Original Article CT guided transthoracic catheter drainage ...
Local Coverage Determination (LCD): Transthoracic ... Guidelines//CMS...Local Coverage Determination...
Transcript of Local Coverage Determination (LCD): Transthoracic ... Guidelines//CMS...Local Coverage Determination...
Local Coverage Determination (LCD): Transthoracic Echocardiography (TTE) (L33577)Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website.
Contractor InformationCONTRACTOR NAME CONTRACT TYPE CONTRACT
NUMBERJURISDICTION STATE(S)
National Government Services, Inc.
MAC - Part A 06101 - MAC A J - 06 Illinois
National Government Services, Inc.
MAC - Part B 06102 - MAC B J - 06 Illinois
National Government Services, Inc.
MAC - Part A 06201 - MAC A J - 06 Minnesota
National Government Services, Inc.
MAC - Part B 06202 - MAC B J - 06 Minnesota
National Government Services, Inc.
MAC - Part A 06301 - MAC A J - 06 Wisconsin
National Government Services, Inc.
MAC - Part B 06302 - MAC B J - 06 Wisconsin
National Government Services, Inc.
A and B and HHH MAC
13101 - MAC A J - K Connecticut
National Government Services, Inc.
A and B and HHH MAC
13102 - MAC B J - K Connecticut
National Government Services, Inc.
A and B and HHH MAC
13201 - MAC A J - K New York - Entire State
National Government Services, Inc.
A and B and HHH MAC
13202 - MAC B J - K New York - Downstate
National Government Services, Inc.
A and B and HHH MAC
13282 - MAC B J - K New York - Upstate
National Government Services, Inc.
A and B and HHH MAC
13292 - MAC B J - K New York - Queens
National Government Services, Inc.
A and B and HHH MAC
14111 - MAC A J - K Maine
National Government Services, Inc.
A and B and HHH MAC
14112 - MAC B J - K Maine
National Government Services, Inc.
A and B and HHH MAC
14211 - MAC A J - K Massachusetts
National Government Services, A and B and HHH 14212 - MAC B J - K Massachusetts
Created on 10/07/2019. Page 1 of 17
CONTRACTOR NAME CONTRACT TYPE CONTRACT NUMBER
JURISDICTION STATE(S)
Inc. MAC
National Government Services, Inc.
A and B and HHH MAC
14311 - MAC A J - K New Hampshire
National Government Services, Inc.
A and B and HHH MAC
14312 - MAC B J - K New Hampshire
National Government Services, Inc.
A and B and HHH MAC
14411 - MAC A J - K Rhode Island
National Government Services, Inc.
A and B and HHH MAC
14412 - MAC B J - K Rhode Island
National Government Services, Inc.
A and B and HHH MAC
14511 - MAC A J - K Vermont
National Government Services, Inc.
A and B and HHH MAC
14512 - MAC B J - K Vermont
LCD Information
Document Information
LCD IDL33577 LCD TitleTransthoracic Echocardiography (TTE) Proposed LCD in Comment PeriodN/A Source Proposed LCDN/A AMA CPT / ADA CDT / AHA NUBC Copyright StatementCPT codes, descriptions and other data only are copyright 2018 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Current Dental Terminology © 2018 American Dental Association. All rights reserved. Copyright © 2019, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No
Original Effective DateFor services performed on or after 10/01/2015 Revision Effective DateFor services performed on or after 10/01/2019 Revision Ending DateN/A Retirement DateN/A Notice Period Start DateN/A Notice Period End DateN/A
Created on 10/07/2019. Page 2 of 17
portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. To license the electronic data file of UB-04 Data Specifications, contact Tim Carlson at (312) 893-6816 or Laryssa Marshall at (312) 893-6814. You may also contact us at [email protected].
CMS National Coverage Policy
Language quoted from Centers for Medicare and Medicaid Services (CMS), National Coverage Determinations (NCDs) and coverage provisions in interpretive manuals is italicized throughout the policy. NCDs and coverage provisions in interpretive manuals are not subject to the Local Coverage Determination (LCD) Review Process (42 CFR 405.860[b] and 42 CFR 426 [Subpart D]). In addition, an administrative law judge may not review an NCD. See Section 1869(f)(1)(A)(i) of the Social Security Act. Unless otherwise specified, italicized text represents quotation from one or more of the following CMS sources: Title XVIII of the Social Security Act (SSA): Section 1862(a)(1)(A) excludes expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Section 1862(a)(7) of Title XVIII of the Social Security Act excludes routine physical examination, unless otherwise covered by statute. Section 1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim. Code of Federal Regulations: 42 CFR, Section 410.32, indicates that diagnostic tests may only be ordered by the treating physician (or other treating practitioner acting within the scope of his or her license and Medicare requirements) who furnishes a consultation or treats a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific medical problem. Tests not ordered by the physician (or other qualified non-physician provider)
Created on 10/07/2019. Page 3 of 17
who is treating the beneficiary are not reasonable and necessary (see Sec. 411.15(k)(1) of this chapter). 42 CFR 410.33 provides credentialing requirements for testing performed in an IDTF by technicians. CMS Publications: CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 9:
100 General Billing Requirements
CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 12:
30.4 Cardiovascular System (Codes 92950-93799)
Coverage Guidance
Coverage Indications, Limitations, and/or Medical Necessity
Abstract: Transthoracic Echocardiography is the ultrasonic examination of the heart through the chest wall. Two-dimensional (2D) TTE may allow visualization of the cardiac chambers, cyclic variation in myocardial wall thickness, valvular structure and function, the proximal great vessels and the pericardium. Doppler flow evaluation uses the changes in frequency when a transmitted ultrasound wave is reflected from moving surfaces (e.g., heart valves, red blood cells) and allows measurement of blood flow velocity which can be used to identify valvular stenosis or regurgitation, estimate cardiac output and intracardiac pressures, or identify the presence of intracardiac shunts. In order to qualify as a valid echocardiographic service, the study must be done for an accepted clinical indication by a properly trained examiner and must include a permanent record of the findings, data sufficient to support the conclusions and an appropriate interpretation and written report. Such a study would meet the standards required for a complete echocardiographic examination, regardless of the size or portability of the instrument used to perform the study. This policy addresses the medically necessary and appropriate application of TTE, including stress echocardiography. Transesophageal echocardiography (TEE) is the subject of a separate policy statement. Indications: Echocardiography is indicated in the evaluation of derangements of valvular, myocardial and pericardial structure and function. The general applications for coverage include: Transthoracic Echocardiogram INDICATIONS: Ventricular Function, Cardiomyopathies and Heart Failure
"When the etiology is in doubt, echocardiography can document or rule out the common cardiac causes of 1.
Created on 10/07/2019. Page 4 of 17
pulmonary congestion: left-sided valvular disease, depressed systolic or diastolic function, and cardiomyopathy. In this regard, echocardiography is the preferred initial diagnostic test when the history, physical examination, and routine laboratory tests suggest (or cannot eliminate) cardiac disease." (ACC/AHA/ASE 2003 Guideline Update, pg. 35)"Echocardiography is recommended for patients with edema with clinical signs of elevated central venous pressure when a potential cardiac etiology is suspected or when central venous pressure cannot be estimated with confidence and clinical suspicion of heart disease is high." TTE is also recommended for patients experiencing "dyspnea with clinical signs of heart disease."(ACC/AHA/ASE 2003 Guideline Update, pg. 37)
2.
"Echocardiography is not recommended in patients with edema when the jugular venous pressure does not appear to be elevated." (ACC/AHA/ASE 2003 Guideline Update, pg. 35).
3.
Hypertensive Cardiovascular Disease
Evaluating the cardiac effects of systemic hypertension (ACC/AHA/ASE 2003 Guideline Update, pg. 42)1. In young individuals and in individuals with borderline hypertension, the decision to commit to long-term antihypertensive therapy may be determined by the presence of left ventricular hypertrophy and /or left ventricular mass calculation.
2.
Acute Myocardial Infarction and Coronary Insufficiency
Evaluation of regional motion, systolic thickening perturbations and mural thinning1. Evaluation of right ventricular ischemia and/or infarction2. Diagnosis or evaluation of complications of acute infarction (e.g., mural thrombi, papillary muscle dysfunction and rupture, septal defects, true or false aneurysm and myocardial rupture)
3.
Following an initial TTE in the setting of acute infarction, repetition frequency will typically be dictated by the acute clinical course. The medical record should document the medical necessity of the frequency for TTE assessment.
4.
"Evaluation of chest pain in patients with suspected acute myocardial ischemia, when baseline ECG and other laboratory markers are nondiagnostic and when study can be obtained during pain or within minutes after its abatement" is recommended in the ACC/AHA/ASE 2003 Guideline Update.
5.
Diagnosis of acute myocardial infarction when the clinical history and ECG findings are nondiagnostic. (ACC/AHA/ASE 2003 Guideline Update, pg. 15)
6.
Exposure to Cardiotoxic Agents (chemotherapeutic and external) An initial complete TTE may be performed prior to first administration of the agent with the frequency of repeat studies determined by the patient's clinical course and the toxicity profile of the agent being administered, although tests performed bimonthly during chemotherapy and at six (6) months following therapy are generally considered medically appropriate. Cardiac Transplant and Rejection Monitoring
TTE is an integral part of the cardiac donor-selection and donor-recipient matching process. Evaluation focuses on analysis of ventricular function and valvular integrity.
1.
TTE in the management of allograft recipients is typically performed weekly for the first four to eight (4-8) weeks following transplant, with reduced frequency over time. Absent acute rejection episodes, approximately two (2) TTE examinations are typically performed yearly in chronic transplant recipients. TTE of cardiac
2.
Created on 10/07/2019. Page 5 of 17
allografts is most appropriately serially performed at transplant centers by examiners with expertise in the management of cardiac allograft recipients. Uses in excess of the generally accepted frequency will be expected to have appropriate medical necessity documentation provided.
Native Valvular Heart Disease
TTE is well established as a technique of primary choice for the evaluation of valvular pathology and its effect upon global myocardial function.
1.
In some patients, Doppler echocardiography is the only noninvasive method capable of identifying the cause of a heart murmur. (ACC/AHA/ASE 2003 Guideline Update, pg. 7)
2.
Absent acute intervention, or a discrete change in otherwise stable clinical signs and symptoms, it is not medically necessary to repeat these examinations more frequently than annually. When the patient's clinical status shows evidence of change or the plan of care includes consideration for imminent valvular surgery, more frequent exams may be necessary.
3.
Prosthetic Heart Valves (Mechanical & Bio-prostheses) TTE assessment after prosthetic valve implant to establish a baseline structural and hemodynamic profile with reassessment following convalescence (3-6 months). Thereafter, re-evaluation of patients with suspected dysfunction, thrombosis or a change in clinical status or symptoms is indicated. Acute Endocarditis
Diagnostic and evaluation of suspected endocarditis or complications or sequelae of acute infective endocarditis.
1.
Examination frequency in the acute phase of illness is dictated by the individual clinical course. When the acute process has been stabilized, the frequency of serial TTE evaluation will be determined by the residual pathophysiology and discrete clinical events, analogous to the serial assessment of chronic valvular dysfunction and/or normally functioning prosthetic valves.
2.
Pericardial Disease
Detection and quantitation of the amount of pericardial effusion.1. To characterize the hemodynamic consequences of pericardial fluid accumulation.2. As an adjunct during the removal of pericardial fluid and creation of pericardial windows.3. Diagnosis of pericardial constriction and differentiating it from restrictive myocardial disease (may require Doppler).
4.
The acute clinical status will dictate examination frequency. In a patient with evolving pericardial pathology, a limited focused TTE exam may be appropriate.
5.
Abnormalities of the Great Vessels
Evaluation of acute or chronic aortic pathology (Note: TEE is often a more determinative study unless images suitable for serial quantitation can be obtained by TTE).
1.
Routine (yearly) evaluation is indicated in patients with severe aortic stenosis or regurgitation, in whom the information obtained will be used in determining or modifying the plan of care.
2.
Created on 10/07/2019. Page 6 of 17
With ascending aortic dilatation or aneurysms, a focused limited follow-up exam to serially measure ascending aortic diameters may be indicated.
3.
Evaluation of the main pulmonary artery segment and the proximal right and left pulmonary arteries.4. Evaluation of the vena cavae and diagnosing congenital and acquired abnormalities such as vena caval thrombosis, vena caval dilation, and thrombosis or extension of tumors from the inferior vena cava to the right-heart chambers.
5.
Congenital Heart Disease
TTE with Doppler hemodynamic measurements for diagnosis and noninvasive serial assessment of most congenital heart diseases.
1.
When the disease process and therapy are stable, assessment more often than annually requires medical necessity documentation.
2.
In asymptomatic patients following repair of ASD, PFO, VSD or PDA follow up examination is only indicated within the first year after correction.
3.
Suspected Cardiac Thrombi and Embolic Sources TTE is indicated for the evaluation for cardiovascular source of embolic events (PFO/ASD, atrial or ventricular thrombus, intracardiac tumor) in evaluation for patients with abrupt occlusion of a major peripheral or visceral artery or for with neurological events without evidence of cerebrovascular disease or other obvious cause. Cardiac Tumors and Masses
Diagnosis and assessment of cardiac tumors.1. Serial TTEs may be medically necessary to monitor tumor size or tumor recurrence.2.
Critically Ill and Trauma Patients
Diagnosis of suspect aortic or central pulmonary pathology, cardiac contusion, or pericardial effusion.1. Assessment of volume status.2. The frequency of these typically acute studies will be dictated by the clinical circumstances.3.
Arrhythmias and Palpitations
Transthoracic echocardiography is useful in defining cardiac function in which arrhythmias occur, and may be useful in the management of cardiac arrhythmias. Some arrhythmias are frequently associated with underlying organic heart disease or may predispose the patient to hemodynamic deterioration. Atrial fibrillation and atrial flutter are examples of arrhythmias in which echocardiography may be appropriate to assess the underlying disorder. Echocardiographic studies are appropriate only when there is evidence of heart disease.
1.
Palpitations without evidence of arrhythmias, or minor arrhythmias (e.g., isolated APC's or VPC's) without evidence of heart disease, are not covered indications for transthoracic echocardiography.
2.
Syncope
Created on 10/07/2019. Page 7 of 17
In the initial evaluation of syncope and when other findings are suggestive of valvular heart disease or obstructive cardiomyopathy. Pulmonary To assess right ventricular size and performance, and quantify the severity of pulmonary hypertension using Doppler flow in unexplained pulmonary hypertension, and pulmonary emboli with suspected right atrial or right ventricular sources of emboli. Contrast Echocardiography Contrast echocardiography is indicated when a conventional study has failed to provide adequate and critically needed information on left ventricular function. A contrast agent is considered medically necessary when it is used to improve the delineation of the left ventricular endocardial borders in a patient whose non-contrast study is inadequate or suboptimal, and for whom the LV function information is essential to the management of the patient. Contrast is indicated when more than two (2) contiguous segments of the left ventricular border are not visualized. LIMITATIONS:
1. Echocardiography performed for screening purposes is not covered. Screening includes testing performed on patients who present with risk factors (including the risk factor as having a positive family history, e.g., familial history of Marfan's disease). A screening service for high-risk patients is considered good medical practice but is not covered by Medicare. When the result of the test is abnormal, subsequent services may be billed with the test-result diagnosis; however, the initial screening test must be listed as screening, even though the result of the screening test may be a covered condition.
The following indications (#2-15) are deemed to be not medically necessary and are therefore not reimbursable: 2. Routine (yearly) evaluation of asymptomatic patients with corrected ASD, VSD or PDA more than one year after successful correction. 3. Routine (yearly) re-evaluation of mitral valve prolapse in patients with no or mild mitral regurgitation and no change in clinical status. 4. Routine (yearly) re-evaluation of an asymptomatic patient with mild native aortic stenosis or mild-moderate native mitral stenosis and no change in clinical status. 5. Routine (yearly) re-evaluation of native valvular regurgitation in an asymptomatic patient with mild regurgitation, no change in clinical status and normal left ventricular size. 6. Routine (yearly) evaluation of a patient with a prosthetic valve in whom there is no suspicion of valvular dysfunction and no change in clinical status. 7. Routine (yearly) re-evaluation of patients with heart failure (systolic or diastolic) in whom there is no change in clinical status. 8. Routine (yearly) evaluation of hypertrophic cardiomyopathy in a patient with no change in clinical status. 9. Patients who have isolated APC or VPC without other evidence of heart disease. 10. Evaluation of LV function with prior ventricular function within the past year with normal (such as prior echocardiogram, left ventriculogram, SPECT, cardiac MRI) in patients in whom there has been no change in clinical status.
Created on 10/07/2019. Page 8 of 17
11. Initial evaluation of patient with suspected pulmonary embolism in order to establish diagnosis. 12. Evaluation of native and/or prosthetic valves in patients with transient fever but without evidence of bacteremia or new murmur. 13. Re-evaluation of a patient with known hypertensive heart disease without a change in clinical status. 14. Routine evaluation of patients with systemic hypertension without suspected hypertensive heart disease. 15. Evaluation of a patient with atrial fibrillation/flutter for left atrial thrombus or spontaneous contrast when a decision has been made to anticoagulate and not to perform cardioversion. [Items 2-15, see ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 Appropriateness Criteria for Transthoracic and Transesophageal Echocardiography, JACC 2007]. Follow-up Studies or Limited Studies INDICATIONS AND LIMITATIONS A complete study includes a full evaluation of all aspects of the heart, including the cardiac chambers, valves, blood flow, and great vessels. The images are reviewed, measured, analyzed and interpreted by the physician. A report is prepared for the patient's record. When a less than complete examination is performed for the purpose of evaluation of one specific cardiac problem, or region of the heart, the service performed is reported as follow-up or limited studies. When a limited service is performed, or the patient's condition requires only a limited examination, these codes must be used to indicate the appropriate service. Examples of appropriate use of a follow-up study of a patient with pericardial effusion following heart surgery, to evaluate progression or resolution of the effusion; or a serial evaluation of left ventricular function during antineoplastic chemotherapy. Examples of appropriate use of recording tricuspid regurgitant velocity in order to estimate pulmonary artery systolic pressure; or sequential evaluation of the transmitral velocity profile in a patient with mitral stenosis, in order to evaluate for a change in gradient or valve area. Doppler Color Flow Velocity Mapping INDICATIONS AND LIMITATIONS Spectral Doppler echocardiography and Doppler color flow-velocity mapping may be necessary in addition to an echocardiogram when the examination could contribute significant information to the patient's condition or treatment plan. Typically, Doppler is indicated in the evaluation of some heart murmurs, valvular problems, shunts, suspected congenital heart disease, complications of myocardial infarction, or cardiomyopathy. Doppler should be medically necessary for the evaluation and management of the patient. "Color/spectral Doppler may not be useful or appropriate in certain relatively small and well-defined patient populations when there is a recent comprehensive examination and the test is being ordered for re-evaluation of a limited problem." (ASE comment). The use of the Doppler is inherent in the ultrasonic cardiac evaluation. However, if the test reports fail to document the use of this technique to assess these structures and function (e.g., measurement of valvular insufficiency or stenosis, myocardial diastolic function, etc. as described by the ASE), or if the medical records fail to document that the examination was "clinically necessary" (e.g., follow-up of pericardial effusion size) then the Doppler portion of the
Created on 10/07/2019. Page 9 of 17
test may be considered medically unnecessary and denied. Limited Capability Ultrasound Scanners INDICATIONS AND LIMITATIONS Some small scanners have more limited capabilities and lack either the permanent recording capabilities or some of the functional capabilities needed to perform a complete examination. Such a study may be quite useful as an extension of the physical examination. However, an examination that does not meet the standards required for a complete diagnostic echocardiographic examination – whether performed with a "conventional" scanner or a limited capability ultrasound scanner - will not be recognized as a valid echocardiographic service and will be non-covered. Stress Echocardiography Stress Echocardiography may be necessary when the evaluation could contribute significant information to the patient's condition or treatment plan. A nonimaging stress test focuses on the hemodynamic and electrocardiographic responses to stress. To enhance the diagnostic specificity, the stress test may be combined with echocardiographic imaging or scintigraphic imaging. A contrast agent may be used with echocardiographic imaging to enhance endocardial visualization and diagnostic accuracy. When two (or more) imaging studies (e.g., ultrasound and scintigraphy) are billed without a supporting clinical indication for each, one of the services will be denied as not medically necessary. This section addresses the echocardiographic imaging that is done in association with a stress test. INDICATIONS Stress echocardiography may be indicated in the care of patients with real or suspected ischemic heart disease in the following clinical settings:
To detect coronary artery disease in patients presenting with chest pains including atypical chest pains and exertional dyspnea when the suspicion of CAD is high.
