Conversion of Select ICD-9-CM Codes/Categories to ICD-10-CM *Codes with a Greater Degree of Specificity Should Be Considered First
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Follow-Up of 134 Pediatric Patients with Wolff-Parkinson-White Pattern: Natural Outcome and Medical Treatment
ORIGINAL ARTICLE Follow-up of 134 Pediatric Patients with Wolff-Parkinson-White Pattern: Natural Outcome and Medical Treatment AMALIA N. STEFANI, GABRIELA R. DAL FABBRO, MARÍA J. BOSALEH, ROBERTH VÁSQUEZ, GUSTAVO A. COSTA, RICARDO SPERANZA, JORGE L. GENTILE, CLAUDIO DE ZULOAGAMTSAC Received: 01/03/2013 ABSTRACT Accepted: 01/03/2013 Address for reprints: Objective Amalia N. Stefani The aim of the study was to evaluate the outcome of a pediatric population with Almafuerte 1722 ventricular pre-excitation pattern, supraventricular tachycardia, atrial fibrillation, (1650) San Martín, cardiomyopathies, mortality and medical treatment. Pcia. de Buenos Aires e-mail: [email protected] Methods From 1976 to 2011, a descriptive observational study was conducted on patients with ventricular pre-excitation in the electrocardiogram. All patients underwent an echocardiogram, 101(75.3%) Holter monitoring, and 69 (51.5%) an ergometric test. Radiofrequency ablation was performed in selected patients. Data were expressed as mean and standard deviation. Results The study population consisted of 134 patients; 80 (59.7%) were male. Age at diag- nosis ranged from 2 days to 18 years (mean 6.5±5 years). Clinical follow-up lasted 1 month to 20 years (mean 3.6±3.9 years). Thirty five patients (26.1%) consulted for supraventricular tachycardia, 16 (11.9%) for ventricular pre-excitation, and the remaining 83 patients (61.9%) for other abnormalities. Seventy-six patients (56.7%) had left conduction pathway and 3 patients double conduction pathway. Sixteen pa- tients (11.9%) presented supraventricular tachycardia during follow-up. Overall, 51 patients (38%) had orthodromic tachycardia at 6.3±5.8 years, 10 patients during the neonatal period. -
ICD-9-ICD-10 Codes for Cardiology
ICD-9-ICD-10 Codes for Cardiology ICD-9 Code ICD-10 Code(s) ICD-10 Descrption(s) Atrial Fibrillation and Flutter 427.31, 427.32 I48.0 Paroxysmal atrial fibrillation I48.1 Persistent atrial fibrillation I48.2 Chronic atrial fibrillation I48.3 Typical atrial flutter I48.4 Atypical atrial flutter I48.91* Unspecified atrial fibrillation I48.92* Unspecified atrial flutter Cardiac Arrhythmias (Other) 427.41, 427.42, 427.60, 427.61, 427.69, 427.81, 427.89, 427.9 I49.01 Ventricular fibrillation I49.02 Ventricular flutter I49.1 Atrial premature depolarization I49.2 Junctional premature depolarization I49.3 Ventricular premature depolarization I49.40 Unspecified premature depolarization I49.49 Other premature depolarization I49.5 Sick sinus syndrome I49.8 Other specified cardiac arrhythmias I49.9* Cardiac arrhythmia, unspecified Chest Pain 411.1, 413.1, 413.9, 786.50 to 786.59 range I20.0 Unstable angina I20.1 Angina pectoris with documented spasm I20.8 Other forms of angina pectoris I20.9 Angina pectoris, unspecified R07.1 Chest pain on breathing R07.2 Precordial pain R07.81 Pleurodynia R07.82 Intercostal pain R07.89 Other chest pain R07.9* Chest pain, unspecified Heart Failure 428.0, 428.1, 428.20 to 428.23 range, 428.30 to 428.33 range, 428.40 to 428.43 range, 428.9 I50.1 Left ventricular failure I50.20* Unspecified systolic (congestive) heart failure I50.21 Acute systolic (congestive) heart failure I50.22 Chronic systolic (congestive) heart failure I50.23 Acute on chronic systolic (congestive) heart failure I50.30* Unspecified diastolic (congestive) -
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. -
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]. -
Acute Coronary Syndrome 1
Acute Coronary Syndrome 1. Which one of the following is not considered a benefit of Chest Pain Center Accreditation? a. Improved patient outcomes b. Streamlined processes to allow for rapid treatment c. Reduce costs and readmission rates d. All of the above are benefits of Chest Pain Center Accreditation 2. EHAC stands for Early Heart Attack Care? a. True b. False 3. What is the primary cause of acute coronary syndrome (ACS)? a. Exercise b. High blood pressure c. Atherosclerosis d. Heart failure 4. Which one of the following is not considered a symptom of ACS? a. Jaw Discomfort b. Abdominal discomfort c. Shortness of breath without chest discomfort d. All of the above are considered symptoms of ACS 5. There are age and gender differences associated with signs and symptoms of ACS? a. True b. False 6. Altered mental status may be a sign of ACS in some individuals? a. True b. False 7. All of the following are considered modifiable risk factors for ACS except: a. Smoking b. Sedentary lifestyle c. Age d. High cholesterol 8. Heart attacks occur immediately and never have warning signs? a. True b. False 9. If someone is having a heart attack, which of the following is the best option for seeking treatment? a. Wait a few hours and see if the symptoms resolve, if they do not, then call your physician b. Drive yourself to the ED. You can get there faster since you know a short-cut c. Call 9-1-1 to activate EMS immediately d. Call a family member or neighbor to drive you to the ED 10. -
