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

AMCI Medical Coding
6 Sept 2023153:12
EducationalLearning
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TLDRThis transcript from an AMCI coding class covers various aspects of cardiovascular coding, focusing on hypertension, acute myocardial infarction (AMI), and cerebrovascular accidents (CVA). The instructor emphasizes the importance of understanding the guidelines for coding these conditions, including the differentiation between types of hypertension and the sequence for coding AMI based on the reason for encounter and type of heart attack. The class also delves into coding scenarios to reinforce the application of guidelines and enhance proficiency in ICD10 CM coding.

Takeaways
  • πŸŽ“ The importance of being an ethical, precise, forensic, and certified coder was emphasized, highlighting the professional standards expected in the field.
  • 🎡 The session began with a brief musical interlude, setting the tone for the educational content to follow.
  • πŸ’¬ A reminder about the copyright and ownership of various medical coding resources, such as AMA, CPC, and AMCI credentials, was provided to ensure proper usage and attribution.
  • πŸ“ˆ The discussion focused on the circulatory system, specifically chapter nine of ICD-10-CM, which covers diseases of the heart and various cardiovascular conditions.
  • πŸ“š Participants were encouraged to follow along with their MCG manual, specifically chapter nine, to enhance their understanding and application of coding guidelines.
  • πŸ” The process of looking up codes in the ICD-10-CM manual was demonstrated, emphasizing the importance of using the alphabetic index and tabular list for accurate coding.
  • 🩺 Hypertension was discussed in detail, including its commonality, potential health risks, and the distinction between primary and secondary hypertension in coding.
  • 🧠 Guidelines for coding hypertension with related conditions such as heart disease, CKD, and CVA were explained, highlighting the presumed causal relationships in certain scenarios.
  • πŸ“ The importance of following the correct sequencing order when coding for multiple conditions was stressed, as it affects the accuracy and validity of the medical records.
  • πŸ’‘ The session concluded with a series of coding exercises and scenarios to test participants' understanding and application of the discussed guidelines and coding principles.
  • πŸ€– A discussion on the potential impact of AI on coding jobs revealed that while AI can assist with volume, it cannot replace the common sense and nuanced decision-making of human coders.
Q & A
  • What does AMCI stand for, and what are the characteristics of an AMCI world-class coder?

    -AMCI stands for American Medical Coders Institute. An AMCI world-class coder is ethical, precise, forensic, and certified.

  • What is the significance of hypertension and how can it lead to serious health conditions?

    -Hypertension is a common condition where the heart is working extra hard due to high blood pressure. It can lead to serious health conditions like congestive heart failure, coronary artery disease (CAD), and other cardiovascular issues.

  • What is the role of the MCG manual in coding scenarios?

    -The MCG (Medical Group Management) manual is used as a guide for coding scenarios. It provides detailed information on ICD-10-CM coding and is used to strengthen guideline knowledge.

  • What is the difference between ICD-10-CM and ICD-10-PCS?

    -ICD-10-CM (Clinical Modification) is used for diagnosis coding, while ICD-10-PCS (Procedure Coding System) is used for inpatient hospital procedure coding.

  • What are the key guidelines for coding hypertension with heart disease?

    -The key guidelines for coding hypertension with heart disease include C9A for essential hypertension, C9A1 for hypertension with heart disease where a causal relationship is presumed, and C9A2 for hypertensive disease with CKD (chronic kidney disease).

  • How is a hypertensive crisis coded in ICD-10-CM?

    -A hypertensive crisis is coded with the category I10 for hypertension, followed by the specific type of crisis (e.g., I16.0 for hypertensive emergency) and any applicable additional codes for associated conditions.

  • What is the importance of following the correct sequencing order when coding for ICD-10-CM?

    -Following the correct sequencing order is crucial for accurate and compliant coding. It ensures that the primary diagnosis or reason for the encounter is captured first, followed by any secondary conditions or related diagnoses, as per the guidelines.

  • What is the role of the 'tap' lecture in the AMCI coding training?

    -The 'tap' lecture is part of the AMCI coding training that teaches how to annotate or put guidelines next to the codes. It helps learners understand how to use the MCG manual effectively and improve their ICD-10-CM coding proficiency.

  • How does the coding for coronary artery disease (CAD) and atherosclerosis differ from coding for angina pectoris?

    -Coding for coronary artery disease (CAD) focuses on the narrowing of the arteries due to plaque buildup. For angina pectoris, the documentation must specify the presence of chest pain (angina), and if the code already includes angina, an additional angina code is not necessary.

  • What is the significance of the 'C9A' guidelines in the context of coding for hypertension-related conditions?

    -The 'C9A' guidelines are crucial for coding hypertension-related conditions as they provide specific instructions on how to code for different scenarios involving hypertension, such as when it is associated with heart disease, CKD, or both. These guidelines help ensure that the coding is accurate and reflects the presumed causal relationships when applicable.

Outlines
00:00
🎡 Introduction to AMCI World Class Coder

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.

05:02
πŸ“š ICD-10 CM Chapter Nine: Circulatory System

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.

10:05
🧠 Applying Guidelines for Hypertension Coding

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.

15:07
🩺 Case Scenarios for Hypertension Coding

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.

20:09
πŸ’‘ Importance of Coding Skills and Human Judgment

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.

