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ICD-10-CM Coding Guidelines - Diseases of the Circulatory System (Chapter 9) and Diseases of the Respiratory System (Chapter 10)
 
 

ICD-10-CM Coding Guidelines - Diseases of the Circulatory System (Chapter 9) and Diseases of the Respiratory System (Chapter 10)

 Diseases of the Circulatory System (Chapter 9)

Chapter 9 of ICD-10-CM is titled "Disease of the Circulatory System," which includes code categories I00-I99. This chapter includes a variety of circulatory disease, such as rheumatic heart disease, hypertension, and ischemic heart disease. 

  •  I00-I02 Acute Rheumatic Fever – Codes in this subsection correspond with those in categories 390-392 of ICD-9-CM. Conditions coded include acute rheumatic pericarditis, myocarditis, and endocarditis, rheumatic fever with or without heart involvement, and rheumatic chorea. 

  • I05-I09 Chronic Rheumatic Heart Diseases - Codes in this subsection correspond with those in categories 393-398 of ICD-9-CM. Conditions coded include numerous disorders related to rheumatic fever. 

  • I10-I15 Hypertensive Diseases - Codes in this subsection correspond with those in categories 402-405 of ICD-9-CM. Conditions in this category include various hypertensive diseases, such as hypertensive heart disease, hypertension with acute renal failure, and hypertension with chronic renal failure. 

  • I20-I25 Ischemic Heart Diseases - Codes in this subsection correspond with those in categories 410-414 of ICD-9-CM. Conditions coded include angina pectoris, myocardial infarction, complications of myocardial infarction, ischemi cardiomyopathy, atherosclerosis, and atherosclerotic cardiovascular disease. 

  •  I26-I28 Pulmonary Heart Disease and Diseases of Pulmonary Circulation - Codes in this subsection correspond with those in categories 415-417 of ICD-9-CM. Conditions coded include pulmonary embolism, pulmonary hypertension, cor pulmonale, arteriovenous fistula, and pulmonary artery aneurysm. 

  •  I30-I52 Other Forms of Heart Disease - Codes in this subsection correspond with those in categories 420-429 of ICD-9-CM. Conditions coded include various forms of pericarditis, cardiomyopathy, heart block, arrhythmias, valve disorders, pericardial effusion, and heart failure.

  • I60-I69 Cerebrovascular Diseases - Codes in this subsection correspond with those in categories 430-434 and 436-438 of ICD-9-CM. Conditions coded include nontraumatic subarachnoid, subdural, and intracerebral hemorrhage, cerebral infarction, occlusion or stenosis of pre-cerebral arteries, and other diseases and sequelae of cerebrovascular disease. 

  • I70-I79 Diseases of Arteries, Arterioles, and Capillaries - Codes in this subsection correspond with those in categories 440-449 of ICD-9-CM. Conditions coded include atherosclerosis, aneurysm, thrombus, embolism, peripheral vascular disease, and other strictures and dissections of these vessels. 

  • I80-I89 Diseases of Veins, Lymphatic Vessels, and Lymph Nodes, NEC - Codes in this subsection correspond with those in categories 451-457 and 459 of ICD-9-CM. Conditions coded include phlebitis, thrombophlebitis, embolism, thrombosis, varicose veins, hemorrhoids, venous insufficiency, vein strictures, lymphangitis, lymphedema, and esophageal varies. 

  • I90-I99 Other and Unspecified Disorders of Circulatory System - Codes in this subsection correspond with those in category 458 of ICD-9-CM. Conditions include hypotension, gangrene, intra-operative and postprocedural complications, and conditions NEC (Grebner & Suarez, 2013). 

General Guidelines

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  • For a patient with chronic renal disease and hypertension, the primary code should be from category I12 Hypertensive chronic kidney disease, followed by a secondary code form category N18 to report the stage of the renal disease. 

  • Gestational hypertension is reported with code O13 or O14, depending on the existence of proteinuria. 

  • If documentation reflects elevated blood pressure, but the patient has not yet been diagnosed with hypertension, the coder should use R03.0. 

  • For reporting angina with existing heart disease, combination codes I25.11 and I25.7 can be used. 

  • When a patient is admitted for a cardiac event and there is an existing cardiac disease diagnosis, the acute event should be listed first, followed by a secondary code for the cardiac disease. 