Risk Stratification in Acute Coronary Syndrome: Focus on Unstable Angina/Non-ST Segment Elevation Myocardial Infarction R Bugiardini
729 EDITORIAL Heart: first published as 10.1136/hrt.2004.034546 on 14 June 2004. Downloaded from Risk stratification in acute coronary syndrome: focus on unstable angina/non-ST segment elevation myocardial infarction R Bugiardini ............................................................................................................................... Heart 2004;90:729–731. doi: 10.1136/hrt.2004.034546 Although there have been advances in the management of fashion. Experts in a variety of fields make decisions using a more intuitive process of unstable angina/non-ST segment elevation myocardial recognising patterns and applying their own infarction syndromes, the rate of cardiovascular mortality rules. In varying proportions, pathophysiologic after discharge is still unacceptably high. With many reasoning, personal clinical experience, and recent published research each play a role in therapeutic options available, the clinician is challenged to the development of our own clinical rules. This identify the safest and most effective treatment for long term approach may produce incorrect use of tools of survival of each individual patient risk stratifications and inappropriate use of treatment strategies and procedures. However, ........................................................................... errors are more often due to ‘‘failure’’ of the system, not of the doctors. Most errors occur at the transfer of care, and particularly at the transfer from the outpatient to the inpatient ‘‘Simple, but not too simple’’—Albert Einstein sites. There are a number of programs now focusing on errors and strategies to reduce errors welve million individuals in the USA and (GAP, CRUSADE QI, JACHO).5–7 All of these 143 million worldwide have coronary artery programs focus on education of physicians, Tdisease. Two million US patients are better interaction between health care organisa- admitted annually to cardiac care units with tions and physicians, and appropriate use of care acute coronary syndromes (ACS). -
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. -
Arrhythmias in Two Patients with Left Ventricular Bypass Transplants'
Br Heart J: first published as 10.1136/hrt.38.7.725 on 1 July 1976. Downloaded from British Heart Journal, 1976, 38, 725-731. Arrhythmias in two patients with left ventricular bypass transplants' Brian M. Kennelly, Peter Corte, Jacques Losman, and Christiaan N. Barnard From the Cardiac Clinic and Department of Cardiothoracic Surgery, Groote Schuur Hospital and the Departments of Medicine and Surgery, University of Cape Town, South Africa Two patients who underwvent left ventricular bypass transplants are described. Both patients sustained post- operative rhythm disturbances of their own hearts during sinus rhythm of the donor hearts. Illustrative examples of atrialflutter, ventricular flutter, ventricular fibrillation, blocked atrial extrasystoles, and double ventricular parasystole in the recipient hearts are presented. The patients tolerated all these arrhythmias well during uninterrupted sinus rhythm in the donor heart. The problems in interpretation of arrhythmias in the presence of two hearts are discussed. [DONOR I IRECIPIENTI Sv C..AOT A ;PULMONARY ARRY http://heart.bmj.com/ RIGHTATRIU_gXARA t,.Y APPENDAGE R.V R.V on September 28, 2021 by guest. Protected copyright. FIG. 1 Position of donor and recipient hearts in anteroposterior view with relevant anasta- moses (Barnard and Losman (1975). Reprinted with permission of South African Medical Journal). The purpose of this report is to illustrate some of right lung and in the right cardiophrenic angle. the bizarre electrocardiograms resulting from Both venae cavae of the donor heart are ligated and cardiac transplantation in man where the recipient the donor right ventricle pumps only its coronary heart is left in situ. The surgical technique was sinus venous return into the recipient's right described in detail by Barnard and Losman (1975). -
