ICD-10 Coding for Ruptured Plaque in Coronary Artery(I25.83, I25.84)
Complete ICD-10-CM coding and documentation guide for Ruptured Plaque in Coronary Artery. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Ruptured Plaque in Coronary Artery
I25.1-I25.9Primary Range
Chronic Ischemic Heart Disease
This range includes codes for coronary atherosclerosis and related conditions, which are relevant for coding ruptured plaques.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I25.83 | Coronary atherosclerosis due to lipid-rich plaque | Use when imaging confirms lipid-rich plaque composition. |
|
| I25.84 | Coronary atherosclerosis due to calcified coronary lesion | Use when calcification is documented on imaging. |
|
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 ruptured plaque coronary artery
Essential facts and insights about Ruptured Plaque in Coronary Artery
Primary ICD-10-CM Codes for ruptured plaque coronary artery
Decision Criteria
clinical Criteria
- Presence of lipid-rich plaque confirmed by imaging
Applicable To
- Lipid-rich plaque
Excludes
- Calcified coronary lesion (I25.84)
Clinical Validation Requirements
- IVUS showing necrotic core >30% plaque area
- CTA with intra-plaque contrast
Code-Specific Risks
- Incorrect use without imaging confirmation
Coding Notes
- Ensure imaging evidence supports the use of this code.
I25.84 - Coronary atherosclerosis due to calcified coronary lesion
Use when calcification is documented on imaging.
Applicable To
- Calcified coronary lesion
Excludes
- Lipid-rich plaque (I25.83)
Clinical Validation Requirements
- CT calcium score >400 Agatston units
- IVUS showing calcified nodule
Coding Notes
Ensure calcification is confirmed by imaging.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute myocardial infarction
I21.01-I21.9Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Ruptured Plaque in Coronary Artery to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I25.83.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with coding standards., Financial: Potential reimbursement issues.
Mitigation Strategy
Educate clinicians on documentation standards, Implement checklist for plaque documentation
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use I25.83 or I25.84 based on plaque composition.
Impact
Lack of imaging evidence for coded plaque type.
Mitigation Strategy
Require imaging reports for all plaque-related codes.
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 Ruptured Plaque in Coronary Artery, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Ruptured Plaque in Coronary Artery
Use these documentation templates to ensure complete and accurate documentation for Ruptured Plaque in Coronary Artery. These templates include all required elements for proper coding and billing.
Ruptured Lipid-Rich Plaque with STEMI
Specialty: CardiologyRequired Elements
- Plaque type and location
- Imaging findings
- Troponin levels
- ECG changes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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