Cardiology Coding Alert

Leave this code off the claim if you have a more specific diagnosis at hand.

Coding for palpitations doesn't have to be as unpleasant as feeling them as long as you keep these simple tips in mind.

ICD-9-CM Code

• 785.1, Palpitations

ICD-10-CM Code

• R00.2, Palpitations

Palpitations are irregular, forceful, or fast heartbeats that a person can feel.

ICD-9 coding rules: Code 785.1 is appropriate for awareness of heart beat, according to a note with the code. ICD-9 also indexes the diagnosis of abnormal pulsations in the neck to 785.1. This code excludes specified dysrhythmias (427.x) and heart failure NOS (428.9).

ICD-10 changes: You should find the switch to R00.2 fairly easy as the definition and use of the code are the same as you're used to under ICD-9, including using the code for awareness of heart beat. ICD-10 excludes specified arrhythmias (I47-I49) from all codes in category R00.- (Abnormalities of heart beat). You'll use I50.9 (Heart failure, unspecified) for heart failure NOS.

Documentation: Your cardiologist shouldn't need to change documentation habits for this diagnosis specifically for ICD-10 because of the straightforward cross between 785.1 and R00.2. 

Coder tips: Report R00.2 only when the cardiologist doesn't document a more specific diagnosis. For instance, check I47.- (Paroxysmal tachycardia), I48.- (Atrial fibrillation and flutter), and I49.- (Other cardiac arrhythmias) for a more appropriate diagnosis based on the documentation.

Remember: CMS has announced Oct. 1, 2015, as the compliance date for ICD-10. 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.