1.
To assess prognosis and functional capacity in patients following an acute myocardial infarction.2. To evaluate the extent of exercise induced ischemia in patients who have had a revascularization procedure (PCTA, stent or coronary bypass) or patients who have known CAD disease.
3.
In women, stress imaging has been recommended as the "initial test."4. To evaluate a prior nondiagnostic or abnormal ECG exercise test as a substitute for a nuclear perfusion study.5. To evaluate patients who are at high risk for myocardial infarction prior to a scheduled major surgical procedure (e.g., aneurysm, vascular surgery, surgeries with large volume shifts, etc) or transplant procedure.
6.
To evaluate patients presenting with various arrhythmias (atrial and/or ventricular) or syncope (near or pre), when the suspicion of occult coronary artery disease is high.
7.
To evaluate patients when an indicated standard exercise ECG is likely to be non-diagnostic, including patients with an abnormal resting ECG, orthostatic or hyperventilation induced ECG changes, nonspecific ST-T abnormalities due to ventricular hypertrophy drugs or associated intraventricular conduction defect.
8.
To assess myocardial viability (hibernating myocardium) for planned revascularization or functional significance of coronary lesions (if not already known) in planning percutaneous transluminal coronary angioplasty.
9.
To evaluate cardiomyopathy when the evaluation could reasonably be expected to contribute significant information regarding the patient's condition or treatment plan.
10.
To evaluate ventricular dysfunction due to post-transplant rejection when the evaluation could reasonably be expected to contribute significant information regarding the patient's condition or treatment plan.
11.
To evaluate congenital heart disease, when stress echocardiography helps to determine systemic and right ventricular function at rest and following stress and the presence of any other structural abnormalities, including valvular lesions that may be accentuated with stress.
12.
Created on 10/07/2019. Page 10 of 17
Additionally the test may combined with Doppler intervention to evaluate exercise hemodynamics in patients with mitral stenosis, mitral regurgitation, pulmonary hypertension, aortic stenosis/regurgitation, prosthetic valves and other conditions where symptoms suggest a more severe impairment than the assessment done at rest.
13.
Dobutamine stress echo may be indicated to detect low gradient, low output (aortic stenosis) or clinically silent transplant coronary disease.
14.
LIMITATIONS
Stress echocardiography used as a screening test for ischemic heart disease in a patient without signs or symptoms is not covered.
1.
"An echocardiographic study is not indicated when the pathology and/or systolic ventricular function have been adequately defined by other techniques, making the echocardiographic study redundant." (ACC/AHA/ASE 2003 Guideline Update, pg. 5).
2.
Since echocardiography, nuclear testing, magnetic resonance imaging (MRI), and positron emission tomography can yield overlapping if not identical information, often with similar or comparable accuracy, when two or more of these tests provide equivalent information, one (but not both/all) will be covered when medically necessary.
3.
Stress tests by multiple modalities (e.g. stress echocardiography, nuclear SPECT) for the same clinical event are covered only if the preceding test was inconclusive or uninterpretable.
4.
Studies with or without contrast will be considered a single study, whether performed on the same or subsequent days.
5.
Contrast echocardiography is not covered when used to evaluate perfusion. Contrast is not indicated unless more than two (2) contiguous segments of the left ventricular border are not visualized.
6.
A stress test must be ordered by a physician or qualified non-physician provider.7. The resting 12 lead EKG and rhythm strip are considered to be part of the stress test. These services are not separately reimbursable.
8.
The initiation of an intravenous line and infusion of a pharmacological agent are considered to be a part of the test, and are not separately reimbursable.
9.
3-Dimensional Echocardiography INDICATIONS AND LIMITATIONS Three-dimensional echocardiography performed in conjunction with transthoracic echocardiography is indicated for:
Pre-operative planning in patients who will be having surgery to repair mitral valve prolapse (in addition to a diagnosis for a pre-operative examination, a secondary diagnosis of mitral valve prolapse is required on the claim).
1.
Monitoring the mitral valve area in patients with moderate to severe mitral stenosis.2.
Three-dimensional echocardiography provides improved calculation of volumetric studies when compared to 2D echocardiography. However, its value in affecting clinical outcomes is not yet proven and is therefore not considered medically necessary. Training Requirements Medicare expects a satisfactory level of competence from providers who submit claims for services rendered.
Created on 10/07/2019. Page 11 of 17
The acceptable levels of competence are outlined as follows: For the technical portion, an acceptable level of competence is fulfilled when the image acquisition is obtained under any one of the following conditions:
The service is performed by a physician; or1. The technical service is performed by an individual who is credentialed as either a Registered Diagnostic Cardiac Sonographer (RDCS) through the American Registry of Diagnostic Medical Sonographers or as a Registered Cardiac Sonographer (RCS) through the Cardiovascular Credentialing International; or
2.
The service is performed at a laboratory (e.g. office, IDTF), credentialed by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL). Any non-physician personnel used by an IDTF to perform tests must demonstrate the basic qualifications to perform the tests in question and have training and proficiency as evidenced by licensure or certification by the appropriate State health or education department. In the absence of a State licensing board, the technician must be certified by an appropriate national credentialing body. The IDTF must maintain documentation available for review that these requirements are met.
3.
For the professional portion, an acceptable level of competence is fulfilled when the interpretation is performed by a physician meeting any one of the following requirements:
The physician is board certified in Cardiovascular Diseases; or•The physician has Level II training in transthoracic echocardiography, as defined by the American College of Cardiology/American Heart Association/ American College of Physicians Task Force on Clinical Competence in Echocardiography, or the equivalent of Level II training as set forth in that document, or has been credentialed for this procedure by the hospital where the physician performs this service.For Facilities, quality requirements should encompass approved ACC/AHA/ASE training standards for physicians, accreditation by ICAEL for facilities, and certification of cardiac sonographers by recognized national credentialing organizations as the appropriate quality standards.The submission of claims for echocardiography will be considered an attestation that both the technical and professional components of the service were provided within the context of the above stated credentials.The requirements have been in effect in New York and Connecticut since prior to 2011 and were effective in Illinois (for Part B providers), Maine, Massachusetts, Minnesota, New Hampshire, Rhode Island, Vermont and Wisconsin (for Part B providers) as of January 1, 2015.
•
Summary of Evidence
N/A
Analysis of Evidence (Rationale for Determination)
N/A
Created on 10/07/2019. Page 12 of 17
General InformationAssociated Information
N/A
Sources of Information
This bibliography presents those sources that were obtained during the development of this policy. National Government Services is not responsible for the continuing viability of Web site addresses listed below. ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 Appropriateness criteria for transthoracic and transesophageal echocardiography. http://www.acc.org/qualityandscience/clinical/pdfs/TTE.TEE.pdf. Accessed February 24, 2007. AHA Position Statement, Cardiac transplantation: recipient selection, donor procurement, and medical follow-up. Circulation. 1992;86(3):1061-1079. American College of Cardiology, Guidelines for the Clinical Application of Echocardiography. www.acc.org. Braunwald E. Heart Disease: A Textbook of Cardiovascular Medicine. 6th ed. Philadelphia, PA: W.B. Saunders Company;2001. Cheitlin MD, Armstrong WF, Aurigemma GP, et al. ACC/AHA/ASE/ASE 2003 guideline update for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (ACC/AHA/ASE/ASE Committee to update the 1997 guidelines for the clinical application of echocardiography). 2003. http://www.acc.org/qualityandscience/clinical/guidelines/echo/index_clean.pdf. Accessed February 24, 2007. CMD Cardiology Work Group. Douglas PS, Khandheria B, Stainback RF, et al. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation appropriateness criteria task force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine. J. Am. Coll. Cardiol. 2008;51;1127-1147; originally published online Mar 3, 2008; doi:10.1016/jacc.2007.12.005. Hung J, Lang R, Flachskampf F, et al. 3D echocardiography: a review of the current status and future directions. J. Am. Soc Echocardiography. 2007;20:213-233. LMRP Workgroup, American College of Cardiology and American Society of Echocardiography. Otto C. The Practice of Clinical Echocardiography. 2nd ed. Philadelphia, PA: W.B. Saunders Company;2002. Pepi M, Tamborini G, Maltagliati A, et al. Head-to-head comparison of two-and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse. J Am Coll Cardiol. 2006;48:2524-2530. Quinones MA, Douglas PS, Foster E, et al. ACC/AHA clinical competence statement on echocardiography. Journal of the American College of Cardiology. 2003;41(4):687-708.
Created on 10/07/2019. Page 13 of 17
Schiller N. Protocols for stress echocardiography in coronary heart disease, UpToDate, Online 13.1. www.uptodate.com.
Bibliography
N/A
Revision History InformationREVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION REASON(S) FOR CHANGE
10/01/2019 R15This LCD was converted to the new "no-codes" format. There has been no change in coverage with this LCD revision.
Revisions Due To Code Removal
•
08/01/2019 R14Consistent with Change Request 10901, all coding information, National coverage provisions, and Associated Information (Documentation Requirements, Utilization Guidelines) have been removed from the LCD and placed in the related Billing and Coding Article, A56781. There has been no change in coverage with this LCD revision.
Other•
10/01/2018 R13LCD revised for annual ICD-10 updates.
ICD-10 code I63.8 was deleted and replaced by I63.81 and I63.89 in Group 1.
ICD-10 codes T81.4XXA, T81.4XXD, and T81.4XXS were deleted and replaced by T8140XA, T8141XA, T8142XA, T8143XA, T8144XA, T8140XD, T8141XD, T8142XD, T8143XD, T8144XD, T8140XS, T8141XS, T8142XS, T8143XS, and T8144XS in Group 1.
DATE (10/01/2018): At this time, the 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Revisions Due To ICD-10-CM Code Changes
•
11/01/2017 R12Formatting changes made Other•
Request for Coverage •11/01/2017 R11
Created on 10/07/2019. Page 14 of 17
REVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION REASON(S) FOR CHANGE
ICD-10 codes I05.1, I05.8, I06.0, I06.1, I06.2, I08.0, I08.2, and I08.8 have been added as payable for Group 4 (codes 93350, 93351, 93352, C8928, C8930).
DATE (11/01/2017): At this time, the 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Request for Coverage by a Practitioner (Part B)
by a Practitioner (Part B)
10/01/2017 R10Correction to Revision 9: this change was listed in error for Group 4: Deleted code I27.2 was replaced by I27.20-I27.29. Group 4 does not include this range of codes.
DATE (10/01/2017): At this time, the 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
Typographical Error•
LCD revised for annual ICD-10 updates for 2018.
For Group 1, (CPT codes 93306, 93307, 93308, C8923, C8924, C8929) deleted code E85.8 was replaced by E85.81, E85.82, and E85.89. Deleted code I27.2 was replaced by I27.20-I27.29. ICD-10 codes I21.9, I21.A1, I21.A9, I50.810-I50.814, I50.82-I50.89 and R06.03 were added.
•
For Group 2 (CPT codes 93303, 93304, C8921, •
10/01/2017 R9Revisions Due To ICD-10-CM Code Changes
•
Created on 10/07/2019. Page 15 of 17
REVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION REASON(S) FOR CHANGE
C8922) deleted code P29.3 was replaced by P29.30 and P29.38.
For Group 4 (CPT codes 93350, 93351, 93352, C8928, C8930), Deleted code I27.2 was replaced by I27.20-I27.29. ICD-10 codes I21.9, I21.A1, I21.A9, I50.810-I50.814, I50.82-I50.89 and R06.03 were added.
•
DATE (10/01/2017): At this time, the 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.
07/01/2017 R8
The following statement has been added to ICD-10 groups 1, 2, 3 and 4: coverage criteria and diagnosis restrictions apply to both the base codes [listed above] and related add-on codes.
Provider Education/Guidance
•
04/01/2017 R7 *ICD-10 codes I08.1, I08.3, I08.9, I34.0, I34.1, I34.8, and I34.9 are payable when billed with CPT codes 93306, 93307, or 93308 only. *ICD-10 code Q23.4 is payable when billed with CPT codes 93303, 93304 only. Wording changes have been made throughout for clarity.
Provider Education/Guidance
•
Request for Coverage by a Practitioner (Part B)
•
10/01/2016 R6 Multiple ICD-10 codes added for annual ICD-10 updates. Added ICD-10 code Z51.81 to Group 1 and instructions for coding TTE done for monitoring effects of chemotherapy.
Provider Education/Guidance
•
Revisions Due To ICD-10-CM Code Changes
•
07/01/2016 R5 CPT/HCPCS Group 2 paragraph was revised as follows to clarify the use of the codes listed: "These stress agents can be billed with stress test codes 93350, 93351, 93352, C8928, and C8930."
Provider Education/Guidance
•
Created on 10/07/2019. Page 16 of 17
REVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION REASON(S) FOR CHANGE
10/01/2015 R4 ICD-10 code Z08 was added to Group 1 diagnoses, payable for HCPCS codes 93306, 93307, 93308, 93321, 93325, C8923, C8924, and C8929, effective 10/1/2015.
Request for Coverage by a Practitioner (Part B)
•
10/01/2015 R3 ICD-10 codes were revised to add the 7th digit for D=subsequent encounter and S=sequela, where the 7th digit, A=initial encounter was already included.
Provider Education/Guidance
•
10/01/2015 R2 An asterisk was added to ICD-10 code Z01.810 in Group 1.
Typographical Error•
10/01/2015 R1 LCD updated with changes made since it was initially posted.
Other•
Associated DocumentsAttachments
N/A
Related Local Coverage Documents
Article(s) A56781 - Billing and Coding: Transthoracic Echocardiography (TTE)
Related National Coverage Documents
N/A
Public Version(s)
Updated on 09/17/2019 with effective dates 10/01/2019 - N/A Updated on 07/25/2019 with effective dates 08/01/2019 - 09/30/2019 Updated on 09/13/2018 with effective dates 10/01/2018 - 07/31/2019 Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.
KeywordsEcho•Cardiac•
Created on 10/07/2019. Page 17 of 17
Local Coverage Article: Billing and Coding: Transthoracic Echocardiography (TTE) (A56781)Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website.
Contractor InformationCONTRACTOR NAME CONTRACT TYPE CONTRACT
NUMBERJURISDICTION STATE(S)
National Government Services, Inc.
MAC - Part A 06101 - MAC A J - 06 Illinois
National Government Services, Inc.
MAC - Part B 06102 - MAC B J - 06 Illinois
National Government Services, Inc.
MAC - Part A 06201 - MAC A J - 06 Minnesota
National Government Services, Inc.
MAC - Part B 06202 - MAC B J - 06 Minnesota
National Government Services, Inc.
MAC - Part A 06301 - MAC A J - 06 Wisconsin
National Government Services, Inc.
MAC - Part B 06302 - MAC B J - 06 Wisconsin
National Government Services, Inc.
A and B and HHH MAC
13101 - MAC A J - K Connecticut
National Government Services, Inc.
A and B and HHH MAC
13102 - MAC B J - K Connecticut
National Government Services, Inc.
A and B and HHH MAC
13201 - MAC A J - K New York - Entire State
National Government Services, Inc.
A and B and HHH MAC
13202 - MAC B J - K New York - Downstate
National Government Services, Inc.
A and B and HHH MAC
13282 - MAC B J - K New York - Upstate
National Government Services, Inc.
A and B and HHH MAC
13292 - MAC B J - K New York - Queens
National Government Services, Inc.
A and B and HHH MAC
14111 - MAC A J - K Maine
National Government Services, Inc.
A and B and HHH MAC
14112 - MAC B J - K Maine
National Government Services, Inc.
A and B and HHH MAC
14211 - MAC A J - K Massachusetts
National Government Services, A and B and HHH 14212 - MAC B J - K Massachusetts
Created on 10/07/2019. Page 1 of 73
CONTRACTOR NAME CONTRACT TYPE CONTRACT NUMBER
JURISDICTION STATE(S)
Inc. MAC
National Government Services, Inc.
A and B and HHH MAC
14311 - MAC A J - K New Hampshire
National Government Services, Inc.
A and B and HHH MAC
14312 - MAC B J - K New Hampshire
National Government Services, Inc.
A and B and HHH MAC
14411 - MAC A J - K Rhode Island
National Government Services, Inc.
A and B and HHH MAC
14412 - MAC B J - K Rhode Island
National Government Services, Inc.
A and B and HHH MAC
14511 - MAC A J - K Vermont
National Government Services, Inc.
A and B and HHH MAC
14512 - MAC B J - K Vermont
Article Information
General Information
Article IDA56781 Article TitleBilling and Coding: Transthoracic Echocardiography (TTE) Article TypeBilling and Coding AMA CPT / ADA CDT / AHA NUBC Copyright StatementCPT codes, descriptions and other data only are copyright 2018 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Current Dental Terminology © 2018 American Dental Association. All rights reserved. Copyright © 2019, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the
Original Effective Date08/01/2019 Revision Effective Date10/01/2019 Revision Ending DateN/A Retirement DateN/A
Created on 10/07/2019. Page 2 of 73
express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. To license the electronic data file of UB-04 Data Specifications, contact Tim Carlson at (312) 893-6816 or Laryssa Marshall at (312) 893-6814. You may also contact us at [email protected].
CMS National Coverage Policy
N/A
Article GuidanceArticle Text:
This article contains coding and other guidelines that complement the Local Coverage Determination (LCD) for Transthoracic Echocardiography (TTE).
Coding Information:
Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or OPPS packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare.
For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
A claim submitted without a valid ICD-10-CM diagnosis code will be returned to the provider as an incomplete claim under Section 1833(e) of the Social Security Act.
The diagnosis code(s) must best describe the patient's condition for which the service was performed. For diagnostic tests, report the result of the test if known; otherwise the symptoms prompting the performance of the test should be reported.
Documentation Requirements:
Created on 10/07/2019. Page 3 of 73
The patient's medical record must contain documentation that fully supports the medical necessity for services included within the LCD. (See "Indications and Limitations of Coverage.") This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures, as well as reasons for repeat testing.
Each service requires a formal written report with interpretation. This report should be kept on file with copies of image documentation (paper or tape) for review if requested. All appropriate measurements should be included in the report.
At a minimum, a complete study should contain M mode and/or 2D measurements of LV end diastolic diameter, LV end systolic diameter, LV wall thickness, left atrial diameter, aortic valve excursion and a qualitative description of the LV function, whenever possible given any technical limitations in a particular case. Individual echocardiographic laboratories (providers) may choose valid substitutes for these parameters such as LV volumes, ejection fraction and mass measurements.
A Doppler interrogation should state the modes used and should give both qualitative and quantitative information.
Claims for contrast echocardiography services must be supported by documentation that conventional studies were inconclusive and there was a need for the contrast enhancement.
The medical record should clearly document the reasons for performing multiple tests, as well as prior data which has been reviewed. If specific prior test results were requested and not received, necessitating repeat or additional testing, then this should also be noted in the records.
In the case of disease processes that could preclude the performance of exercise stress testing, the medical documentation should clearly describe why the patient cannot perform exercise stress testing. The documentation must include (but is not limited to) history and physical exam findings demonstrating that the patient could not reasonably be expected to perform exercise stress testing.
Documentation of the qualifications of personnel performing tests, as described in the Indications section of the LCD, should be available on request.
In those instances in which repeat tests were denied, the physician must document a good faith effort was made to identify them and to request copies of them from previous providers, in order for NGS to consider reimbursement for such tests on appeal.
Documentation must be available to Medicare upon request.