Coronary Artery Disease Management
HealthPartners Inspire® Special Needs Basic Care Clinical Care Planning and Resource Guide CORONARY ARTERY DISEASE MANAGEMENT The following Evidence Base Guideline was used in developing this clinical care guide: National Institute of Health (NIH); American Heart Association (AHA) Documented Health Condition: Coronary Artery Disease, Coronary Heart Disease, Heart Disease What is Coronary Artery Disease? Coronary artery disease (CAD) is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen‐rich blood to your heart muscle. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH‐er‐o‐skler‐O‐sis). The buildup of plaque occurs over many years. Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen‐rich blood to the heart. If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. Over time, ruptured plaque also hardens and narrows the coronary arteries. Common Causes of Coronary Artery Disease? If the flow of oxygen‐rich blood to your heart muscle is reduced or blocked, angina or a heart attack can occur. Angina is chest pain or discomfort. It may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. A heart attack occurs if the flow of oxygen‐rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. -
Cardiology 1
Cardiology 1 SINGLE BEST ANSWER (SBA) a. Sick sinus syndrome b. First-degree AV block QUESTIONS c. Mobitz type 1 block d. Mobitz type 2 block 1. A 19-year-old university rower presents for the pre- e. Complete heart block Oxford–Cambridge boat race medical evaluation. He is healthy and has no significant medical history. 5. A 28-year-old man with no past medical history However, his brother died suddenly during football and not on medications presents to the emergency practice at age 15. Which one of the following is the department with palpitations for several hours and most likely cause of the brother’s death? was found to have supraventricular tachycardia. a. Aortic stenosis Carotid massage was attempted without success. b. Congenital long QT syndrome What is the treatment of choice to stop the attack? c. Congenital short QT syndrome a. Intravenous (IV) lignocaine d. Hypertrophic cardiomyopathy (HCM) b. IV digoxin e. Wolff–Parkinson–White syndrome c. IV amiodarone d. IV adenosine 2. A 65-year-old man presents to the heart failure e. IV quinidine outpatient clinic with increased shortness of breath and swollen ankles. On examination his pulse was 6. A 75-year-old cigarette smoker with known ischaemic 100 beats/min, blood pressure 100/60 mmHg heart disease and a history of cardiac failure presents and jugular venous pressure (JVP) 10 cm water. + to the emergency department with a 6-hour history of The patient currently takes furosemide 40 mg BD, increasing dyspnoea. His ECG shows a narrow complex spironolactone 12.5 mg, bisoprolol 2.5 mg OD and regular tachycardia with a rate of 160 beats/min. -
Short-Term Exposure to Air Pollution and Cardiac Arrhythmia: a Meta-Analysis and Systematic Review
Int. J. Environ. Res. Public Health 2016, 13, doi:10.3390/ijerph13070642 S1 of S7 Supplementary Materials: Short-Term Exposure to Air Pollution and Cardiac Arrhythmia: A Meta-Analysis and Systematic Review Xuping Song, Yu Liu, Yuling Hu, Xiaoyan Zhao, Jinhui Tian, Guowu Ding and Shigong Wang Figure S1. Flow chart of the literature screening process. Int. J. Environ. Res. Public Health 2016, 13, doi:10.3390/ijerph13070642 S2 of S7 Figure S2. Association between particulate and gaseous components with hospitalization or mortality due to arrhythmia. Int. J. Environ. Res. Public Health 2016, 13, doi:10.3390/ijerph13070642 S3 of S7 Table S1. Search Strategy for PubMed. No. Search Strategy air pollution*/or air pollutant*/or air polluted/or air contamination*/or atmosphere pollution*/or atmosphere pollutant*/ or atmosphere contamination*/or atmospheric pollution*/or atmospheric #1 pollutant*/or atmospheric contamination*/or “particulate matter”/or “PM10”/or “PM2.5”/or ozone/ or “O3”/or “carbon monoxide”/or carbonmonoxide/or “CO“/or “nitrogen dioxide”/or “NO2”/or “sulphur dioxide”/or “sulphur dioxyde”/or “sulfurous anhydride“/or “SO2”.ti,ab. Air Pollution/or Particulate Matter/or Ozone/or Carbon Monoxide/or Nitrogen Dioxide/or Sulfur #2 Dioxide.sh. #3 or/1,2 #4 arrhythmia* /or dysrhythmia* /or “CA”.ti,ab. #5 Arrhythmias, Cardiac.sh. “Sick Sinus Syndrome”/or “SSS”/or “Sick Sinus Node Syndrom”/or Sinus Node Dysfunction*/or #6 Sinus Node Disease*/or Sinus Arrest*.ti,ab. #7 Arrhythmia, Sinus/or Sick Sinus Syndrome/or Sinus Arrest, Cardiac.sh. #8 atrial fibrillation*/or auricular fibrillation*/or “AF".ti,ab. #9 Atrial Fibrillation.sh. -
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