Adult Cardiac Surgery ICD9 to ICD10 Crosswalks ICD-9 Code
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Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 3054 Date: August 29, 2014 Change Request 8803
Department of Health & CMS Manual System Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 3054 Date: August 29, 2014 Change Request 8803 SUBJECT: Ventricular Assist Devices for Bridge-to-Transplant and Destination Therapy I. SUMMARY OF CHANGES: This Change Request (CR) is effective for claims with dates of service on and after October 30, 2013; contractors shall pay claims for Ventricular Assist Devices as destination therapy using the criteria in Pub. 100-03, part 1, section 20.9.1, and Pub. 100-04, Chapter 32, sec. 320. EFFECTIVE DATE: October 30, 2013 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: September 30, 2014 Disclaimer for manual changes only: The revision date and transmittal number apply only to red italicized material. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual is not updated) R=REVISED, N=NEW, D=DELETED-Only One Per Row. R/N/D CHAPTER / SECTION / SUBSECTION / TITLE D 3/90.2.1/Artifiical Hearts and Related Devices R 32/Table of Contents N 32/320/Artificial Hearts and Related Devices N 32/320.1/Coding Requirements for Furnished Before May 1, 2008 N 32/320.2/Coding Requirements for Furnished After May 1, 2008 N 32/320.3/ Ventricular Assist Devices N 32/320.3.1/Postcardiotomy N 32/320.3.2/Bridge-To -Transplantation (BTT) N 32/320.3.3/Destination Therapy (DT) N 32/320.3.4/ Other N 32/320.4/ Replacement Accessories and Supplies for External Ventricular Assist Devices or Any Ventricular Assist Device (VAD) III. -
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Phenotype definition for the Vanderbilt Genome-Electronic Records project Identifying genetics determinants of normal QRS duration (QRSd) Patient population: • Patients with DNA whose first electrocardiogram (ECG) is designated as “normal” and lacking an exclusion criteria. • For this study, case and control are drawn from the same population and analyzed via continuous trait analysis. The only difference will be the QRSd. Hypothetical timeline for a single patient: Notes: • The study ECG is the first normal ECG. • The “Mildly abnormal” ECG cannot be abnormal by presence of heart disease. It can have abnormal rate, be recorded in the presence of Na-channel blocking meds, etc. For instance, a HR >100 is OK but not a bundle branch block. • Y duration = from first entry in the electronic medical record (EMR) until one month following normal ECG • Z duration = most recent clinic visit or problem list (if present) to one week following the normal ECG. Labs values, though, must be +/- 48h from the ECG time Criteria to be included in the analysis: Criteria Source/Method “Normal” ECG must be: • QRSd between 65-120ms ECG calculations • ECG designed as “NORMAL” ECG classification • Heart Rate between 50-100 ECG calculations • ECG Impression must not contain Natural Language Processing (NLP) on evidence of heart disease concepts (see ECG impression. Will exclude all but list below) negated terms (e.g., exclude those with possible, probable, or asserted bundle branch blocks). Should also exclude normalization negations like “LBBB no longer present.” -
A Case of Stenosis of Mitral and Tricuspid Valves in Pregnancy, Treated by Percutaneous Sequential Balloon Valvotomy
Case Report Annals of Clinical Medicine and Research Published: 30 Jun, 2020 A Case of Stenosis of Mitral and Tricuspid Valves in Pregnancy, Treated by Percutaneous Sequential Balloon Valvotomy Vipul Malpani, Mohan Nair*, Pritam Kitey, Amitabh Yaduvanshi, Vikas Kataria and Gautam Singal Department of Cardiology, Holy Family Hospital, New Delhi, India Abstract Rheumatic mitral stenosis is associated with other lesions, but combination of mitral stenosis and tricuspid stenosis is unusual. We are reporting a case of mitral and tricuspid stenosis in a pregnant lady that was successfully treated by sequential balloon valvuloplasty in a single sitting. Keywords: Mitral stenosis; Tricuspid stenosis; Balloon valvotomy Abbreviations MS: Mitral Stenosis; TS: Tricuspid Stenosis; BMV: Balloon Mitral Valvotomy; CMV: Closed Mitral