Short description: Tachycardia NOS. ICD-9-CM 785.0 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 785.0 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes).
500 results found. Showing 1-25: ICD-10-CM Diagnosis Code R00.0 [convert to ICD-9-CM] Tachycardia, unspecified. Inappropriate sinus tachycardia; Inappropriate sinus tachycardia (rapid heart beat); Sinus tachycardia; Sinus tachycardia (fast heart beat); Tachycardia; neonatal tachycardia (P29.11); paroxysmal tachycardia (I47.-);
Billable Medical Code for Tachycardia, Unspecified Diagnosis Code for Reimbursement Claim: ICD-9-CM 785.0. Code will be replaced by October 2015 and relabeled as ICD-10-CM 785.0. The Short Description Is: Tachycardia NOS. Known As. Tachycardia is also known as tachycardia.
· Can you please help me with a dx code for wide complex tachycardiaq? Thank you for any help. Menu. Home. Forums. New ... Diagnosis Coding . wide complex tachycardia ... . wide complex tachycardia. Thread starter ggparker14; Start date Feb 18, 2013; G. ggparker14 True Blue. Messages 629 Best answers 0. Feb 18, 2013 #1 Can you please help me with ...
Ventricular tachycardia refers to a wide QRS complex heart rhythm — that is, a QRS duration beyond 120 milliseconds — originating in the ventricles at a rate of greater than 100 beats per minute.
I47. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
A wide complex tachycardia (WCT) is simple enough to define: a cardiac rhythm with a rate >100 beats per minute and a QRS width >120 milliseconds (ms).
Wide complex tachycardia is a dysrhythmia with a long list of potential causes that ranges from various arrhythmias, structural heart abnormalities, electrolyte disturbances, toxins, and many more.
ICD-10 | Ventricular tachycardia (I47. 2)
ICD-10 | Cerebral infarction, unspecified (I63. 9)
Wide QRS complex tachycardia can be originated by 3 main mechanisms1: Ventricular tachycardia (VT). Supraventricular tachycardia (SVT) with an aberrant conduction attributable to a preexisting bundle-branch block or functional bundle-branch block induced by the fast heart rate.
Supraventricular tachycardias are usually narrow-complex tachycardias with a QRS interval of 100 ms or less on an electrocardiogram (ECG). Occasionally, they may show a wide QRS complex in the case of a pre-existing conduction delay, an aberrancy due to rate-related conduction delay or a bundle branch block.
Wide Complex Tachycardia: Definition of Wide and Narrow. Aberrancy, ventricular tachycardia, supraventricular tachycardia, right-bundle branch block (RBBB), left-bundle branch block (LBBB), intraventricular conduction delay (IVCD), pre-excited tachycardia.
The ECG shows a regular wide complex tachycardia with a left bundle-branch block configuration, northwest axis, and a negative concordance in precordial leads. High in the differential is atrial flutter, an arrhythmia often facilitated by flecainide.
A “wide QRS complex” refers to a QRS complex duration ≥120 ms. Widening of the QRS complex is related to slower spread of ventricular depolarization, either due to disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization.
Although procainamide, lidocaine and sotalol are proven to be effective and even preferred by some clinicians, amiodarone (Class III antiarrhythmic with potassium, calcium, and sodium channel blocking properties) remains the primary antiarrhythmic agent in the prehospital setting for wide complex tachycardia.
Causes of a widened QRS complex include right or left BBB, pacemaker, hyperkalemia, ventricular preexcitation as is seen in Wolf-Parkinson-White pattern, and a ventricular rhythm. Because there is a P wave associated with every QRS complex, a ventricular rhythm can be ruled out.
Tachycardia is also known as tachycardia. This excludes neonatal tachycardia (779.82) and paroxysmal tachycardia (427.0-427.2). This applies to rapid heart beat.
Tachycardia is when a person has a abnormally fast resting heart rate. This happens because electrical signals in the upper chamber of the heart fire abnormally and interfere with signals coming from the sinoatrial node, which is the heart’s natural pacemaker.
A wide complex tachycardia (WCT) is simple enough to define: a cardiac rhythm with a rate >100 beats per minute and a QRS width >120 milliseconds (ms). Unfortunately, beyond this simple definition lies a complex differential diagnosis with prognoses ranging from utterly benign to potentially lethal, requiring treatment strategies ranging from medications to emergent non-sedated cardioversion and implantable cardioverter defibrillator (ICD) implantation (see Table 1). Practically, however, the differential diagnosis typically devolves to the question of ventricular tachycardia (VT) versus supraventricular tachycardia (SVT) with aberration. An intelligent, organised approach to WCTs is crucial to all practitioners responsible for the interpretation of an electrocardiogram (ECG), whether in emergency medicine, cardiology or primary care.
