary heart eseases. For secondary pulmonary ypertension (27,1272, de alo any assisted conditions or adverse effects of drugs or toxins. The sequencing fs bared on the reason forthe encounter, except for adverse fect of drugs Se Seton IC 19.) ‘alHypertension, Resistant Resistant hypertension refers to blood pressure ofa patient ‘wth hypertension that ema above goa in spite ofthe use ‘of antihypertensive medcatlons Assgn code HA, Resistant Inypertension, as an additonal code when apparent treatment {esistont hypertension treatment resistant hypertension or tue ‘resistant hypertension is documented bythe provider A code fr the ‘Specie type of existing Hypertension is sequenced fst known. _Athorosdlerotic Coronary Artery Disease and Angina 1CO-10-0 has combination codes or atherosclerotic heart leease ‘th angina pectoris. The subcategories fr these codes ar 25.11, Dtheroelerti heart disease of native coronary artery with angina pectoris {and 252, Atherosclerosis of coronary artery bypass rats) and coronary artery of transplanted heat with angina pectors \When using ane ofthese combination codes its not necessary toute an ‘atonal coe for angina petors A caus relationship can be asimed ina pationt with both atherosclerosis ond angina pectoris uness the ‘documentation indicates the angina i due to something ater than the | Stheroelaos if patent wth coronary artery leezee admitted due to an acute ‘myocar infarction (AM, the AMI should be sequenced before the Coronary tery dase See Seton C3, Acute myocardial infarction AMD. Intraoperative and Postprocedural Cerebrovascular Acldent Mecical record documentation should cleat spect the couse-and-ffet ‘elationship between the metal intervenon and the cerebrovascular {accident inorder to assign a code for invaoperative or pastrocedual Cerebrovascular accident Proper code assignment depends on whether twas an infarction or hemorrhage and whether occured invaoperativey or postoperatively Ifitwas a eerbral hemonage code sgnment cepends onthe Spe of procedure performed. S g ca 2 fs ct 3 Chapter 9: Diseases ofthe Circulatory System (100-199) 1d. Sequelae of Cerebrovascular Disease 1) Category 69, Sequelae of Cerebrovascular disease Category 69s used to ndcate conditions casfible to categories 160167 asthe causes of sequela neurologic deft) thease ‘asd evewhere These Tote clots neue eroagl defies that persis afer tol onsa of coneions clssfable to categorie 160167 The neurologic dicts caused by corebrovanclretease may be sent fom the onant or maya at any theater the onset ofthe Condition lssiabe ta categories 67, Codes from category 169, Sequelae of cerebrovascular dese, thet spec hemiplegia hemipatess and monoplega identity whethe the clominant or nondominant sede affected shoul the affected side be ‘documented but not speci as dominant ornondominant andthe ‘assification system des nt indicate a default code selection Is 38 fotows: For ambidertous patient, the default shouldbe dominant. ithe lefts is fected the defaults non-dominant. the ight sie is afected the deat is dominant. 2) Codes from category 169 with codes rom 150467 oes rom category 19 may be assigned on a health ere record with codes fom 160167, the patient hata curen cerebrovascular disease fad deft from anol cerebrovascular gecae, 3) Codes from category 169 and Persona history of transient schemic attack TA) and cerebral infarction (286.73) codes rom category I should not be assigned the patent doesnot have neurologic des. See Seton LC.2.4 Mistry erase of personal histo codes 1. Acute myocardial infarction (AMI) 1) Type 1ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI) The KD: 10-CM codes for type 1 acute myocar infarction (AND ‘enti the st, suchas anterolateral wal ora terior wal, Subcategories 2.0121. and code 213 are ved for ype 1 ST elevation myocar ircton STEM, Code 24 ton 5 leation (usTEN) myocardial infarction, s used for type I nan ST eevation ‘myocar infarction (STEM? and nontransmutal Mls Hfetype 1 NSTEMI evolves to STEM, assign the STEMI code. a ype STEMI converts to NSTEM due to thrombolytic therapy, ki sil coed assTEM For encounters occuring whl the myocardial infarction s equ to, orles tha, four weeks lg, Inctuing transfers to another ace Setting ora posiacite setting, and the myoeaaa inaction meets the ‘defniton for other dagnoses Gee Section I Reporting Addon Diagnosis codes rr category 21 may cantina tobe reported For encounters after the ek time frame al he pater i il recehing ‘re related to the myoeaanarction the appropate fercare code shoul be asineet tater than a coe ram cregry Fo ld or healed myocar narcions at eating fare ent, a 