ICD 10 CM Chapter Specific Guidelines I. C9

This paragraph introduces the focus on ICD-10-CM chapter 9, which covers diseases of the circulatory system. It emphasizes the importance of hypertension and its presumed relationship with heart and kidney involvement in the ICD-10-CM coding system. The speaker provides detailed guidance on coding hypertension with heart disease (I11), hypertension with chronic kidney disease (I12), and hypertensive heart and CKD (I13). It also clarifies the conditions under which these codes should be used, including the presence of heart failure and CKD stages, and notes the exclusions and sequencing rules for these codes.

The second paragraph delves into specific complications related to hypertension, such as hypertensive chronic kidney disease with acute renal failure and the use of additional codes for renal failure. It discusses the tabular list instruction for adding code Z99.2 when applicable. The speaker also covers combination codes for hypertensive heart and CKD, the coding of hypertensive cerebral vascular diseases, and the importance of understanding the similarities and differences in codes I60 through I69 for accurate code assignment. Additionally, it touches on secondary hypertension, transient hypertension during pregnancy, and controlled hypertension, providing the appropriate codes for each scenario.

This section discusses hypertensive crises and the use of category I16 for coding. It explains the coding for pulmonary hypertension, including secondary pulmonary hypertension and the associated conditions or adverse effects of drugs or toxins. The speaker emphasizes that sequencing for these conditions is based on the reason for the encounter, with exceptions for adverse drug effects covered in chapter 19. The paragraph also covers sclerotic coronary artery disease and angina, providing the combination codes for these conditions and the rules for sequencing when a patient has an acute myocardial infarction.

The fourth paragraph focuses on the coding of cerebral vascular accidents, including the documentation requirements for intraoperative and post-procedural situations. It explains the use of category I69 for sequelae of cerebral vascular disease, such as neurologic deficits, and the rules for assigning these codes based on the affected side and whether the deficits are dominant or non-dominant. The speaker also mentions the code Z86.73 for personal history of transient ischemic attack and cerebral infarction, and provides guidance on coding acute myocardial infarction (AMI), including the different types and the conditions under which each should be coded.

The final paragraph provides a comprehensive overview of acute myocardial infarction (AMI) coding, including the distinction between type 1 and type 2 MIs, the use of codes I21.0 to I21.9 for type 1 MIs, and the conditions for using subsequent MI codes (I22). It clarifies the rules for coding non-STEMI conversions to STEMI, the appropriate coding for encounters beyond the four-week timeframe after an MI, and the use of code I25.2 for old or healed MIs. The speaker also addresses other types of myocardial infarction, such as types 3, 4, and 5, and their coding under code I21.9. The paragraph concludes with a reminder to follow code notes related to complications and post-procedural MIs during or following surgery.