Volume 2, Issue 4, August 2015 Last Revised: April 2018

Risk Adjustment Coding Academy- Coding Focus

Don’t let coding for tachycardia make your heart race!

or SVT has to be documented as defibrillation and implanted cardioverter “paroxysmal” in order to assign ICD‐9 defibrillators (ICDs), cardiac ablation, code 427.0 (HCC 96), Paroxysmal and/or surgery. Look for evidence of supraventricular tachyardia. current treatment such as tachycardia medication and/or anticoagulants. In ICD‐10, code I47.1 (HCC 96), Tachycardia is considered historical Supraventricular (paroxysmal) status post surgical correction or when tachycardia, is inclusive of atrial an electronic implant has been placed to tachycardia, PAT, SVT, and PSVT.3 There treat tachycardia specifically. Per AHA is no distinction in the code assignment Coding Clinic, “No code assignment is for atrial tachycardia or SVT documented required if no attention or treatment is as paroxysmal. provided to the condition or device.”4 Types of Tachycardia Sinus Tachycardia In adults, a heart rate of more than 100 ICD-10 Mapping beats per minute is called tachycardia.1 Sinus tachycardia is a regular increase in The table below provides an ICD‐9 to Tachycardia can reduce the heart’s the heart rate. The sinoatrial node sends ICD‐10 crosswalk for SVT and PSVT. ability to pump causing symptoms such out electrical signals quicker than usual. as shortness of breath, chest pain, The heart rate is fast, but the heart beats lightheadedness or loss of properly. Sinus tachycardia also leads to ICD-10 Mapping consciousness. If severe, it can also ICD‐9 code 427.89 (no HCC), Other cause a heart attack or even death. specified cardiac dysrhythmias. ICD-9 Code ICD-10 Code There are three types of tachycardia: In ICD‐10, sinus tachycardia leads to 427.89 (no HCC)- I47.1 (HCC 96)- code R00.0 (no HCC), Tachycardia 1. Atrial or Supraventricular Other specified Supraventricular unspecified, unless documented as Tachycardia cardiac (paroxysmal) “paroxysmal” which then leads to code 2. Sinus Tachycardia dysrhythmias tachycardia I47.1 (HCC 96), PSVT. 3. Ventricular Tachycardia 427.0 (HCC 96)- Ventricular Tachycardia Supraventricular Tachycardia Paroxysmal Ventricular tachycardia is a rapid heart supraventricular Atrial or Supraventricular Tachycardia rate in the lower chambers of the heart, tachycardia (SVT) is a rapid heart rate in the upper the ventricles. Electrical signals in the chambers of the heart. SVT happens ventricles fire irregularly, interfering with when electrical signals in the heart's electrical signals coming from the upper chambers fire abnormally. This sinoatrial node. The appropriate ICD‐9 1 American Heart Association website, interferes with the electrical signals code for ventricular tachycardia is 427.1 Tachycardia (accessed August 2015): coming from the sinoatrial node, the (HCC 96), Paroxysmal ventricular heart.org heart's natural pacemaker. tachycardia, (with or without 2 2012 Professional: International If SVT alone is documented, assign ICD‐9 documentation of “paroxysmal”). In ICD‐ Classification of Diseases, 9th revision, Clinical Modification. Eden Prairie, MN: code 427.89 (no HCC), Other specified 10, ventricular tachycardia leads to code 2 OptumInsight. cardiac dysrhythmias. I47.2 (HCC 96), Ventricular tachycardia. 3 Anita Schmidt, K.K., &, P.W. (2016). ICD‐10‐ CM Expert for Physicians. Optum360 Some forms are called paroxysmal atrial Tachycardia Treatment tachycardia (PAT) or paroxysmal 4 AHA Coding Clinic, 1993, Issue 5, Sick Sinus Syndrome with previously installed supraventricular tachycardia (PSVT). Treatment for tachycardia may include pacemaker Paroxysmal means the arrhythmia begins lifestyle changes, medicine, and ends sporatically. Atrial tachycardia anticoagulants, pacemaker, cardiac Coverage provided by Amerigroup, Inc. Reference the ICD-10-CM codebook, CMS-HCC Risk Adjustment Model V23, and AHA Coding Clinic for complete code sets and official coding guidance. It is not guaranteed that the information supplied is without defect. Any redistribution or other use is strictly forbidden.

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