Wiki NCD implantable Automatic Defibrillators

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where can i go to find the 'newest' information on whether or not specific ICD10 codes require a second diagnosis?
As in, a cardiomyopathy needs a heart failure code.

I am specifically looking for information on Sarcoid myocarditis D86.85 as in, whether or not this would require a secondary diagnosis.

thanks in advance.
 
Hi,

I came across these links.

1. https://www.bluecrossma.org/medical-policies/sites/g/files/csphws2091/files/acquiadam-assets/070 Implantable Cardioverter Defibrillator prn.pdf
(PAGE - 3)
**Criteria for Implantable Cardioverter Defibrillator Implantation in Patients with Cardiac Sarcoid Criteria for ICD placement in patients with cardiac sarcoid derive from a 2014 consensus statement from the Heart Rhythm Society (HRS) and 2017 joint guidelines from the American Heart Association, American College of Cardiology, and HRS.

Indications for consideration of ICD placement in patients diagnosed with cardiac sarcoid are as follows:
• Spontaneous sustained ventricular arrhythmias, including prior cardiac arrest, if meaningful survival of greater than 1 year is expected; 4
• LVEF 35% or less, despite optimal medical therapy and a period of immunosuppression (if there is active inflammation), if meaningful survival of greater than 1 year is expected;
• LVEF greater than 35%, if meaningful survival of greater than 1 year is expected; AND o syncope or near-syncope, felt to be arrhythmic in etiology OR o evidence of myocardial scar by cardiac MRI or positron emission tomographic (PET) scan OR o Inducible sustained ventricular arrhythmias (>30 seconds of monomorphic VT orpolymorphic VT) or clinically relevant VF • An indication for permanent pacemaker implantation.

2. https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?proposed=N&NCAId=288
  • In patients with cardiac sarcoidosis who have sustained VT or are survivors of SCA or have an LVEF of 35% or less, an ICD is recommended, if meaningful survival of greater than 1 year is expected (1-5) (LOE: B-NR)
I have not come across such scenario, but with reference to this, I think the secondary should either be Sustained VT - I47.2 or SCA - Z86. 74 .

Hope this is helpful.
Do let us know if you found an answer different from this one !
 
Last edited:
What a coincidence!

I am coding for a claim today with similar scenario and I had to write this !

Glad I looked into the details out of curiosity and posted it here. It's helping me today!
:)
 
I also suggest looking on your local MAC carrier for billing and coding articles for ICD, my MAC has Billing and Coding: Implantable Automatic Defibrillators (A56391)
 
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