Valvotomy; BTV: Balloon Tricuspid Valvotomy; PHT: Pressure Half Time; MVA: Mitral Valve Area; TVA: Tricuspid Valve Area; LA: Left Atrium; RA: Right Atrium; TR: Tricuspid Regurgitation Introduction Rheumatic Tricuspid valve Stenosis (TS) is rare, and it generally accompanies mitral valve disease [1]. TS is found in 15% cases of rheumatic heart disease but it is of clinical significance in only 5% cases [2]. Isolated TS accounts for about 2.4% of all cases of organic tricuspid valve disease and is mostly seen in young women [3,4]. Combined stenosis of mitral and tricuspid valves is extremely uncommon. Combined stenosis of both the valves has never been reported in pregnancy. Balloon Mitral Valvotomy (BMV) and surgical Closed Mitral Valvotomy (CMV) are two important OPEN ACCESS therapeutic options in the management of rheumatic mitral stenosis. Significant stenosis of the *Correspondence: tricuspid valve can also be treated by Balloon Tricuspid Valvotomy (BTV) [5,6]. -
New Emergency Room Requirement for Hospital and Autopay List of Diagnosis Codes
Provider update New emergency room requirement for hospitals Dell Children’s Health Plan reviewed our emergency room (ER) claims data and identified numerous reimbursements for services with diagnoses that are not indicative of urgent or emergent conditions. As a managed care organization, we promote the provision of services in the most appropriate setting and reinforce the need for members to coordinate care with their PCP unless the injury or sudden onset of illness requires immediate medical attention. Effective on or after August 1, 2020, for nonparticipating hospitals and on or after October 1, 2020, for participating hospitals, Dell Children’s Health Plan will only process an ER claim for a hospital as emergent and reimburse at the applicable contracted rate or valid out‐ of‐network Medicaid fee‐for‐service rate when a diagnosis from a designated auto‐pay list is billed as the primary diagnosis on the claim. If the primary diagnosis is not on the auto‐pay list, the provider must submit medical records with the claim. Upon receipt, the claim and records will be reviewed by a prudent layperson standard to determine if the presenting symptoms qualify the patient’s condition as emergent. If the reviewer confirms the visit was emergent, according to the prudent layperson criteria, the claim will pay at the applicable contracted rate or valid out‐of‐network Medicaid fee‐for‐service rate. If it is determined to be nonemergent, the claim will pay a triage fee. In the event a claim from a hospital is submitted without a diagnosis from the auto‐pay list as the primary diagnosis and no medical records are attached, the claim for the ER visit will automatically pay a triage fee. -
Vectorcardiographic Study of Aberrant Conduction' of Intraventricular Block
Br Heart J: first published as 10.1136/hrt.38.6.549 on 1 June 1976. Downloaded from British Heart journal, 1976, 38, 549-557. Vectorcardiographic study of aberrant conduction' Anterior displacement of QRS: another form of intraventricular block H. E. Kulbertus, F. de Leval-Rutten, and P. Casters From the Division of Cardiology, Institute of Medicine, University of Liege School of Medicine, Liege, Belgium Aberrant ventricular conduction was induced in 44 subjects by introduction of atrialpremature beats through a transvenous catheter-electrode. Multiple patterns of aberrant ventricular conduction were obtained in 32 patients and, in the whole group, 116 different configurations were recorded. Of these, 104 showed a classical pattern of mono- or biventricular conduction disturbance. The pattertn frequencies were as follows: right bundle-branch block, 28; left anterior hemiblock combined with right bundle-branch block, 21; left anterior hemiblock, 17; left posterior hemiblock combined with right bundle-branch block, 12; left posterior hemiblock, 10; complete left bundle-branch block, 10; and incomplete left bundle-branch block, 6. The remaining 12 configurations could not be classified into the usual categories of intraventricular blocks. In 7 of them, the alterations only consisted of trivial modifications of the QRS contour. In the other 5 instances, aberrant conduction manifested itself by a conspicuous anterior displacement of the QRS loop, with increased duration of anteriorforces. The latter observation is worthy of notice, as it indicates that, in the differential diagnosis of the vectorcardiographic pattern characterized by prominent anteriorforces, conduction disturbances should http://heart.bmj.com/ be considered a possible aetiological factor in addition to right ventricular hypertrophy, and true posterior wall myocardial infarction. -
