ICD-10 Coding for Non-Ischemic Cardiomyopathy(I42.8, I42.0)
Complete ICD-10-CM coding and documentation guide for Non-Ischemic Cardiomyopathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Non-Ischemic Cardiomyopathy
I42-I43Primary Range
Cardiomyopathy
This range includes all types of cardiomyopathy, with specific codes for non-ischemic types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I42.8 | Other cardiomyopathies | Use when non-ischemic cardiomyopathy is confirmed but not further specified. |
|
| I42.0 | Dilated cardiomyopathy | Use when dilated cardiomyopathy is specifically documented. |
|
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 non-ischemic cardiomyopathy
Essential facts and insights about Non-Ischemic Cardiomyopathy
Primary ICD-10-CM Codes for non-ischemic cardiomyopathy
Decision Criteria
clinical Criteria
- Confirmed non-ischemic cardiomyopathy without specific subtype
Applicable To
- Non-ischemic cardiomyopathy
Excludes
- Ischemic cardiomyopathy (I25.5)
Clinical Validation Requirements
- Negative stress test or angiogram
- BNP >400 pg/mL
- Absence of amyloid deposits on CMR
Code-Specific Risks
- Risk of claim denial if not supported by specific diagnostic evidence.
Coding Notes
- Ensure documentation specifies non-ischemic nature to avoid using I42.9.
I42.0 - Dilated cardiomyopathy
Use when dilated cardiomyopathy is specifically documented.
Applicable To
- Non-ischemic dilated cardiomyopathy
Clinical Validation Requirements
- Echocardiogram showing LVEF ≤40%
- Chamber dilation
Coding Notes
Ensure echocardiogram results are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Heart failure, unspecified
I50.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Non-Ischemic Cardiomyopathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I42.8.
Impact
Clinical: Inadequate assessment of heart function., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Use structured templates for cardiology notes., Regular training on documentation standards.
Impact
Reimbursement: Potential claim denial due to lack of specificity., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation of patient condition.
Mitigation Strategy
Use I42.8 when non-ischemic cardiomyopathy is confirmed.
Impact
Risk of audits due to use of unspecified codes.
Mitigation Strategy
Ensure documentation supports specific coding.
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 Non-Ischemic Cardiomyopathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Non-Ischemic Cardiomyopathy
Use these documentation templates to ensure complete and accurate documentation for Non-Ischemic Cardiomyopathy. These templates include all required elements for proper coding and billing.
Non-Ischemic Cardiomyopathy Diagnosis
Specialty: CardiologyRequired Elements
- LVEF measurement
- Absence of coronary artery disease
- Specific type of cardiomyopathy
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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