ICD-10-CM 2017 Is Coming Soon — Get Ready for Cardiology Changes

Mon, Jun 27, 2016 --

Coding Updates, ICD-10

Cardiology, ICD-10-CM, FY 2017, icd-10 changes, new icd-10 codes, new cardiology codes

Oct. 1 will be here before we know it, and with that date comes updates to ICD-10-CM for fiscal year 2017 — that’s about 2,000 new codes!  Cardiology diagnosis coding in particular gains some new codes that you’ll want to know about.

Lose the Pure, Instead Report Familial Hypercholesterolemia

To code the condition familial hypercholesterolemia today, you’d have to settle for E78.0 (Pure hypercholesterolemia). But the term “pure hypercholesterolemia” (as opposed to mixed hypercholesterolemia) is an imprecise way of referring to the genetic condition familial hypercholesterolemia (FH), which can be associated with other manifestations besides high blood cholesterol, such as yellowish patches of cholesterol deposits under the skin in areas such as the eyelids. Because ICD-10 is all about precision, for FY 2017 it deletes E78.0 and adds the following new codes:

  • E78.00, Pure hypercholesterolemia, unspecified
  • E78.01, Familial hypercholesterolemia.

You’d use the new E78.00 in events where the type of hypercholesterolemia was unspecified. Note also that the Oct. 1 version of ICD-10-CM adds a new code for reporting family history of FH:

  • Z83.42, Family history of familial hypercholesterolemia.

Get Specific With Hypertensive Crisis

Today, when you check the index of the current version of ICD-10-CM for “urgency, hypertensive,” you’re directed to the general Hypertension entry at I10. But hypertensive crisis is different from plain hypertension. A hypertensive crisis is a sudden, severe rise in blood pressure that can be extremely dangerous, requiring early evaluation of both blood pressure elevation and organ function. According to the American Heart Association, hypertensive crises can present as hypertensive urgency or as hypertensive emergency.

In hypertensive urgency, the blood pressure is elevated to 180 or higher for the systolic (top number) or 110 or higher for the diastolic pressure (bottom number), without associated organ damage. Hypertensive emergency is the more critical of the two conditions: here, similar blood pressure elevations occur (exceeding 180/110) but the hypertension is accompanied by symptoms of organ damage, such as chest pain, loss of consciousness, back pain, etc.

To go along with this accepted hypertensive crisis terminology, ICD-10-CM adds the following new codes on Oct. 1:

  • I16.0, Hypertensive urgency
  • I16.1, Hypertensive emergency
  • I16.9, Hypertensive crisis, unspecified.

If the provider’s documentation doesn’t specify urgency or emergency, you’ll report the unspecified code.

Keep Your Eye out for More Oct. 1 Cardiology Changes

The list of new ICD-10-CM codes also includes additional specificity for aneurysm and dissection codes, congenital aorta anomaly codes, prosthetic device complication codes, and vascular stent stenosis. The latter condition gains initial encounter, subsequent encounter, and sequela reporting options for stenosis of coronary artery, peripheral vascular, cardiac, and vascular stents.

Watch for Proposed MI Classification Codes, Too

Plus, more updates are under consideration. Current ICD-10-CM myocardial infarction code choices don’t quite line up with the actual MI classification cardiologists use, but the American College of Cardiology and American Heart Association Task Force on Clinical Data Standards proposed a change to fix that. The new codes would add inclusion notes to STEMI and NSTEMI codes I21.0 to I21.4, specifying that those codes are appropriate to report type 1, spontaneous, MIs. The proposal would then add a new subcategory for the remaining types of MI, which are types 3, 4a, 4b, 4c, and 5.

Remember that these new MI codes are still only proposed, but a fast-track approval request is under consideration for them to make it into the Oct. 1 ICD-10-CM code set. For that reason, you won’t find them on the preliminary list of FY2017 ICD-10-CM codes posted on the CDC website. You can find the full proposal packet here; the above-noted MI changes are located on page 16.

How About You?

Personally, I’m excited to see new, more precisely worded ICD-10-CM codes that better reflect the language we actually use in clinical documentation. But what about you? Are you feeling a little daunted about having to learn so many more ICD-10 codes? Or is this all old hat now? Let us know what you think in the comment box below!

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Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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