Wiki Ischemic Dilated Cardiomyopathy

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Code: I42.9

Code Name: ICD-10 Code for Cardiomyopathy, unspecified

Block: Other forms of heart disease (I30-I52)

Details: Cardiomyopathy, unspecified

Cardiomyopathy (primary) (secondary) NOS

I42

Code first pre-existing cardiomyopathy complicating pregnancy and puerperium (O99.4)

Includes: myocardiopathy

Excludes2: ischemic cardiomyopathy (I25.5)
peripartum cardiomyopathy (O90.3)
ventricular hypertrophy (I51.7)

Guidelines: Diseases of the circulatory system (I00-I99)

Excludes 2: certain conditions originating in the perinatal period (P04-P96)
certain infectious and parasitic diseases (A00-B99)
complications of pregnancy, childbirth and the puerperium (O00-O9A)
congenital malformations, deformations, and chromosomal abnormalities (Q00-Q99)
endocrine, nutritional and metabolic diseases (E00-E88)
injury, poisoning and certain other consequences of external causes (S00-T88)
neoplasms (C00-D49)
symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
systemic connective tissue disorders (M30-M36)
transient cerebral ischemic attacks and related syndromes (G45.-)

For more details on I42.9 , ICD-10 Code for Cardiomyopathy, unspecified , visit: https://coder.aapc.com/icd-10-codes/I42.9

chaimz

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Hello there fellow coders,

My doctor documents "Ischemic dilated cardiomyopathy" There is an excludes note 1 under I42.0 (dilated cardiomyopathy). Upon asking the Doctor, he states that the dilation is due to ischemia. My research as well shows that dilation of the ventricular heart muscle can be caused by ischemia of the coronary arteries.

So my question is, how would I code Ischemic Dilated Cardiomyopathy? My initial thought would be Cardiomyopathy, unspecified - down coding it. Would this be correct?
 
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chaimz

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What about "I42.8 Other Cardiomyopathies". I think I would code "other", before I coded "unspecified".
You are awesome. Yes, that makes complete sense. He did specify, so the only logical answer would be other cardiomyopathy.

Thanks :)
 

chaimz

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That's why I love these forums. When there is a brain block, there are other brains to help tear down that wall to see the other side. A super-brain this allows us to be :p
 

chaimz

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but in the presence of ischemia, dilation is integral unless the provider documents that it's from a different etiology.
Ok, so let me see if I am understanding you correctly. If ischemia occurs, dilation will follow, so essentially the code is Ischemic Cardiomyopathy and the Doctor is just documenting the inevitable stage of dilation which is good documentation, but not necessary for coding because ischemia is specific enough for ICD 10. Dilated Cardiomyopathy is less specific because it doesn't specify the etiology (Example: Ischemia).
 
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Ischemic cardiomyopathy is a condition that occurs when the heart muscle is weakened. In this condition, the left ventricle, which is the main heart muscle, is usually enlarged and dilated.

Ischemic cardiomyopathy is the most common type of dilated cardiomyopathy. In Ischemic CM, the heart's ability to pump blood is decreased because the heart's main pumping chamber, the left ventricle, is enlarged, dilated and weak. This is caused by ischemia - a lack of blood supply to the heart muscle caused by coronary artery disease and heart attacks.

Ischemic Cardiomyopathy should be your code in this case because it is more specific than dilated cardiomyopathy as it is stated that it is the most common type of dilated cardiomyopathy.

Other Names/types for Dilated Cardiomyopathy

Alcoholic cardiomyopathy. (A term used when overuse of alcohol causes the disease)
Congestive cardiomyopathy
Diabetic cardiomyopathy
Familial dilated cardiomyopathy
Idiopathic cardiomyopathy
Ischemic cardiomyopathy (A term used when coronary heart disease, also called coronary artery disease or heart
attack cause the disease. Not all forms of DCM are ischemic in origin.)
Peripartum cardiomyopathy. (A term used when the disease develops in a woman shortly before or after she gives
birth.)
Primary cardiomyopathy


Dilated cardiomyopathy is integral to ischemic cardiomyopathy because the word ischemic cardiomyopathy itself covers the dilation.
 
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Additional for this;

when the patient has a certain type of disease like C.A.D., the supply of blood to the heart impedes causing ischemia and because of this the body compensate by pumping more blood making the heart enlarge and dilated which causes the muscle of the heart to weakened and because of that the heart's function decreases thus lessen the ability of heart to pump adequate blood to the body causing Ischemic Cardiomyopathy.

Again ischemic cardiomyopathy is a type of dilated cardiomyopathy thus coding ischemic cardiomyopathy to be more specific.
 
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