Severe Tricuspid Valve Stenosis
Severe Tricuspid Valve Stenosis A Cause of Silent Mitral Stenosis Abdolhamid SHEIKHZADEH, M.D., Homayoon MOGHBELI, M.D., Parviz GHABUSSI, M.D., and Siavosh TARBIAT, M.D. SUMMARY The diastolic rumbling murmur of mitral stenosis (MS) may be attenuated in the presence of low cardiac output, right ventri- cular enlargement, Lutembacher's syndrome, pulmonary emphy- sema, and obesity. In this report we would like to stress that the presence of tricuspid stenosis (TS) is an additional significant cause of silent MS. The clinical material consisted of 73 patients with rheumatic TS who had undergone cardiac surgery. Five of these cases had clinical findings of TS without auscultatory findings of MS. They were found to have severe MS at the time of operation and to re- quire mitral valve surgery. At cardiac catheterization the mean diastolic gradient (MDG) across the mitral valve (MV) was less than 3mmHg and pulmonary arterial systolic pressure was 29- 42mmHg. The MDG across the tricuspid valve was 6-17mmHg. In conclusion, TS can mask clinical and hemodynamic find- ings of MS. The reason for this is the mechanical barrier imposed by TS proximal to the MV. Additional Indexing Words: Rheumatic valvular disease Atrial imprint Tricuspid valve surgery HE most common silent valvular lesion is that of mitral stenosis (MS).1) T The auscultatory findings of MS particularly the diastolic rumble, can be masked in patients with low cardiac output,2) severe pulmonary hyperten- sion right ventricular hypertrophy,3) Lutembacher's syndrome,4) pulmonary emphysema, and obesity.2) The purpose of this communication is to report another cause of true silent MS. -
Early Outcomes of Percutaneous Pulmonary Valve Implantation with Pulsta and Melody Valves: the First Report from Korea
Journal of Clinical Medicine Article Early Outcomes of Percutaneous Pulmonary Valve Implantation with Pulsta and Melody Valves: The First Report from Korea Ah Young Kim 1,2 , Jo Won Jung 1,2, Se Yong Jung 1,2 , Jae Il Shin 1,2 , Lucy Youngmin Eun 1,2 , Nam Kyun Kim 3 and Jae Young Choi 1,2,* 1 Division of Pediatric Cardiology, Center for Congenital Heart Disease, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; [email protected] (A.Y.K.); [email protected] (J.W.J.); [email protected] (S.Y.J.); [email protected] (J.I.S.); [email protected] (L.Y.E.) 2 Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea 3 Department of Pediatrics, Emory University, Atlanta, GA 30322, USA; [email protected] * Correspondence: [email protected] Received: 25 July 2020; Accepted: 24 August 2020; Published: 26 August 2020 Abstract: Percutaneous pulmonary valve implantation (PPVI) is used to treat pulmonary stenosis (PS) or pulmonary regurgitation (PR). We described our experience with PPVI, specifically valve-in-valve transcatheter pulmonary valve replacement using the Melody valve and novel self-expandable systems using the Pulsta valve. We reviewed data from 42 patients undergoing PPVI. Twenty-nine patients had Melody valves in mostly bioprosthetic valves, valved conduits, and homografts in the pulmonary position. Following Melody valve implantation, the peak right ventricle-to-pulmonary artery gradient decreased from 51.3 11.5 to 16.7 3.3 mmHg and right ventricular systolic pressure ± ± fell from 70.0 16.8 to 41.3 17.8 mmHg. -
Building Blocks of Clinical Practice Helping Athletic Trainers Build a Strong Foundation Issue #7: Cardiac Assessment: Basic Cardiac Auscultation Part 2 of 2
