Tachycardia: ICD-10 Coding
Tachycardia typically means a heart rate of more than 100 beats per minute. Symptoms of tachycardia include dizziness, shortness of breath, chest pain, and more. Risk factors include: heart disease, hypertension, smoking, heavy alcohol use, heavy caffeine use, recreational drug use, psychological stress/anxiety, age, and heredity.
There are several varieties of ventricular tachycardia.
Re-entry ventricular tachycardia occurs due to electrical difficulties in the heart.
Example: A 45-year-old male patient presents for electrophysiology test results. He originally complained of chest pain and palpitations with one episode of syncope. His results confirm re-entry ventricular tachycardia. Proper coding is I47.0 Re-entry ventricular tachycardia.
Supraventricular tachycardia (SVT) is a faster heart rate in the atria, caused by electrical impulses in the atria firing abnormally. Supraventricular tachycardia includes atrial tachycardia, atrioventricular tachycardia, atrioventricular re-entrant tachycardia, junctional tachycardia, and nodal tachycardia. SVT is the most common type of arrhythmia in children.
Example: An 8-year-old boy is brought in by his parents with complaints of chest pain, shortness of breath, and fatigue for one month. Upon examination his heart rate was 160 BPM. Labs and ECG are performed and he is diagnosed with supraventricular tachycardia. Proper coding is I47.1 Supraventricular tachycardia.
Ventricular tachycardia (Vtach) occurs when there is a fast heart rate in the ventricles, which can be life threatening and cause cardiac arrest.
Example: The cardiologist is called to the emergency department. A 60-year-old male, was rushed to the ED after a skydive jump. The patient states that while making his descent from the plane, he became very dizzy and thinks that he may have passed out for a brief time. Upon arrival to the ED, he was found to be in a wide complex ventricular tachycardia (VT) at a rate of 214 bpm. His systolic blood pressure was 58 mmHg. He was cardioverted and given a bolus of IV amiodarone. The patient was rushed to the cardiac cath lab. Proper coding is I47.2 Ventricular tachycardia.
Atrial fibrillation is the most common type of supraventricular tachycardia. In atrial fibrillation, the heart’s electrical signals don’t begin where they should, which creates a fast, irregular heart rhythm.
Atrial flutter describes a condition in which the electrical signal travels along a pathway within the right atrium. It moves in an organized circular motion, or “ circuit,” causing the atria to beat faster than the ventricles.
Clinical documentation should include the type of tachycardia (re-entry, ventricular, etc.). Code selection is straightforward:
I47.0 Re-entry ventricular tachycardia
I47.1 Supraventricular tachycardia
I47.2 Ventricular tachycardia
I47.9 Paroxysmal tachycardia, unspecified
I48.0 Paroxysmal atrial fibrillation
I48.1 Persistent atrial fibrillation
I48.2 Chronic atrial fibrillation
I48.3 Typical atrial flutter
I48.4 Atypical atrial flutter
R00.0 Tachycardia, unspecified
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