The Association of Home Care Coding & Compliance has asked the CDC’s National Center for Health Statistics to provide updated guidance when reporting codes from the Ischemic Heart Diseases category I20-I25 for patients with hypertension.
The diagnosis of CAD very rarely meets the requirements for primary diagnosis in any setting, yet the ICD-10-CM Official Guidelines for the Ischemic Heart Diseases Category I20-I25 include a convention that requires coders to “use additional code to identify the presence of hypertension (I10-I15).“
Sequencing rules for the use additional code convention require coders to list the additional code diagnosis after the diagnosis where the convention is in place. As result, when a patient has any condition included in I20- I25, including angina, atherosclerotic heart disease without angina, and old MIs, these conditions must be coded prior to the hypertension.
Home health agencies have already experienced denials for listing the condition from I20-I25 as primary when the physician indicated that heart failure is the primary reason for care. The primary purpose of the classification system is to accurately collect statistical data. AHCC suggests revising the instruction to “code also” to clarify that two codes may be required to fully describe the condition while eliminating sequencing direction.
Watch future issues of this E-zine for updates on this matter.