Utilization Guidelines:
Repeat echocardiographic studies should be guided by the clinical status of the patient. The frequency of services is guided by the circumstances outlined in the Indications and Limitations section of the attached LCD. Repeat studies are appropriate to monitor changes in cardiac structure or function when there are changes in the clinical status of the patient, or when disease progression is otherwise suspected.
Services performed in the Emergency Room and other emergency services are excluded from any frequency
Created on 10/07/2019. Page 4 of 73
limitations on coverage for repeat testing. While Emergency Room services would be identified on the claim by the place of service code (23), emergency services provided at other sites would require post-pay review of the documentation provided in the medical record.
In those instances in which repeat tests were denied and a physician has documented a good faith effort to identify them and to request copies of them from previous providers, then NGS could reimburse such tests on appeal.
Coding Information
CPT/HCPCS Codes
Group 1 Paragraph:
N/A
Group 1 Codes:
CODE DESCRIPTION
76376 3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER TOMOGRAPHIC MODALITY WITH IMAGE POSTPROCESSING UNDER CONCURRENT SUPERVISION; NOT REQUIRING IMAGE POSTPROCESSING ON AN INDEPENDENT WORKSTATION
76377 3D RENDERING WITH INTERPRETATION AND REPORTING OF COMPUTED TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND, OR OTHER TOMOGRAPHIC MODALITY WITH IMAGE POSTPROCESSING UNDER CONCURRENT SUPERVISION; REQUIRING IMAGE POSTPROCESSING ON AN INDEPENDENT WORKSTATION
93303 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE
93304 TRANSTHORACIC ECHOCARDIOGRAPHY FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY
93306 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL DOPPLER ECHOCARDIOGRAPHY, AND WITH COLOR FLOW DOPPLER ECHOCARDIOGRAPHY
93307 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITHOUT SPECTRAL OR COLOR DOPPLER ECHOCARDIOGRAPHY
93308 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED STUDY
Created on 10/07/2019. Page 5 of 73
CODE DESCRIPTION
93320 DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); COMPLETE
93321 DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPLAY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING); FOLLOW-UP OR LIMITED STUDY (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHIC IMAGING)
93325 DOPPLER ECHOCARDIOGRAPHY COLOR FLOW VELOCITY MAPPING (LIST SEPARATELY IN ADDITION TO CODES FOR ECHOCARDIOGRAPHY)
93350 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT;
93351 ECHOCARDIOGRAPHY, TRANSTHORACIC, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT; INCLUDING PERFORMANCE OF CONTINUOUS ELECTROCARDIOGRAPHIC MONITORING, WITH SUPERVISION BY A PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL
93352 USE OF ECHOCARDIOGRAPHIC CONTRAST AGENT DURING STRESS ECHOCARDIOGRAPHY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
A9700 SUPPLY OF INJECTABLE CONTRAST MATERIAL FOR USE IN ECHOCARDIOGRAPHY, PER STUDY
C8921 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; COMPLETE
C8922 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, FOR CONGENITAL CARDIAC ANOMALIES; FOLLOW-UP OR LIMITED STUDY
C8923 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITHOUT SPECTRAL OR COLOR DOPPLER ECHOCARDIOGRAPHY
C8924 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, FOLLOW-UP OR LIMITED STUDY
Created on 10/07/2019. Page 6 of 73
CODE DESCRIPTION
C8928 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT
C8929 TRANSTHORACIC ECHOCARDIOGRAPHY WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, COMPLETE, WITH SPECTRAL DOPPLER ECHOCARDIOGRAPHY, AND WITH COLOR FLOW DOPPLER ECHOCARDIOGRAPHY
C8930 TRANSTHORACIC ECHOCARDIOGRAPHY, WITH CONTRAST, OR WITHOUT CONTRAST FOLLOWED BY WITH CONTRAST, REAL-TIME WITH IMAGE DOCUMENTATION (2D), INCLUDES M-MODE RECORDING, WHEN PERFORMED, DURING REST AND CARDIOVASCULAR STRESS TEST USING TREADMILL, BICYCLE EXERCISE AND/OR PHARMACOLOGICALLY INDUCED STRESS, WITH INTERPRETATION AND REPORT; INCLUDING PERFORMANCE OF CONTINUOUS ELECTROCARDIOGRAPHIC MONITORING, WITH PHYSICIAN SUPERVISION
Q9955 INJECTION, PERFLEXANE LIPID MICROSPHERES, PER ML
Q9956 INJECTION, OCTAFLUOROPROPANE MICROSPHERES, PER ML
Q9957 INJECTION, PERFLUTREN LIPID MICROSPHERES, PER ML
Group 2 Paragraph:
These stress agents can be billed with stress test codes 93350, 93351, 93352, C8928, and C8930.
Group 2 Codes:
CODE DESCRIPTION
J0153 INJECTION, ADENOSINE, 1 MG (NOT TO BE USED TO REPORT ANY ADENOSINE PHOSPHATE COMPOUNDS)
J0280 INJECTION, AMINOPHYLLIN, UP TO 250 MG
J0461 INJECTION, ATROPINE SULFATE, 0.01 MG
J1245 INJECTION, DIPYRIDAMOLE, PER 10 MG
J1250 INJECTION, DOBUTAMINE HYDROCHLORIDE, PER 250 MG
J2785 INJECTION, REGADENOSON, 0.1 MG
CPT/HCPCS Modifiers
N/A
Created on 10/07/2019. Page 7 of 73
ICD-10 Codes that Support Medical Necessity
Group 1 Paragraph:
The use of an ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in the attached determination.
Applicable to codes 93306, 93307, 93308, C8923, C8924, C8929 (coverage criteria and diagnosis restrictions apply to both the base codes [listed above] and related add-on codes):
When reporting ICD-10 codes for pre-operative services, a secondary diagnosis for mitral valve prolapse is also required.
Report ICD-10 code Z01.818 when the test is performed as a baseline study before chemotherapy.
Report ICD-10-CM code Z51.81 for subsequent monitoring while the patient is receiving chemotherapy.
Report ICD-10-CM code Z08 for testing when chemotherapy is completed.
Group 1 Codes:
ICD-10 CODE DESCRIPTION
A18.84 Tuberculosis of heart
A36.81 Diphtheritic cardiomyopathy
A39.53 Meningococcal pericarditis
A40.0 Sepsis due to streptococcus, group A
A40.1 Sepsis due to streptococcus, group B
A40.3 Sepsis due to Streptococcus pneumoniae
A40.8 Other streptococcal sepsis
A40.9 Streptococcal sepsis, unspecified
A41.01 Sepsis due to Methicillin susceptible Staphylococcus aureus
A41.02 Sepsis due to Methicillin resistant Staphylococcus aureus
A41.1 Sepsis due to other specified staphylococcus
A41.2 Sepsis due to unspecified staphylococcus
A41.3 Sepsis due to Hemophilus influenzae
A41.4 Sepsis due to anaerobes
A41.50 Gram-negative sepsis, unspecified
A41.51 Sepsis due to Escherichia coli [E. coli]
A41.52 Sepsis due to Pseudomonas
A41.53 Sepsis due to Serratia
Created on 10/07/2019. Page 8 of 73
ICD-10 CODE DESCRIPTION
A41.59 Other Gram-negative sepsis
A41.81 Sepsis due to Enterococcus
A41.89 Other specified sepsis
A41.9 Sepsis, unspecified organism
A42.7 Actinomycotic sepsis
A52.01 Syphilitic aneurysm of aorta
A52.02 Syphilitic aortitis
A52.03 Syphilitic endocarditis
A52.06 Other syphilitic heart involvement
A54.83 Gonococcal heart infection
A69.20 Lyme disease, unspecified
A69.21 Meningitis due to Lyme disease
A69.22 Other neurologic disorders in Lyme disease
A69.23 Arthritis due to Lyme disease
A69.29 Other conditions associated with Lyme disease
B33.20 Viral carditis, unspecified
B33.21 Viral endocarditis
B33.22 Viral myocarditis
B33.23 Viral pericarditis
B37.6 Candidal endocarditis
B57.0 Acute Chagas' disease with heart involvement
B57.2 Chagas' disease (chronic) with heart involvement
B58.81 Toxoplasma myocarditis
C38.0 Malignant neoplasm of heart
C45.2 Mesothelioma of pericardium
C79.89 Secondary malignant neoplasm of other specified sites
C79.9 Secondary malignant neoplasm of unspecified site
D15.1 Benign neoplasm of heart
D48.7 Neoplasm of uncertain behavior of other specified sites
D49.89 Neoplasm of unspecified behavior of other specified sites
D86.0 Sarcoidosis of lung
D86.1 Sarcoidosis of lymph nodes
Created on 10/07/2019. Page 9 of 73
ICD-10 CODE DESCRIPTION
D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes
D86.3 Sarcoidosis of skin
D86.81 Sarcoid meningitis
D86.82 Multiple cranial nerve palsies in sarcoidosis
D86.83 Sarcoid iridocyclitis
D86.84 Sarcoid pyelonephritis
D86.85 Sarcoid myocarditis
D86.86 Sarcoid arthropathy
D86.87 Sarcoid myositis
D86.89 Sarcoidosis of other sites
D86.9 Sarcoidosis, unspecified
E03.5 Myxedema coma
E83.10 Disorder of iron metabolism, unspecified
E83.110 Hereditary hemochromatosis
E83.111 Hemochromatosis due to repeated red blood cell transfusions
E83.118 Other hemochromatosis
E83.119 Hemochromatosis, unspecified
E83.19 Other disorders of iron metabolism
E85.0 Non-neuropathic heredofamilial amyloidosis
E85.1 Neuropathic heredofamilial amyloidosis
E85.2 Heredofamilial amyloidosis, unspecified
E85.3 Secondary systemic amyloidosis
E85.4 Organ-limited amyloidosis
E85.81 Light chain (AL) amyloidosis
E85.82 Wild-type transthyretin-related (ATTR) amyloidosis
E85.89 Other amyloidosis
E85.9 Amyloidosis, unspecified
G06.0 Intracranial abscess and granuloma
G06.1 Intraspinal abscess and granuloma
G45.0 Vertebro-basilar artery syndrome
G45.1 Carotid artery syndrome (hemispheric)
G45.2 Multiple and bilateral precerebral artery syndromes
Created on 10/07/2019. Page 10 of 73
ICD-10 CODE DESCRIPTION
G45.3 Amaurosis fugax
G45.8 Other transient cerebral ischemic attacks and related syndromes
G45.9 Transient cerebral ischemic attack, unspecified
G46.0 Middle cerebral artery syndrome
G46.1 Anterior cerebral artery syndrome
G46.2 Posterior cerebral artery syndrome
G47.30 Sleep apnea, unspecified
G47.31 Primary central sleep apnea
G47.33 Obstructive sleep apnea (adult) (pediatric)
H34.00 Transient retinal artery occlusion, unspecified eye
H34.01 Transient retinal artery occlusion, right eye
H34.02 Transient retinal artery occlusion, left eye
H34.03 Transient retinal artery occlusion, bilateral
I01.0 Acute rheumatic pericarditis
I01.1 Acute rheumatic endocarditis
I01.2 Acute rheumatic myocarditis
I01.8 Other acute rheumatic heart disease
I01.9 Acute rheumatic heart disease, unspecified
I02.0 Rheumatic chorea with heart involvement
ICD-10 CODE DESCRIPTION
I02.9 Rheumatic chorea without heart involvement
I05.0 Rheumatic mitral stenosis
I05.1 Rheumatic mitral insufficiency
I05.2 Rheumatic mitral stenosis with insufficiency
I05.8 Other rheumatic mitral valve diseases
I05.9 Rheumatic mitral valve disease, unspecified
I06.0 Rheumatic aortic stenosis
I06.1 Rheumatic aortic insufficiency
I06.2 Rheumatic aortic stenosis with insufficiency
I06.8 Other rheumatic aortic valve diseases
I06.9 Rheumatic aortic valve disease, unspecified
I07.0 Rheumatic tricuspid stenosis
Created on 10/07/2019. Page 11 of 73
ICD-10 CODE DESCRIPTION
I07.1 Rheumatic tricuspid insufficiency
I07.2 Rheumatic tricuspid stenosis and insufficiency
I07.8 Other rheumatic tricuspid valve diseases
I07.9 Rheumatic tricuspid valve disease, unspecified
I08.0 Rheumatic disorders of both mitral and aortic valves
I08.1 Rheumatic disorders of both mitral and tricuspid valves
I08.2 Rheumatic disorders of both aortic and tricuspid valves
I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I08.9 Rheumatic multiple valve disease, unspecified
I09.0 Rheumatic myocarditis
I09.1 Rheumatic diseases of endocardium, valve unspecified
I09.2 Chronic rheumatic pericarditis
I09.81 Rheumatic heart failure
I09.89 Other specified rheumatic heart diseases
I10 Essential (primary) hypertension
I11.0 Hypertensive heart disease with heart failure
I11.9 Hypertensive heart disease without heart failure
I13.0 Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.2 Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease
I15.0 Renovascular hypertension
I15.1 Hypertension secondary to other renal disorders
I16.0 Hypertensive urgency
I16.1 Hypertensive emergency
I16.9 Hypertensive crisis, unspecified
I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.8 Other forms of angina pectoris
I20.9 Angina pectoris, unspecified
I21.01 ST elevation (STEMI) myocardial infarction involving left main coronary artery
Created on 10/07/2019. Page 12 of 73
ICD-10 CODE DESCRIPTION
I21.02 ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery
I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.21 ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery
I21.29 ST elevation (STEMI) myocardial infarction involving other sites
I21.3 ST elevation (STEMI) myocardial infarction of unspecified site
I21.4 Non-ST elevation (NSTEMI) myocardial infarction
I21.9 Acute myocardial infarction, unspecified
I21.A1 Myocardial infarction type 2
I21.A9 Other myocardial infarction type
I22.0 Subsequent ST elevation (STEMI) myocardial infarction of anterior wall
I22.1 Subsequent ST elevation (STEMI) myocardial infarction of inferior wall
I22.2 Subsequent non-ST elevation (NSTEMI) myocardial infarction
I22.8 Subsequent ST elevation (STEMI) myocardial infarction of other sites
I22.9 Subsequent ST elevation (STEMI) myocardial infarction of unspecified site
I23.0 Hemopericardium as current complication following acute myocardial infarction
I23.1 Atrial septal defect as current complication following acute myocardial infarction
I23.2 Ventricular septal defect as current complication following acute myocardial infarction
I23.3 Rupture of cardiac wall without hemopericardium as current complication following acute myocardial infarction
I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction
I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction
I23.6 Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction
I23.7 Postinfarction angina
I23.8 Other current complications following acute myocardial infarction
I24.0 Acute coronary thrombosis not resulting in myocardial infarction
Created on 10/07/2019. Page 13 of 73
ICD-10 CODE DESCRIPTION
I24.1 Dressler's syndrome
I24.8 Other forms of acute ischemic heart disease
I24.9 Acute ischemic heart disease, unspecified
I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2 Old myocardial infarction
I25.3 Aneurysm of heart
I25.41 Coronary artery aneurysm
I25.42 Coronary artery dissection
I25.5 Ischemic cardiomyopathy
I25.6 Silent myocardial ischemia
I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
Created on 10/07/2019. Page 14 of 73
ICD-10 CODE DESCRIPTION
I25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
ICD-10 CODE DESCRIPTION
I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina I25.799
Created on 10/07/2019. Page 15 of 73
ICD-10 CODE DESCRIPTION
pectoris
I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82 Chronic total occlusion of coronary artery
I25.89 Other forms of chronic ischemic heart disease
I25.9 Chronic ischemic heart disease, unspecified
I26.01 Septic pulmonary embolism with acute cor pulmonale
I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale
I26.09 Other pulmonary embolism with acute cor pulmonale
I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale
I26.99 Other pulmonary embolism without acute cor pulmonale
I27.0 Primary pulmonary hypertension
I27.1 Kyphoscoliotic heart disease
I27.20 Pulmonary hypertension, unspecified
I27.21 Secondary pulmonary arterial hypertension
I27.22 Pulmonary hypertension due to left heart disease
I27.23 Pulmonary hypertension due to lung diseases and hypoxia
I27.24 Chronic thromboembolic pulmonary hypertension
I27.29 Other secondary pulmonary hypertension
I27.82 Chronic pulmonary embolism
I27.83 Eisenmenger's syndrome
I27.89 Other specified pulmonary heart diseases
I28.0 Arteriovenous fistula of pulmonary vessels
I28.1 Aneurysm of pulmonary artery
I30.0 Acute nonspecific idiopathic pericarditis
I30.1 Infective pericarditis
I30.8 Other forms of acute pericarditis
I30.9 Acute pericarditis, unspecified
I31.0 Chronic adhesive pericarditis
Created on 10/07/2019. Page 16 of 73
ICD-10 CODE DESCRIPTION
I31.1 Chronic constrictive pericarditis
I31.2 Hemopericardium, not elsewhere classified
I31.3 Pericardial effusion (noninflammatory)
I31.4 Cardiac tamponade
I31.8 Other specified diseases of pericardium
I31.9 Disease of pericardium, unspecified
I32 Pericarditis in diseases classified elsewhere
I33.0 Acute and subacute infective endocarditis
I33.9 Acute and subacute endocarditis, unspecified
I34.0 Nonrheumatic mitral (valve) insufficiency
I34.1 Nonrheumatic mitral (valve) prolapse
I34.2 Nonrheumatic mitral (valve) stenosis
I34.8 Other nonrheumatic mitral valve disorders
I34.9 Nonrheumatic mitral valve disorder, unspecified
I35.0 Nonrheumatic aortic (valve) stenosis
I35.1 Nonrheumatic aortic (valve) insufficiency
I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8 Other nonrheumatic aortic valve disorders
I35.9 Nonrheumatic aortic valve disorder, unspecified
I36.0 Nonrheumatic tricuspid (valve) stenosis
I36.1 Nonrheumatic tricuspid (valve) insufficiency
I36.2 Nonrheumatic tricuspid (valve) stenosis with insufficiency
I36.8 Other nonrheumatic tricuspid valve disorders
I36.9 Nonrheumatic tricuspid valve disorder, unspecified
I37.0 Nonrheumatic pulmonary valve stenosis
I37.1 Nonrheumatic pulmonary valve insufficiency
I37.2 Nonrheumatic pulmonary valve stenosis with insufficiency
I37.8 Other nonrheumatic pulmonary valve disorders
I37.9 Nonrheumatic pulmonary valve disorder, unspecified
I38 Endocarditis, valve unspecified
I39 Endocarditis and heart valve disorders in diseases classified elsewhere
I40.0 Infective myocarditis
Created on 10/07/2019. Page 17 of 73
ICD-10 CODE DESCRIPTION
I40.1 Isolated myocarditis
I40.8 Other acute myocarditis
I40.9 Acute myocarditis, unspecified
I41 Myocarditis in diseases classified elsewhere
I42.0 Dilated cardiomyopathy
I42.1 Obstructive hypertrophic cardiomyopathy
I42.2 Other hypertrophic cardiomyopathy
I42.3 Endomyocardial (eosinophilic) disease
I42.4 Endocardial fibroelastosis
I42.5 Other restrictive cardiomyopathy
I42.6 Alcoholic cardiomyopathy
I42.7 Cardiomyopathy due to drug and external agent
I42.8 Other cardiomyopathies
I42.9 Cardiomyopathy, unspecified
I43 Cardiomyopathy in diseases classified elsewhere
I44.1 Atrioventricular block, second degree
I44.2 Atrioventricular block, complete
I44.30 Unspecified atrioventricular block
I44.39 Other atrioventricular block
I44.7 Left bundle-branch block, unspecified
I45.2 Bifascicular block
I45.3 Trifascicular block
I45.4 Nonspecific intraventricular block
I45.5 Other specified heart block
I45.6 Pre-excitation syndrome
I45.9 Conduction disorder, unspecified
I46.2 Cardiac arrest due to underlying cardiac condition
I46.8 Cardiac arrest due to other underlying condition
I46.9 Cardiac arrest, cause unspecified
ICD-10 CODE DESCRIPTION
I47.0 Re-entry ventricular arrhythmia
I47.1 Supraventricular tachycardia
Created on 10/07/2019. Page 18 of 73
ICD-10 CODE DESCRIPTION
I47.2 Ventricular tachycardia
I47.9 Paroxysmal tachycardia, unspecified
I48.0 Paroxysmal atrial fibrillation
I48.11 Longstanding persistent atrial fibrillation
I48.19 Other persistent atrial fibrillation
I48.20 Chronic atrial fibrillation, unspecified
I48.21 Permanent atrial fibrillation
I48.3 Typical atrial flutter
I48.4 Atypical atrial flutter
I48.91 Unspecified atrial fibrillation
I48.92 Unspecified atrial flutter
I49.01 Ventricular fibrillation
I49.02 Ventricular flutter
I49.1 Atrial premature depolarization
I49.2 Junctional premature depolarization
I49.3 Ventricular premature depolarization
I49.40 Unspecified premature depolarization
I49.49 Other premature depolarization
I49.8 Other specified cardiac arrhythmias
I50.1 Left ventricular failure, unspecified
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
Acute on chronic combined systolic (congestive) and diastolic (congestive) heart I50.43
Created on 10/07/2019. Page 19 of 73
ICD-10 CODE DESCRIPTION
failure
I50.810 Right heart failure, unspecified
I50.811 Acute right heart failure
I50.812 Chronic right heart failure
I50.813 Acute on chronic right heart failure
I50.814 Right heart failure due to left heart failure
I50.82 Biventricular heart failure
I50.83 High output heart failure
I50.84 End stage heart failure
I50.89 Other heart failure
I50.9 Heart failure, unspecified
I51.0 Cardiac septal defect, acquired
I51.1 Rupture of chordae tendineae, not elsewhere classified
I51.2 Rupture of papillary muscle, not elsewhere classified
I51.3 Intracardiac thrombosis, not elsewhere classified
I51.4 Myocarditis, unspecified
I51.5 Myocardial degeneration
