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Home , Unstable angina

Volume 6, Issue 1, January 2019

Medicare Risk Adjustment Coding Focus

Unstable

Signs and Symptoms angina pectoris (category I20). 4 Documentation must specifically state Symptoms of unstable angina vary in the type of angina as unstable in order to frequency and intensity and may include: be coded as such. Coders should be  shortness of breath aware of alternative terms that may be  radiating used, such as crescendo angina, to  discomfort (tightness, burning) identify unstable angina. Additionally, Unstable angina is a warning sign of a there are combination codes for attack and emergency medical care atherosclerotic heart disease with angina should be sought out.3 pectoris (subcategories I25.11 and I25.7), for which a causal relationship between Overview Treatment the two conditions can be assumed Angina refers to pain or discomfort in unless otherwise documented as Treatment for unstable angina focuses unrelated. the chest area, near or around the heart on perfusion performance of coronary muscle. Unstable angina is a form of arteries. There are two options (CAD) which is available for perfusion performance: the leading cause of death worldwide. non-invasive and invasive treatments. I20 Angina Pectoris Unlike the usual symptoms of stable The non-invasive method includes (HCC 87/88) angina, unstable angina results in varying medicinal treatments such as , patterns, which are irregular and difficult blood thinners for their antiplatelet I20.0 – Unstable Angina (HCC 87) to distinguish from a myocardial properties, or other I20.1 – Angina pectoris with infarction (heart attack). According to vasodilators, in addition to oxygen. The documented spasm (HCC 88) the National Institutes of Health, goal of non-invasive treatment is to I20.8 – Other forms of angina pectoris unstable angina affects over 14 million reduce the workload of the heart. The (HCC 88) 1 people in the United States. invasive method would be the I20.9 – Angina pectoris, unspecified performance of surgery by either (HCC 88) Cause Percutaneous Transluminal Coronary Artery, coronary artery stenting, or Coronary artery disease is the principal coronary artery bypass graft. contributor of unstable angina, which causes blood flow and oxygen depletion Prevention Resources to the heart muscles known as the : myocardium. The depletion is a result of Adjustments in lifestyle habits can help 1 National Institutes of Health. (n.d.) Unstable the narrowing of by with prevention efforts for angina Angina-Stat Pearls-NCBI Bookshelf. Accessed ruptured plaque or blood clots in which a attacks. Maintaining healthy eating partial or total blockage in the artery can December 11, 2018 from nih.gov habits, regular exercise, and decreasing 2 American Heart Association. (n.d.) Unstable occur.2 If this obstruction develops, it alcohol intake are a few ways to assist in Angina. Accessed December 11, 2018 from can lead to irreversible damage to the lowering risk. heart.org myocardium supplied by that artery with 3 Medline Plus. (n.d.) Unstable Angina: Medline the potential for developing a Coding Guidance Plus Medical Encyclopedia. Accessed December 11, , stroke, or even 2018 from medlineplus.gov death. Chapter 9 of the ICD-10-CM codebook 4 Schmidt, A. & Patterson, L. (2019). ICD-10-CM contain diagnoses codes related to Expert for Physicians. Optum Insight Inc.

This publication contains proprietary information of Anthem, Inc. It is intended to be used as informational by individuals participating in Anthem’s Medicare Advantage plans. Reference the ICD-10-CM codebook, CMS-HCC Risk Adjustment Model V23, and AHA Coding Clinic for complete code sets and official coding guidance. Anthem does not guarantee that the information supplied is without defect. Any redistribution or other use is strictly forbidden.

Y0114_18_38166_I_01/08/2019 AGPCARE-0055-19 April 2019