Cardiology Coding Alert

Match a single code to Mobitz block type 1 and 2.

When you make a comparison, you'll find that some diagnoses that fall under multiple ICD-9 2011 codes fall under a single ICD-10 2011 code. Consider the case of second-degree atrioventricular (AV) blocks.

Heart block or AV block refers to impairment of the electrical signal (not blood flow) from the heart's upper to lower chambers. In a second-degree heart block, some of the signals from the atria don't reach the ventricles, resulting in a skipped beat (typical of type I) or a slow beat, which may require a pacemaker (typical of type II).

ICD-9 coding rules: ICD-9 divides coding for seconddegree AV blocks between 426.12 (Mobitz [type] II atrioventricular block) and 426.13 (Other second degree atrioventricular block). Code 426.12 is appropriate for the more serious Mobitz II AV block. Code 426.13 is appropriate for all other second-degree AV blocks, including Mobitz I (also called Wenckebach's) and second-degree not otherwise specified.

ICD-10 changes: ICD-10 2011 uses one code, I44.1 (Atrioventricular block, second degree), to cover all second-degree AV blocks.

Documentation: Your clinician's documentation will not need to change for you to get the information you need for ICD-10 coding of second-degree AV block.

Coder tips: ICD-10's notes with I44.1 tell you that the code is appropriate for any of the following:

Atrioventricular block, type I and II; Mobitz block, type I and II; Second degree block, type I and II; Wenckebach's block.

Remember: When ICD-10 goes into effect on Oct. 1, 2013, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.