I51.7 Cardiomegaly
I51.81 Takotsubo syndrome
I51.89 Other ill-defined heart diseases
I51.9 Heart disease, unspecified
I52 Other heart disorders in diseases classified elsewhere
I60.00 Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation
I60.01 Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation
I60.02 Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation
I60.10 Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery
I60.11 Nontraumatic subarachnoid hemorrhage from right middle cerebral artery
I60.12 Nontraumatic subarachnoid hemorrhage from left middle cerebral artery
I60.2 Nontraumatic subarachnoid hemorrhage from anterior communicating artery
I60.30 Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery
Created on 10/07/2019. Page 20 of 73
ICD-10 CODE DESCRIPTION
I60.31 Nontraumatic subarachnoid hemorrhage from right posterior communicating artery
I60.32 Nontraumatic subarachnoid hemorrhage from left posterior communicating artery
I60.4 Nontraumatic subarachnoid hemorrhage from basilar artery
I60.50 Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery
I60.51 Nontraumatic subarachnoid hemorrhage from right vertebral artery
I60.52 Nontraumatic subarachnoid hemorrhage from left vertebral artery
I60.6 Nontraumatic subarachnoid hemorrhage from other intracranial arteries
I60.7 Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery
I60.8 Other nontraumatic subarachnoid hemorrhage
I60.9 Nontraumatic subarachnoid hemorrhage, unspecified
I63.013 Cerebral infarction due to thrombosis of bilateral vertebral arteries
I63.113 Cerebral infarction due to embolism of bilateral vertebral arteries
I63.133 Cerebral infarction due to embolism of bilateral carotid arteries
I63.213 Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries
I63.233 Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid arteries
I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery
I63.311 Cerebral infarction due to thrombosis of right middle cerebral artery
I63.312 Cerebral infarction due to thrombosis of left middle cerebral artery
I63.313 Cerebral infarction due to thrombosis of bilateral middle cerebral arteries
I63.319 Cerebral infarction due to thrombosis of unspecified middle cerebral artery
I63.321 Cerebral infarction due to thrombosis of right anterior cerebral artery
I63.322 Cerebral infarction due to thrombosis of left anterior cerebral artery
I63.323 Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries
I63.329 Cerebral infarction due to thrombosis of unspecified anterior cerebral artery
I63.331 Cerebral infarction due to thrombosis of right posterior cerebral artery
I63.332 Cerebral infarction due to thrombosis of left posterior cerebral artery
I63.333 Cerebral infarction due to thrombosis of bilateral posterior cerebral arteries
I63.339 Cerebral infarction due to thrombosis of unspecified posterior cerebral artery
I63.341 Cerebral infarction due to thrombosis of right cerebellar artery
I63.342 Cerebral infarction due to thrombosis of left cerebellar artery
Created on 10/07/2019. Page 21 of 73
ICD-10 CODE DESCRIPTION
I63.343 Cerebral infarction due to thrombosis of bilateral cerebellar arteries
I63.349 Cerebral infarction due to thrombosis of unspecified cerebellar artery
I63.39 Cerebral infarction due to thrombosis of other cerebral artery
I63.40 Cerebral infarction due to embolism of unspecified cerebral artery
I63.411 Cerebral infarction due to embolism of right middle cerebral artery
I63.412 Cerebral infarction due to embolism of left middle cerebral artery
I63.413 Cerebral infarction due to embolism of bilateral middle cerebral arteries
ICD-10 CODE DESCRIPTION
I63.419 Cerebral infarction due to embolism of unspecified middle cerebral artery
I63.421 Cerebral infarction due to embolism of right anterior cerebral artery
I63.422 Cerebral infarction due to embolism of left anterior cerebral artery
I63.423 Cerebral infarction due to embolism of bilateral anterior cerebral arteries
I63.429 Cerebral infarction due to embolism of unspecified anterior cerebral artery
I63.431 Cerebral infarction due to embolism of right posterior cerebral artery
I63.432 Cerebral infarction due to embolism of left posterior cerebral artery
I63.433 Cerebral infarction due to embolism of bilateral posterior cerebral arteries
I63.439 Cerebral infarction due to embolism of unspecified posterior cerebral artery
I63.441 Cerebral infarction due to embolism of right cerebellar artery
I63.442 Cerebral infarction due to embolism of left cerebellar artery
I63.443 Cerebral infarction due to embolism of bilateral cerebellar arteries
I63.449 Cerebral infarction due to embolism of unspecified cerebellar artery
I63.49 Cerebral infarction due to embolism of other cerebral artery
I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery
I63.511 Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery
I63.512 Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery
I63.513 Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries
I63.519 Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery
Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral I63.521
Created on 10/07/2019. Page 22 of 73
ICD-10 CODE DESCRIPTION
artery
I63.522 Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery
I63.523 Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries
I63.529 Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery
I63.531 Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery
I63.532 Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery
I63.533 Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries
I63.539 Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery
I63.541 Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery
I63.542 Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery
I63.543 Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar arteries
I63.549 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery
I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery
I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic
I63.81 Other cerebral infarction due to occlusion or stenosis of small artery
I63.89 Other cerebral infarction
I63.9 Cerebral infarction, unspecified
I66.01 Occlusion and stenosis of right middle cerebral artery
I66.02 Occlusion and stenosis of left middle cerebral artery
I66.03 Occlusion and stenosis of bilateral middle cerebral arteries
I66.09 Occlusion and stenosis of unspecified middle cerebral artery
I66.11 Occlusion and stenosis of right anterior cerebral artery
I66.12 Occlusion and stenosis of left anterior cerebral artery
I66.13 Occlusion and stenosis of bilateral anterior cerebral arteries
I66.19 Occlusion and stenosis of unspecified anterior cerebral artery
Created on 10/07/2019. Page 23 of 73
ICD-10 CODE DESCRIPTION
I66.21 Occlusion and stenosis of right posterior cerebral artery
I66.22 Occlusion and stenosis of left posterior cerebral artery
I66.23 Occlusion and stenosis of bilateral posterior cerebral arteries
I66.29 Occlusion and stenosis of unspecified posterior cerebral artery
I66.3 Occlusion and stenosis of cerebellar arteries
I66.8 Occlusion and stenosis of other cerebral arteries
I66.9 Occlusion and stenosis of unspecified cerebral artery
I67.841 Reversible cerebrovascular vasoconstriction syndrome
I67.848 Other cerebrovascular vasospasm and vasoconstriction
I67.89 Other cerebrovascular disease
I70.0 Atherosclerosis of aorta
I71.00 Dissection of unspecified site of aorta
I71.01 Dissection of thoracic aorta
I71.02 Dissection of abdominal aorta
I71.03 Dissection of thoracoabdominal aorta
I71.1 Thoracic aortic aneurysm, ruptured
I71.2 Thoracic aortic aneurysm, without rupture
I71.3 Abdominal aortic aneurysm, ruptured
I71.4 Abdominal aortic aneurysm, without rupture
I71.5 Thoracoabdominal aortic aneurysm, ruptured
I71.6 Thoracoabdominal aortic aneurysm, without rupture
I71.8 Aortic aneurysm of unspecified site, ruptured
I71.9 Aortic aneurysm of unspecified site, without rupture
I74.11 Embolism and thrombosis of thoracic aorta
I74.2 Embolism and thrombosis of arteries of the upper extremities
I74.3 Embolism and thrombosis of arteries of the lower extremities
I74.4 Embolism and thrombosis of arteries of extremities, unspecified
I74.5 Embolism and thrombosis of iliac artery
I74.8 Embolism and thrombosis of other arteries
I74.9 Embolism and thrombosis of unspecified artery
I76 Septic arterial embolism
I77.810 Thoracic aortic ectasia
Created on 10/07/2019. Page 24 of 73
ICD-10 CODE DESCRIPTION
I79.0 Aneurysm of aorta in diseases classified elsewhere
I95.1 Orthostatic hypotension
I95.2 Hypotension due to drugs
I95.81 Postprocedural hypotension
I95.89 Other hypotension
I95.9 Hypotension, unspecified
I97.0 Postcardiotomy syndrome
I97.110 Postprocedural cardiac insufficiency following cardiac surgery
I97.111 Postprocedural cardiac insufficiency following other surgery
I97.120 Postprocedural cardiac arrest following cardiac surgery
I97.121 Postprocedural cardiac arrest following other surgery
I97.130 Postprocedural heart failure following cardiac surgery
I97.131 Postprocedural heart failure following other surgery
I97.190 Other postprocedural cardiac functional disturbances following cardiac surgery
I97.191 Other postprocedural cardiac functional disturbances following other surgery
I97.710 Intraoperative cardiac arrest during cardiac surgery
I97.711 Intraoperative cardiac arrest during other surgery
I97.790 Other intraoperative cardiac functional disturbances during cardiac surgery
I97.791 Other intraoperative cardiac functional disturbances during other surgery
I97.88 Other intraoperative complications of the circulatory system, not elsewhere classified
I97.89 Other postprocedural complications and disorders of the circulatory system, not elsewhere classified
J80 Acute respiratory distress syndrome
J81.0 Acute pulmonary edema
J95.1 Acute pulmonary insufficiency following thoracic surgery
ICD-10 CODE DESCRIPTION
J95.2 Acute pulmonary insufficiency following nonthoracic surgery
J95.3 Chronic pulmonary insufficiency following surgery
J95.821 Acute postprocedural respiratory failure
J95.822 Acute and chronic postprocedural respiratory failure
J95.84 Transfusion-related acute lung injury (TRALI)
Created on 10/07/2019. Page 25 of 73
ICD-10 CODE DESCRIPTION
J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.01 Acute respiratory failure with hypoxia
J96.02 Acute respiratory failure with hypercapnia
J96.20 Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
J96.21 Acute and chronic respiratory failure with hypoxia
J96.22 Acute and chronic respiratory failure with hypercapnia
K68.11 Postprocedural retroperitoneal abscess
M30.3 Mucocutaneous lymph node syndrome [Kawasaki]
M31.4 Aortic arch syndrome [Takayasu]
M32.0 Drug-induced systemic lupus erythematosus
M32.10 Systemic lupus erythematosus, organ or system involvement unspecified
M32.11 Endocarditis in systemic lupus erythematosus
M32.12 Pericarditis in systemic lupus erythematosus
M32.13 Lung involvement in systemic lupus erythematosus
M32.14 Glomerular disease in systemic lupus erythematosus
M32.15 Tubulo-interstitial nephropathy in systemic lupus erythematosus
M32.19 Other organ or system involvement in systemic lupus erythematosus
M32.8 Other forms of systemic lupus erythematosus
M32.9 Systemic lupus erythematosus, unspecified
N26.2 Page kidney
N98.0 Infection associated with artificial insemination
O90.3 Peripartum cardiomyopathy
O90.89 Other complications of the puerperium, not elsewhere classified
Q20.0 Common arterial trunk
Q20.2 Double outlet left ventricle
Q20.3 Discordant ventriculoarterial connection
Q20.5 Discordant atrioventricular connection
Q20.8 Other congenital malformations of cardiac chambers and connections
Q21.0 Ventricular septal defect
Q21.1 Atrial septal defect
Q21.2 Atrioventricular septal defect
Created on 10/07/2019. Page 26 of 73
ICD-10 CODE DESCRIPTION
Q21.3 Tetralogy of Fallot
Q21.9 Congenital malformation of cardiac septum, unspecified
Q22.1 Congenital pulmonary valve stenosis
Q22.2 Congenital pulmonary valve insufficiency
Q22.3 Other congenital malformations of pulmonary valve
Q22.4 Congenital tricuspid stenosis
Q22.5 Ebstein's anomaly
Q22.6 Hypoplastic right heart syndrome
Q22.8 Other congenital malformations of tricuspid valve
Q22.9 Congenital malformation of tricuspid valve, unspecified
Q23.0 Congenital stenosis of aortic valve
Q23.1 Congenital insufficiency of aortic valve
Q23.2 Congenital mitral stenosis
Q23.3 Congenital mitral insufficiency
Q23.8 Other congenital malformations of aortic and mitral valves
Q23.9 Congenital malformation of aortic and mitral valves, unspecified
Q24.0 Dextrocardia
Q24.1 Levocardia
Q24.2 Cor triatriatum
Q24.3 Pulmonary infundibular stenosis
Q24.4 Congenital subaortic stenosis
Q24.5 Malformation of coronary vessels
Q24.6 Congenital heart block
Q24.8 Other specified congenital malformations of heart
Q25.0 Patent ductus arteriosus
Q25.1 Coarctation of aorta
Q25.21 Interruption of aortic arch
Q25.29 Other atresia of aorta
Q25.3 Supravalvular aortic stenosis
Q25.40 - Q25.49 Congenital malformation of aorta unspecified - Other congenital malformations of aorta
Q25.5 Atresia of pulmonary artery
Created on 10/07/2019. Page 27 of 73
ICD-10 CODE DESCRIPTION
Q25.6 Stenosis of pulmonary artery
Q25.71 Coarctation of pulmonary artery
Q25.72 Congenital pulmonary arteriovenous malformation
Q25.79 Other congenital malformations of pulmonary artery
Q25.8 Other congenital malformations of other great arteries
Q25.9 Congenital malformation of great arteries, unspecified
Q26.0 Congenital stenosis of vena cava
Q26.1 Persistent left superior vena cava
Q26.2 Total anomalous pulmonary venous connection
Q26.3 Partial anomalous pulmonary venous connection
Q26.4 Anomalous pulmonary venous connection, unspecified
Q26.8 Other congenital malformations of great veins
Q26.9 Congenital malformation of great vein, unspecified
Q27.9 Congenital malformation of peripheral vascular system, unspecified
Q28.2 Arteriovenous malformation of cerebral vessels
Q28.3 Other malformations of cerebral vessels
Q28.9 Congenital malformation of circulatory system, unspecified
Q33.2 Sequestration of lung
Q33.3 Agenesis of lung
Q33.6 Congenital hypoplasia and dysplasia of lung
Q40.1 Congenital hiatus hernia
Q67.6 Pectus excavatum
Q67.7 Pectus carinatum
Q87.40 Marfan's syndrome, unspecified
Q87.410 Marfan's syndrome with aortic dilation
Q87.418 Marfan's syndrome with other cardiovascular manifestations
Q87.42 Marfan's syndrome with ocular manifestations
Q87.43 Marfan's syndrome with skeletal manifestation
Q89.01 Asplenia (congenital)
Q89.09 Congenital malformations of spleen
Q89.3 Situs inversus
Q89.9 Congenital malformation, unspecified
Created on 10/07/2019. Page 28 of 73
ICD-10 CODE DESCRIPTION
Q90.0 Trisomy 21, nonmosaicism (meiotic nondisjunction)
ICD-10 CODE DESCRIPTION
Q90.1 Trisomy 21, mosaicism (mitotic nondisjunction)
Q90.2 Trisomy 21, translocation
Q90.9 Down syndrome, unspecified
Q96.0 Karyotype 45, X
Q96.1 Karyotype 46, X iso (Xq)
Q96.2 Karyotype 46, X with abnormal sex chromosome, except iso (Xq)
Q96.3 Mosaicism, 45, X/46, XX or XY
Q96.4 Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 Other variants of Turner's syndrome
Q96.9 Turner's syndrome, unspecified
R00.0 Tachycardia, unspecified
R00.2 Palpitations
R00.8 Other abnormalities of heart beat
R00.9 Unspecified abnormalities of heart beat
R01.0 Benign and innocent cardiac murmurs
R01.1 Cardiac murmur, unspecified
R01.2 Other cardiac sounds
R06.00 Dyspnea, unspecified
R06.02 Shortness of breath
R06.03 Acute respiratory distress
R06.09 Other forms of dyspnea
R06.2 Wheezing
R06.3 Periodic breathing
R06.81 Apnea, not elsewhere classified
R06.82 Tachypnea, not elsewhere classified
R06.83 Snoring
R06.89 Other abnormalities of breathing
R07.2 Precordial pain
R07.82 Intercostal pain
R07.89 Other chest pain
Created on 10/07/2019. Page 29 of 73
ICD-10 CODE DESCRIPTION
R07.9 Chest pain, unspecified
R09.2 Respiratory arrest
R22.2 Localized swelling, mass and lump, trunk
R23.0 Cyanosis
R40.20 Unspecified coma
R40.2110 Coma scale, eyes open, never, unspecified time
R40.2111 Coma scale, eyes open, never, in the field [EMT or ambulance]
R40.2112 Coma scale, eyes open, never, at arrival to emergency department
R40.2113 Coma scale, eyes open, never, at hospital admission
R40.2114 Coma scale, eyes open, never, 24 hours or more after hospital admission
R40.2120 Coma scale, eyes open, to pain, unspecified time
R40.2121 Coma scale, eyes open, to pain, in the field [EMT or ambulance]
R40.2122 Coma scale, eyes open, to pain, at arrival to emergency department
R40.2123 Coma scale, eyes open, to pain, at hospital admission
R40.2124 Coma scale, eyes open, to pain, 24 hours or more after hospital admission
R40.2210 Coma scale, best verbal response, none, unspecified time
R40.2211 Coma scale, best verbal response, none, in the field [EMT or ambulance]
R40.2212 Coma scale, best verbal response, none, at arrival to emergency department
R40.2213 Coma scale, best verbal response, none, at hospital admission
R40.2214 Coma scale, best verbal response, none, 24 hours or more after hospital admission
R40.2220 Coma scale, best verbal response, incomprehensible words, unspecified time
R40.2221 Coma scale, best verbal response, incomprehensible words, in the field [EMT or ambulance]
R40.2222 Coma scale, best verbal response, incomprehensible words, at arrival to emergency department
R40.2223 Coma scale, best verbal response, incomprehensible words, at hospital admission
R40.2224 Coma scale, best verbal response, incomprehensible words, 24 hours or more after hospital admission
R40.2310 Coma scale, best motor response, none, unspecified time
R40.2311 Coma scale, best motor response, none, in the field [EMT or ambulance]
R40.2312 Coma scale, best motor response, none, at arrival to emergency department
R40.2313 Coma scale, best motor response, none, at hospital admission
R40.2314 Coma scale, best motor response, none, 24 hours or more after hospital admission
Created on 10/07/2019. Page 30 of 73
ICD-10 CODE DESCRIPTION
R40.2320 Coma scale, best motor response, extension, unspecified time
R40.2321 Coma scale, best motor response, extension, in the field [EMT or ambulance]
R40.2322 Coma scale, best motor response, extension, at arrival to emergency department
R40.2323 Coma scale, best motor response, extension, at hospital admission
R40.2324 Coma scale, best motor response, extension, 24 hours or more after hospital admission
R40.2340 Coma scale, best motor response, flexion withdrawal, unspecified time
R40.2341 Coma scale, best motor response, flexion withdrawal, in the field [EMT or ambulance]
R40.2342 Coma scale, best motor response, flexion withdrawal, at arrival to emergency department
R40.2343 Coma scale, best motor response, flexion withdrawal, at hospital admission
R40.2344 Coma scale, best motor response, flexion withdrawal, 24 hours or more after hospital admission
R40.4 Transient alteration of awareness
R47.01 Aphasia
R50.2 Drug induced fever
R50.81 Fever presenting with conditions classified elsewhere
R50.82 Postprocedural fever
R50.9 Fever, unspecified
R55 Syncope and collapse
R57.0 Cardiogenic shock
R57.1 Hypovolemic shock
R57.8 Other shock
R57.9 Shock, unspecified
R60.0 Localized edema
R60.1 Generalized edema
R60.9 Edema, unspecified
R65.21 Severe sepsis with septic shock
R68.89 Other general symptoms and signs
R78.81 Bacteremia
R94.31 Abnormal electrocardiogram [ECG] [EKG]
S22.5XXA Flail chest, initial encounter for closed fracture
Created on 10/07/2019. Page 31 of 73
ICD-10 CODE DESCRIPTION
S22.5XXB Flail chest, initial encounter for open fracture
S22.5XXG Flail chest, subsequent encounter for fracture with delayed healing
S22.5XXK Flail chest, subsequent encounter for fracture with nonunion
S22.5XXS Flail chest, sequela
S25.00XA Unspecified injury of thoracic aorta, initial encounter
S25.00XD Unspecified injury of thoracic aorta, subsequent encounter
S25.00XS Unspecified injury of thoracic aorta, sequela
S25.01XA Minor laceration of thoracic aorta, initial encounter