25.2. Old ‘ocala naretlon, may be asin, 2} Acute myocar infarction, unspecified Code 218, Acute myocardial infarton unspecified the def for unepecfed acute myocar infarction or onspecied ip any type 1 STEM or transmural Mvithut the ste documented sign code 213, ST elevation STEM) myocardial ifarction of unapecfed ste, 3) AMI documented as nontransmural or subendocerdial but site provided fan AM is documented as nortansmiral or subendacardia but the Stes proved, tis stil coded as a subendcardal AM See Section 1621.3 fe iflormation on coding status post administration Of tPhinoeentfaity within the lat 24 ours 4) Subsequent acute myocardial infarction ‘code fom category 12, Sue ST leaton (STEM) and non ST levaton NSTEMD myocardial inaction so be used vines a patent who has suffered a type Tor uospected ll has anes All win the week Ue fame ofthe ital AIM A cove fom category 122 must be sed in conjunction with code fem category 2-The sequencing of the 22 and 12 codes depen an the ecurotenes ofthe encoun, 672 s ° Tabular List Do not assign code 12 for subsequent myocedia infarctions other than ‘ype 1 orunspectied For subsequent type 2 AMI acsign ony code 21 At Forsubsequent type 4 or type 5AM assign only code 2. A9. Ira subsequent myocrdat infarction of one ype occurs within 4 weeks ‘fa cca frction ofa diferent ype, sgn the appropiate ‘odes fom eategory 2 widen each ype Do not ssa code {rom 2, Coles rom catagory 22 shoud only he asagned oth the Inland subsequent myocardial incon are type Tor unset. Other Types of Myocardial Infarction ‘The CD-10-CM provides codes for ferent types of myocar Infarction Type | myocardial infacions are asigned to codes iowa ‘Type 2 myocardial infarction (myocardial nfrcton due to demand Ischemia or secondary to ischemic imbalance) essigned to code. ‘Ni, Myocardial infarction type 2 withthe underlying couse coded fs. Delnot assign cde 248, Other forms of acute chemi her ease, focthe demand ischemia. \fatype2 AW is described as NSTEMI or STEM ont ation code 21. A (Codes 2101-214 shoud ony Beassgned for type AMS. ‘Acute myocar infarctions type 3,4, 4, 4c and 5 are signed to ‘ode I21A9, Other myocar Infarction ype. ‘The Code also" and Code fst notes should be followed related to complications and for coding of postprocedral myocardial infarctions ‘during o following aréiae surgery. "Myocardial infarction with Coronary Microvascular Dysfunction Coronary microvascular dysfunction (CMO) ia condition that Innpactsthe microvasculature by restricting mlcrovasculr flow and Increasing microvascular redstance. Code 21.8, Myocardial infarction vith coronary microvascular dysfunction, ie assigned for myocar Infarction with coronary micovascular disease, myocardial nfarction vith coronary microvascular stunetion, and myccadl nfaction, ith non obstrictive coronary areres(MINOCA with mictovaseulr Siease 20241CcD-10-cm Chapter 9 Diseases ofthe Circulatory System (100-199) Tabular List Anatomy of the Cardiovascular System | Introduction ‘The human vascular system comprises a series of tubes (which ae known as vessels that travel in almost alps ofthe human body. Wis categorized into the bicod vascular system and the hmphati vascular system, 1 Blood Vascular System ‘The blood vascular system Figure 9 Includes the hear nd blood vessels required to facta the creusaton ofthe colored Mud (oo0d) insigethe body. cemajuguar vein ‘ain Internal jog vin sera carotid artery Internal oot onto subciavanven Super veracave Cephateven Inferno Capa be "natin Subcavanarery tings Pulmonary vein Sacha Spleen seven eat apenus Anterior aval aery Poneto Postaiortalatery Figure 9.4 Blood Vascular System Arteries and Veins 9) The Structure of Arteries ‘The atres pores tronger and thicker walle than the coresponding vwins anlar based onthe llowing components: Tunlatetima 1 Tunlea Media i) Tunica Extema 1) Thestructureof Veins ‘The vin have asimiar structure as that ofthe artes The ‘components ofa typical vein are described below 1 Tunic nie |) Tunee Mea i) Tunic Eterna ©) The Blood The blood i considered a uniquely specialized connective tsue that is composed ofthe formed elements or he blood cls) and the Mid portion or plasm) The formed elements of aed are tated onthe fed blood cel (82 or erythrocyte) the white blood cl (ECs oF leukocytes) and te platelets (or trombocyes. The blond coneibates| ‘about a of total bady weight. The quant of blood nan average human vals between St ters The element of blood ae ‘categorized as ollows 6) Erythrocytes or Red Blood Calls ‘he el blood cells re the most common type af blood cls that

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