Have you ever stopped to wonder about “other” Cardiology codes, such as E78.4 for “other” hyperlipidemia? While these catch-all codes have their purpose—i.e., for when there’s really no more specific code to capture what the doctor describes happened—with the newly added 2019 ICD-10-CM codes, you’ll have to resort to miscellaneous Cardiology coding choices less often. And that’s good news for painting an accurate patient health picture—and pleasing payers.
But annual ICD-10 updates do come at a price: a sometimes steep learning curve. So get a head start on the changes that take effect October 1, 2018, advises healthcare industry educator Terry Fletcher in her 2019 ICD-10 Cardiology Coding live webinar with ProfEdOnDemand. After all, knowing the ins and outs of each ICD-10 Cardiology code (especially those recently added and revised) is critical to your practice’s bottom line.
‘Other’ Codes: Don’t Throw Out, But Use Sparingly
To make sure your claims are as specific as possible, you’ll want to make use of this year’s changes that expand your options beyond “other.” Here’s a breakdown of some important cardiology coding changes for 2019:
- 41 / E78.49 replace E78.4 (other hyperlipidemia): Newly added code E78.49 still describes “other hyperlipedemia,” but now you also have E78.41 to describe a situation with elevated lipoprotein(a).
- 02 replaces E88.09 (other disorders of plasma-protein metabolism): E88.02 was added this year to specify situations of plasminogen deficiency (a disorder which may be related to thrombosis).
- 81 / I63.89 replace I63.8 (other cerebral infarction): I63.89 still gives the option to code for “other cerebral infarction,” while I63.81 specifies that the infarction was caused by either a partial or total obstruction (occlusion), or abnormal narrowing (stenosis) of a small artery.
- 82 replaces Q93.89 (other deletions from the autosomes): Autosome deletion syndromes involve missing genetic material in numbered (non-sex) chromosomes. Added code Q93.82 specifies Williams Syndrome, caused by the deletion of genetic material on chromosome 7. This disease is characterized by various medical issues, including cardiovascular disease.
- 430 / Z83.438 replace Z83.49 (family history of other endocrine, nutritional, and metabolic diseases): Added codes Z83.430 and Z83.438 (under new parent code Z83.43) get rid of some of the vague wording found in Z83.49. Z83.430 should be used to code for a family history of elevated lipoprotein(a), whereas Z83.438 is for situations where there’s a family history of “other disorder” of lipoprotein metabolism/other lipidemia.
- 850 / I67.858 replace I67.89 (other cerebrovascular disease): These 2 new billable codes come under new parent code I67.85 (Hereditary cerebrovascular diseases). I67.850is to describe cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (an umbrella term for brain white matter diseases). I67.858 describes “other” cerebrovascular diseases that are hereditary.
Source: You can download and view the 2019 ICD-10-CM Conversion Table here.
Watch the numbers: Many of the new code numbers are similar to what you’ve been coding (e.g., new code E78.49 versus E78.4). This can be confusing, so pay extra attention when using these new codes come October 1, 2018.
Cardiology in 2019: Clarity is the Key
Hopefully by now you’ve noticed a key word that can describe the 2019 cardiology codes: specific. Whether it’s specifying Types 1-4 with the acute myocardial infarction ICD-10 codes, using new codes to describe disorders previously falling under an “other” code, or even picking the right heart failure ICD-10 code, you have a good amount of changes to absorb in the coming months to get your billing skills in top shape.
The changes in ICD-10 for 2019 will have a significant impact on cardiology billing. All the number changes, as well as added, deleted and revised codes, can easily trip you up, but don’t let them. Instead, take the time now to get all the information you need in one place for an easy reference guide when things get hectic.
