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ICD-10 Coding for Abnormal Calcium Score(R93.1, I25.84)

Complete ICD-10-CM coding and documentation guide for Abnormal Calcium Score. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Coronary Artery CalcificationCACCoronary Calcium Score

Related ICD-10 Code Ranges

Complete code families applicable to Abnormal Calcium Score

I25.1-I25.9Primary Range

Chronic Ischemic Heart Disease

Includes codes for atherosclerosis and calcified coronary lesions relevant to abnormal calcium scores.

Abnormal findings on diagnostic imaging of heart and coronary circulation

Used for abnormal imaging findings such as an elevated calcium score without confirmed atherosclerosis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R93.1Abnormal findings on diagnostic imaging of heart and coronary circulationUse when an abnormal calcium score is detected without confirmed atherosclerosis.
  • Documented Agatston score greater than 0
  • Imaging report indicating coronary calcification
I25.84Atherosclerosis of coronary artery due to calcified coronary lesionUse when atherosclerosis with calcified lesions is confirmed.
  • Imaging or clinical documentation of calcified coronary lesions
  • Symptoms or risk factors for coronary artery disease

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for abnormal calcium score

Essential facts and insights about Abnormal Calcium Score

The ICD-10 code for an abnormal calcium score is R93.1, indicating abnormal findings on diagnostic imaging of the heart.

Primary ICD-10-CM Codes for abnormal calcium score

Abnormal findings on diagnostic imaging of heart and coronary circulation
Billable Code

Decision Criteria

clinical Criteria

  • Presence of coronary calcification on imaging

documentation Criteria

  • Agatston score must be documented

Applicable To

  • Abnormal coronary calcium score

Excludes

  • Atherosclerosis with calcified lesions (I25.84)

Clinical Validation Requirements

  • Documented Agatston score greater than 0
  • Imaging report indicating coronary calcification

Code-Specific Risks

  • May not be reimbursed if used without clinical indication

Coding Notes

  • Ensure documentation specifies the Agatston score and any clinical correlation.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Encounter for examination for normal comparison and control in clinical research program

Z00.6
Use for asymptomatic screening purposes.

Abnormal findings on diagnostic imaging of heart and coronary circulation

R93.1
Use to confirm imaging findings of calcification.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Atherosclerosis of coronary artery due to calcified coronary lesion

I25.84
Use when there is documented atherosclerosis with calcified lesions.

Atherosclerosis of coronary artery with lipid-rich plaque

I25.83
Use when lipid-rich plaques are dominant without calcification.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Abnormal Calcium Score to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R93.1.

Impact

Clinical: Inadequate risk assessment, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials

Mitigation Strategy

Always document specific Agatston score, Include clinical correlation

Impact

Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Ensure documentation specifies calcified lesions for I25.84.

Impact

Misclassification of calcified lesions can lead to audit findings.

Mitigation Strategy

Ensure accurate documentation and code selection.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Abnormal Calcium Score, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Abnormal Calcium Score

Use these documentation templates to ensure complete and accurate documentation for Abnormal Calcium Score. These templates include all required elements for proper coding and billing.

Patient with abnormal calcium score

Specialty: Cardiology

Required Elements

  • Agatston score
  • Anatomic location of calcification
  • Clinical correlation

Example Documentation

Agatston score of 275 in LAD. Intermediate risk. Recommend statin therapy.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Abnormal calcium score. Follow-up needed.
Good Documentation Example
Agatston score 275 (60th percentile for age/gender). Intermediate risk. Initiate statin therapy.
Explanation
The good example provides specific score, risk assessment, and treatment plan.

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