Angina (411 and 413) ICD-9-CM • Angina (411, 413) o Chest pain due to ischemia of the heart o Subcategory 411.1, Unstable angina o Category 413, Angina pectoris • Sequencing rules o Known cause of angina is sequenced first o Angina may not be coded when considered an inherent part of the condition
32 Chronic Ischemic Heart Disease (414) ICD-9-CM • Coronary arteriosclerosis or arteriosclerotic heart disease (414.0) o Fifth digit used to identify whether the arteriosclerosis is present in a native artery or in a bypass graft • 414.00, Coronary artery disease with no information in the record as to location of disease • 414.01, Coronary artery disease in a patient with no history of coronary artery bypass surgery
33 Chronic Ischemic Heart Disease (414) (continued) ICD-9-CM • Coronary arteriosclerosis (414.0) • 414.02, Coronary artery disease in an autologous vein bypass graft • 414.03, Coronary artery disease in a nonautologous vein bypass graft • 414.04, Coronary artery disease in an internal mammary artery used for a bypass graft • 414.05, Coronary artery disease in a bypassed vessel but not known if graft was arterial or venous
34 Chronic Ischemic Heart Disease (414) (continued) ICD-9-CM • Chronic total occlusion of coronary artery (414.2) • Used as an additional diagnosis code • Used to code the patient with coronary atherosclerosis who has a complete blockage of a coronary artery • Increased risk of myocardial infarction or death • Treated with angioplasty and/or coronary stent placement but procedure is more difficult in patients with chronic total occlusion of the coronary artery
35 Chronic Ischemic Heart Disease (414) (continued) ICD-9-CM • Coronary atherosclerosis due to lipid rich plaque (414.3) • Used to code the patient with coronary atherosclerosis due to a specific form of plaque within the vessel • Important information for the cardiologist to determine the most appropriate type of stent to place within the vessel • Code used in addition to a code for the location and type of coronary atherosclerosis that exists in the patient (414.00–414.07)
36 Heart Failure—ICD-9-CM • Heart failure is the heart’s inability to contract with enough force to properly pump blood • Cause may be coronary artery disease, past myocardial infarction, cardiomyopathy, hypertension, or heart valve disease • Three effects: o Pressure in the lungs is increased o Kidney function is hampered o Blood is not properly circulated throughout the body
37 Heart Failure (continued)—ICD-9-CM • Signs and symptoms are not coded in addition to heart failure o Sudden weight gain, Shortness of breast o Walking up breathless at night, trouble sleeping o Cough especially when lying down o Increased fatigue and weakness o Dizziness and fainting o Swollen feet, ankles, legs o Nausea with abdominal swelling, pain, tenderness
38 Heart Failure (continued)—ICD-9-CM • Left-sided Heart Failure o Left side of heart must work harder to pump blood o Systolic heart failure occurs when left ventricle loses its ability to contract normally. Heart cannot pump blood with sufficient force to push blood into circulation o Diastolic heart failure is when left ventricle loses its ability to relax and heart cannot fill with blood during resting period between each beat
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- Fall '19