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ICD-10 Coding for Cardiac Sarcoidosis(D86.85)

Complete ICD-10-CM coding and documentation guide for Cardiac Sarcoidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Sarcoid MyocarditisCardiac Involvement in Sarcoidosis

Related ICD-10 Code Ranges

Complete code families applicable to Cardiac Sarcoidosis

D86.85Primary Range

Sarcoid myocarditis

This code is used for cardiac sarcoidosis with myocardial involvement.

Pulmonary sarcoidosis

Used when systemic sarcoidosis with cardiac involvement is present.

Key Information: ICD-10 code for cardiac sarcoidosis

Essential facts and insights about Cardiac Sarcoidosis

The ICD-10 code for cardiac sarcoidosis is D86.85, used when cardiac involvement is confirmed.

Primary ICD-10-CM Code for cardiac sarcoidosis

Sarcoid myocarditis
Billable Code

Decision Criteria

clinical Criteria

  • Presence of non-caseating granulomas or imaging evidence of cardiac involvement.

documentation Criteria

  • Detailed documentation of diagnostic tests confirming cardiac involvement.

Applicable To

  • Cardiac sarcoidosis
  • Sarcoid heart disease

Excludes

  • Isolated pulmonary sarcoidosis (D86.2)

Clinical Validation Requirements

  • Non-caseating granulomas on endomyocardial biopsy
  • Cardiac MRI shows late gadolinium enhancement (LGE) in basal septum
  • PET scan demonstrates focal FDG uptake in myocardium with perfusion defects

Code-Specific Risks

  • Misclassification if not confirmed by appropriate diagnostic tests.

Coding Notes

  • Ensure documentation supports the use of D86.85 with appropriate diagnostic evidence.

Ancillary Codes

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

Ventricular tachycardia

I47.2
Use when ventricular tachycardia is present as a manifestation.

Atrioventricular block, complete

I44.3
Use when AV block is present as a manifestation.

Differential Codes

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

Pulmonary sarcoidosis

D86.2
Use when sarcoidosis primarily affects the lungs with secondary cardiac involvement.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Cardiac Sarcoidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D86.85.

Impact

Clinical: Potential misdiagnosis or incomplete treatment., Regulatory: Non-compliance with coding standards., Financial: Loss of reimbursement for specific cardiac care.

Mitigation Strategy

Ensure thorough documentation of cardiac symptoms and diagnostic tests.

Impact

Reimbursement: Potential underpayment due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in clinical data reporting.

Mitigation Strategy

Ensure specific documentation of cardiac involvement to use D86.85.

Impact

Risk of audits due to non-specific coding of sarcoidosis.

Mitigation Strategy

Ensure detailed documentation of cardiac involvement.

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 Cardiac Sarcoidosis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Cardiac Sarcoidosis

Use these documentation templates to ensure complete and accurate documentation for Cardiac Sarcoidosis. These templates include all required elements for proper coding and billing.

Confirmed cardiac sarcoidosis with heart block

Specialty: Cardiology

Required Elements

  • Patient history
  • Diagnostic imaging results
  • Biopsy findings
  • Exclusion of other causes

Example Documentation

Patient with biopsy-proven sarcoidosis presents with complete heart block. CMR shows LGE in basal septum. Diagnosed with cardiac sarcoidosis.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has sarcoidosis with heart issues.
Good Documentation Example
Patient diagnosed with cardiac sarcoidosis confirmed by CMR showing LGE in basal septum.
Explanation
The good example specifies the diagnostic evidence supporting the diagnosis.

Need help with ICD-10 coding for Cardiac Sarcoidosis? Ask your questions below.

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