ICD-10 Coding for History of Coronary Artery Disease(Z86.79, Z95.1)
Complete ICD-10-CM coding and documentation guide for History of Coronary Artery Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Coronary Artery Disease
Z86.7Primary Range
Personal history of diseases of the circulatory system
Used for patients with a resolved history of coronary artery disease without current manifestations.
Presence of coronary angioplasty implant and graft
Used for patients with a history of coronary revascularization procedures like CABG.
Atherosclerotic heart disease of native coronary artery
Used when coronary artery disease is still present and managed.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z86.79 | Personal history of other diseases of the circulatory system | Use when the patient has a history of CAD that is resolved and asymptomatic. |
|
| Z95.1 | Presence of coronary angioplasty implant and graft | Use when documenting the presence of coronary artery bypass grafts. |
|
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 history of coronary artery disease
Essential facts and insights about History of Coronary Artery Disease
Primary ICD-10-CM Codes for history of coronary artery disease
Decision Criteria
clinical Criteria
- Patient has no current symptoms and normal cardiac tests.
documentation Criteria
- Documentation must specify 'history of CAD' with no current symptoms.
Applicable To
- Resolved coronary artery disease without current symptoms
Excludes
- Active coronary artery disease (I25.10)
Clinical Validation Requirements
- No current symptoms of CAD
- Normal stress test results
- No anti-anginal medications
Code-Specific Risks
- Incorrectly using this code for active CAD
Coding Notes
- Ensure documentation clearly states the resolved nature of CAD.
Z95.1 - Presence of coronary angioplasty implant and graft
Use when documenting the presence of coronary artery bypass grafts.
Applicable To
- History of CABG
Clinical Validation Requirements
- Operative report confirming revascularization
- Current graft patency documentation
Coding Notes
Ensure operative reports are available to support coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Coronary Artery Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.79.
Impact
Clinical: Misrepresentation of patient's health status., Regulatory: Potential audit issues., Financial: Denied claims due to incorrect coding.
Mitigation Strategy
Review medication list during documentation, Ensure all relevant details are included
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Ensure CAD is resolved and asymptomatic before using Z86.79.
Impact
Using history codes for active conditions.
Mitigation Strategy
Regular training on ICD-10 guidelines.
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 History of Coronary Artery Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Coronary Artery Disease
Use these documentation templates to ensure complete and accurate documentation for History of Coronary Artery Disease. These templates include all required elements for proper coding and billing.
Resolved CAD Documentation
Specialty: CardiologyRequired Elements
- Date of CAD diagnosis
- Date of last symptom
- Current medication list
- Recent test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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