ICD-10-CM 2017 Is Coming Soon Get Ready for

Cardiology Changes
By Susan Dooley

Oct. 1 will be here before we know it, and with that date comes updates to ICD-10-CM for fiscal year
2017 thats about 2,000 new codes! Cardiology diagnosis coding in particular gains some new codes
that youll want to know about.

Lose the Pure, Instead Report Familial Hypercholesterolemia

To code the condition familial hypercholesterolemia today, youd have to settle for E78.0 (Pure
hypercholesterolemia). But the term pure hypercholesterolemia (as opposed to mixed
hypercholesterolemia) is an imprecise way of referring to the genetic condition familial
hypercholesterolemia (FH), which can be associated with other manifestations besides high blood
cholesterol, such as yellowish patches of cholesterol deposits under the skin in areas such as the eyelids.
Because ICD-10 is all about precision, for FY 2017 it deletes E78.0 and adds the following new codes:
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

E78.00, Pure hypercholesterolemia, unspecified

E78.01, Familial hypercholesterolemia.

Youd use the new E78.00 in events where the type of hypercholesterolemia was unspecified. Note also
that the Oct. 1 version of ICD-10-CM adds a new code for reporting family history of FH:

Z83.42, Family history of familial hypercholesterolemia.

Get Specific With Hypertensive Crisis

Today, when you check the index of the current version of ICD-10-CM for urgency, hypertensive,
youre directed to the general Hypertension entry at I10. But hypertensive crisis is different from plain
hypertension. A hypertensive crisis is a sudden, severe rise in blood pressure that can be extremely
dangerous, requiring early evaluation of both blood pressure elevation and organ function. According to
the American Heart Association, hypertensive crises can present as hypertensive urgency or as
hypertensive emergency.

In hypertensive urgency, the blood pressure is elevated to 180 or higher for the systolic (top number) or
110 or higher for the diastolic pressure (bottom number), without associated organ damage.
Hypertensive emergency is the more critical of the two conditions: here, similar blood pressure
elevations occur (exceeding 180/110) but the hypertension is accompanied by symptoms of organ
damage, such as chest pain, loss of consciousness, back pain, etc.
To go along with this accepted hypertensive crisis terminology, ICD-10-CM adds the following new codes
on Oct. 1:

I16.0, Hypertensive urgency

I16.1, Hypertensive emergency
I16.9, Hypertensive crisis, unspecified.

If the providers documentation doesnt specify urgency or emergency, youll report the unspecified
code.

Keep Your Eye out for More Oct. 1 Cardiology Changes

The list of new ICD-10-CM codes also includes additional specificity for aneurysm and dissection codes,
congenital aorta anomaly codes, prosthetic device complication codes, and vascular stent stenosis. The
latter condition gains initial encounter, subsequent encounter, and sequela reporting options for
stenosis of coronary artery, peripheral vascular, cardiac, and vascular stents.

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com

Watch for Proposed MI Classification Codes, Too

Plus, more updates are under consideration. Current ICD-10-CM myocardial infarction code choices
dont quite line up with the actual MI classification cardiologists use, but the American College of
Cardiology and American Heart Association Task Force on Clinical Data Standards proposed a change to
fix that. The new codes would add inclusion notes to STEMI and NSTEMI codes I21.0 to I21.4, specifying
that those codes are appropriate to report type 1, spontaneous, MIs. The proposal would then add a
new subcategory for the remaining types of MI, which are types 3, 4a, 4b, 4c, and 5.
Remember that these new MI codes are still only proposed, but a fast-track approval request is under
consideration for them to make it into the Oct. 1 ICD-10-CM code set. For that reason, you wont find
them on the preliminary list of FY2017 ICD-10-CM codes posted on the CDC website. You can find the
full proposal packet here; the above-noted MI changes are located on page 16.

How About You?

Personally, Im excited to see new, more precisely worded ICD-10-CM codes that better reflect the
language we actually use in clinical documentation. But what about you? Are you feeling a little daunted
about having to learn so many more ICD-10 codes? Or is this all old hat now? Let us know what you
think in the comment box below!

Need to Find Cardiology Code Changes Fast? Try Cardiology Coder!

With Cardiology Coder, you can search simultaneously across ICD-10-CM, CPT, and HCPCS codes to find
what youre looking for fast. You also get help with Medicare compliance using Cardiology Coders builtin CCI Edits Checker, 7-in-1 Fee Schedule, and LCD/NCD Lookup tools. Plus, with Cardiology Coder, you
get searchable access to that indispensable resource, Cardiology Coding Alert. Theres even a 14-day
free trial! Contact us for a free tiral today!

Contact Us:
Name: Sam Nair
Title: Associate Director
Email: shyamn@codinginstitute.com
Direct: 704 303 8150

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713

The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com