Cardiology Coding Alert

Pericarditis is “the inflammation of the pericardium, a sac-like structure with two thin layers of tissue that surround the heart to hold it in place and help it work,” according to the American Heart Association (AHA).

This inflammation can be acute or chronic, according to Sharon Jane Oliver, CPC, CDEO, CPMA, CRC, at the recent 2021 HEALTHCON session, “The Disease of Hypertension.”

Acute pericarditis happens suddenly and doesn’t last long, while chronic will develop over a long period of time and may take your cardiologist longer to treat, per the AHA.

Manifestations of pericarditis include fever, malaise, chest pain, dyspnea, chills, anxious feeling, pounding heart, grating sound, and possible tachycardia.

Pericarditis can be caused by viruses, bacteria, trauma, rhematic fever, and malignant neoplastic disease, Oliver said. Pericarditis can also be secondary to a myocardial infarction (MI).

Additionally, pericarditis can cause scarring and loss of elasticity, affecting the heart’s ability to contract normally, Oliver said.

You should look to the following ICD-10-CM codes when reporting pericarditis:

• I30.0 (Acute nonspecific idiopathic pericarditis)
• I30.1 (Infective pericarditis)
• I30.8 (Other forms of acute pericarditis)
• I30.9 (Acute pericarditis, unspecified)
• I31.0 (Chronic adhesive pericarditis)
• 131.1 (Chronic constrictive pericarditis)
• I31.2 (Hemopericardium, not elsewhere classified)
• I31.3 (Pericardial effusion (noninflammatory)
• I31.4 (Cardiac tamponade) Note: ICD-10-CM advises you to code first the underlying cause.
• I31.8 (Other specified diseases of pericardium)
• I31.9 (Disease of pericardium, unspecified)
• I32 (Pericarditis in diseases classified elsewhere)

Note: ICD-10-CM advises you to code first the underlying disease.

Type 2: Pinpoint Myocarditis Codes for Heart Muscle Inflammation

Another type of heart inflammation is myocarditis, which is inflammation of the muscular walls of the heart (the myocardium).

ICD-10-CM: You should report the following codes for myocarditis:

• I01.2 (Acute rheumatic myocarditis) Note: This code includes any condition from code I00 (Rheumatic fever without heart involvement) with myocarditis, according to ICD-10-CM.
• I09.0 (Rheumatic myocarditis)
• I40.0 (Infective myocarditis) Note: Use additional B95-B97 code to identify infectious agent), per ICD-10-CM guidelines.
• I40.1 (Isolated myocarditis) Note: This diagnosis also includes isolated myocarditis, Fiedler’s myocarditis, Giant cell myocarditis, and idiopathic myocarditis.
• I40.8 (Other acute myocarditis)
• I40.9 (Acute myocarditis, unspecified)
• I41 (Myocarditis in diseases classified elsewhere) Note: You should code first the underlying disease A75.0-A75.9, according to ICD-10-CM.
• I51.4 (Myocarditis, unspecified) for myocarditis. Note: This diagnosis also includes the following chronic (interstitial) myocarditis, myocardial fibrosis, and myocarditis NOS, according to ICD-10-CM.

Myocarditis can be caused from complications of influenza, diphtheria, mumps, rheumatic fever and associated with an MI, Oliver said.

Signs and symptoms of myocarditis include palpitations, fatigue, dyspnea, fever, arrhythmia, and tenderness in the chest.

Type 3: Rely on Endocarditis Codes for Inflammation of Heart Lining

Endocarditis is inflammation of the lining of the heart’s chambers and valves (the endocardium).

Endocarditis is usually secondary to infection elsewhere in the body, a result of pre-existing heart disease, or a consequence of an abnormal immunologic reaction, Oliver said. Pronounced symptoms include infection, fever, chills, night sweats, weakness, anorexia, and fatigue.

Here are some ICD-10-CM choices for endocarditis:

• I01.1 (Acute rheumatic endocarditis)
• I33.0 (Acute and subacute infective endocarditis)
• I33.9 (Acute and subacute endocarditis, unspecified)
• I38 (Endocarditis, valve unspecified) Note: This code includes endocarditis (chronic) NOS, valvular incompetence NOS, valvular insufficiency NOS, valvular regurgitation NOS, valvular stenosis NOS, and valvulitis (chronic) NOS, per ICD-10-CM.
• I39 (Endocarditis and heart valve disorders in diseases classified elsewhere) Note: You should code first the underlying disease, according to ICD-10-CM.