Multiple prior series have shown that, due to prevalence alone, the pre-test probability of a WCT being VT is in excess of 80 %.1-4That is to say that if a reader simply declares all WCTs to be VT, that irresponsible individual will still be correct four out of five times. Furthermore, if the patient is known to have prior myocardial infarction, and symptoms of tachycardia did not begin until some time after the infarction, the odds of a WCT being VT exceed 90 %.3,4The bar is thus set high for a differentiating algorithm to significantly improve on this accuracy in revealing the true diagnosis of WCT.
There exist only four ‘aberrant’ ways an atrial impulse can conduct over the atrioventricular (AV) node (AVN) and His-Purkinje system (HPS) to the ventricles: right bundle branch block (RBBB), RBBB with either left or right hemiblock and left bundle branch block (LBBB). As a first approximation, if the QRS complex during WCT cannot be resolved as using one of these four routes, the ventricle must be activating outside the specialised conduction tissue, limiting the differential to VT or SVT with ventricular activation over an AV accessory pathway (AP). Rarely, do patients with unusual hypertrophy patterns or repaired congenital heart disease have bizarre, wide QRS patterns during sinus rhythm; SVT in these patients will thus be similarly bizarre, potentially causing an SVT to appear most unusual for what is otherwise ‘normal’ conduction. Though this group of patients is growing in size, it remains a small proportion of all WCTs.
The work of Sandler and Marriott published in 1965 laid the foundation for the use of ECG criteria instead of, or in complement to, physical exam skills for the diagnosis of VT. Their pioneering work showed that conventional assumptions about how normal ECG patterns ‘should’ present were often misleading. From analysis of 100 premature ventricular contractions (PVCs), 50 RBBB aberrancies and 100 fixed RBBBs, they drew many conclusions, a few of which have withstood the test of time. The generally accepted morphology criteria from their work as well as that of other investigators are summarised in Figure 1.
Wide Complex Tachycardias (WCTs) are also known as Broad Complex or Wide QRS Complex Tachycardias. It is easiest to understand this nomenclature by considering these terms independently. Widerefers to a QRS complex duration (width) of greater than or equal to 0.12 seconds (120 msec), corresponding to three small boxes on the ECG paper. There are many reasons for QRS complexes to be widened (see Table 1). Any cause of a widened QRS complex can result in a sustained or nonsustained wide complex tachycardia if the rate is greater than 100 beats per minute. Etiologies of various WCTs are listed in Table 2, with schematic diagrams to better appreciate the conduction pathways and electrophysiology behind WCTs provided in Figure 1. The QRS Complexis the electrical stimulus on the ECG tracing as it passes from the AV node down the ventricular conduction system, terminating in the ventricular myocardial cells.8This definition, however, proves to be rather limited, as the electrical stimulus that results in the QRS complex may travel in either the forward or backward direction (anterogradeor retrograde) using various pathways as part of the conduction circuit (orthodromicor antidromic). The direction of and pathway used by the electrical impulse greatly affects the duration of the QRS complex, which may impact the heart rate achieved. Tachycardiais generally defined as any heart rate or pulse greater than 100 beats per minute, whether or not this is sustained.
Tachycardiais generally defined as any heart rate or pulse greater than 100 beats per minute , whether or not this is sustained. Open in a separate window. Figure 1.
The pill electrode has an unlikely role in the emergency department identification and management of WCTs due to its cost, availability, ease of use, safety, and lack of emergency physician experience using them. These pills are not indicated for patients experiencing hemodynamic compromise.
Vagal maneuvers, such as cautious carotid massage, gagging or coughing, and valsalva can slow the ventricular response in many tachycardias of supraventricular origin, allowing atrial activity to be more apparent . These maneuvers tend to be ineffective in tachycardias of ventricular origin. Open in a separate window.
Neither the heart rate nor the width of the QRS complex in a single patient presenting with a WCT can definitively determine the origin of the rhythm disturbance. Many references state that a faster heart rate is more likely found in WCTs of supraventricular origin than in those of ventricular etiology. Ranges of heart rates that occur in SVT with aberrant conduction or VT are often given in a table, for example. However, presenting this information in this manner gives the illusion that there is a distinct heart rate above which VT does not occur. This is not true, as the range of heart rates found in SVTs and VTs overlap, depending on the underlying condition, medications, and physiological reserve of individuals experiencing these rhythms. Overall, the heart rate of WCTs due to aberrantly-conducted SVTs tend to beslightly faster than the rates due to VTs, but in a single individual at a given time, heart rate is not useful in determining the etiology of the WCT.
An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the bundle of his, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide qrs complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (av dissociation).
A cardiac rhythm characterized by 3 or more consecutive complexes in duration emanating from the ventricles at a rate of >100 bpm (cycle length: <600 ms).
The 2022 edition of ICD-10-CM I47.2 became effective on October 1, 2021.