S25.01XD Minor laceration of thoracic aorta, subsequent encounter
S25.01XS Minor laceration of thoracic aorta, sequela
S25.02XA Major laceration of thoracic aorta, initial encounter
ICD-10 CODE DESCRIPTION
S25.02XD Major laceration of thoracic aorta, subsequent encounter
S25.02XS Major laceration of thoracic aorta, sequela
S25.09XA Other specified injury of thoracic aorta, initial encounter
S25.09XD Other specified injury of thoracic aorta, subsequent encounter
S25.09XS Other specified injury of thoracic aorta, sequela
S25.20XA Unspecified injury of superior vena cava, initial encounter
S25.20XD Unspecified injury of superior vena cava, subsequent encounter
S25.20XS Unspecified injury of superior vena cava, sequela
S25.21XA Minor laceration of superior vena cava, initial encounter
S25.21XD Minor laceration of superior vena cava, subsequent encounter
S25.21XS Minor laceration of superior vena cava, sequela
S25.22XA Major laceration of superior vena cava, initial encounter
S25.22XD Major laceration of superior vena cava, subsequent encounter
S25.22XS Major laceration of superior vena cava, sequela
S25.29XA Other specified injury of superior vena cava, initial encounter
S25.29XD Other specified injury of superior vena cava, subsequent encounter
S25.29XS Other specified injury of superior vena cava, sequela
S25.401A Unspecified injury of right pulmonary blood vessels, initial encounter
S25.401D Unspecified injury of right pulmonary blood vessels, subsequent encounter
S25.401S Unspecified injury of right pulmonary blood vessels, sequela
Created on 10/07/2019. Page 32 of 73
ICD-10 CODE DESCRIPTION
S25.402A Unspecified injury of left pulmonary blood vessels, initial encounter
S25.402D Unspecified injury of left pulmonary blood vessels, subsequent encounter
S25.402S Unspecified injury of left pulmonary blood vessels, sequela
S25.409A Unspecified injury of unspecified pulmonary blood vessels, initial encounter
S25.409D Unspecified injury of unspecified pulmonary blood vessels, subsequent encounter
S25.409S Unspecified injury of unspecified pulmonary blood vessels, sequela
S25.411A Minor laceration of right pulmonary blood vessels, initial encounter
S25.411D Minor laceration of right pulmonary blood vessels, subsequent encounter
S25.411S Minor laceration of right pulmonary blood vessels, sequela
S25.412A Minor laceration of left pulmonary blood vessels, initial encounter
S25.412D Minor laceration of left pulmonary blood vessels, subsequent encounter
S25.412S Minor laceration of left pulmonary blood vessels, sequela
S25.419A Minor laceration of unspecified pulmonary blood vessels, initial encounter
S25.419D Minor laceration of unspecified pulmonary blood vessels, subsequent encounter
S25.419S Minor laceration of unspecified pulmonary blood vessels, sequela
S25.421A Major laceration of right pulmonary blood vessels, initial encounter
S25.421D Major laceration of right pulmonary blood vessels, subsequent encounter
S25.421S Major laceration of right pulmonary blood vessels, sequela
S25.422A Major laceration of left pulmonary blood vessels, initial encounter
S25.422D Major laceration of left pulmonary blood vessels, subsequent encounter
S25.422S Major laceration of left pulmonary blood vessels, sequela
S25.429A Major laceration of unspecified pulmonary blood vessels, initial encounter
S25.429D Major laceration of unspecified pulmonary blood vessels, subsequent encounter
S25.429S Major laceration of unspecified pulmonary blood vessels, sequela
S25.491A Other specified injury of right pulmonary blood vessels, initial encounter
S25.491D Other specified injury of right pulmonary blood vessels, subsequent encounter
S25.491S Other specified injury of right pulmonary blood vessels, sequela
S25.492A Other specified injury of left pulmonary blood vessels, initial encounter
S25.492D Other specified injury of left pulmonary blood vessels, subsequent encounter
S25.492S Other specified injury of left pulmonary blood vessels, sequela
S25.499A Other specified injury of unspecified pulmonary blood vessels, initial encounter
S25.499D Other specified injury of unspecified pulmonary blood vessels, subsequent encounter
Created on 10/07/2019. Page 33 of 73
ICD-10 CODE DESCRIPTION
S25.499S Other specified injury of unspecified pulmonary blood vessels, sequela
S26.00XA Unspecified injury of heart with hemopericardium, initial encounter
S26.00XD Unspecified injury of heart with hemopericardium, subsequent encounter
S26.00XS Unspecified injury of heart with hemopericardium, sequela
S26.01XA Contusion of heart with hemopericardium, initial encounter
S26.01XD Contusion of heart with hemopericardium, subsequent encounter
S26.01XS Contusion of heart with hemopericardium, sequela
S26.020A Mild laceration of heart with hemopericardium, initial encounter
S26.020D Mild laceration of heart with hemopericardium, subsequent encounter
S26.020S Mild laceration of heart with hemopericardium, sequela
S26.021A Moderate laceration of heart with hemopericardium, initial encounter
S26.021D Moderate laceration of heart with hemopericardium, subsequent encounter
S26.021S Moderate laceration of heart with hemopericardium, sequela
S26.022A Major laceration of heart with hemopericardium, initial encounter
S26.022D Major laceration of heart with hemopericardium, subsequent encounter
S26.022S Major laceration of heart with hemopericardium, sequela
S26.09XA Other injury of heart with hemopericardium, initial encounter
S26.09XD Other injury of heart with hemopericardium, subsequent encounter
S26.09XS Other injury of heart with hemopericardium, sequela
S26.10XA Unspecified injury of heart without hemopericardium, initial encounter
S26.10XD Unspecified injury of heart without hemopericardium, subsequent encounter
S26.10XS Unspecified injury of heart without hemopericardium, sequela
S26.11XA Contusion of heart without hemopericardium, initial encounter
S26.11XD Contusion of heart without hemopericardium, subsequent encounter
S26.11XS Contusion of heart without hemopericardium, sequela
S26.12XA Laceration of heart without hemopericardium, initial encounter
S26.12XD Laceration of heart without hemopericardium, subsequent encounter
S26.12XS Laceration of heart without hemopericardium, sequela
S26.19XA Other injury of heart without hemopericardium, initial encounter
S26.19XD Other injury of heart without hemopericardium, subsequent encounter
S26.19XS Other injury of heart without hemopericardium, sequela
Unspecified injury of heart, unspecified with or without hemopericardium, initial S26.90XA
Created on 10/07/2019. Page 34 of 73
ICD-10 CODE DESCRIPTION
encounter
S26.90XD Unspecified injury of heart, unspecified with or without hemopericardium, subsequent encounter
S26.90XS Unspecified injury of heart, unspecified with or without hemopericardium, sequela
S26.91XA Contusion of heart, unspecified with or without hemopericardium, initial encounter
S26.91XD Contusion of heart, unspecified with or without hemopericardium, subsequent encounter
S26.91XS Contusion of heart, unspecified with or without hemopericardium, sequela
S26.92XA Laceration of heart, unspecified with or without hemopericardium, initial encounter
S26.92XD Laceration of heart, unspecified with or without hemopericardium, subsequent encounter
S26.92XS Laceration of heart, unspecified with or without hemopericardium, sequela
S26.99XA Other injury of heart, unspecified with or without hemopericardium, initial encounter
S26.99XD Other injury of heart, unspecified with or without hemopericardium, subsequent encounter
S26.99XS Other injury of heart, unspecified with or without hemopericardium, sequela
S29.001A Unspecified injury of muscle and tendon of front wall of thorax, initial encounter
S29.001D Unspecified injury of muscle and tendon of front wall of thorax, subsequent encounter
S29.001S Unspecified injury of muscle and tendon of front wall of thorax, sequela
S29.002A Unspecified injury of muscle and tendon of back wall of thorax, initial encounter
S29.002D Unspecified injury of muscle and tendon of back wall of thorax, subsequent encounter
ICD-10 CODE DESCRIPTION
S29.002S Unspecified injury of muscle and tendon of back wall of thorax, sequela
S29.009A Unspecified injury of muscle and tendon of unspecified wall of thorax, initial encounter
S29.009D Unspecified injury of muscle and tendon of unspecified wall of thorax, subsequent encounter
S29.009S Unspecified injury of muscle and tendon of unspecified wall of thorax, sequela
S29.091A Other injury of muscle and tendon of front wall of thorax, initial encounter
S29.091D Other injury of muscle and tendon of front wall of thorax, subsequent encounter
S29.091S Other injury of muscle and tendon of front wall of thorax, sequela
S29.092A Other injury of muscle and tendon of back wall of thorax, initial encounter
Created on 10/07/2019. Page 35 of 73
ICD-10 CODE DESCRIPTION
S29.092D Other injury of muscle and tendon of back wall of thorax, subsequent encounter
S29.092S Other injury of muscle and tendon of back wall of thorax, sequela
S29.099A Other injury of muscle and tendon of unspecified wall of thorax, initial encounter
S29.099D Other injury of muscle and tendon of unspecified wall of thorax, subsequent encounter
S29.099S Other injury of muscle and tendon of unspecified wall of thorax, sequela
S29.8XXA Other specified injuries of thorax, initial encounter
S29.8XXD Other specified injuries of thorax, subsequent encounter
S29.8XXS Other specified injuries of thorax, sequela
S29.9XXA Unspecified injury of thorax, initial encounter
S29.9XXD Unspecified injury of thorax, subsequent encounter
S29.9XXS Unspecified injury of thorax, sequela
T41.0X5A Adverse effect of inhaled anesthetics, initial encounter
T41.0X5D Adverse effect of inhaled anesthetics, subsequent encounter
T41.0X5S Adverse effect of inhaled anesthetics, sequela
T41.1X5A Adverse effect of intravenous anesthetics, initial encounter
T41.1X5D Adverse effect of intravenous anesthetics, subsequent encounter
T41.1X5S Adverse effect of intravenous anesthetics, sequela
T41.205A Adverse effect of unspecified general anesthetics, initial encounter
T41.205D Adverse effect of unspecified general anesthetics, subsequent encounter
T41.205S Adverse effect of unspecified general anesthetics, sequela
T41.295A Adverse effect of other general anesthetics, initial encounter
T41.295D Adverse effect of other general anesthetics, subsequent encounter
T41.295S Adverse effect of other general anesthetics, sequela
T41.3X5A Adverse effect of local anesthetics, initial encounter
T41.3X5D Adverse effect of local anesthetics, subsequent encounter
T41.3X5S Adverse effect of local anesthetics, sequela
T41.45XA Adverse effect of unspecified anesthetic, initial encounter
T41.45XD Adverse effect of unspecified anesthetic, subsequent encounter
T41.45XS Adverse effect of unspecified anesthetic, sequela
T45.1X1A Poisoning by antineoplastic and immunosuppressive drugs, accidental (unintentional), initial encounter
Created on 10/07/2019. Page 36 of 73
ICD-10 CODE DESCRIPTION
T45.1X1D Poisoning by antineoplastic and immunosuppressive drugs, accidental (unintentional), subsequent encounter
T45.1X1S Poisoning by antineoplastic and immunosuppressive drugs, accidental (unintentional), sequela
T45.1X4A Poisoning by antineoplastic and immunosuppressive drugs, undetermined, initial encounter
T45.1X4D Poisoning by antineoplastic and immunosuppressive drugs, undetermined, subsequent encounter
T45.1X4S Poisoning by antineoplastic and immunosuppressive drugs, undetermined, sequela
T45.1X5A Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter
T45.1X5D Adverse effect of antineoplastic and immunosuppressive drugs, subsequent encounter
T45.1X5S Adverse effect of antineoplastic and immunosuppressive drugs, sequela
T46.904A Poisoning by unspecified agents primarily affecting the cardiovascular system, undetermined, initial encounter
T46.904D Poisoning by unspecified agents primarily affecting the cardiovascular system, undetermined, subsequent encounter
T46.904S Poisoning by unspecified agents primarily affecting the cardiovascular system, undetermined, sequela
T50.905A Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter
T50.905D Adverse effect of unspecified drugs, medicaments and biological substances, subsequent encounter
T50.905S Adverse effect of unspecified drugs, medicaments and biological substances, sequela
T51.3X1A Toxic effect of fusel oil, accidental (unintentional), initial encounter
T51.3X1D Toxic effect of fusel oil, accidental (unintentional), subsequent encounter
T51.3X1S Toxic effect of fusel oil, accidental (unintentional), sequela
T51.3X2A Toxic effect of fusel oil, intentional self-harm, initial encounter
T51.3X2D Toxic effect of fusel oil, intentional self-harm, subsequent encounter
T51.3X2S Toxic effect of fusel oil, intentional self-harm, sequela
T51.3X3A Toxic effect of fusel oil, assault, initial encounter
T51.3X3D Toxic effect of fusel oil, assault, subsequent encounter
T51.3X3S Toxic effect of fusel oil, assault, sequela
T51.3X4A Toxic effect of fusel oil, undetermined, initial encounter
Created on 10/07/2019. Page 37 of 73
ICD-10 CODE DESCRIPTION
T51.3X4D Toxic effect of fusel oil, undetermined, subsequent encounter
T51.3X4S Toxic effect of fusel oil, undetermined, sequela
T58.94XA Toxic effect of carbon monoxide from unspecified source, undetermined, initial encounter
T58.94XD Toxic effect of carbon monoxide from unspecified source, undetermined, subsequent encounter
T58.94XS Toxic effect of carbon monoxide from unspecified source, undetermined, sequela
T66.XXXA Radiation sickness, unspecified, initial encounter
T66.XXXD Radiation sickness, unspecified, subsequent encounter
T66.XXXS Radiation sickness, unspecified, sequela
T75.00XA Unspecified effects of lightning, initial encounter
T75.00XD Unspecified effects of lightning, subsequent encounter
T75.00XS Unspecified effects of lightning, sequela
T75.01XA Shock due to being struck by lightning, initial encounter
T75.01XD Shock due to being struck by lightning, subsequent encounter
T75.01XS Shock due to being struck by lightning, sequela
T75.09XA Other effects of lightning, initial encounter
T75.09XD Other effects of lightning, subsequent encounter
T75.09XS Other effects of lightning, sequela
T75.4XXA Electrocution, initial encounter
T75.4XXD Electrocution, subsequent encounter
T75.4XXS Electrocution, sequela
T79.0XXA Air embolism (traumatic), initial encounter
T79.0XXD Air embolism (traumatic), subsequent encounter
T79.0XXS Air embolism (traumatic), sequela
T79.1XXA Fat embolism (traumatic), initial encounter
T79.1XXD Fat embolism (traumatic), subsequent encounter
T79.1XXS Fat embolism (traumatic), sequela
T79.4XXA Traumatic shock, initial encounter
T79.4XXD Traumatic shock, subsequent encounter
T79.4XXS Traumatic shock, sequela
T80.0XXA Air embolism following infusion, transfusion and therapeutic injection, initial encounter
Created on 10/07/2019. Page 38 of 73
ICD-10 CODE DESCRIPTION
T80.0XXD Air embolism following infusion, transfusion and therapeutic injection, subsequent encounter
T80.0XXS Air embolism following infusion, transfusion and therapeutic injection, sequela
T80.211A Bloodstream infection due to central venous catheter, initial encounter
T80.211D Bloodstream infection due to central venous catheter, subsequent encounter
T80.211S Bloodstream infection due to central venous catheter, sequela
T80.212A Local infection due to central venous catheter, initial encounter
T80.212D Local infection due to central venous catheter, subsequent encounter
T80.212S Local infection due to central venous catheter, sequela
ICD-10 CODE DESCRIPTION
T80.218A Other infection due to central venous catheter, initial encounter
T80.218D Other infection due to central venous catheter, subsequent encounter
T80.218S Other infection due to central venous catheter, sequela
T80.219A Unspecified infection due to central venous catheter, initial encounter
T80.219D Unspecified infection due to central venous catheter, subsequent encounter
T80.219S Unspecified infection due to central venous catheter, sequela
T80.22XA Acute infection following transfusion, infusion, or injection of blood and blood products, initial encounter
T80.22XD Acute infection following transfusion, infusion, or injection of blood and blood products, subsequent encounter
T80.22XS Acute infection following transfusion, infusion, or injection of blood and blood products, sequela
T80.29XA Infection following other infusion, transfusion and therapeutic injection, initial encounter
T80.29XD Infection following other infusion, transfusion and therapeutic injection, subsequent encounter
T80.29XS Infection following other infusion, transfusion and therapeutic injection, sequela
T80.51XA Anaphylactic reaction due to administration of blood and blood products, initial encounter
T80.51XD Anaphylactic reaction due to administration of blood and blood products, subsequent encounter
T80.51XS Anaphylactic reaction due to administration of blood and blood products, sequela
T80.52XA Anaphylactic reaction due to vaccination, initial encounter
T80.52XD Anaphylactic reaction due to vaccination, subsequent encounter
Created on 10/07/2019. Page 39 of 73
ICD-10 CODE DESCRIPTION
T80.52XS Anaphylactic reaction due to vaccination, sequela
T80.59XA Anaphylactic reaction due to other serum, initial encounter
T80.59XD Anaphylactic reaction due to other serum, subsequent encounter
T80.59XS Anaphylactic reaction due to other serum, sequela
T81.10XA Postprocedural shock unspecified, initial encounter
T81.10XD Postprocedural shock unspecified, subsequent encounter
T81.10XS Postprocedural shock unspecified, sequela
T81.11XA Postprocedural cardiogenic shock, initial encounter
T81.11XD Postprocedural cardiogenic shock, subsequent encounter
T81.11XS Postprocedural cardiogenic shock, sequela
T81.12XA Postprocedural septic shock, initial encounter
T81.12XD Postprocedural septic shock, subsequent encounter
T81.12XS Postprocedural septic shock, sequela
T81.19XA Other postprocedural shock, initial encounter
T81.19XD Other postprocedural shock, subsequent encounter
T81.19XS Other postprocedural shock, sequela
T81.40XA Infection following a procedure, unspecified, initial encounter
T81.40XD Infection following a procedure, unspecified, subsequent encounter
T81.40XS Infection following a procedure, unspecified, sequela
T81.41XA Infection following a procedure, superficial incisional surgical site, initial encounter
T81.41XD Infection following a procedure, superficial incisional surgical site, subsequent encounter
T81.41XS Infection following a procedure, superficial incisional surgical site, sequela
T81.42XA Infection following a procedure, deep incisional surgical site, initial encounter
T81.42XD Infection following a procedure, deep incisional surgical site, subsequent encounter
T81.42XS Infection following a procedure, deep incisional surgical site, sequela
T81.43XA Infection following a procedure, organ and space surgical site, initial encounter
T81.43XD Infection following a procedure, organ and space surgical site, subsequent encounter
T81.43XS Infection following a procedure, organ and space surgical site, sequela
T81.44XA Sepsis following a procedure, initial encounter
T81.44XD Sepsis following a procedure, subsequent encounter
Created on 10/07/2019. Page 40 of 73
ICD-10 CODE DESCRIPTION
T81.44XS Sepsis following a procedure, sequela
T81.718A Complication of other artery following a procedure, not elsewhere classified, initial encounter
T81.718D Complication of other artery following a procedure, not elsewhere classified, subsequent encounter
T81.718S Complication of other artery following a procedure, not elsewhere classified, sequela
T81.719A Complication of unspecified artery following a procedure, not elsewhere classified, initial encounter
T81.719D Complication of unspecified artery following a procedure, not elsewhere classified, subsequent encounter
T81.719S Complication of unspecified artery following a procedure, not elsewhere classified, sequela