Building Blocks of Clinical Practice Helping Athletic Trainers Build a Strong Foundation Issue #7: Cardiac Assessment: Basic Cardiac Auscultation Part 2 of 2 AUSCULTATION Indications for Cardiac Auscultation • History of syncope, dizziness • Chest pain, pressure or dyspnea during or after activity / exercise • Possible indication of hypertrophic cardiomyopathy • Sensations of heart palpitations • Tachycardia or bradycardia • Sustained hypertension and/or hypercholesterolemia • History of heart murmur or heart infection • Noted cyanosis • Trauma to the chest • Signs of Marfan’s syndrome * Enlarged or bulging aorta * Ectomorphic, scoliosis or kyphosis, pectus excavatum or pectus carinatum * Severe myopia Stethoscope • Diaphragm – best for hearing high pitched sounds • Bell – best for hearing low pitched sounds • Ideally, auscultate directly on skin, not over clothes Adult Rate • > 100 bpm = tachycardia • 60-100 bpm = normal (60-95 for children 6-12 years old) • < 60 bpm = bradycardia Rhythm • Regular • Irregular – regularly irregular or “irregularly” irregular Auscultation Sites / Valvular Positions (see part 1 of 2 for more information) • Aortic: 2nd right intercostal space • Pulmonic: 2nd left intercostal space • Tricuspid: 4th left intercostal space • Mitral: Apex, 5th intercostal space (mid-clavicular line) Auscultate at each valvular area with bell and diaphragm and assess the following: • Cardiac rhythm – regular or irregular • Heart sounds – note the quality • Murmurs – valvular locations • Extra-Cardiac Sounds – clicks, snaps and -
Atrioventricular Conduction in Patients with Clinical Indications for Transvenous Cardiac Pacing1
British Heart Journal, 1975, 37, 583-592. Atrioventricular conduction in patients with clinical indications for transvenous cardiac pacing1 Stafford I. Cohen, L. Kent Smith, Julian M. Aoresty, Panagiotis Voukydis, and Eugene Morkin From the Cardiac Unit, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts, U.S.A. Eighty patients with clinical indications for cardiac pacing had atrioventricular conduction analysed by His bundle study. The indicationsfor cardiac pacing included high grade atrioventricular block, sick sinus node syndrome without tachycardia, bradycardia-tachycardia syndrome, unstable bilateral bundle-branch block, and uncontrolled ventricular irritability. Complete heart block, Wenckebach block (Mobitz I), and 2:i block were notedproximal and distal to the His bundle. Mobitz II block only occurred distal to the His bundle. Ofspecial interest were the high incidence ofdistal conduction abnormalities by His bundle analysis (40/80, 5o%), the re-establishment ofnormal atrio- ventricular conduction in acutely ill patients with recent evidence of heart block, and the high incidence of intraventricular conduction disturbances on standard electrocardiogram (48/8o, 60%). Intensive study of atrioventricular conduction by occurring electrophysiological data in this large His bundle analysis has been performed in a variety group of patients in clinical need of pacemakers of patient populations. In many instances studies constitutes the substance of this report. The data were electively undertaken in patients who had should be representative of the cardiac conduction never been threatened by a compromising cardiac abnormalities which present in a general hospital. arrhythmia. In addition, abnormalities of atrio- ventricular conduction were frequently achieved by Subjects and methods pacemaker-induced acceleration of the atrial rate. -
CMS Limitations Guide - Cardiovascular Services
CMS Limitations Guide - Cardiovascular Services Starting October 1, 2015, CMS will update their It is the responsibility of the provider to code to the existing medical necessity limitations on tests and highest level specified in the ICD-10-CM. The correct procedures to correspond to ICD-10 codes. This use of an ICD-10-CM code listed below does not limitations guide provides you with the latest assure coverage of a service. The service must be changes. reasonable and necessary in the specific case and must meet the criteria specified in this This guide is not an all-inclusive list of National determination. Coverage Documents (NCD) and Local Coverage Documents (LCD). You can search by LCD or NCD or We will continue to update this list as new CMS keyword and region on the CMS website at: limitations are announced. You can always find the https://www.cms.gov/medicare-coverage- most current list at: database/overview-and-quick- www.munsonhealthcare.org/medicalnecessity. search.aspx?clickon=search. If you have any questions, please contact Kari Smith, CMS will deny payment if the correct diagnosis Office Coordinator, at (231) 935-2296, or Karen codes are not entered on the order form, and your Popa, Director, Patient Access Services, at (231) 935- 7493. patient’s test or procedure will not be covered. We compiled this information in one location to make it easier for you to find the proper codes for medically necessary diagnoses. CMS Limitations Guide – Cardiovascular Services (L34636) Electrocardiographic (EKG or ECG) Monitoring (Holter -
