Cardiology Coding Alert
I49.0- Will Keep Your Ventricular Flutter and Fibrillation Claims in the Clear Under ICD-10
Be sure any abbreviations are clear enough to pass the auditor test.
The ICD-10 to ICD-9 crosswalk for ventricular flutter and fibrillation is a simple one, but you still need to be sure you can identify the difference between these two diagnoses, including in the documentation.
ICD-9-CM Codes
ICD-10-CM Codes
Ventricular fibrillation involves rapid uncoordinated contractions of the lower heart chambers (ventricles), which can be fatal if not stopped. The chambers jiggle rather than beat. Ventricular flutter is similar in that it involves rapid heart rate beginning in the ventricles, but in flutter the heart continues to beat. Flutter may degenerate into ventricular fibrillation.
ICD-9 coding rules: ICD-9 offers separate codes for fibrillation and flutter. An excludes note under 427 (Cardiac dysrhythmias) tells you to look elsewhere if the diagnosis is one complicating abortion, ectopic or molar pregnancy, or labor or delivery.
ICD-10 changes: ICD-10 also offers separate codes for fibrillation and flutter involving the ventricles. As with the ICD-9 range, notes for the ICD-10 range reference proper coding for arrhythmia related to obstetric encounters. For ICD-10, you should “code first” tachycardia complicating:
Documentation: Your provider’s documentation will not need to change for you to find the appropriate ICD-10 code, assuming it is currently sufficient.
Coder tips: Providers use a variety of abbreviations for ventricular fibrillation and flutter. You may see VFib or V-Fib for ventricular fibrillation. Ventricular flutter may be abbreviated as VFL, V-FLUT, or V-flutter. Be alert for use of VF — one provider may use this for ventricular fibrillation while another may use it for ventricular flutter. If your providers choose to use abbreviations, be sure they use ones that won’t cause confusion or doubt. Auditors will want to see clear documentation.
Remember: Congress has delayed the ICD-10 compliance date of Oct. 1, 2014, until at least Oct. 1, 2015. When ICD-10-CM goes into effect, 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.
Cardiology Coding Alert
- Coding Updates:
Wondering What's Ahead for Cardiology in CPT® 2015? Start the Search Here
Check out what the CPT® Editorial Summary of Panel Actions reveals. With summer fast approaching, [...] - Modifiers:
Keep Modifier 57 Use Under Control By Understanding When It Does and Doesn't Apply
Don’t miss the 3 tips at the end on how to handle repeat denials. Proper [...] - Modifier 57 Checklist
Use for E/M services only. Use when an E/M service results in a surgery. Make [...] - You Be the Coder:
Tackle This Tilt Table Test Question
Question: Documentation shows use of a finger BP cuff during a tilt table test. May I [...] - ICD-10-CM:
I49.0- Will Keep Your Ventricular Flutter and Fibrillation Claims in the Clear Under ICD-10
Be sure any abbreviations are clear enough to pass the auditor test. The ICD-10 to [...] - Reader Question:
Limit HPI Collection to Billing Physician
Question: I’ve heard the physician needs to document HPI. Is validating an HPI taken by other [...] - Reader Question:
Remember 30 Day Rule for 93272
Question: We report 93270 and 93272 to Medicare for the first day. We then report 93272 [...] - Reader Question:
Clinical Trial Number Alternative Available
Question: I’ve been hearing different things about the clinical trial number requirements on Medicare claims. What’s [...]