T81.72XA Complication of vein following a procedure, not elsewhere classified, initial encounter
T81.72XD Complication of vein following a procedure, not elsewhere classified, subsequent encounter
T81.72XS Complication of vein following a procedure, not elsewhere classified, sequela
T82.01XA Breakdown (mechanical) of heart valve prosthesis, initial encounter
T82.01XD Breakdown (mechanical) of heart valve prosthesis, subsequent encounter
T82.01XS Breakdown (mechanical) of heart valve prosthesis, sequela
T82.02XA Displacement of heart valve prosthesis, initial encounter
T82.02XD Displacement of heart valve prosthesis, subsequent encounter
T82.02XS Displacement of heart valve prosthesis, sequela
T82.03XA Leakage of heart valve prosthesis, initial encounter
T82.03XD Leakage of heart valve prosthesis, subsequent encounter
T82.03XS Leakage of heart valve prosthesis, sequela
T82.09XA Other mechanical complication of heart valve prosthesis, initial encounter
T82.09XD Other mechanical complication of heart valve prosthesis, subsequent encounter
T82.09XS Other mechanical complication of heart valve prosthesis, sequela
T82.110A Breakdown (mechanical) of cardiac electrode, initial encounter
T82.110D Breakdown (mechanical) of cardiac electrode, subsequent encounter
T82.110S Breakdown (mechanical) of cardiac electrode, sequela
T82.111A Breakdown (mechanical) of cardiac pulse generator (battery), initial encounter
T82.111D Breakdown (mechanical) of cardiac pulse generator (battery), subsequent encounter
Created on 10/07/2019. Page 41 of 73
ICD-10 CODE DESCRIPTION
T82.111S Breakdown (mechanical) of cardiac pulse generator (battery), sequela
T82.118A Breakdown (mechanical) of other cardiac electronic device, initial encounter
T82.118D Breakdown (mechanical) of other cardiac electronic device, subsequent encounter
T82.118S Breakdown (mechanical) of other cardiac electronic device, sequela
T82.119A Breakdown (mechanical) of unspecified cardiac electronic device, initial encounter
T82.119D Breakdown (mechanical) of unspecified cardiac electronic device, subsequent encounter
T82.119S Breakdown (mechanical) of unspecified cardiac electronic device, sequela
T82.120A Displacement of cardiac electrode, initial encounter
T82.120D Displacement of cardiac electrode, subsequent encounter
T82.120S Displacement of cardiac electrode, sequela
T82.121A Displacement of cardiac pulse generator (battery), initial encounter
T82.121D Displacement of cardiac pulse generator (battery), subsequent encounter
T82.121S Displacement of cardiac pulse generator (battery), sequela
T82.128A Displacement of other cardiac electronic device, initial encounter
T82.128D Displacement of other cardiac electronic device, subsequent encounter
T82.128S Displacement of other cardiac electronic device, sequela
T82.129A Displacement of unspecified cardiac electronic device, initial encounter
T82.129D Displacement of unspecified cardiac electronic device, subsequent encounter
T82.129S Displacement of unspecified cardiac electronic device, sequela
T82.190A Other mechanical complication of cardiac electrode, initial encounter
T82.190D Other mechanical complication of cardiac electrode, subsequent encounter
T82.190S Other mechanical complication of cardiac electrode, sequela
T82.191A Other mechanical complication of cardiac pulse generator (battery), initial encounter
T82.191D Other mechanical complication of cardiac pulse generator (battery), subsequent encounter
T82.191S Other mechanical complication of cardiac pulse generator (battery), sequela
T82.198A Other mechanical complication of other cardiac electronic device, initial encounter
ICD-10 CODE DESCRIPTION
T82.198D Other mechanical complication of other cardiac electronic device, subsequent encounter
T82.198S Other mechanical complication of other cardiac electronic device, sequela
T82.199A Other mechanical complication of unspecified cardiac device, initial encounter
Created on 10/07/2019. Page 42 of 73
ICD-10 CODE DESCRIPTION
T82.199D Other mechanical complication of unspecified cardiac device, subsequent encounter
T82.199S Other mechanical complication of unspecified cardiac device, sequela
T82.211A Breakdown (mechanical) of coronary artery bypass graft, initial encounter
T82.211D Breakdown (mechanical) of coronary artery bypass graft, subsequent encounter
T82.211S Breakdown (mechanical) of coronary artery bypass graft, sequela
T82.212A Displacement of coronary artery bypass graft, initial encounter
T82.212D Displacement of coronary artery bypass graft, subsequent encounter
T82.212S Displacement of coronary artery bypass graft, sequela
T82.213A Leakage of coronary artery bypass graft, initial encounter
T82.213D Leakage of coronary artery bypass graft, subsequent encounter
T82.213S Leakage of coronary artery bypass graft, sequela
T82.218A Other mechanical complication of coronary artery bypass graft, initial encounter
T82.218D Other mechanical complication of coronary artery bypass graft, subsequent encounter
T82.218S Other mechanical complication of coronary artery bypass graft, sequela
T82.221A Breakdown (mechanical) of biological heart valve graft, initial encounter
T82.221D Breakdown (mechanical) of biological heart valve graft, subsequent encounter
T82.221S Breakdown (mechanical) of biological heart valve graft, sequela
T82.222A Displacement of biological heart valve graft, initial encounter
T82.222D Displacement of biological heart valve graft, subsequent encounter
T82.222S Displacement of biological heart valve graft, sequela
T82.223A Leakage of biological heart valve graft, initial encounter
T82.223D Leakage of biological heart valve graft, subsequent encounter
T82.223S Leakage of biological heart valve graft, sequela
T82.228A Other mechanical complication of biological heart valve graft, initial encounter
T82.228D Other mechanical complication of biological heart valve graft, subsequent encounter
T82.228S Other mechanical complication of biological heart valve graft, sequela
T82.310A Breakdown (mechanical) of aortic (bifurcation) graft (replacement), initial encounter
T82.310D Breakdown (mechanical) of aortic (bifurcation) graft (replacement), subsequent encounter
T82.310S Breakdown (mechanical) of aortic (bifurcation) graft (replacement), sequela
T82.311A Breakdown (mechanical) of carotid arterial graft (bypass), initial encounter
Created on 10/07/2019. Page 43 of 73
ICD-10 CODE DESCRIPTION
T82.311D Breakdown (mechanical) of carotid arterial graft (bypass), subsequent encounter
T82.311S Breakdown (mechanical) of carotid arterial graft (bypass), sequela
T82.312A Breakdown (mechanical) of femoral arterial graft (bypass), initial encounter
T82.312D Breakdown (mechanical) of femoral arterial graft (bypass), subsequent encounter
T82.312S Breakdown (mechanical) of femoral arterial graft (bypass), sequela
T82.318A Breakdown (mechanical) of other vascular grafts, initial encounter
T82.318D Breakdown (mechanical) of other vascular grafts, subsequent encounter
T82.318S Breakdown (mechanical) of other vascular grafts, sequela
T82.319A Breakdown (mechanical) of unspecified vascular grafts, initial encounter
T82.319D Breakdown (mechanical) of unspecified vascular grafts, subsequent encounter
T82.319S Breakdown (mechanical) of unspecified vascular grafts, sequela
T82.320A Displacement of aortic (bifurcation) graft (replacement), initial encounter
T82.320D Displacement of aortic (bifurcation) graft (replacement), subsequent encounter
T82.320S Displacement of aortic (bifurcation) graft (replacement), sequela
T82.321A Displacement of carotid arterial graft (bypass), initial encounter
T82.321D Displacement of carotid arterial graft (bypass), subsequent encounter
T82.321S Displacement of carotid arterial graft (bypass), sequela
T82.322A Displacement of femoral arterial graft (bypass), initial encounter
T82.322D Displacement of femoral arterial graft (bypass), subsequent encounter
T82.322S Displacement of femoral arterial graft (bypass), sequela
T82.328A Displacement of other vascular grafts, initial encounter
T82.328D Displacement of other vascular grafts, subsequent encounter
T82.328S Displacement of other vascular grafts, sequela
T82.329A Displacement of unspecified vascular grafts, initial encounter
T82.329D Displacement of unspecified vascular grafts, subsequent encounter
T82.329S Displacement of unspecified vascular grafts, sequela
T82.330A Leakage of aortic (bifurcation) graft (replacement), initial encounter
T82.330D Leakage of aortic (bifurcation) graft (replacement), subsequent encounter
T82.330S Leakage of aortic (bifurcation) graft (replacement), sequela
T82.331A Leakage of carotid arterial graft (bypass), initial encounter
T82.331D Leakage of carotid arterial graft (bypass), subsequent encounter
T82.331S Leakage of carotid arterial graft (bypass), sequela
Created on 10/07/2019. Page 44 of 73
ICD-10 CODE DESCRIPTION
T82.332A Leakage of femoral arterial graft (bypass), initial encounter
T82.332D Leakage of femoral arterial graft (bypass), subsequent encounter
T82.332S Leakage of femoral arterial graft (bypass), sequela
T82.338A Leakage of other vascular grafts, initial encounter
T82.338D Leakage of other vascular grafts, subsequent encounter
T82.338S Leakage of other vascular grafts, sequela
T82.339A Leakage of unspecified vascular graft, initial encounter
T82.339D Leakage of unspecified vascular graft, subsequent encounter
T82.339S Leakage of unspecified vascular graft, sequela
T82.390A Other mechanical complication of aortic (bifurcation) graft (replacement), initial encounter
T82.390D Other mechanical complication of aortic (bifurcation) graft (replacement), subsequent encounter
T82.390S Other mechanical complication of aortic (bifurcation) graft (replacement), sequela
T82.391A Other mechanical complication of carotid arterial graft (bypass), initial encounter
T82.391D Other mechanical complication of carotid arterial graft (bypass), subsequent encounter
T82.391S Other mechanical complication of carotid arterial graft (bypass), sequela
T82.392A Other mechanical complication of femoral arterial graft (bypass), initial encounter
T82.392D Other mechanical complication of femoral arterial graft (bypass), subsequent encounter
T82.392S Other mechanical complication of femoral arterial graft (bypass), sequela
T82.398A Other mechanical complication of other vascular grafts, initial encounter
T82.398D Other mechanical complication of other vascular grafts, subsequent encounter
T82.398S Other mechanical complication of other vascular grafts, sequela
T82.399A Other mechanical complication of unspecified vascular grafts, initial encounter
T82.399D Other mechanical complication of unspecified vascular grafts, subsequent encounter
T82.399S Other mechanical complication of unspecified vascular grafts, sequela
T82.41XA Breakdown (mechanical) of vascular dialysis catheter, initial encounter
T82.41XD Breakdown (mechanical) of vascular dialysis catheter, subsequent encounter
T82.41XS Breakdown (mechanical) of vascular dialysis catheter, sequela
T82.42XA Displacement of vascular dialysis catheter, initial encounter
T82.42XD Displacement of vascular dialysis catheter, subsequent encounter
Created on 10/07/2019. Page 45 of 73
ICD-10 CODE DESCRIPTION
T82.42XS Displacement of vascular dialysis catheter, sequela
T82.43XA Leakage of vascular dialysis catheter, initial encounter
T82.43XD Leakage of vascular dialysis catheter, subsequent encounter
T82.43XS Leakage of vascular dialysis catheter, sequela
T82.49XA Other complication of vascular dialysis catheter, initial encounter
T82.49XD Other complication of vascular dialysis catheter, subsequent encounter
ICD-10 CODE DESCRIPTION
T82.49XS Other complication of vascular dialysis catheter, sequela
T82.510A Breakdown (mechanical) of surgically created arteriovenous fistula, initial encounter
T82.510D Breakdown (mechanical) of surgically created arteriovenous fistula, subsequent encounter
T82.510S Breakdown (mechanical) of surgically created arteriovenous fistula, sequela
T82.511A Breakdown (mechanical) of surgically created arteriovenous shunt, initial encounter
T82.511D Breakdown (mechanical) of surgically created arteriovenous shunt, subsequent encounter
T82.511S Breakdown (mechanical) of surgically created arteriovenous shunt, sequela
T82.512A Breakdown (mechanical) of artificial heart, initial encounter
T82.512D Breakdown (mechanical) of artificial heart, subsequent encounter
T82.512S Breakdown (mechanical) of artificial heart, sequela
T82.513A Breakdown (mechanical) of balloon (counterpulsation) device, initial encounter
T82.513D Breakdown (mechanical) of balloon (counterpulsation) device, subsequent encounter
T82.513S Breakdown (mechanical) of balloon (counterpulsation) device, sequela
T82.514A Breakdown (mechanical) of infusion catheter, initial encounter
T82.514D Breakdown (mechanical) of infusion catheter, subsequent encounter
T82.514S Breakdown (mechanical) of infusion catheter, sequela
T82.515A Breakdown (mechanical) of umbrella device, initial encounter
T82.515D Breakdown (mechanical) of umbrella device, subsequent encounter
T82.515S Breakdown (mechanical) of umbrella device, sequela
T82.518A Breakdown (mechanical) of other cardiac and vascular devices and implants, initial encounter
T82.518D Breakdown (mechanical) of other cardiac and vascular devices and implants, subsequent encounter
Created on 10/07/2019. Page 46 of 73
ICD-10 CODE DESCRIPTION
T82.518S Breakdown (mechanical) of other cardiac and vascular devices and implants, sequela
T82.519A Breakdown (mechanical) of unspecified cardiac and vascular devices and implants, initial encounter
T82.519D Breakdown (mechanical) of unspecified cardiac and vascular devices and implants, subsequent encounter
T82.519S Breakdown (mechanical) of unspecified cardiac and vascular devices and implants, sequela
T82.520A Displacement of surgically created arteriovenous fistula, initial encounter
T82.520D Displacement of surgically created arteriovenous fistula, subsequent encounter
T82.520S Displacement of surgically created arteriovenous fistula, sequela
T82.521A Displacement of surgically created arteriovenous shunt, initial encounter
T82.521D Displacement of surgically created arteriovenous shunt, subsequent encounter
T82.521S Displacement of surgically created arteriovenous shunt, sequela
T82.522A Displacement of artificial heart, initial encounter
T82.522D Displacement of artificial heart, subsequent encounter
T82.522S Displacement of artificial heart, sequela
T82.523A Displacement of balloon (counterpulsation) device, initial encounter
T82.523D Displacement of balloon (counterpulsation) device, subsequent encounter
T82.523S Displacement of balloon (counterpulsation) device, sequela
T82.524A Displacement of infusion catheter, initial encounter
T82.524D Displacement of infusion catheter, subsequent encounter
T82.524S Displacement of infusion catheter, sequela
T82.525A Displacement of umbrella device, initial encounter
T82.525D Displacement of umbrella device, subsequent encounter
T82.525S Displacement of umbrella device, sequela
T82.528A Displacement of other cardiac and vascular devices and implants, initial encounter
T82.528D Displacement of other cardiac and vascular devices and implants, subsequent encounter
T82.528S Displacement of other cardiac and vascular devices and implants, sequela
T82.529A Displacement of unspecified cardiac and vascular devices and implants, initial encounter
T82.529D Displacement of unspecified cardiac and vascular devices and implants, subsequent encounter
Created on 10/07/2019. Page 47 of 73
ICD-10 CODE DESCRIPTION
T82.529S Displacement of unspecified cardiac and vascular devices and implants, sequela
T82.530A Leakage of surgically created arteriovenous fistula, initial encounter
T82.530D Leakage of surgically created arteriovenous fistula, subsequent encounter
T82.530S Leakage of surgically created arteriovenous fistula, sequela
T82.531A Leakage of surgically created arteriovenous shunt, initial encounter
T82.531D Leakage of surgically created arteriovenous shunt, subsequent encounter
T82.531S Leakage of surgically created arteriovenous shunt, sequela
T82.532A Leakage of artificial heart, initial encounter
T82.532D Leakage of artificial heart, subsequent encounter
T82.532S Leakage of artificial heart, sequela
T82.533A Leakage of balloon (counterpulsation) device, initial encounter
T82.533D Leakage of balloon (counterpulsation) device, subsequent encounter
T82.533S Leakage of balloon (counterpulsation) device, sequela
T82.534A Leakage of infusion catheter, initial encounter
T82.534D Leakage of infusion catheter, subsequent encounter
T82.534S Leakage of infusion catheter, sequela
T82.535A Leakage of umbrella device, initial encounter
T82.535D Leakage of umbrella device, subsequent encounter
T82.535S Leakage of umbrella device, sequela
T82.538A Leakage of other cardiac and vascular devices and implants, initial encounter
T82.538D Leakage of other cardiac and vascular devices and implants, subsequent encounter
T82.538S Leakage of other cardiac and vascular devices and implants, sequela
T82.539A Leakage of unspecified cardiac and vascular devices and implants, initial encounter
T82.539D Leakage of unspecified cardiac and vascular devices and implants, subsequent encounter
T82.539S Leakage of unspecified cardiac and vascular devices and implants, sequela
T82.590A Other mechanical complication of surgically created arteriovenous fistula, initial encounter
T82.590D Other mechanical complication of surgically created arteriovenous fistula, subsequent encounter
T82.590S Other mechanical complication of surgically created arteriovenous fistula, sequela
T82.591A Other mechanical complication of surgically created arteriovenous shunt, initial encounter
Created on 10/07/2019. Page 48 of 73
ICD-10 CODE DESCRIPTION
T82.591D Other mechanical complication of surgically created arteriovenous shunt, subsequent encounter
T82.591S Other mechanical complication of surgically created arteriovenous shunt, sequela
T82.592A Other mechanical complication of artificial heart, initial encounter
T82.592D Other mechanical complication of artificial heart, subsequent encounter
T82.592S Other mechanical complication of artificial heart, sequela
T82.593A Other mechanical complication of balloon (counterpulsation) device, initial encounter
T82.593D Other mechanical complication of balloon (counterpulsation) device, subsequent encounter
T82.593S Other mechanical complication of balloon (counterpulsation) device, sequela
T82.594A Other mechanical complication of infusion catheter, initial encounter
T82.594D Other mechanical complication of infusion catheter, subsequent encounter
T82.594S Other mechanical complication of infusion catheter, sequela
T82.595A Other mechanical complication of umbrella device, initial encounter
T82.595D Other mechanical complication of umbrella device, subsequent encounter
T82.595S Other mechanical complication of umbrella device, sequela
T82.598A Other mechanical complication of other cardiac and vascular devices and implants, initial encounter
T82.598D Other mechanical complication of other cardiac and vascular devices and implants, subsequent encounter
T82.598S Other mechanical complication of other cardiac and vascular devices and implants, sequela
T82.599A Other mechanical complication of unspecified cardiac and vascular devices and implants, initial encounter
T82.599D Other mechanical complication of unspecified cardiac and vascular devices and implants, subsequent encounter
T82.599S Other mechanical complication of unspecified cardiac and vascular devices and implants, sequela
T82.6XXA Infection and inflammatory reaction due to cardiac valve prosthesis, initial encounter
T82.6XXD Infection and inflammatory reaction due to cardiac valve prosthesis, subsequent encounter
T82.6XXS Infection and inflammatory reaction due to cardiac valve prosthesis, sequela
ICD-10 CODE DESCRIPTION
Infection and inflammatory reaction due to other cardiac and vascular devices, T82.7XXA