Cardiovascular Magnetic Resonance (CMR) Page 1 of 11
Cardiovascular Magnetic Resonance (CMR) Page 1 of 11 No review or update is scheduled on this Medical Policy as it is unlikely that further published literature would change the policy position. If there are questions about coverage of this service, please contact Blue Cross and Blue Shield of Kansas customer service, your professional or institutional relations representative, or submit a predetermination request. Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Cardiovascular Magnetic Resonance (CMR) Professional Institutional Original Effective Date: August 4, 2005 Original Effective Date: July 1, 2006 Revision Date(s): February 27, 2006, Revision Date(s): May 2, 2007; May 2, 2007; November 1, 2007; November 1, 2007; January 1, 2010; January 1, 2010; February 15, 2013; February 15, 2013; December 11, 2013; December 11, 2013; April 15, 2014; April 15, 2014; July 15, 2014; June 10, 2015; July 15, 2014; June 10, 2015; June 8, 2016; June 8, 2016; October 1, 2016; October 1, 2016; May 10, 2017; May 10, 2017; April 25, 2018; April 25, 2018; October 1, 2018 October 1, 2018 Current Effective Date: July 15, 2014 Current Effective Date: July 15, 2014 Archived Date: July 3, 2019 Archived Date: July 3, 2019 State and Federal mandates and health plan member contract language, including specific provisions/exclusions, take precedence over Medical Policy and must be considered first in determining eligibility for coverage. To verify a member's benefits, contact Blue Cross and Blue Shield of Kansas Customer Service. The BCBSKS Medical Policies contained herein are for informational purposes and apply only to members who have health insurance through BCBSKS or who are covered by a self-insured group plan administered by BCBSKS. -
Surgical Management of Tricuspid Stenosis
Art of Operative Techniques Surgical management of tricuspid stenosis Marisa Cevasco, Prem S. Shekar Division of Cardiac Surgery, Brigham and Women’s Hospital, Boston, MA, USA Correspondence to: Prem S. Shekar, MD. Chief of Cardiac Surgery, 75 Francis Street, Boston, MA 02115, USA. Email: [email protected]. Tricuspid valve stenosis (TS) is rare, affecting less than 1% of patients in developed nations and approximately 3% of patients worldwide. Detection requires careful evaluation, as it is almost always associated with left-sided valve lesions that may obscure its significance. Primary TS is most frequently caused by rheumatic valvulitis. Other causes include carcinoid, radiation therapy, infective endocarditis, trauma from endomyocardial biopsy or pacemaker placement, or congenital abnormalities. Surgical management of TS is not commonly addressed in standard cardiac texts but is an important topic for the practicing surgeon. This paper will elucidate the anatomy, pathophysiology, and surgical management of TS. Keywords: Tricuspid stenosis (TS); tricuspid valve replacement (TVR) Submitted Feb 26, 2017. Accepted for publication Apr 21, 2017. doi: 10.21037/acs.2017.05.14 View this article at: http://dx.doi.org/10.21037/acs.2017.05.14 Introduction has also been accommodated in the design of annuloplasty rings, which have a gap in the ring in this area. Anatomy The anterior papillary muscle provides chordae to the The tricuspid valve consists of three leaflets (anterior, anterior and posterior leaflets, the posterior papillary muscle posterior, and septal), their associated chordae tendineae provides chordae to the posterior and septal leaflets, and the and papillary muscles, the fibrous tricuspid annulus, and the septal wall gives chordae to the anterior and septal leaflets.