Don’t Skip a Beat with New Hyperlipidemia, Cerebral Infarction 2019 ICD-10-CM Codes

Vague cardiology codes for several disorders have been deleted—learn their replacements

Our coverage of ICD-10-CM 2019 continues here with a few more updates on what’s new for cardiology. The updated codes take effect in just two short months—on October 1, 2018—so it’s time to put your preparation efforts in high gear.

Knowing your cardiology diagnosis codes inside and out will help you tell the patient’s full story to the payer, says coding educator Terry Fletcher in a AudioEducator webinar. During her presentation “2019 ICD-10-CM Update: Code Changes for Cardiology,” Fletcher outlines the new, revised, and deleted ICD-10 heart failure codes and clarifies key terms—such as plasminogen deficiency, hyperlipidemia and Williams Syndrome—so you can quickly pinpoint the right code from the documentation.

Other edits this year refer to cerebral infarctions and cerebrovascular disease. Here’s a preview of what’s to come…

Updated Hyperlipidemia, Plasminogen Deficiency Codes

A previous post details many of this year’s new ICD-10 cardiology codes, which include changes to hyperlipidemia, plasminogen deficiency, autosome deletion, and lipidemia codes, among others. Here’s a quick recap:

  • Hyperlipidemia: Code E78.4 is out the door, with E78.41 and E78.49 as its replacements.
  • Plasminogen deficiency: Say goodbye to E88.09, and use instead E88.02.
  • Autosome deletion: Yet another “other” code, Q93.89, is deleted, replaced by Q93.82, a code describing Williams Syndrome.
  • Lipidemia/lipoprotein metabolism: You can breathe more easily now that the imprecise Z83.49 is now gone, replaced by Z83.430 and Z83.438.
  • Cerebrovascular disease: Bid farewell to I67.89 – and say hello to I67.850 and I67.858.

I63: Catch Up to the Edits for Cerebral Infarctions

Breathe Easy: The edits to this year’s cerebral infarction codes aren’t dramatic enough to write home about. Instead, they’re mostly switching a plural word or two to the singular, or adding words that were previously missing, for clarity. These revisions include:

219:

  • Previously: Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries
  • Now: Last word now reads “artery.”

239:

  • Previously: Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid arteries
  • Now: Last word now reads “artery.”

An example of a typo corrected lies in code 333:

  • Previously: Cerebral infarction to thrombosis of bilateral posterior cerebral arteries
  • Now: Cerebral infarction due to thrombosis of bilateral posterior cerebral arteries.

The same applies for code 343, which now reads, Cerebral infarction due to thrombosis of bilateral cerebellar arteries.

In addition to the revised codes, you’ll one code (I63.8, Other cerebral infarction) deleted and replaced by two new codes:

  • 81, Other cerebral infarction due to occlusion or stenosis of small artery
  • 89, Other cerebral infarction

‘Other’ Is Not Your Friend

At the risk of overstating the point: Use increasing caution with “other” codes. This one small word seems to irritate payers more and more each year.

How to get around it: Follow proper usage for “other” codes outlined on page 10 of the 2019 Coding Guidelines, and always use them as a last resort. Skim the documentation carefully for any opportunity to use a more specific code, and contact the physician first for further details.

Thanks to minor edits and just a handful of new codes, cardiology coders won’t have much to memorize this year. Instead you can spend more time nailing down the significant changes from last year—and namely, the edits made to acute myocardial infarction (MI) codes—as well as fine-tuning the specificity of your diagnosis coding to better please payers.

Tip: Remember to differentiate between the types of acute MI, and remember which code goes with each type. For a full recap of these edits, check here.

When it comes to training for cardiology coding, Fletcher’s webinars are opportunities you don’t want to miss. With over 30 years of direct experience with AAPC, AHIMA, and DecisionHealth, Fletcher’s expertise will clarify even your most persistent questions.

To join the conference or see a replay, order a DVD or transcript, or read more

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