Cardiology Coding Alert

Hint: You should report I47.1 for supraventricular tachycardia.

When your cardiologist sees a patient for tachycardia, you must check the medical documentation to specify exactly what type of tachycardia the patient has because you will report different ICD-10-CM codes depending upon this information. You must also understand how to handle situations when your cardiologist performs cardioversion to treat tachycardia.

Read on to learn more.

First, Define Tachycardia for Clarity

Question 1: What is tachycardia?

Answer 1: Tachycardia is a type of arrhythmia, which is an abnormal rate or rhythm of a heartbeat. When a patient has tachycardia, his heart rate is higher than normal when he is at rest. You may see this diagnosis documented when the patient’s heart rate is more than 100 beats per minute (BPM).

Rely on This Code for Ventricular Tachycardia

Question 2: Which ICD-10-CM code should I report for ventricular tachycardia?

Answer 2: You should report I47.2 (Ventricular tachycardia) for ventricular tachycardia, which is a fast heart rhythm that starts in the lower chambers of the heart.Don’t miss: “The code for ventricular tachycardia, I47.2, covers both sustained and non-sustained ventricular tachycardia as well as a rare condition called Torsades de Pointes (TdP),” says Robin Peterson, CPC, CPMA, Manager of Professional Coding, Pinnacle Integrated Coding Solutions, LLC. “Sustained ventricular tachycardia can degenerate into ventricular fibrillation, which is a chaotic, rapid beating of the heart, often described as a quivering of the ventricles. Ventricular fibrillation, if not treated, will lead to cardiac arrest where the heart stops beating mechanically.”

Code I47.1 Encompasses Multiple Included Conditions

Question 3: My cardiologist documented paroxysmal supraventricular tachycardia. How should I report this condition?

Answer 3: You should report I47.1 (Supraventricular tachycardia) for this condition. Supraventricular tachycardia refers to a faster than normal heart rate that originates in the atria or the atrioventricular node. Paroxysmal means the rapid heart rate happens occasionally.

Included conditions for I47.1 include:

• Atrial (paroxysmal) tachycardia
• Atrioventricular [AV] (paroxysmal) tachycardia
• Atrioventricular re-entrant (nodal) tachycardia [AVNRT] [AVRT]
• Junctional (paroxysmal) tachycardia
• Nodal (paroxysmal) tachycardia

Don’t miss: A code first note instructs you to sequence tachycardia complicating the following conditions first, followed by I47.1:

• O00.0 (Abdominal pregnancy) through O07 (Failed attempted termination of pregnancy)
• O08 (Complications following ectopic and molar pregnancy)
• O75.4 (Other complications of obstetric surgery and procedures)

Turn to AHA Coding Advice in This Case

Question 4: Which ICD-10-CM code should I report for catecholaminergic polymorphic ventricular tachycardia (CPVT)?

Answer 4: You would actually report I47.2 for CPVT. “All ventricular tachycardias are classified to code I47.2,” according to AHA ICD-10-CM Coding Clinic Vol. 30, No. 3.

CPVT defined: “Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a disorder in which the heart cells are electrically unstable and are predisposed to developing atypical rapid arrhythmias,” per AHA ICD-10-CM Coding Clinic.

Don’t Let Bouveret-Hoffman Syndrome Dx Stump You

Question 5: Which ICD-10-CM code should I report for Bouveret-Hoffman syndrome?

Answer 5: Bouveret-Hoffman is a type of paroxysmal tachycardia, so you would report I47.9 (Paroxysmal tachycardia, unspecified) for this condition.

Don’t miss: When you look under code I47.9 in the ICD-10-CM manual, you can see that Bouveret-Hoffman syndrome is a covered condition for this code.

Depend on P29.11 for Neonatal Tachycardia

Question 6: If my cardiologist documents a case of neonatal tachycardia, does ICD-10-CM give me a code for that?

Answer 6: Yes. You should report P29.11 (Neonatal tachycardia) for neonatal tachycardia.

Cardiologist Performed Cardioversion to Treat Tachycardia? Do This

Question 7: After he prepped and anesthetized the patient, my cardiologist laid the patient in the supine position and attached cardioversion pads onto his chest and back. My cardiologist documented the patient’s baseline cardiac output rates. My cardiologist then connected the cardioversion pads to an external defibrillator to deliver an electric shock that brought the patient’s heart rate and rhythm back to normal. My cardiologist performed this planned procedure to treat the patient’s paroxysmal ventricular tachycardia. Which CPT^® and ICD-10-CM codes should I report on my claim?

Answer 7: This is an example of cardioversion, which is the conversion of one cardiac rhythm to another or electrical pattern, usually an abnormal one to normal. You should report 92960 (Cardioversion, elective, electrical conversion of arrhythmia; external) as the CPT^® code on your claim. Your cardiologist performed the cardioversion to treat the patient’s paroxysmal ventricular tachycardia, so you should report I47.2 as the ICD-10-CM code on your claim.