25:12
πŸš‘ Acute Myocardial Infarction (AMI): Introduction

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.

31:39
πŸ“ˆ ECG Interpretation and AMI Coding

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.

36:40
🧠 Coding Exercises for Myocardial Infarctions

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.

42:02
πŸ“š Summary of Myocardial Infarction Coding

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.

47:04
🩹 Case Scenario: Acute Posterolateral Myocardial Infarction

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.

52:07
🧠 Testing MCI Guidelines for Myocardial Infarction Coding

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.

57:10
🩺 Chronic Combined Heart Failure Coding

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.

02:11
🧠 Coding Exercises for Cerebrovascular Accidents

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.

07:12
πŸ“š Summary and Final Thoughts on Coding

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.

Mindmap
Keywords
πŸ’‘AMCI world class coder
An AMCI world class coder refers to a professional who is ethical, precise, forensic, and certified in the field of medical coding. This term is used to describe individuals who adhere to the highest standards of coding practices and are recognized by the American Medical Coding Institute (AMCI) for their expertise.
πŸ’‘ICD-10-CM
ICD-10-CM stands for the International Classification of Diseases, 10th Revision, Clinical Modification. It is a coding system used in the United States for documenting diagnoses and procedures for medical records, billing, and statistical purposes. The video discusses the application of ICD-10-CM codes in various clinical scenarios.
πŸ’‘Hypertension
Hypertension, also known as high blood pressure, is a medical condition where the blood pressure in the arteries is persistently elevated. It can lead to serious health problems, including heart disease and stroke, if not managed properly. In the video, hypertension is discussed as a common condition that requires careful coding to ensure accurate medical documentation.
πŸ’‘Cerebrovascular Accident (CVA)
A cerebrovascular accident, commonly referred to as a stroke, occurs when the blood supply to the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. This can result in brain cell damage or death. The term CVA is used in medical coding to classify and record such incidents.
πŸ’‘Cardiovascular System
The cardiovascular system comprises the heart and blood vessels and is responsible for circulating blood and nutrients throughout the body. It plays a crucial role in maintaining overall health and is the focus of the medical coding discussion in the video, particularly in relation to diseases and conditions affecting this system.
πŸ’‘Coding Scenarios
Coding scenarios are hypothetical situations or case studies used to practice and demonstrate the application of medical coding rules and guidelines. They are essential for coders to develop their skills in translating medical diagnoses and procedures into the appropriate ICD-10-CM codes.
πŸ’‘Guidelines
In the context of medical coding, guidelines are the standardized rules and instructions that coders must follow to accurately assign ICD-10-CM codes based on documentation and clinical findings. These guidelines ensure consistency and compliance in the coding process.
πŸ’‘Chronic Kidney Disease (CKD)
Chronic kidney disease, or CKD, is a long-term condition where the kidneys are damaged and lose their ability to function properly over time. It is a significant health concern that can lead to end-stage renal disease if not managed effectively. In medical coding, CKD is coded using specific ICD-10-CM codes that reflect the stage and severity of the condition.
πŸ’‘Coronary Artery Disease (CAD)
Coronary artery disease, or CAD, is a condition where the blood vessels that supply the heart muscle with oxygen and nutrients become narrowed or blocked due to plaque buildup. This can lead to angina or heart attacks and is a significant risk factor for cardiovascular events. In medical coding, CAD is coded using ICD-10-CM codes that specify the presence of angina and the severity of the disease.
πŸ’‘Myocardial Infarction (MI)
Myocardial infarction, commonly known as a heart attack, occurs when blood flow to a part of the heart is blocked, usually by a blood clot. This can damage or destroy part of the heart muscle. MI is a serious medical emergency and is coded using specific ICD-10-CM codes that indicate the type and location of the infarction.
Highlights

The session focuses on AMCI world class coders and their ethical, precise, forensic, and certified nature.

The importance of hypertension awareness and its potential to lead to serious conditions like congestive heart failure is discussed.

The session covers the coding of diseases of the circulatory system, particularly hypertension, CVA, and AMI.

Guidelines for coding hypertension with heart disease and hypertension with CKD are explained.

The difference between coding for hypertension and hypertensive heart disease is clarified.

Instructions on how to use the MCG manual for coding scenarios are provided.

The lecture emphasizes the significance of following guidelines for proper ICD10 CM coding.

The importance of understanding the sequencing order in coding is highlighted.

The session provides a walkthrough on how to look up hypertension-related diagnoses in the ICD10 CM manual.

The lecture discusses the coding of coronary artery disease and atherosclerosis, including the use of combination codes.

The session includes a practical exercise on coding scenarios involving hypertension and other related conditions.

The lecture addresses the role of AI in coding and emphasizes the irreplaceable nature of human coders due to their common sense and ability to apply guidelines.

The session concludes with a discussion on acute myocardial infarction (heart attack) and its coding.

The difference between STEMI and NSTEMI heart attacks is explained, along with their coding implications.

The lecture provides a quick tutorial on reading ECG results to determine the type of myocardial infarction.

Guidelines for coding heart attacks based on type and location, as well as the duration of myocardial infarction, are detailed.

The session ends with an exercise on coding a patient's admission for an acute myocardial infarction involving the left circumflex coronary artery.

Transcripts
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