In ICD-10-CM the codes would be I47.2, ventricular tachycardia, and code I46.9, Cardiac arrest, unspecified.
As far as the coding of these conditions, under (I46) cardiac arrest there is an Excludes 1 note for cardiogenic shock (R57.0), but if the cardiac arrest is due to an underlying cardiac condition (I46.2), there is a code first note for the underlying cardiac condition.
F02.80 A man arrested for disorderly conduct is brought to the emergency room. He is a known alcoholic-dependent patient. Alcohol blood level indicates intoxication F10.221 Initial encounter for cardiac arrest due to cocaine dependence I46.8 F14.20 F14.23 Delirium tremors due to withdrawal from cocaine dependence F14.23
Could you use a Z code, specifically Z86.74, Personal history of sudden cardiac arrest, to represent the out of hospital arrest in someone who’s already resuscitated? I think you can, but with a specific caution.
ICD-10 code I46 for Cardiac arrest is a medical classification as listed by WHO under the range - Diseases of the circulatory system .
Fall on same level, unspecified, initial encounter W18. 30XA is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM W18. 30XA became effective on October 1, 2021.
Code 427.5, Cardiac arrest, may be used as a secondary code in the following instances: The patient arrives in the hospital's emergency service unit in a state of cardiac arrest and is resuscitated (and admitted) with the condition prompting the cardiac arrest known, such as ventricular tachycardia or trauma.
ICD-10 code: I46. 1 Sudden cardiac death, so described.
ICD-10 code T14. 90XA for Injury, unspecified, initial encounter is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes .
90XA - Injury, unspecified [initial encounter] is a topic covered in the ICD-10-CM.
Cardiac Arrest Medical Coding Coding Clinic review states the underlying cause of the cardiac arrest should be sequenced first, if known. If the cause is unknown, the cardiac arrest may be the Principal Diagnosis (1Q 2013, pages 10-12, 3Q 1995 p.
If the patient dies in-house from the cardiac arrest without attempt at resuscitation, such that the cardiac arrest is their terminal event, you do not code the arrest. The fact that the patient died in the hospital is embedded in their discharge status and there is an alternate mechanism to report inpatient deaths.
Causes of Death in Cardiogenic Shock and Cardiac Arrest The causes and predictors of death differ between CS and CA: ABI is the primary cause of death in patients with CA, whereas CS patients typically die via refractory shock, organ failure, and arrhythmias.
Ill-defined and unknown cause of mortality The 2022 edition of ICD-10-CM R99 became effective on October 1, 2021.
Z82. 41 - Family history of sudden cardiac death | ICD-10-CM.
Coronary artery disease is the most common cause of sudden cardiac death, accounting for up to 80% of all cases. Cardiomyopathies and genetic channelopathies account for the remaining causes. The most common causes of non-ischemic sudden cardiac death are cardiomyopathy related to obesity, alcoholism, and fibrosis.
code blueHospital staff may call a code blue if a patient goes into cardiac arrest, has respiratory issues, or experiences any other medical emergency. Hospitals typically have rapid response teams ready to go when they get notified about a code blue.
The cardiogenic shock code is still a “symptom” code that is not usually reported if the underlying cause is stated. If the cardiogenic shock leads to cardiac arrest, then it makes sense that only the cardiac arrest code would be reported.
It is included in cardiopulmonary resuscitation (CPT code 92950).
CPRCPT states 92950 is intended to describe CPR to restore and maintain the patient's respiration and circulation after cessation of heartbeat and breathing.
The sudden cessation of cardiac activity so that the victim subject/patient becomes unresponsive, without normal breathing and no signs of circulation. Cardiac arrest may be reversed by cpr, and/or defibrillation, cardioversion or cardiac pacing.
Cessation of heart beat or myocardial contraction. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.
The cardiac arrest codes are found in I46. The options are I46.2, Cardiac arrest due to an underlying cardiac condition, I46.8, Cardiac arrest due to other underlying condition, and I46.9, Cardiac arrest, cause unspecified. I46.2 and I46.8 would be secondary diagnoses because if you establish the underlying cause, ...
There are approximately 350,000-400,000 cases of cardiac arrest arising outside of the hospital setting per year, and not all of these patients make it to the emergency department. The incidence in any given hospital on any given shift is somewhere between zero and what you see on TV medical shows.