Created on 10/07/2019. Page 49 of 73
ICD-10 CODE DESCRIPTION
implants and grafts, initial encounter
T82.7XXD Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, subsequent encounter
T82.7XXS Infection and inflammatory reaction due to other cardiac and vascular devices, implants and grafts, sequela
T82.817A Embolism due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.817D Embolism due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.817S Embolism due to cardiac prosthetic devices, implants and grafts, sequela
T82.827A Fibrosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.827D Fibrosis due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.827S Fibrosis due to cardiac prosthetic devices, implants and grafts, sequela
T82.837A Hemorrhage due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.837D Hemorrhage due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.837S Hemorrhage due to cardiac prosthetic devices, implants and grafts, sequela
T82.847A Pain due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.847D Pain due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.847S Pain due to cardiac prosthetic devices, implants and grafts, sequela
T82.855A - T82.855S Stenosis of coronary artery stent, initial encounter - Stenosis of coronary artery stent, sequela
T82.856A - T82.856S Stenosis of peripheral vascular stent, initial encounter - Stenosis of peripheral vascular stent, sequela
T82.857A Stenosis of other cardiac prosthetic devices, implants and grafts, initial encounter
T82.857D Stenosis of other cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.857S Stenosis of other cardiac prosthetic devices, implants and grafts, sequela
T82.867A Thrombosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.867D Thrombosis due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.867S Thrombosis due to cardiac prosthetic devices, implants and grafts, sequela
T82.897A Other specified complication of cardiac prosthetic devices, implants and grafts, initial encounter
Other specified complication of cardiac prosthetic devices, implants and grafts, T82.897D
Created on 10/07/2019. Page 50 of 73
ICD-10 CODE DESCRIPTION
subsequent encounter
T82.897S Other specified complication of cardiac prosthetic devices, implants and grafts, sequela
T82.9XXA Unspecified complication of cardiac and vascular prosthetic device, implant and graft, initial encounter
T82.9XXD Unspecified complication of cardiac and vascular prosthetic device, implant and graft, subsequent encounter
T82.9XXS Unspecified complication of cardiac and vascular prosthetic device, implant and graft, sequela
T84.50XA Infection and inflammatory reaction due to unspecified internal joint prosthesis, initial encounter
T84.50XD Infection and inflammatory reaction due to unspecified internal joint prosthesis, subsequent encounter
T84.50XS Infection and inflammatory reaction due to unspecified internal joint prosthesis, sequela
T84.51XA Infection and inflammatory reaction due to internal right hip prosthesis, initial encounter
T84.51XD Infection and inflammatory reaction due to internal right hip prosthesis, subsequent encounter
T84.51XS Infection and inflammatory reaction due to internal right hip prosthesis, sequela
T84.52XA Infection and inflammatory reaction due to internal left hip prosthesis, initial encounter
T84.52XD Infection and inflammatory reaction due to internal left hip prosthesis, subsequent encounter
T84.52XS Infection and inflammatory reaction due to internal left hip prosthesis, sequela
T84.53XA Infection and inflammatory reaction due to internal right knee prosthesis, initial encounter
T84.53XD Infection and inflammatory reaction due to internal right knee prosthesis, subsequent encounter
T84.53XS Infection and inflammatory reaction due to internal right knee prosthesis, sequela
T84.54XA Infection and inflammatory reaction due to internal left knee prosthesis, initial encounter
T84.54XD Infection and inflammatory reaction due to internal left knee prosthesis, subsequent encounter
T84.54XS Infection and inflammatory reaction due to internal left knee prosthesis, sequela
Infection and inflammatory reaction due to other internal joint prosthesis, initial T84.59XA
Created on 10/07/2019. Page 51 of 73
ICD-10 CODE DESCRIPTION
encounter
T84.59XD Infection and inflammatory reaction due to other internal joint prosthesis, subsequent encounter
T84.59XS Infection and inflammatory reaction due to other internal joint prosthesis, sequela
T85.79XA Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter
T85.79XD Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, subsequent encounter
T85.79XS Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, sequela
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
T88.0XXA Infection following immunization, initial encounter
T88.0XXD Infection following immunization, subsequent encounter
T88.0XXS Infection following immunization, sequela
T88.59XA Other complications of anesthesia, initial encounter
T88.59XD Other complications of anesthesia, subsequent encounter
T88.59XS Other complications of anesthesia, sequela
Z01.30 Encounter for examination of blood pressure without abnormal findings
Z01.31 Encounter for examination of blood pressure with abnormal findings
Z01.810 Encounter for preprocedural cardiovascular examination
Z01.818 Encounter for other preprocedural examination
Z01.89 Encounter for other specified special examinations
Encounter for follow-up examination after completed treatment for malignant Z08
Created on 10/07/2019. Page 52 of 73
ICD-10 CODE DESCRIPTION
neoplasm
Z09 Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm
Z12.11 Encounter for screening for malignant neoplasm of colon
Z13.6 Encounter for screening for cardiovascular disorders
Z48.21 Encounter for aftercare following heart transplant
Z48.22 Encounter for aftercare following kidney transplant
Z48.23 Encounter for aftercare following liver transplant
Z48.24 Encounter for aftercare following lung transplant
Z48.280 Encounter for aftercare following heart-lung transplant
Z48.288 Encounter for aftercare following multiple organ transplant
Z48.290 Encounter for aftercare following bone marrow transplant
Z48.298 Encounter for aftercare following other organ transplant
Z51.11 Encounter for antineoplastic chemotherapy
Z51.81 Encounter for therapeutic drug level monitoring
Z52.89 Donor of other specified organs or tissues
Z79.3 Long term (current) use of hormonal contraceptives
Z79.891 Long term (current) use of opiate analgesic
Z79.899 Other long term (current) drug therapy
Z86.73 Personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits
Z86.74 Personal history of sudden cardiac arrest
Z94.1 Heart transplant status
Z94.2 Lung transplant status
Z94.3 Heart and lungs transplant status
Z95.2 Presence of prosthetic heart valve
Z95.3 Presence of xenogenic heart valve
Z95.4 Presence of other heart-valve replacement
Z95.811 Presence of heart assist device
Z95.812 Presence of fully implantable artificial heart
ICD-10 CODE DESCRIPTION
Z98.890 Other specified postprocedural states
Created on 10/07/2019. Page 53 of 73
Group 2 Paragraph:
Applicable to codes 93303, 93304, C8921, C8922 (coverage criteria and diagnosis restrictions apply to both the base codes [listed above] and related add-on codes):
Group 2 Codes:
ICD-10 CODE DESCRIPTION
D82.1 Di George's syndrome
P22.8 Other respiratory distress of newborn
P22.9 Respiratory distress of newborn, unspecified
P28.3 Primary sleep apnea of newborn
P28.4 Other apnea of newborn
P28.89 Other specified respiratory conditions of newborn
P29.0 Neonatal cardiac failure
P29.11 Neonatal tachycardia
P29.12 Neonatal bradycardia
P29.2 Neonatal hypertension
P29.30 Pulmonary hypertension of newborn
P29.38 Other persistent fetal circulation
P29.4 Transient myocardial ischemia in newborn
P29.89 Other cardiovascular disorders originating in the perinatal period
P29.9 Cardiovascular disorder originating in the perinatal period, unspecified
P94.1 Congenital hypertonia
P94.2 Congenital hypotonia
P94.8 Other disorders of muscle tone of newborn
P94.9 Disorder of muscle tone of newborn, unspecified
P96.0 Congenital renal failure
P96.3 Wide cranial sutures of newborn
P96.5 Complication to newborn due to (fetal) intrauterine procedure
P96.89 Other specified conditions originating in the perinatal period
Q20.0 Common arterial trunk
Q20.1 Double outlet right ventricle
Q20.2 Double outlet left ventricle
Q20.3 Discordant ventriculoarterial connection
Created on 10/07/2019. Page 54 of 73
ICD-10 CODE DESCRIPTION
Q20.4 Double inlet ventricle
Q20.5 Discordant atrioventricular connection
Q20.6 Isomerism of atrial appendages
Q20.8 Other congenital malformations of cardiac chambers and connections
Q20.9 Congenital malformation of cardiac chambers and connections, unspecified
Q21.0 Ventricular septal defect
Q21.1 Atrial septal defect
Q21.2 Atrioventricular septal defect
Q21.3 Tetralogy of Fallot
Q21.4 Aortopulmonary septal defect
Q21.8 Other congenital malformations of cardiac septa
Q21.9 Congenital malformation of cardiac septum, unspecified
Q22.0 Pulmonary valve atresia
Q22.1 Congenital pulmonary valve stenosis
Q22.2 Congenital pulmonary valve insufficiency
Q22.3 Other congenital malformations of pulmonary valve
Q22.4 Congenital tricuspid stenosis
Q22.5 Ebstein's anomaly
Q22.6 Hypoplastic right heart syndrome
Q22.8 Other congenital malformations of tricuspid valve
Q22.9 Congenital malformation of tricuspid valve, unspecified
Q23.0 Congenital stenosis of aortic valve
Q23.1 Congenital insufficiency of aortic valve
Q23.2 Congenital mitral stenosis
Q23.3 Congenital mitral insufficiency
Q23.4 Hypoplastic left heart syndrome
Q23.8 Other congenital malformations of aortic and mitral valves
Q23.9 Congenital malformation of aortic and mitral valves, unspecified
Q24.0 Dextrocardia
Q24.1 Levocardia
Q24.2 Cor triatriatum
Q24.3 Pulmonary infundibular stenosis
Created on 10/07/2019. Page 55 of 73
ICD-10 CODE DESCRIPTION
Q24.4 Congenital subaortic stenosis
Q24.5 Malformation of coronary vessels
Q24.6 Congenital heart block
Q24.8 Other specified congenital malformations of heart
Q24.9 Congenital malformation of heart, unspecified
Q25.0 Patent ductus arteriosus
Q25.1 Coarctation of aorta
Q25.21 Interruption of aortic arch
Q25.29 Other atresia of aorta
Q25.3 Supravalvular aortic stenosis
Q25.40 - Q25.49 Congenital malformation of aorta unspecified - Other congenital malformations of aorta
Q25.5 Atresia of pulmonary artery
Q25.6 Stenosis of pulmonary artery
Q25.71 Coarctation of pulmonary artery
Q25.72 Congenital pulmonary arteriovenous malformation
Q25.79 Other congenital malformations of pulmonary artery
Q25.8 Other congenital malformations of other great arteries
Q25.9 Congenital malformation of great arteries, unspecified
Q26.0 Congenital stenosis of vena cava
Q26.1 Persistent left superior vena cava
Q26.2 Total anomalous pulmonary venous connection
Q26.3 Partial anomalous pulmonary venous connection
Q26.4 Anomalous pulmonary venous connection, unspecified
Q26.8 Other congenital malformations of great veins
Q26.9 Congenital malformation of great vein, unspecified
Q27.0 Congenital absence and hypoplasia of umbilical artery
Q27.9 Congenital malformation of peripheral vascular system, unspecified
Q28.2 Arteriovenous malformation of cerebral vessels
Q28.3 Other malformations of cerebral vessels
Q28.9 Congenital malformation of circulatory system, unspecified
Q30.0 Choanal atresia
Created on 10/07/2019. Page 56 of 73
ICD-10 CODE DESCRIPTION
Q33.2 Sequestration of lung
Q33.3 Agenesis of lung
Q33.6 Congenital hypoplasia and dysplasia of lung
Q40.1 Congenital hiatus hernia
Q67.6 Pectus excavatum
Q67.7 Pectus carinatum
Q87.40 Marfan's syndrome, unspecified
Q87.410 Marfan's syndrome with aortic dilation
Q87.418 Marfan's syndrome with other cardiovascular manifestations
Q87.42 Marfan's syndrome with ocular manifestations
Q87.43 Marfan's syndrome with skeletal manifestation
ICD-10 CODE DESCRIPTION
Q89.01 Asplenia (congenital)
Q89.09 Congenital malformations of spleen
Q89.3 Situs inversus
Q89.7 Multiple congenital malformations, not elsewhere classified
Q89.9 Congenital malformation, unspecified
Q90.0 Trisomy 21, nonmosaicism (meiotic nondisjunction)
Q90.1 Trisomy 21, mosaicism (mitotic nondisjunction)
Q90.2 Trisomy 21, translocation
Q90.9 Down syndrome, unspecified
Q91.0 Trisomy 18, nonmosaicism (meiotic nondisjunction)
Q91.1 Trisomy 18, mosaicism (mitotic nondisjunction)
Q91.2 Trisomy 18, translocation
Q91.3 Trisomy 18, unspecified
Q91.4 Trisomy 13, nonmosaicism (meiotic nondisjunction)
Q91.5 Trisomy 13, mosaicism (mitotic nondisjunction)
Q91.6 Trisomy 13, translocation
Q91.7 Trisomy 13, unspecified
Q96.0 Karyotype 45, X
Q96.1 Karyotype 46, X iso (Xq)
Q96.2 Karyotype 46, X with abnormal sex chromosome, except iso (Xq)
Created on 10/07/2019. Page 57 of 73
ICD-10 CODE DESCRIPTION
Q96.3 Mosaicism, 45, X/46, XX or XY
Q96.4 Mosaicism, 45, X/other cell line(s) with abnormal sex chromosome
Q96.8 Other variants of Turner's syndrome
Q96.9 Turner's syndrome, unspecified
R78.81 Bacteremia
Group 3 Paragraph:
Applicable to codes 93308, C8924 (coverage criteria and diagnosis restrictions apply to both the base codes [listed above] and related add-on codes):
Group 3 Codes:
ICD-10 CODE DESCRIPTION
I10 Essential (primary) hypertension
I11.9 Hypertensive heart disease without heart failure
I13.10 Hypertensive heart and chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease
I13.11 Hypertensive heart and chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease
I15.0 Renovascular hypertension
I16.0 Hypertensive urgency
I16.1 Hypertensive emergency
I16.9 Hypertensive crisis, unspecified
Group 4 Paragraph:
Applicable to codes 93350, 93351, 93352, C8928, C8930 (coverage criteria and diagnosis restrictions apply to both the base codes [listed above] and related add-on codes):
Group 4 Codes:
ICD-10 CODE DESCRIPTION
A18.84 Tuberculosis of heart
I05.1 Rheumatic mitral insufficiency
I05.8 Other rheumatic mitral valve diseases
I06.0 Rheumatic aortic stenosis
I06.1 Rheumatic aortic insufficiency
I06.2 Rheumatic aortic stenosis with insufficiency
I08.0 Rheumatic disorders of both mitral and aortic valves
Created on 10/07/2019. Page 58 of 73
ICD-10 CODE DESCRIPTION
I08.2 Rheumatic disorders of both aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I10 Essential (primary) hypertension
I20.0 Unstable angina
I20.1 Angina pectoris with documented spasm
I20.8 Other forms of angina pectoris
I20.9 Angina pectoris, unspecified
I21.09 ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall
I21.11 ST elevation (STEMI) myocardial infarction involving right coronary artery
I21.19 ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall
I21.29 ST elevation (STEMI) myocardial infarction involving other sites
I21.4 Non-ST elevation (NSTEMI) myocardial infarction
I21.9 Acute myocardial infarction, unspecified
I21.A1 Myocardial infarction type 2
I21.A9 Other myocardial infarction type
I24.0 Acute coronary thrombosis not resulting in myocardial infarction
I24.1 Dressler's syndrome
I24.8 Other forms of acute ischemic heart disease
I24.9 Acute ischemic heart disease, unspecified
I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.2 Old myocardial infarction
I25.3 Aneurysm of heart
I25.41 Coronary artery aneurysm
I25.42 Coronary artery dissection
Created on 10/07/2019. Page 59 of 73
ICD-10 CODE DESCRIPTION
I25.5 Ischemic cardiomyopathy
I25.6 Silent myocardial ischemia
I25.700 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectoris
I25.701 Atherosclerosis of coronary artery bypass graft(s), unspecified, with angina pectoris with documented spasm
I25.708 Atherosclerosis of coronary artery bypass graft(s), unspecified, with other forms of angina pectoris
I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris
I25.710 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unstable angina pectoris
I25.711 Atherosclerosis of autologous vein coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.718 Atherosclerosis of autologous vein coronary artery bypass graft(s) with other forms of angina pectoris
I25.719 Atherosclerosis of autologous vein coronary artery bypass graft(s) with unspecified angina pectoris
I25.720 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unstable angina pectoris
I25.721 Atherosclerosis of autologous artery coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.728 Atherosclerosis of autologous artery coronary artery bypass graft(s) with other forms of angina pectoris
I25.729 Atherosclerosis of autologous artery coronary artery bypass graft(s) with unspecified angina pectoris
I25.730 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unstable angina pectoris
I25.731 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.738 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with other forms of angina pectoris
I25.739 Atherosclerosis of nonautologous biological coronary artery bypass graft(s) with unspecified angina pectoris
I25.750 Atherosclerosis of native coronary artery of transplanted heart with unstable angina
I25.751 Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm
Created on 10/07/2019. Page 60 of 73
ICD-10 CODE DESCRIPTION
I25.758 Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris
I25.759 Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris
I25.760 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina
I25.761 Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm
I25.768 Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris
I25.769 Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris
I25.790 Atherosclerosis of other coronary artery bypass graft(s) with unstable angina pectoris
I25.791 Atherosclerosis of other coronary artery bypass graft(s) with angina pectoris with documented spasm
I25.798 Atherosclerosis of other coronary artery bypass graft(s) with other forms of angina pectoris
I25.799 Atherosclerosis of other coronary artery bypass graft(s) with unspecified angina pectoris
I25.810 Atherosclerosis of coronary artery bypass graft(s) without angina pectoris
I25.811 Atherosclerosis of native coronary artery of transplanted heart without angina pectoris
I25.812 Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris
I25.82 Chronic total occlusion of coronary artery
I25.89 Other forms of chronic ischemic heart disease
I25.9 Chronic ischemic heart disease, unspecified
I34.0 Nonrheumatic mitral (valve) insufficiency
I34.1 Nonrheumatic mitral (valve) prolapse
I34.2 Nonrheumatic mitral (valve) stenosis
I34.8 Other nonrheumatic mitral valve disorders
I34.9 Nonrheumatic mitral valve disorder, unspecified
I35.0 Nonrheumatic aortic (valve) stenosis
I35.1 Nonrheumatic aortic (valve) insufficiency
Created on 10/07/2019. Page 61 of 73
ICD-10 CODE DESCRIPTION
I35.2 Nonrheumatic aortic (valve) stenosis with insufficiency
I35.8 Other nonrheumatic aortic valve disorders
I35.9 Nonrheumatic aortic valve disorder, unspecified
I42.0 Dilated cardiomyopathy
I42.1 Obstructive hypertrophic cardiomyopathy
I42.2 Other hypertrophic cardiomyopathy
I42.4 Endocardial fibroelastosis
I42.5 Other restrictive cardiomyopathy
I42.6 Alcoholic cardiomyopathy
I42.7 Cardiomyopathy due to drug and external agent
I42.8 Other cardiomyopathies
I42.9 Cardiomyopathy, unspecified
I43 Cardiomyopathy in diseases classified elsewhere
I44.4 Left anterior fascicular block
I44.5 Left posterior fascicular block
I44.60 Unspecified fascicular block
I44.69 Other fascicular block
I44.7 Left bundle-branch block, unspecified
I45.0 Right fascicular block
I45.10 Unspecified right bundle-branch block
I45.19 Other right bundle-branch block
I48.91 Unspecified atrial fibrillation
I50.1 Left ventricular failure, unspecified
ICD-10 CODE DESCRIPTION
I50.20 Unspecified systolic (congestive) heart failure
I50.21 Acute systolic (congestive) heart failure
I50.22 Chronic systolic (congestive) heart failure
I50.23 Acute on chronic systolic (congestive) heart failure
I50.30 Unspecified diastolic (congestive) heart failure
I50.31 Acute diastolic (congestive) heart failure