  • If a patient has a cerebral infarction, a secondary code (Z92.82) should be assigned if the patient received tissue plasminogen activator within 24 hours of admission (Grebner & Suarez, 2013).

Diseases of the Respiratory System (Chapter 10)

The structures of the respiratory system support the process of breathing and gas exchange across the smaller alveoli of the lungs. The ICD-10-CM Chapter 10 is titled "Diseases of the Respiratory System," and it includes code categories J00-J99.

  • J00-J06 Acute Upper Respiratory Infections - Codes in this subsection correspond with those in categories 460-465 of ICD-9-CM. Conditions coded include the common cold, acute sinusitis, acute pharyngitis, acute laryngitis, acute tracheitis, and acute tonsillitis. 

  • J09-J18 Influenza and Pneumonia - Codes in this subsection correspond with those in categories 480-488 of ICD-9-CM. Conditions coded include various forms of influenza and pneumonia.

  • J20-J22 Other Acute Lower Respiratory Infections - Codes in this subsection correspond with those in category 466 of ICD-9-CM. Conditions coded include acute bronchitis and acute bronchiolitis.

  • J30-J39 Other Disease of Upper Respiratory Tract - Codes in this subsection correspond with those in categories 470-478 of ICD-9-CM. Conditions coded include chronic obstructive pulmonary disease, sinusitis, rhinitis, and asthma.

  • J40-J47 Chronic Lower Respiratory Diseases - Codes in this subsection correspond with those in categories 490-494 and 496 of ICD-9-CM. Conditions coded include chronic bronchitis, COPD, asthma, emphysema, and bronchiectasis.

  •  J60-J70 Lung Diseases Due to External Agents - Codes in this subsection correspond with those in categories 500-508 of ICD-9-CM. Conditions coded include pneumoconiosis due to organic and inorganic agents, airway disease due to dust, respiratory conditions caused by inhalation of gases, vapors, fumes, and chemicals, and hypersensitivity pneumonitis.

  • J80-J84 Other Respiratory Diseases Principally Affecting the Interstitium - Codes in this subsection correspond with those in categories 514 and 518 of ICD-9-CM. Conditions coded include acute respiratory distress syndrome, pulmonary edema, interstitial pulmonary diseases, and pulmonary eosinophilia. 

  • J85-J86 Suppurative and Necrotic Conditions of the Lower Respiratory Tract - Codes in this subsection correspond with those in categories 510 and 513 of ICD-9-CM. Conditions coded include lung abscesses, lung gangrene, and pyothorax. 

  • J90-J94 Other Diseases of the Pleura - Codes in this subsection correspond with those in categories 511-512 of ICD-9-CM. Conditions coded include pleural plaque, pleural effusion, pneumothorax, hemothorax, and hydropneumothorax. 

  • J95 Intraoperative and Postprocedural Complications and Disorders of the Respiratory System NEC - Codes in this subsection correspond with those in category 519 of ICD-9-CM. Conditions coded include complications that occur during or after procedures, as well as those NEC. 

  • J96-J99 Other Diseases of the Respiratory System - Codes in this subsection correspond with those in categories 517-518 of ICD-9-CM. Conditions coded include acute respiratory failure, chronic respiratory failure, pulmonary collapse, bronchospasm, and interstitial emphysema (Grebner & Suarez, 2013). 

General Guidelines

  • When reporting conditions from category J30-J39 Other Diseases of Upper Respiratory Tract, the coder should identify risk factors by listing additional codes, such as Z77.22, Exposure to environmental tobacco smoke or Z72.0, Tobacco use. 

  • The coder will use an additional code for the infectious agent when reporting peritonsillar abscess as the first-listed code. 

  • When coding a chronic condition for a patient who has a history of smoking, the coder would first assign a code for the lung condition, followed by a secondary code of Z87.891, Personal history of nicotine dependence. 

  • For first-listed codes from category J95, Intraoperative and Postprocedureal Complications and Disorders of Respiratory System NEC, the coder may need to use additional codes to report adverse effects of anesthesia, type of pneumonia, or type of infection. 

  • If a patient is admitted with a respiratory condition related to HIV, the code B20, HIV disease must be reported prior to the code for the respiratory condition (Grebner & Suarez, 2013).

 

 
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