Cardiology Coding Alert

Question: My cardiologist ordered an electrocardiogram for a patient diagnosed with stenosis of the aortic and mitral valves. During the ECG, she took 14 leads. What would be the correct coding for this scenario? Specifically, how many ICD-9 codes should I report to reflect the patient's condition?/


Arkansas Subscriber


Answer: You'll use one diagnosis code to represent the stenosis in both valves. When patients have stenosis (or another affliction) in the mitral and aortic valves, you should choose a code from the 396.x series (Diseases of mitral and aortic valves) to identify both conditions.

Aortic stenosis has its own code, 424.1 (Aortic valve disorders). Under the exclusions section for 424.1, however, ICD-9 states that the diagnosis does not include "that of unspecified cause but with mention of diseases of mitral valve (396.0-396.9)."

ICD-9 coding: The proper code for your claim is 396.0 (Mitral valve stenosis and aortic valve stenosis).

CPT coding: Choose from one of these ECG codes, depending on the encounter's specifics:

• 93000 -- Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report

• 93005 -- ... tracing only, without interpretation and report

• 93010 -- ... interpretation and report only.

Note: The fact that the doctor used more than 12 leads does not change the proper procedure codes. The verbiage "with at least 12 leads" in the official code definition for each of these CPT codes indicates that you should report these codes when your cardiologist uses 12 or more leads.