ICD-10-CM Chapter 9 Circulatory (Cardiovascular) System Coding Private Class

The video begins with a musical introduction and a reminder to the audience to check the sound quality of the speaker's microphone. The speaker then introduces the topic of the video, which is about being an AMCI (American Medical Certification Institute) world-class coder. The speaker emphasizes the importance of being an ethical, precise, forensic, and certified coder. The video continues with a discussion about copyright information related to the AMA (American Medical Association) and the use of specific credentials and trademarks owned by different organizations. The speaker then reviews the previous class's content, highlighting the learning outcomes and the topics covered, such as diabetes, pain, and coding scenarios. The goal for the current class is to focus on chapter nine of ICD-1 CM, which deals with diseases of the circulatory system, and to practice coding scenarios to improve proficiency in ICD-10 CM coding.

The speaker delves into the specifics of ICD-10 CM chapter nine, which covers diseases of the circulatory system. The discussion includes a detailed look at hypertension, its implications, and how it is coded in different scenarios. The speaker provides guidelines for coding hypertension with heart disease (C9A1), hypertension with chronic kidney disease (C9A2), and hypertension with both heart disease and CKD (C983). The speaker also addresses coding for hypertensive cerebral vascular disease (C9A4) and provides a walkthrough on how to look up hypertension-related diagnoses in the ICD-10 CM manual.

The speaker continues the discussion on hypertension by applying coding guidelines to various scenarios. The focus is on understanding the sequencing of codes when dealing with comorbid conditions such as heart disease and CKD. The speaker emphasizes the importance of following the correct sequencing order as per the guidelines, which can help in eliminating incorrect code options. The discussion also touches on the difference between coding for transient hypertension (R03.0) and chronic hypertension (I10), and the significance of the reason for the encounter (RF) in determining the principal diagnosis.

The speaker presents a series of case scenarios to test the audience's understanding of hypertension coding guidelines. Each scenario involves a patient with hypertension and other conditions, and the audience is challenged to determine the correct ICD-10 CM codes based on the given information. The speaker provides the correct answers and explains the rationale behind each coding decision, reinforcing the importance of following guidelines and understanding the clinical context.

The speaker discusses the role of human judgment in coding, emphasizing that AI cannot replace the common sense and expertise of human coders. The speaker encourages the audience to trust their training and the guidelines provided by their MCG (Medical Group) manual. The speaker also provides a final thought on the importance of understanding the differences between categories of hypertension and how they are coded in ICD-10 CM.

The speaker transitions from hypertension to acute myocardial infarction (AMI), commonly known as a heart attack. The speaker explains the causes of AMI, with a focus on the buildup of plaque that restricts blood flow. The discussion includes the different types of heart attacks, such as STEMI and NSTEMI, and how they are diagnosed using an ECG. The speaker provides a brief overview of the ECG and its significance in determining the presence of a myocardial infarction.

The speaker continues with the topic of AMI by explaining how to interpret an ECG, focusing on the ST segment and its elevation or depression in STEMI and NSTEMI, respectively. The speaker provides a visual guide to help the audience understand the differences between a normal ECG, STEMI, and NSTEMI. The discussion then moves to the guidelines for coding heart attacks, emphasizing the importance of coding according to the type and location of the infarction. The speaker also introduces the concept of subsequent and old myocardial infarctions and their coding implications.

The speaker presents a series of coding exercises related to myocardial infarctions, challenging the audience to apply the guidelines and knowledge learned in the previous sections. Each exercise involves a patient scenario and requires the audience to determine the correct ICD-10 CM codes. The speaker provides the correct answers and explains the rationale behind each coding decision, reinforcing the importance of understanding the clinical context and following the correct sequencing order for coding myocardial infarctions.

The speaker summarizes the key points related to coding myocardial infarctions, including the differences between type one and type two AMIs, the coding implications of demand ischemia, and the categorization of myocardial infarctions associated with revascularization surgery. The speaker also provides a chart on how to code type one AMIs, emphasizing the importance of knowing the reason for the patient's visit and whether there was a previous AMI. The discussion concludes with a review of the duration of acute myocardial infarctions and the coding of subsequent and old myocardial infarctions.

The speaker presents a case scenario involving a patient with an acute posterolateral myocardial infarction. The speaker guides the audience through the process of coding this scenario, emphasizing the importance of identifying the correct location of the infarction and whether the patient had a previous AMI. The speaker provides a step-by-step explanation of how to look up the code in the ICD-10 CM manual and how to verify the code using the tabular list. The correct ICD-10 CM code for the scenario is I21.29, which represents an acute STEMI of the posterior lateral wall.

The speaker presents a series of testing scenarios related to myocardial infarction coding, challenging the audience to apply the MCI guidelines and determine the correct ICD-10 CM codes. The scenarios involve patients with multiple myocardial infarctions and require the audience to consider the timing and sequencing of the codes. The speaker provides the correct answers and explains the rationale behind each coding decision, reinforcing the importance of understanding the guidelines and the clinical context of each scenario.

The speaker discusses the coding of chronic combined heart failure, providing the correct ICD-10 CM code for a patient with this condition. The speaker emphasizes the importance of coding for both systolic and diastolic heart failure when they coexist and provides a step-by-step explanation of how to determine the correct code based on the patient's clinical presentation and the guidelines. The correct ICD-10 CM code for the scenario presented is I50.42, which represents chronic combined systolic and diastolic heart failure.

The speaker presents coding exercises related to cerebrovascular accidents, also known as strokes. The exercises involve determining the correct ICD-10 CM codes based on patient scenarios that describe the type of stroke and its effects. The speaker provides the correct answers and explains the rationale behind each coding decision, highlighting the importance of understanding the difference between ischemic and hemorrhagic strokes and the guidelines for coding their sequelae.

The speaker concludes the video with a summary of the key points discussed, including the importance of coding accurately for hypertension, myocardial infarctions, and cerebrovascular accidents. The speaker encourages the audience to keep coding and learning, emphasizing that persistence and practice are essential for success in the field of medical coding. The speaker also provides a motivational message, reminding the audience to keep moving forward even when faced with challenges.