I50.32 Chronic diastolic (congestive) heart failure
I50.33 Acute on chronic diastolic (congestive) heart failure
Created on 10/07/2019. Page 62 of 73
ICD-10 CODE DESCRIPTION
I50.40 Unspecified combined systolic (congestive) and diastolic (congestive) heart failure
I50.41 Acute combined systolic (congestive) and diastolic (congestive) heart failure
I50.42 Chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.43 Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure
I50.810 Right heart failure, unspecified
I50.811 Acute right heart failure
I50.812 Chronic right heart failure
I50.813 Acute on chronic right heart failure
I50.814 Right heart failure due to left heart failure
I50.82 Biventricular heart failure
I50.83 High output heart failure
I50.84 End stage heart failure
I50.89 Other heart failure
I50.9 Heart failure, unspecified
I51.7 Cardiomegaly
I97.0 Postcardiotomy syndrome
I97.110 Postprocedural cardiac insufficiency following cardiac surgery
I97.111 Postprocedural cardiac insufficiency following other surgery
I97.120 Postprocedural cardiac arrest following cardiac surgery
I97.121 Postprocedural cardiac arrest following other surgery
I97.130 Postprocedural heart failure following cardiac surgery
I97.131 Postprocedural heart failure following other surgery
I97.190 Other postprocedural cardiac functional disturbances following cardiac surgery
I97.191 Other postprocedural cardiac functional disturbances following other surgery
R00.2 Palpitations
R06.00 Dyspnea, unspecified
R06.01 Orthopnea
R06.02 Shortness of breath
R06.03 Acute respiratory distress
R06.09 Other forms of dyspnea
R06.83 Snoring
Created on 10/07/2019. Page 63 of 73
ICD-10 CODE DESCRIPTION
R06.89 Other abnormalities of breathing
R07.2 Precordial pain
R07.82 Intercostal pain
R07.89 Other chest pain
R07.9 Chest pain, unspecified
R55 Syncope and collapse
R94.31 Abnormal electrocardiogram [ECG] [EKG]
T82.310A Breakdown (mechanical) of aortic (bifurcation) graft (replacement), initial encounter
T82.310D Breakdown (mechanical) of aortic (bifurcation) graft (replacement), subsequent encounter
T82.310S Breakdown (mechanical) of aortic (bifurcation) graft (replacement), sequela
T82.311A Breakdown (mechanical) of carotid arterial graft (bypass), initial encounter
T82.311D Breakdown (mechanical) of carotid arterial graft (bypass), subsequent encounter
T82.311S Breakdown (mechanical) of carotid arterial graft (bypass), sequela
T82.312A Breakdown (mechanical) of femoral arterial graft (bypass), initial encounter
T82.312D Breakdown (mechanical) of femoral arterial graft (bypass), subsequent encounter
T82.312S Breakdown (mechanical) of femoral arterial graft (bypass), sequela
T82.318A Breakdown (mechanical) of other vascular grafts, initial encounter
T82.318D Breakdown (mechanical) of other vascular grafts, subsequent encounter
T82.318S Breakdown (mechanical) of other vascular grafts, sequela
T82.319A Breakdown (mechanical) of unspecified vascular grafts, initial encounter
T82.319D Breakdown (mechanical) of unspecified vascular grafts, subsequent encounter
T82.319S Breakdown (mechanical) of unspecified vascular grafts, sequela
T82.320A Displacement of aortic (bifurcation) graft (replacement), initial encounter
T82.320D Displacement of aortic (bifurcation) graft (replacement), subsequent encounter
T82.320S Displacement of aortic (bifurcation) graft (replacement), sequela
T82.321A Displacement of carotid arterial graft (bypass), initial encounter
T82.321D Displacement of carotid arterial graft (bypass), subsequent encounter
T82.321S Displacement of carotid arterial graft (bypass), sequela
T82.322A Displacement of femoral arterial graft (bypass), initial encounter
T82.322D Displacement of femoral arterial graft (bypass), subsequent encounter
T82.322S Displacement of femoral arterial graft (bypass), sequela
Created on 10/07/2019. Page 64 of 73
ICD-10 CODE DESCRIPTION
T82.328A Displacement of other vascular grafts, initial encounter
T82.328D Displacement of other vascular grafts, subsequent encounter
T82.328S Displacement of other vascular grafts, sequela
T82.329A Displacement of unspecified vascular grafts, initial encounter
T82.329D Displacement of unspecified vascular grafts, subsequent encounter
T82.329S Displacement of unspecified vascular grafts, sequela
T82.330A Leakage of aortic (bifurcation) graft (replacement), initial encounter
T82.330D Leakage of aortic (bifurcation) graft (replacement), subsequent encounter
T82.330S Leakage of aortic (bifurcation) graft (replacement), sequela
T82.331A Leakage of carotid arterial graft (bypass), initial encounter
T82.331D Leakage of carotid arterial graft (bypass), subsequent encounter
T82.331S Leakage of carotid arterial graft (bypass), sequela
T82.332A Leakage of femoral arterial graft (bypass), initial encounter
T82.332D Leakage of femoral arterial graft (bypass), subsequent encounter
T82.332S Leakage of femoral arterial graft (bypass), sequela
T82.338A Leakage of other vascular grafts, initial encounter
T82.338D Leakage of other vascular grafts, subsequent encounter
T82.338S Leakage of other vascular grafts, sequela
T82.339A Leakage of unspecified vascular graft, initial encounter
T82.339D Leakage of unspecified vascular graft, subsequent encounter
T82.339S Leakage of unspecified vascular graft, sequela
T82.390A Other mechanical complication of aortic (bifurcation) graft (replacement), initial encounter
T82.390D Other mechanical complication of aortic (bifurcation) graft (replacement), subsequent encounter
T82.390S Other mechanical complication of aortic (bifurcation) graft (replacement), sequela
T82.391A Other mechanical complication of carotid arterial graft (bypass), initial encounter
T82.391D Other mechanical complication of carotid arterial graft (bypass), subsequent encounter
T82.391S Other mechanical complication of carotid arterial graft (bypass), sequela
T82.392A Other mechanical complication of femoral arterial graft (bypass), initial encounter
T82.392D Other mechanical complication of femoral arterial graft (bypass), subsequent encounter
Created on 10/07/2019. Page 65 of 73
ICD-10 CODE DESCRIPTION
T82.392S Other mechanical complication of femoral arterial graft (bypass), sequela
ICD-10 CODE DESCRIPTION
T82.398A Other mechanical complication of other vascular grafts, initial encounter
T82.398D Other mechanical complication of other vascular grafts, subsequent encounter
T82.398S Other mechanical complication of other vascular grafts, sequela
T82.399A Other mechanical complication of unspecified vascular grafts, initial encounter
T82.399D Other mechanical complication of unspecified vascular grafts, subsequent encounter
T82.399S Other mechanical complication of unspecified vascular grafts, sequela
T82.41XA Breakdown (mechanical) of vascular dialysis catheter, initial encounter
T82.41XD Breakdown (mechanical) of vascular dialysis catheter, subsequent encounter
T82.41XS Breakdown (mechanical) of vascular dialysis catheter, sequela
T82.42XA Displacement of vascular dialysis catheter, initial encounter
T82.42XD Displacement of vascular dialysis catheter, subsequent encounter
T82.42XS Displacement of vascular dialysis catheter, sequela
T82.43XA Leakage of vascular dialysis catheter, initial encounter
T82.43XD Leakage of vascular dialysis catheter, subsequent encounter
T82.43XS Leakage of vascular dialysis catheter, sequela
T82.49XA Other complication of vascular dialysis catheter, initial encounter
T82.49XD Other complication of vascular dialysis catheter, subsequent encounter
T82.49XS Other complication of vascular dialysis catheter, sequela
T82.510A Breakdown (mechanical) of surgically created arteriovenous fistula, initial encounter
T82.510D Breakdown (mechanical) of surgically created arteriovenous fistula, subsequent encounter
T82.510S Breakdown (mechanical) of surgically created arteriovenous fistula, sequela
T82.511A Breakdown (mechanical) of surgically created arteriovenous shunt, initial encounter
T82.511D Breakdown (mechanical) of surgically created arteriovenous shunt, subsequent encounter
T82.511S Breakdown (mechanical) of surgically created arteriovenous shunt, sequela
T82.513A Breakdown (mechanical) of balloon (counterpulsation) device, initial encounter
T82.513D Breakdown (mechanical) of balloon (counterpulsation) device, subsequent encounter
T82.513S Breakdown (mechanical) of balloon (counterpulsation) device, sequela
T82.514A Breakdown (mechanical) of infusion catheter, initial encounter
Created on 10/07/2019. Page 66 of 73
ICD-10 CODE DESCRIPTION
T82.514D Breakdown (mechanical) of infusion catheter, subsequent encounter
T82.514S Breakdown (mechanical) of infusion catheter, sequela
T82.515A Breakdown (mechanical) of umbrella device, initial encounter
T82.515D Breakdown (mechanical) of umbrella device, subsequent encounter
T82.515S Breakdown (mechanical) of umbrella device, sequela
T82.518A Breakdown (mechanical) of other cardiac and vascular devices and implants, initial encounter
T82.518D Breakdown (mechanical) of other cardiac and vascular devices and implants, subsequent encounter
T82.518S Breakdown (mechanical) of other cardiac and vascular devices and implants, sequela
T82.520A Displacement of surgically created arteriovenous fistula, initial encounter
T82.520D Displacement of surgically created arteriovenous fistula, subsequent encounter
T82.520S Displacement of surgically created arteriovenous fistula, sequela
T82.521A Displacement of surgically created arteriovenous shunt, initial encounter
T82.521D Displacement of surgically created arteriovenous shunt, subsequent encounter
T82.521S Displacement of surgically created arteriovenous shunt, sequela
T82.523A Displacement of balloon (counterpulsation) device, initial encounter
T82.523D Displacement of balloon (counterpulsation) device, subsequent encounter
T82.523S Displacement of balloon (counterpulsation) device, sequela
T82.524A Displacement of infusion catheter, initial encounter
T82.524D Displacement of infusion catheter, subsequent encounter
T82.524S Displacement of infusion catheter, sequela
T82.525A Displacement of umbrella device, initial encounter
T82.525D Displacement of umbrella device, subsequent encounter
T82.525S Displacement of umbrella device, sequela
T82.528A Displacement of other cardiac and vascular devices and implants, initial encounter
T82.528D Displacement of other cardiac and vascular devices and implants, subsequent encounter
T82.528S Displacement of other cardiac and vascular devices and implants, sequela
T82.529A Displacement of unspecified cardiac and vascular devices and implants, initial encounter
Displacement of unspecified cardiac and vascular devices and implants, subsequent T82.529D
Created on 10/07/2019. Page 67 of 73
ICD-10 CODE DESCRIPTION
encounter
T82.529S Displacement of unspecified cardiac and vascular devices and implants, sequela
T82.530A Leakage of surgically created arteriovenous fistula, initial encounter
T82.530D Leakage of surgically created arteriovenous fistula, subsequent encounter
T82.530S Leakage of surgically created arteriovenous fistula, sequela
T82.531A Leakage of surgically created arteriovenous shunt, initial encounter
T82.531D Leakage of surgically created arteriovenous shunt, subsequent encounter
T82.531S Leakage of surgically created arteriovenous shunt, sequela
T82.533A Leakage of balloon (counterpulsation) device, initial encounter
T82.533D Leakage of balloon (counterpulsation) device, subsequent encounter
T82.533S Leakage of balloon (counterpulsation) device, sequela
T82.534A Leakage of infusion catheter, initial encounter
T82.534D Leakage of infusion catheter, subsequent encounter
T82.534S Leakage of infusion catheter, sequela
T82.535A Leakage of umbrella device, initial encounter
T82.535D Leakage of umbrella device, subsequent encounter
T82.535S Leakage of umbrella device, sequela
T82.538A Leakage of other cardiac and vascular devices and implants, initial encounter
T82.538D Leakage of other cardiac and vascular devices and implants, subsequent encounter
T82.538S Leakage of other cardiac and vascular devices and implants, sequela
T82.590A Other mechanical complication of surgically created arteriovenous fistula, initial encounter
T82.590D Other mechanical complication of surgically created arteriovenous fistula, subsequent encounter
T82.590S Other mechanical complication of surgically created arteriovenous fistula, sequela
T82.591A Other mechanical complication of surgically created arteriovenous shunt, initial encounter
T82.591D Other mechanical complication of surgically created arteriovenous shunt, subsequent encounter
T82.591S Other mechanical complication of surgically created arteriovenous shunt, sequela
T82.593A Other mechanical complication of balloon (counterpulsation) device, initial encounter
T82.593D Other mechanical complication of balloon (counterpulsation) device, subsequent encounter
Created on 10/07/2019. Page 68 of 73
ICD-10 CODE DESCRIPTION
T82.593S Other mechanical complication of balloon (counterpulsation) device, sequela
T82.594A Other mechanical complication of infusion catheter, initial encounter
T82.594D Other mechanical complication of infusion catheter, subsequent encounter
T82.594S Other mechanical complication of infusion catheter, sequela
T82.595A Other mechanical complication of umbrella device, initial encounter
T82.595D Other mechanical complication of umbrella device, subsequent encounter
T82.595S Other mechanical complication of umbrella device, sequela
T82.598A Other mechanical complication of other cardiac and vascular devices and implants, initial encounter
T82.598D Other mechanical complication of other cardiac and vascular devices and implants, subsequent encounter
T82.598S Other mechanical complication of other cardiac and vascular devices and implants, sequela
T82.817A Embolism due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.817D Embolism due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.817S Embolism due to cardiac prosthetic devices, implants and grafts, sequela
T82.827A Fibrosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.827D Fibrosis due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.827S Fibrosis due to cardiac prosthetic devices, implants and grafts, sequela
T82.837A Hemorrhage due to cardiac prosthetic devices, implants and grafts, initial encounter
ICD-10 CODE DESCRIPTION
T82.837D Hemorrhage due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.837S Hemorrhage due to cardiac prosthetic devices, implants and grafts, sequela
T82.847A Pain due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.847D Pain due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.847S Pain due to cardiac prosthetic devices, implants and grafts, sequela
T82.855A - T82.855S Stenosis of coronary artery stent, initial encounter - Stenosis of coronary artery stent, sequela
T82.856A - T82.856S Stenosis of peripheral vascular stent, initial encounter - Stenosis of peripheral vascular stent, sequela
T82.857A Stenosis of other cardiac prosthetic devices, implants and grafts, initial encounter
Created on 10/07/2019. Page 69 of 73
ICD-10 CODE DESCRIPTION
T82.857D Stenosis of other cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.857S Stenosis of other cardiac prosthetic devices, implants and grafts, sequela
T82.867A Thrombosis due to cardiac prosthetic devices, implants and grafts, initial encounter
T82.867D Thrombosis due to cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.867S Thrombosis due to cardiac prosthetic devices, implants and grafts, sequela
T82.897A Other specified complication of cardiac prosthetic devices, implants and grafts, initial encounter
T82.897D Other specified complication of cardiac prosthetic devices, implants and grafts, subsequent encounter
T82.897S Other specified complication of cardiac prosthetic devices, implants and grafts, sequela
T82.9XXA Unspecified complication of cardiac and vascular prosthetic device, implant and graft, initial encounter
T82.9XXD Unspecified complication of cardiac and vascular prosthetic device, implant and graft, subsequent encounter
T82.9XXS Unspecified complication of cardiac and vascular prosthetic device, implant and graft, sequela
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
Z01.810 Encounter for preprocedural cardiovascular examination
Z79.3 Long term (current) use of hormonal contraceptives
Z79.891 Long term (current) use of opiate analgesic
Z79.899 Other long term (current) drug therapy
Created on 10/07/2019. Page 70 of 73
Group 5 Paragraph:
The following diagnoses are covered for CPT codes 76376 and 76377 when performed for 3-D imaging following CPT codes 93303, 93304, 93306, 93307, or 93308:
ICD-10 codes I08.1, I08.3, I08.9, I34.0, I34.1, I34.8, and I34.9 are payable when billed with CPT codes 93306, 93307, or 93308 only.
ICD-10 code Q23.4 is payable when billed with CPT codes 93303, 93304 only.
Group 5 Codes:
ICD-10 CODE DESCRIPTION
I05.0 Rheumatic mitral stenosis
I05.1 Rheumatic mitral insufficiency
I05.2 Rheumatic mitral stenosis with insufficiency
I05.8 Other rheumatic mitral valve diseases
I05.9 Rheumatic mitral valve disease, unspecified
I08.0 Rheumatic disorders of both mitral and aortic valves
I08.1 Rheumatic disorders of both mitral and tricuspid valves
I08.3 Combined rheumatic disorders of mitral, aortic and tricuspid valves
I08.8 Other rheumatic multiple valve diseases
I08.9 Rheumatic multiple valve disease, unspecified
I23.4 Rupture of chordae tendineae as current complication following acute myocardial infarction
I23.5 Rupture of papillary muscle as current complication following acute myocardial infarction
I33.0 Acute and subacute infective endocarditis
I34.0 Nonrheumatic mitral (valve) insufficiency
I34.1 Nonrheumatic mitral (valve) prolapse
I34.8 Other nonrheumatic mitral valve disorders
I34.9 Nonrheumatic mitral valve disorder, unspecified
I39 Endocarditis and heart valve disorders in diseases classified elsewhere
I51.1 Rupture of chordae tendineae, not elsewhere classified
I51.2 Rupture of papillary muscle, not elsewhere classified
Q23.2 Congenital mitral stenosis
Q23.3 Congenital mitral insufficiency
Created on 10/07/2019. Page 71 of 73
ICD-10 CODE DESCRIPTION
Q23.4 Hypoplastic left heart syndrome
ICD-10 Codes that DO NOT Support Medical Necessity
N/A
Additional ICD-10 Information
N/A
Bill Type Codes:
Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the policy does not apply to that Bill Type.Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the policy should be assumed to apply equally to all claims.
N/A
Revenue Codes:
Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the policy, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the policy should be assumed to apply equally to all Revenue Codes.
N/A
Other Coding Information
N/A
Revision History InformationREVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION
Article revised for annual ICD-10 updates for 2020. ICD-10 codes I48.11, I48.19, I48.20, and I48.21 have replaced deleted codes I48.1 and I48.2 in Group 1.
Reference to CPT code 75571 was deleted.
10/01/2019 R2
Created on 10/07/2019. Page 72 of 73
REVISION HISTORY DATE
REVISION HISTORY NUMBER
REVISION HISTORY EXPLANATION
The article was converted to the new Billing and Coding Article type.
Bill types and Revenue codes have been removed from this article. Guidance on these codes is available in the Bill type and Revenue code sections.
08/01/2019 R1Reinstated coding instructions for Group 1 ICD-10 codes that were omitted from the previous version of the article.
Associated DocumentsRelated Local Coverage Document(s)
LCD(s) L33577 - Transthoracic Echocardiography (TTE)
Related National Coverage Document(s)
N/A
Statutory Requirements URL(s)
N/A
Rules and Regulations URL(s)
N/A
CMS Manual Explanations URL(s)
N/A
Other URL(s)
N/A
Public Version(s)
Updated on 09/17/2019 with effective dates 10/01/2019 - N/A Updated on 08/06/2019 with effective dates 08/01/2019 - N/A Updated on 07/25/2019 with effective dates 08/01/2019 - N/A
KeywordsN/A
Created on 10/07/2019. Page 73 of 73