The last facet of documenting the emergency department cardiac arrest is to be sure to take inventory of the resultant conditions. Did the patient fall and sustain fractures or lacerations? Were there fractured ribs from CPR? Are there sequelae such as coma or anoxic brain injury, respiratory failure or arrest, shock liver, acute kidney injury, etc.? Make precise, thorough, and exhaustive diagnoses with appropriate linkage.
If the patient dies during the admission, the cardiac arrest will not serve as a major complication or comorbidity (MCC).
This intellectual exercise reminded me of debates I had previously about whether you code cardiac arrest in the hospital if the patient is not successfully resuscitated. For that, I and Coding Clinic have a definitive answer. If a patient sustains cardiac arrest in the hospital and you attempt (or are successful at) resuscitation, you code it and the procedures performed. If the patient dies during the admission, the cardiac arrest will not serve as a major complication or comorbidity (MCC).
If there are residual issues or deficits, those could be definitive diagnoses. For instance, if the patient has anoxic brain damage and is in respiratory arrest and on a ventilator, those could be the captured diagnoses. However, I think leaving out the cardiac arrest would be leaving out a key part of the story.
On the other hand, you are doing the workup because it occurred. If a patient has a symptom that elicits a work up, but it has resolved by the time they are brought into the ED, you still can code it, such as with syncope or altered mental status.
The 2022 edition of ICD-10-CM T46.0X1A became effective on October 1, 2021.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code.
The 2022 edition of ICD-10-CM T40.1X1A became effective on October 1, 2021.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code. Type 1 Excludes.
T40- Poisoning by , adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens]
In ICD-10-CM the codes would be I47.2, ventricular tachycardia, and code I46.9, Cardiac arrest, unspecified.
If the cardiac arrest is due to “other” underlying condition (I46.8), the code first note is for the underlying condition, and we still have a code (I46.9) cardiac arrest, cause unspecified. There is also an Excludes 1 note for ventricular tachycardia, which states that if the documentation provides specificity regarding the type of tachycardia, ...
Per the Official Guidelines for Coding and Reporting (Section II.C), when two or more diagnoses equally meet the criteria for principal diagnosis as determined by the circumstances of admission, diagnostic workup, and/or therapy provided and the Alphabetic Index, Tabular List or another coding guideline does not provide sequencing direction, any one of the diagnosis may be sequenced first.
Diabetes mellitus codes are combination codes that include the type of diabetes as well as the body system involved and complications affecting the body system
Multiple coding is when it takes more than one code to fully describe the condition, circumstance, or manifestation
Code 427.5, Cardiac arrest, may be used as a secondary code in the following instances:#N#The patient arrives in the hospital’s emergency service unit in a state of cardiac arrest and is resuscitated (and admitted) with the condition prompting the cardiac arrest known, such as ventricular tachycardia or trauma. The condition causing the cardiac arrest is sequenced first followed by code 427.5, Cardiac arrest.#N#When cardiac arrest occurs during the course of hospitalization and the patient is resuscitated, code 427.5 may be used as a secondary code except as outlined in the exclusion note under category 427. 1 The patient arrives in the hospital’s emergency service unit in a state of cardiac arrest and is resuscitated (and admitted) with the condition prompting the cardiac arrest known, such as ventricular tachycardia or trauma. The condition causing the cardiac arrest is sequenced first followed by code 427.5, Cardiac arrest. 2 When cardiac arrest occurs during the course of hospitalization and the patient is resuscitated, code 427.5 may be used as a secondary code except as outlined in the exclusion note under category 427.
When cardiac arrest occurs during the course of hospitalization and the patient is resuscitated, code 427.5 may be used as a secondary code except as outlined in the exclusion note under category 427.
When the physician records cardiac arrest to indicate an inpatient death, do not assign code 427.5 when the underlying cause or contributing cause of death is known since the Uniform Hospital Discharge Data Set (UHDDS) has a separate item for reporting deaths occurring during an inpatient stay.
If the patient is freshly resuscitated and brought to the hospital, I don’t think the Z code would be appropriate, as the evaluation and care of the prehospital arrest is still in process. However, during subsequent admissions (or office visits, for that matter), the Z code would be entirely appropriate for use, as the acute episode of cardiac arrest precipitating the index admission to the hospital is resolved.